Acculturative stress and diminishing family cohesion among recent Latino immigrants

Impacts of Acculturative, Parenting, and Family Stress on US Born and Immigrant Latina/o/x Parent's Mental Health and Substance Use

Latina/o/x face acculturative stressors which are unique to being an immigrant and/or racial/ethnic minority. Furthermore, Latina/o/x parents face an additional layer of stress related to parenting and family challenges. Little is known about how immigrant and non-immigrant parents cope with stress related to parenting and family stress and how these additional stressors impact parental mental health and substance use. The sample for this secondary data analysis included 1197 parents between 18 and 56 years of age. All analyses controlled for age, gender and number of persons living at home; for the immigrant subsample, we controlled for time in the USA and for the non-immigrant sample, we controlled for generational status. Analyses were conducted to examine the relationship between (1) acculturative stress and mental health and substance use and (2) parenting and family stress and mental health and substance use for immigrants and non-immigrants. Results of multivariate regression models revealed that acculturative stress was significantly associated with mental health, alcohol use, cigarette use, and other tobacco product use for both immigrant and non-immigrants. For both immigrants and non-immigrants, parenting stress and family stress were consistently associated with psychological distress. Parenting stress was associated with greater substance use, including cigarette, other tobacco use, and alcohol use. Given the different associations between acculturative, parenting, and family stress with mental health and substance use among immigrant and non-immigrant parents, family-based interventions should address these stressors to prevent poor health outcomes among Latina/o/x parents and their children.

Strès ak Pwoblèm Pap Janm Fini: Deciphering migration-related stress from the perspectives of Haitian immigrants in Florida

Relocating and starting a new life in a foreign country may entail a constellation of new stressors for Haitian immigrants; thus, research that enhances our understanding of how this vulnerable population contextualizes migration-related stress is necessary. The objectives of this study were to: (a) identify what factors are associated with migration-related stress, and (b) describe which and why specific migration-related stressors were most significant from the perspective of those suffering from high migration-related stress post migration via the stress proliferation lens of the stress process model. In this mixed-methods, sequential, explanatory pilot study, first-generation Haitian immigrants (N = 76) were recruited to operationalize migration-related stress, using the Demands of Immigration Scale (DIS). Participants (n = 8), who scored 25 or higher on the DIS, completed an in-depth audio-recorded follow-up interview that consisted of open-ended questions and a stressor-ranking questionnaire. Descriptive statistics, Pearson correlations, multiple linear regression (quantitative), and thematic analysis with a double-coded approach (qualitative) were employed to analyze the data. Female gender, older age, English fluency, and migration after the age of 18 years were associated with higher migration-related stress. However, only gender and English fluency predicted migration-related stress. In interviews, participants ranked five migration-related stressors as most stressful: language barriers, financial strains, loss of social networks, family conflicts, and exposure to discrimination/stigma. A nuanced depiction of migration-related stressors and proliferation mechanisms of migration-related stress may help identify areas where support and preventive efforts should be directed to improve social integration, stress levels, and mental well-being among immigrants.

A Social Ecological Approach to Latino Immigrant Trauma and Intervention: An Integrative Review

This paper presents an application that can be taken when conducting mental health intervention within the Latino immigrant population. Using a social ecological lens, it provides an overview of experiences and factors to detail the characteristics, trauma, and resilience factors present within this population. Utilizing Ungar's framework on resilience, that decenters the individual from experiences of trauma to position them alongside their social network and resources, it proposes an application for future intervention and research efforts. Addressing intervention at a foundational level allows for the supplementing and shaping of current methods to address the mental health needs of this community.

An exploration of parenting styles, cultural values, and infant development in a sample of Latin American immigrants in Canada

The objective of the current research was to investigate the relationship between parenting style, culture, and infant development in a sample of Latin American mother-infant dyads in Toronto, Canada. We examined associations between mothers' self-reported parenting style and infant cognitive and socioemotional development, which we compared to results from mothers belonging to two other Canadian immigrant populations. We further examined whether specific cultural correlates, including affiliation with traditional Latinx cultural beliefs familism and fatalism and acculturation, were associated with positive parenting behaviors in the Latin American sample. Across all three cultural groups, authoritative parenting predicted adaptive socio-emotional development , an effect which differed in magnitude across groups, providing support for the hypothesis that the effect of parenting behaviors on infant development are moderated by culture. Within the Latin American sample, affiliation with the value of familism was associated with higher scores of authoritative parenting, but familism decreased as acculturation to the host culture increased. This research adds to our understanding of factors that contribute to the well-being of Latin American families in Canada. Findings carry implications for provision of infant mental health services to Latin American immigrant families by identifying cultural variables which should be considered when providing parenting interventions to make such interventions more culturally relevant.

Implications of racial/ethnic perinatal health inequities on long-term neurodevelopmental outcomes and health services utilization

Infants born preterm and with low birth weight have increased risk for neurodevelopmental challenges later in life compared to term-born peers. These include functional motor impairment, cognitive and speech delays, neurobehavioral disorders, and atypical social development. There are well-documented inequities in the population distributions of preterm birth and associated short-term morbidities by race, ethnicity, language, and nativity. Far less is known about how these inequities affect long-term outcomes, though the impact of unequal access to post-discharge support services for preterm infants raises concerns about widening gaps in health, development, and functioning. In this review, we describe what is currently known about the impact of race, ethnicity, nativity, and language on long-term outcomes. We provide a framework for understanding inequities in social, political, and historical context. And we offer guidance for next steps to delineate mechanistic pathways and to identify interventions to eliminate inequities in long-term neurodevelopmental outcomes through research, intervention, and advocacy.

