Predictors of emotional problems and physical aggression among children of Hong Kong Chinese, Mainland Chinese and Filipino immigrants to Canada

Caring in the Context of Systems: Service Provider Perspectives on the Mental Health Needs of Newcomer Young Men

In this study, we applied an intersectional framework to explore service providers' perspectives on the mental health needs of newcomer young men. We conducted focus groups and interviews with 26 service providers in Edmonton, Calgary, and Vancouver, Canada. Findings show that service providers made sense of young men's mental health needs and service access in the context of systems. We identified three interconnected themes: newcomer young men's senses of self in relation to macro-systems, including racism and economic marginalization; settling well as a determinant of mental health; and systems capacities and interdependent resilience. While service providers are engaged in cross-sectoral work in support of newcomer young men's mental health, this work is not being sufficiently supported. Further work is needed around cross-sector capacity bridging and advocacy, as well as the tailoring of services to young men without the assumption and reinforcement of gender stereotypes.

Neighbourhood and family correlates of immigrant children's mental health: a population-based cross-sectional study in Canada

BACKGROUND

Immigrant children exhibit significant variation in their mental health outcomes despite disproportionate exposure to socio-economic adversity compared to their non-immigrant peers. Identifying aspects of neighbourhood and family contexts that are most salient for immigrant children's mental health can help to inform and target interventions to prevent mental disorder and promote mental well-being among this population.

METHODS

The study analyzed multi-informant data from 943 first- and second-generation immigrant caregiver and child dyads from the Hamilton Youth Study, a representative sample of immigrant and non-immigrant families in Hamilton, Ontario. Multivariate multilevel regression models examined associations between neighbourhood and family characteristics and processes, and parent and child self reports of internalizing and externalizing problems.

RESULTS

Positive and negative parenting behaviours were significantly associated with internalizing and externalizing problems, with negative parenting demonstrating associations with externalizing problems across both parent and child reports (b = 0.26-1.27). Neighbourhood social disorder and parental trauma exposure were associated with greater internalizing and externalizing problems, and neighbourhood immigrant concentration was associated with fewer externalizing problems for parent reports only. Adding parental distress and parenting behaviour to the models reduced the coefficients for parental trauma exposure by 37.2% for internalizing problems and 32.5% for externalizing problems and rendered the association with neighbourhood social disorder non-significant. Besides the parenting variables, there were no other significant correlates of child-reported internalizing and externalizing problems.

CONCLUSIONS

Results highlight the importance of parenting behaviour and parental experiences of trauma and distress for immigrant children's mental health. While not unique to immigrants, the primacy of these processes for immigrant children and families warrants particular attention given the heightened risk of exposure to migration-related adverse experiences that threaten parental and family well-being. To prevent or mitigate downstream effects on child mental health, it is imperative to invest in developing and testing trauma-informed and culturally responsive mental health and parenting interventions for immigrant families.

Neighbourhood context and diagnosed mental health conditions among immigrant and non-immigrant youth: a population-based cohort study in British Columbia, Canada

PURPOSE

Evidence from systematic reviews suggests that adult immigrants living in areas of higher immigrant density (areas with a higher proportion of foreign-born residents) tend to experience fewer mental health problems-likely through less discrimination, greater access to culturally/linguistically appropriate services, and greater social support. Less is known about how such contexts are associated with mental health during childhood-a key period in the onset and development of many mental health challenges. This study examined associations between neighbourhood immigrant density and youth mental health conditions in British Columbia (BC; Canada).

METHODS

Census-derived neighbourhood characteristics were linked to medical records for youth present in ten of BC's largest school districts from age 5 through 19 over the study period (1995-2016; n = 138,090). Occurrence of physician assessed diagnoses of mood and/or anxiety disorders, attention deficit hyperactivity disorder (ADHD), and conduct disorder was inferred through International Classification of Diseases (ICD) diagnostic codes in universal public health insurance records. Multi-level logistic regression was used to model associations between neighbourhood characteristics and odds of diagnoses for each condition; models were stratified by generation status (first-generation: foreign-born; second-generation: Canadian-born to a foreign-born parent; non-immigrant).

RESULTS

Higher neighbourhood immigrant density was associated with lower odds of disorders among first-generation immigrant youth (e.g., adjusted odds of mood-anxiety disorders for those in neighbourhoods with the highest immigrant density were 0.67 times lower (95% CI: 0.49, 0.92) than those in neighbourhoods with the lowest immigrant density). Such protective associations generally extended to second-generation and non-immigrant youth, but were-for some disorders-stronger for first-generation than second-generation or non-immigrant youth.

CONCLUSIONS

Findings suggest there may be protective mechanisms associated with higher neighbourhood immigrant density for mental health conditions in immigrant and non-immigrant youth. It is important that future work examines potential pathways by which contextual factors impact immigrant and non-immigrant youth mental health.

Immigrant child health in Canada: a scoping review

Introduction

Understanding the health of immigrant children from birth to 18 years of age is important given the significance of the early childhood years and complexity of factors that may influence the health status of immigrant populations. Thus, the purpose of this review was to understand the extent and nature of the literature on the health of immigrant children in Canada.

Methods

We conducted a scoping review of the literature. The review was focused on studies of first-generation and second-generation immigrant children aged 0–18 years. We completed standardised data extraction of immigration status, immigration route, age of children, data source, health or clinical focus, country of origin and major findings.

Results

In total, 250 published papers representing data from 237 studies met the inclusion criteria for this study. A total of 178 articles used quantitative methodologies (mostly survey and cross-sectional study designs), 54 used qualitative methodologies and 18 used mixed methodologies. The articles considered in this review included 147 (59%) focusing on physical health, 76 (30%) focusing on mental health and 37 (15%) focusing on the social aspects of health for refugee and first-generation and second-generation immigrant children across the provinces and territories of Canada.

Conclusions

Several literature gaps exist with respect to child immigrant health in Canada. For instance, there are no exclusive studies on immigrant boys and limited studies on children of international students.

Perceived Discrimination and Aggression Among Chinese Migrant Adolescents: A Moderated Mediation Model

Previous research has showed that Chinese rural-to-urban migrant adolescents are at high risk for discrimination, negative emotions, and aggression. However, little is known about how discrimination, negative emotions, and aggression are interrelated and whether social support addressing the emotional needs of the adolescents would moderate the relationship of discrimination to aggression. This study attempts to fill these gaps. Based on prior research, it is proposed that perceived discrimination relates to reactive aggression by increasing negative emotions that foster aggressive responses to stressful events. Considering the central role that negative emotions may play, it is also hypothesized that socioemotional support provided by family, friends, and community mitigates the impact of perceived discrimination on reactive aggression by reducing negative emotions. The results obtained from the analysis of two-wave survey data collected from a probability sample of 470 migrant students aged 11-17 (46.17% female; mean age = 13.49) in China supported these hypotheses. The findings indicate that perceived discrimination fosters negative emotions, which in turn increase reactive aggression. Additionally, socioemotional support reduces the adverse impact of perceived discrimination on reactive aggression by weakening the link between perceived discrimination and negative emotions. Practical and policy implications of these findings are discussed.

Emotional School Engagement and Psychiatric Symptoms among 6-9-Year-old Children with an Immigrant Background in the First Years of School in Finland

The aim of this study is to examine emotional school engagement and psychiatric symptoms among 6-9-year-old children with an immigrant background (n = 148) in their first years of school compared to children with a Finnish native background (n = 2430). The analyzed data consisted of emotional school engagement measures completed by children and Strengths and Difficulties Questionnaires completed by both parents and teachers. Children with an immigrant background had lower self-reported emotional school engagement than children with a native background with reference to less courage to talk about their thoughts in the class and more often felt loneliness. Further, they reported that they had more often been bullies and seen bullying in the class. Children with an immigrant background had more emotional symptoms and peer problems reported by parents than children with a native background. However, teachers did not report any significant differences.

Waterloo Better Beginnings as a Transformative Prevention Project: Impacts on Children, Parents, and the Community

Better Beginnings Waterloo (BBW) is an ecological, community-driven, prevention program for children aged 4–8 and their families. BBW was implemented in two low-income communities with high percentages of visible minorities. Data on Grade 1–2 children and their parents (the baseline comparison group) were gathered through parent interviews (n = 34) and teacher reports (n = 68) in 2015, prior to BBW programs, and in the period 2018–2019, the same data were collected through parent interviews (n = 47) and teacher reports (n = 46) for children and parents participating in programs (the BBW group). As well, qualitative, open-ended individual interviews with parents (n = 47) and two focus groups were conducted in the period 2018–2019. Children in the BBW cohort were rated by their teachers as having a significantly lower level of emotional and behavioural problems than those in the baseline sample; parents in the BBW cohort had significantly higher levels of social support than parents in the baseline cohort; BBW parents rated their communities significantly more positively than parents at baseline. The qualitative data confirmed these findings. The quantitative and qualitative short-term findings from the BBW research showed similar positive impacts to previous research on program effectiveness, thus demonstrating that the Better Beginnings model can be successfully transferred to new communities.

Racial and Ethnic Differences in Bullying: Review and Implications for Intervention

Despite increased research on bullying over the past few decades, researchers still have little understanding of how bullying differentially affects racial and ethnic minority and immigrant youth. To facilitate efforts to better evaluate the impact of bullying among racial and ethnic minority youth and improve interventions, we integrated research from multiple disciplines and conducted a systematic search to review relevant cross-cultural research on the prevalence of bullying, risk and protective factors, and differences in behaviors and outcomes associated with bullying in these populations. Studies measuring differences in bullying prevalence by racial and ethnic groups are inconclusive, and discrepancies in findings may be explained by differences in how bullying is measured and the impact of school and social environments. Racial and ethnic minorities and immigrants are disproportionately affected by contextual-level risk factors associated with bullying (e.g., adverse community, home, and school environments), which may moderate the effects of individual-level predictors of bullying victimization or perpetration (e.g., depressive symptoms, empathy, hostility, etc.) on involvement and outcomes. Minority youth may be more likely to perpetrate bullying, and are at much higher risk for poor health and behavioral outcomes as a result of bias-based bullying. At the same time, racial and ethnic minorities and immigrants may be protected against bullying involvement and its negative consequences as a result of strong ethnic identity, positive cultural and family values, and other resilience factors. Considering these findings, we evaluate existing bullying interventions and prevention programs and propose directions for future research.

Filhos das fronteiras: revisão de literatura sobre imigração involuntária, infância e saúde mental

Na atualidade há um expressivo contingente de refugiados que deixam suas casas devido a conflitos –guerras, perseguições e violações dos direitos humanos– em busca de novas oportunidades. O Brasil tem se tornado um dos destinos destas pessoas, inclusive recebendo crianças refugiadas. Este estudo objetiva revisar a literatura científica disponível em bases de dados eletrônicas nos últimos treze anos a respeito dos impactos psicológicos da imigração involuntária em crianças. A pesquisa foi realizada em cinco bases de dados (BVS-PSI, Periódicos Capes, Francis, Redalyc e PsycARTICLES), a partir da interseção dos descritores “immigration”, “children” e “mental health”. Selecionou-se 48 artigos para análise, sendo constatada a ausência de publicações nacionais. Os conteúdos abordados nos trabalhos foram agrupados constituindo três categorias, a saber: 1) desafios enfrentados pelas crianças ao chegar ao país de acolhimento, 2) impactos psicológicos do processo migratório forçado na infância e 3) propostas de intervenção na saúde mental dos pequenos refugiados. A partir das informações obtidas, enfatiza-se a elaboração de políticas públicas no contexto brasileiro, sobretudo direcionadas a Atenção Básica com vistas a considerar as singularidades da criança refugiada no seu acolhimento.

A population-based analysis of life satisfaction and social support among children of diverse backgrounds in British Columbia, Canada

PURPOSE

The Satisfaction With Life Scale adapted for Children (SWLS-C) is a self-report measure of children's quality of life and has exhibited sound psychometric properties. In light of increasing ethno-cultural diversity, it is important to understand child life satisfaction across diverse subgroups. Employing children's language background as a proxy for cultural background among children in British Columbia, Canada, we examined (a) the cross-cultural measurement equivalence of the SWLS-C; and (b) cross-cultural relations of peer support and adult support with SWLS-C.

METHODS

Participants were 20,119 children (M_age 9.2; 50.2% boys) who provided data as part of a self-report child health survey (the Middle-years Development Instrument). Measurement equivalence across eight language/cultural background groups was tested via multi-group confirmatory factor analysis. Multi-level analyses were used to compare: a) SWLS-C means; and b) associations of peer support and adult support with SWLS-C scores, by language/cultural background.

RESULTS

Findings supported strict measurement equivalence between the English language/cultural background group and all other language/cultural background groups for the SWLS-C. Relative to the English language background group, SWLS-C means differed for several language/cultural background groups. Within every language/cultural background group, however, peer and adult support scale scores were significant positive correlates of SWLS-C scores.

CONCLUSIONS

This study provided evidence for measurement equivalence of a life satisfaction measure across children from diverse language/cultural backgrounds and identified between-group differences in the level of child life satisfaction that were generally consistent with prior theory and findings. Moreover, results provided evidence of promotive associations of adult support and peer support with life satisfaction among diverse groups of children.

Influence of Perceived Racial Discrimination on the Health of Immigrant Children in Canada

Racial discrimination and racism are recognized as determinants of health for adults. Less is understood regarding the influence of discrimination targeted towards parents, the family, or the cultural and children’s health. Data from the New Canadian Children and Youth Study (NCCYS) are used in this paper. The NCCYS is a national, longitudinal study of children whose families settled in urban centers of Canada. We analyzed data from individuals who settled in the metropolitan Vancouver area from six ethnic communities: Mainland China, Hong Kong, the Philippines, Iran, Afghanistan, and the Punjab who were interviewed at two times, approximately 2 years apart. Data were collected on perceived parental, family, and cultural discrimination. Our dependent variable was parent-reported child health status. Over time, perceived parental discrimination and perceived family discrimination decreased; and both forms of discrimination had a positive effect on child health. In contrast, perceived cultural discrimination increased over time and had a negative effect on child health at both times. Different forms of discrimination have different effects on child health. Racial discrimination is complex. Its influence on either increasing family cohesion, and thereby leading to improved health, or increasing stress, thereby leading to poorer health needs to be explored further.

Predictors of positive mental health among refugees: Results from Canada's General Social Survey

Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.

Parenting for the promotion of adolescent mental health: a scoping review of programmes targeting ethnoculturally diverse families

A scoping review of the literature on parenting programmes that target the promotion of adolescent mental health was conducted to examine the quality of the studies and unique content of programmes for parents from ethnoculturally diverse communities. PsycINFO and Web of Science were searched in April, 2011 (for all publications prior to that date) and again in August, 2015 (for publications from April, 2011 to August, 2015) using specific keywords and inclusion criteria. A hand search was also conducted. Overall, 107 studies met inclusion criteria for final data extraction and included evaluations of interventions targeted at substance use, early/risky sexual activity and behavioural problems. Eighteen of the 107 studies described programmes targeting parents of adolescents from diverse ethnocultural communities; the quality of these 18 studies was assessed using a marginally modified version of the Downs and Black Checklist (Downs & Black 1998). Their average quality assessment score was 16 out of 28. In addition, two key themes reflected in successful interventions emerged: strengthening parent-adolescent relationship through communication, and importance of community engagement in designing and implementing the intervention. Findings indicate gaps in service delivery to parents of adolescents from ethnoculturally diverse communities; there are a limited number of studies on programmes targeting ethnoculturally diverse parents of adolescents, and the quality of studies that do exist is overall low. Given increasing diversity, more emphasis should be placed on developing and modifying programmes to meet the needs of ethnoculturally diverse communities. More rigorous, standardised efforts should be made to evaluate programmes that do exist.

The health of immigrant children who live in areas with high immigrant concentration

OBJECTIVES

Our objective is to contribute to the literature regarding the association between immigrant children's health, their ethnicity and their living in neighbourhoods with a high ethnic concentration of one's own ethnicity. Using data from families from five ethnic groups who all immigrated to Vancouver metropolitan region in Canada, our research question asks: How ethnicity, ethnic concentration and living in a neighbourhood with others of the same ethnic background contribute to the health of immigrant children?

DESIGN

Two data sets are integrated in our study. The first is the New Canadian Children and Youth Study, which collected original data from five ethnic groups who immigrated to metropolitan Vancouver. The second data set, from which we derived neighbourhood data, is the Canadian census. The dependent variable is health status as reported by the parent. Independent variables are at both the individual and neighbourhood levels, including ethnicity, sex and the percentage of people living in the neighbourhood of the same ethnic background. Analysis was completed using hierarchical linear modelling.

RESULTS

Children (n = 759) from 24 neighbourhoods were included in the analyses. Health status varied by ethnicity and ethnic concentration, indicating the heterogeneity of immigrant populations.

CONCLUSION

With the lack of research on the health of immigrant children and youth living in ethnic concentrations, our findings make an important contribution to understanding the influences on the well-being of immigrant populations.

Mental Health Effects of Premigration Trauma and Postmigration Discrimination on Refugee Youth in Canada

This report examines the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health. Data were derived from mother-youth refugee and immigrant dyads from six countries of origin who were living in Canada at the time of the study. Youth reports of emotional problems (EP) and aggressive behavior (AB) were the mental health outcomes. EP and AB were regressed on predictor blocks: a) status (refugee versus immigrant), visible minority, and gender; b) premigration trauma and postmigration discrimination; c) parent and youth human and social capital; d) poverty, neighborhood, and schools. Refugees suffered higher levels of EP and AB, premigration traumas, and discrimination. Postmigration perception of discrimination predicted both EP and AB and explained immigrant versus refugee differences in EP. Antirefugee discrimination net of discrimination based on immigrant or visible minority status has deleterious mental health consequences.

Mental Health Outcomes of Drug Conflict Among University Students at the U.S.-Mexico Border

The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug-related armed conflict from 2008 through 2012, and the effect of type and number of traumatic events on mental health outcomes. Using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist, 202 university students living in the El Paso-Ciudad Juárez border region were surveyed for symptoms of depression, anxiety, and posttraumatic stress. Students with close ties to Mexico reported symptoms of anxiety and posttraumatic stress at significantly higher rates compared with those without connection to Mexico, but there was no significant difference in rates of depression. Although more than a third of participants reported experiencing 5 or more traumatic events connected with the drug war, being confined to home had the most significant effect. Frequency of traumatic events reported by students as well as rates of anxiety and posttraumatic stress symptoms were higher among students with greater connection to Mexico. Rates of clinically-significant depressive symptoms among all students were higher than expected for U.S. adults but comparable with all U.S. college students. This study presents important new data on the mental health effects of Mexico's drug war.

The bright side of migration: hedonic, psychological, and social well-being in immigrants in Spain

The aim of this study was to examine the multi-dimensional structure of well-being in immigrant population, as well as to explore the complexity of well-being disparities between immigrants and host nationals. We analyzed hedonic, psychological, and social well-being in a sample of 1250 immigrants from Bolivia, Colombia, Morocco, Romania and Sub-Saharan Africa, together with that of 500 matched host nationals from Spain. Participants were selected by means of probability sampling with stratification by age and sex. Confirmatory factor analyses revealed that the re-specified tripartite model of well-being, including hedonic, psychological, and social components of the individual's functioning, was the best fitting model, as compared to alternative models. Importantly, after adjustment for perceived friendship and support, marital status, income, sex and age, immigrants presented higher levels of well-being than host nationals. Compared to host nationals, immigrants reported especially higher eudaimonic well-being: social contribution and actualization, personal growth, self-acceptance, and purpose in life, and lower levels of well-being only in terms of positive relations with others and negative affect. These results are discussed in the context of positive psychology.

We left one war and came to another: resource loss, acculturative stress, and caregiver-child relationships in Somali refugee families

Refugee families often encounter a number of acculturative and resettlement stressors as they make lives for themselves in host countries. These difficulties may be compounded by past trauma and violence exposure, posing increased risk for mental health problems. Greater knowledge is needed about protective processes contributing to positive development and adjustment in refugee families despite risk (e.g., resilience). The aims of this research were to identify and examine strengths and resources utilized by Somali refugee children and families in the Boston area to overcome resettlement and acculturative stressors. We used maximum variation sampling to conduct a total of 9 focus groups: 5 focus groups (total participants N = 30) among Somali refugee adolescents and youth, capturing gender and a range of ages (15 to 25 years), as well as 4 focus groups of Somali refugee mothers and fathers in groups (total participants N = 32) stratified by gender. Drawing from conservation of resources theory (COR), we identified 5 forms of resources comprising individual, family, and collective/community strengths: religious faith, healthy family communication, support networks, and peer support. "Community talk" was identified as a community dynamic having both negative and positive implications for family functioning. Protective resources among Somali refugee children and families can help to offset acculturative and resettlement stressors. Many of these locally occurring protective resources have the potential to be leveraged by family and community-based interventions. These findings are being used to design preventative interventions that build on local strengths among Somali refugees in the Boston area.

Stress, illness, and the social environment: depressive symptoms among first generation mandarin speaking Chinese in greater Los Angeles

This study documents the indirect effects of social and environmental variables as mediated by immigrant stress and physical health. Using data from a large dual frame sample of first generation mandarin speaking Chinese immigrants in metropolitan Los Angeles counties with the largest groups of Chinese immigrants, this study uses a path analytic approach to trace how predictors are related to depressive symptoms and to measure direct and indirect influences of variables. Although bivariate analyses suggested that many predictors were associated with depressive symptoms, multivariate path analysis revealed a more complex structure of mediated associations. In the multivariate path analysis only reports of physical health and immigrant stress were directly related to depressive symptoms (P < 0.05), while acculturation, time in the US, income, US citizenship, and distance of persons on whom one could rely were related to stress (but not to physical health status) and only to depressive symptoms as mediated by stress. Age and educational attainment were related to health status (and to stress as mediated by physical health) and to depressive symptoms as mediated by both health and stress. These variables were also unrelated directly to health status and to depressive symptoms. Associations were evaluated using statistical significance, P < 0.05. This study demonstrates the significance of stress and health as mediators of variables in the larger context of the physical environment and suggests that the mechanisms linking ecological characteristics of immigrants to depressive symptoms may be stress and physical health among immigrants.

Predictors of immigrant children's mental health in Canada: selection, settlement contingencies, culture, or all of the above?

BACKGROUND AND STUDY AIMS

A previous publication from the New Canadian Children and Youth Study, a national study of immigrant children and youth in Canada, showed a gradient of levels of emotional distress with children from Hong Kong (HK) at the most severe end, Filipino children at the least severe, and children from the People's Republic of China (PRC) in between. Based on the premise that country of origin can be regarded as an index for differing immigration trajectories, the current study examines the extent to which arrival characteristics, resettlement contingencies and cultural factors account for country of origin variations in immigrant children's mental health. Arrival characteristics included child's age at arrival, parental education, parental fluency in English or French, and assistance from family at arrival. Resettlement contingencies included parental mental health, intra-familial conflict, settlement stress, separations from parents and child's age when mother started working outside the home. Cultural factors included one-child family composition and parenting styles.

METHODS

A national survey of 2,031 families with at least one child between the ages of 4 and 6 or 11 and 13 from HK, the PRC and the Philippines was conducted with the Person Most Knowledgeable (PMK) in snowball-generated samples in 6 different cities across Canada. Predictors of the dependent variable, emotional problems (EP), were examined in a hierarchical block regression analysis. EP was regressed on ethnic and country of origin group in model 1; arrival characteristics were added in model 2; resettlement contingencies in model 3 and cultural factors in model 4.

RESULTS

The final set of predictor variables accounted for 19.3 % of the variance in EP scores among the younger cohort and 23.2 % in the older. Parental human and social capital variables accounted for only a small amount of the overall variance in EP, but there were statistically significant inverse relationships between EP and PMK fluency in English or French. Settlement contingencies accounted for a significant increase in the explanatory power of the regression equation, net of the effects of country of origin and selection characteristics. This block of variables also accounted for the Filipino mental health advantage. Levels of parent's depression and somatization, harsh parenting, intrafamilial conflict, and resettlement stress each varied directly with levels of children's EP. Cultural variables made a significant contribution to explaining the variance in EP scores. Harsh parenting was significantly associated with increased levels of EP in both age groups, and supportive parenting was a mental health protective factor for younger children.

CONCLUSIONS

Immigrant family human and social capital, according to which immigrants are selected for admission to Canada, play a relatively small role in determining children's mental health. These effects are overshadowed by resettlement contingencies and cultural influences. Concentrating on trying to find a formula to select the "right" immigrants while neglecting settlement and culture is likely to pay limited dividends for ensuring the mental health of children.

A pilot randomized controlled trial to decrease adaptation difficulties in chinese new immigrants to Hong Kong

Immigration occurs globally, and immigrants are vulnerable to the development of adaptation difficulties. Little evidence is available for effective programs to enhance immigrant adaptation outside of the West. This pilot randomized controlled trial tested the effectiveness of two interventions used to decrease adaptation difficulties by (a) providing knowledge of resources that are relevant to the Hong Kong context or (b) enhancing personal resilience in immigrants to Hong Kong from Mainland China. A total of 220 participants were randomly assigned to three conditions: information, resilience, or control arms. They completed measures on adaptation difficulties, knowledge, and personal resilience at baseline, immediately after the intervention (postintervention), and at a 3-month follow-up. The information intervention resulted in higher increases postintervention in knowledge than did the other two arms. The resilience intervention reported greater increases in personal resilience than did the control arm at both postintervention and 3 months later; it also reported greater increases than the information arm did at the 3-month follow-up. Although both interventions reported greater decreases in adaptation difficulties than the control arm did at postintervention and 3 months later, no significant differences were found when they were compared with each other at both time points. Both programs had high acceptability and were feasible to implement in the community. Change in knowledge had no significant mediation effect on adaption difficulties, but change in personal resilience from baseline to postintervention mediated the effect of the intervention on the outcome of adaptation difficulties at the 3-month follow-up. These findings indicate evidence for benefits of the information and resilience interventions, and they inform further development of our programs.

Migration background and juvenile mental health: a descriptive retrospective analysis of diagnostic rates of psychiatric disorders in young people

Introduction

This article presents diagnostic rates for specific mental disorders in a German pediatric inpatient population over a period of 20 years with respect to migration background and socioeconomic status (SES).

Methods

Diagnostic data were obtained over a period of 20 years from 8,904 patients who visited a child and adolescent psychiatry mental health service in Germany. Data from 5,985 diagnosed patients (ICD-9 and ICD-10 criteria) were included with respect to gender, migration background, and SES.

Results

Migration- and gender-specific effects were found for both periods of assessment. The group of boys with a migration background showed significantly higher rates of reactions to severe stress, adjustment disorders, and posttraumatic stress disorder compared to their male, non-migrant counterparts. Conversely, boys without a migration background showed a significantly higher percentage rate of hyperkinetic disorders than male migrants. Similar results were found for female migrants in the latter assessment period (ICD-10). In addition, female migrants showed lower rates of emotional disorders whose onset occurs in childhood compared to their non-migrant counterparts.

Conclusions

Data from this investigation provide preliminary evidence that the prevalence of various psychiatric disorders in children and adolescents is influenced by migration background and SES.

A comparison of levels and predictors of emotional problems among preadolescent Ethiopians in Addis Ababa, Ethiopia, and Toronto, Canada

According to a literature of theory and advocacy, immigration and resettlement jeopardize the mental health of children and youth, largely because of factors such as intergenerational tensions arising from conflicts about the retention of traditional values, and experiences of prejudice and discrimination. The current study examines the specificity of these putative mental health risks to the immigration experience. The level and predictors of emotional problems among preadolescent Ethiopians living in immigrant families in Toronto, Canada, were compared with a matched sample of Ethiopian youngsters in Addis Ababa, Ethiopia. Data came from structured interviews with the person most knowledgeable about the family (usually a parent), as well as from the children themselves. Youth reported higher levels of emotional problems (EP) than their parents. Predictors differed for parent and child ratings. In both the Toronto and Addis Ababa samples, parental mental health predicted parent-rated, but not self-rated EP. Contrary to immigration stress theory, parental perceptions of prejudice predicted EP in Addis Ababa, but not Toronto, and parent-child discordance regarding ethnic adherence were predictors of self-rated emotional problems in Ethiopia, but not in Canada. Perceived discrimination was a significant predictor of self-rated emotional problems in both settings. Implications for theory and further research are discussed.

Symptoms of anxiety and associated risk and protective factors in young Asian American children

Anxiety is one of the most prevalent mental health problems in young children but there has been a dearth of studies focusing on Asian American children. This study examines the patterns and the predictors of childhood anxiety and related symptoms in young children in a diverse Asian American (ASA) sample (n = 101). Findings indicate that ASA children are at higher risk for anxiety, somatization, and depressive problems than their peers. Parents' level of acculturation (i.e., American identity, English competence), parental negative emotion socialization, conflicted parent-child relationship, child emotional knowledge and adaptive skills, as well as teachers' ethnic background and school class types were all associated with ASA children's anxiety. A combination of cultural, family, and school factors explained from 17 to 39 % of the variance in anxiety symptoms. Findings inform prevention services for young ASA children.

Perceived ethnic discrimination and social exclusion: newcomer immigrant children in Canada

This article examines relationships between perceived ethnic discrimination, social exclusion, psychosocial functioning, and academic performance among newcomer immigrant children from the People's Republic of China, Hong Kong, and the Philippines using a subsample from the New Canadian Children and Youth Study of children aged 11-13 years (1,053) living in Montreal, Toronto, Vancouver, and the Prairies. Bivariate analysis showed that 25% of children reported being treated unfairly by peers and 14% by teachers because of who they are. Regression analyses revealed that perceived ethnic discrimination by peers and teachers was negatively related to children's sense of social competence in peer relationships. Children's self-esteem and sense of academic competence were negatively related to perceived discrimination by teachers. One in 5 children reported feeling like an outsider, with boys revealing higher levels of psychological isolation than girls. More than 1 in 10 were socially isolated and reported never participating in organized activities. This may reflect economic exclusion, as over one third of respondents belonged to families living below the Canadian Income Adequacy Measure. Psychological isolation, social isolation, and economic exclusion were significant predictors of children's sense of academic competence and actual academic grades. Variations exist across age, sex, ethnicity, family structure, parental education, region of settlement, and length of time since arrival in Canada.

Influence of Perceived Racial Discrimination on Health and Behaviour of Immigrant Children in British Columbia

This study examines the influence of perceived discrimination on the health and behaviour of ethnic minority immigrant children in British Columbia, Canada. Using data from the New Canadian Children and Youth Study, we examine perceived discrimination experienced by the parent, family, and cultural group in Canada to test the influence of micro-, meso-, and macrolevels of discrimination on children. Families from 6 ethnic backgrounds participated in the study. Parents’ perceptions of the child’s health and six behavioral scales (hyperactivity, prosocial behaviour, emotional problems, aggression, indirect aggression, and a general combined behaviour scale) were examined as outcome variables. After controlling for ethnicity and background variables, our findings suggest that perceived micro- and macrodiscrimination has the greatest influence on the health and behaviour of our immigrant child sample. Variation among ethnic groups provided the largest explanation of health and behavioural discrepancies in our study.

Immigrant parents' perceptions of school environment and children's mental health and behavior

BACKGROUND

Research has increasingly identified the perception of school environment as an influential factor in children's lives. There has been sparse research attention, however, on the potential importance of parents' perceptions of school environment on child adjustment. This study examined the relationship between parents' perceptions of school environment and children's emotional and behavioral problems.

METHODS

Data were derived from the New Canadian Children and Youth Study, a study of the children (aged 4-6 and 11-13) of immigrant parents. Analyses focused on a subsample of Mainland Chinese, Hong Kong Chinese, and Filipino immigrants in a large metropolitan area.

RESULTS

Parental perception of school environment was negatively associated with physical aggression in children even after controlling for child age and gender, parental characteristics, family functioning, and aspects of acculturation. In contrast, parental perception was not significantly related to symptoms of emotional distress in children. There were some ethnic differences in perception of school environment.

CONCLUSIONS

Parental perception of school environment is important to the well-being of the children of immigrant parents, and reinforces the relevance of initiatives to improve the dynamics between parents and schools.

A career in culture and psychiatry research: reflections on forty-plus years

The report chronicles a 44-year career in cultural psychiatry spent at Duke, Cornell, Harvard, the University of British Columbia, the University of Toronto, and Ryerson Universities. It describes my studies in a rural community in Nova Scotia, in traditional villages in Senegal, West Africa, on Canadian First Nations reserves and American Indian reservations, in refugee camps in Southeast Asia, among immigrant and refugee communities in Canada, in Ethiopia, and in Israel. The report summarizes major findings resulting from these research efforts, and discusses contributions to theory as well as potential implications for practice as well as policy. The article concludes with reflections about the present state of cultural psychiatry, raises concerns about where the field seems to be in danger of going wrong, and offers suggestions about what needs to be done next.