Impact of pre-migration assets and pre-migration trauma on acculturative stress among recent Latinx immigrant young adults

BACKGROUND

Pre-migration trauma is associated with adverse mental health outcomes among Latinx immigrants. Pre-migration assets like family cohesion and social support may promote positive mental health outcomes in this population. The current study aims to identify the cumulative and interaction effects of pre-migration trauma, social support, and family cohesion on acculturative stress among recent Latinx immigrants (RLIs).

METHOD

The current study utilizes baseline data from an on-going longitudinal study following 540 RLIs during their initial 3 years in the U.S. Simple main effects of the predictor variables on acculturative stress were estimated using hierarchical multiple regression (HMR). Predictor variables were entered into the HMR model as follows: (1) demographic variables were entered in the first block, (2) family cohesion and social support in the second block and (3) pre-migration trauma in the third block. Interaction effects between family cohesion and social support on the association between pre-migration trauma and acculturative stress were examined.

RESULTS

Results showed that 20.6% of the variance of acculturative stress was explained by the predictor variables entered into the HMR model. The first predictor block included demographic variables and explained 13.5% of the variability in acculturative stress, R2 = 13.5, F(6, 521) = 13.55, p < .001. The second block added family cohesion and social support to the HMR model and showed an ΔR2 of 4.5%, R2 = 18.0, F(8, 519) = 14.22, p < .001. The third block added pre- migration trauma to the HMR model and showed an ΔR2 change of 2.6%, R2 = 20.6, F(9, 518) = 14.93, p < .001. Significant interaction effects were found for family cohesion among documented RLIs. Social support was not a significant moderator.

CONCLUSION

Study findings suggest pre-migration resources such as family cohesion and social support may ameliorate post-immigration acculturative stress among RLI, while pre-migration trauma, may exacerbate acculturative stress.

Cumulative Lifetime Adversity in a National Sample of Hispanic/Latino Immigrants: Exploring Construct Validity Across Six Hispanic/Latino Groups Using Data From the HCHS/SOL Sociocultural Ancillary Study

Hispanic/Latino immigrants often experience significant adversity before, during, and after migrating to the United States. However, no extant studies have tested the construct validity of a cumulative measure of lifetime adversity with Hispanic/Latino immigrants. Our objective was to assess the construct validity of a comprehensive measurement model of lifetime adversity (i.e., adverse childhood experiences, adult chronic stress, adult perceived stress, adult acculturation stress, and lifetime ethnic discrimination) with a national sample of Hispanic/Latinos born outside the mainland United States. Guided by the life course perspective, we examined the (a) dimensionality of cumulative lifetime adversity; (b) extent to which the functioning of this measurement model differed across various Hispanic/Latino subgroups including Mexicans, Cubans, Puerto Ricans, Dominicans, Central Americans, and South Americans; and (c) association between cumulative lifetime adversity and other constructs (e.g., anxiety and depression). We used existing data from the Hispanic Community Health Survey/Study of Latinos-Sociocultural Ancillary Study, a national survey of Hispanic/Latinos living in the United States (N = 3,296). Results from confirmatory factor analyses indicated that a five-factor bifactor measurement model for cumulative lifetime adversity fit the data adequately (e.g., comparative fit index = .91, root mean square error of approximation = .04, standardized root mean square residual = .07). Results from multigroup confirmatory factor analyses suggested that the measurement model functioned similarly across Hispanic/Latino subgroups, providing evidence for measurement invariance. The model also displayed convergent and discriminant validity based on associations with other constructs. We discuss implications for advancing the precision of assessment instruments for lifetime adversity with populations with high within-group diversity.

Gender Norms, Discrimination, Acculturation, and Depressive Symptoms among Latino Men in a New Settlement State

Purpose

Drawing from major theoretical and conceptual frameworks on minority men's mental health, we designed the current observational study to assess the associations of gender norms, discrimination, and acculturation with clinically significant depressive symptoms (CESD≥16) among a sample of immigrant Latino men in North Carolina.

Methods

We used data from a baseline survey of men (n=111) recruited for a peer-led health intervention. To assess the associations with depressive symptoms, we performed descriptive and bivariate analyses, followed by multiple logistic regression.

Results

Men in the sample tended to be young (mean age 18.5 years), recent immigrants (70.3% immigrated after age 16), and to have incomplete high school education (76.5%). About half (51.4%) reported experiencing discrimination due to their ethnicity and more than a third (37.8%) reported experiencing discrimination due to their race. Using the short form Conformity to Masculine Norms instrument, their mean masculinity score was 52.0; their average 12-item Short Acculturation Scale for Latinos score was 21.8. More than one-quarter of participants (26.1%) had clinically significant depressive symptoms. Multiple logistic regression models showed among this sample of immigrant Latino men in the Southeast, traditional masculine norms-but not perceived discrimination nor acculturation-were associated with clinically significant depressive symptoms.

Conclusions

Our results suggest a potential future avenue for intervention research: testing whether changing gender norms could result in improvements to mental health.

Familial Acculturative Stress and Adolescent Internalizing and Externalizing Behaviors in Latinx Immigrant Families of the Southwest

Experiencing acculturative stress burdens Latinx families in a variety of negative and deleterious ways. Using the Family Stress Model, this study aims to explore the patterns and experiences of acculturative stress in Latinx families, and how these experiences related to Latinx adolescent internalizing and externalizing behaviors. Data came from baseline reports of three cohorts of parent-youth dyads (n = 532) participating in a longitudinal randomized control effectiveness trial testing a parenting intervention in southwestern U.S. area. Findings indicate that youth exhibited more depressive symptomology when both parent and child reported higher acculturative stress. While youths' anti-social behaviors were only associated with their own acculturative stress and not their parents' acculturative stress levels. This study advances new knowledge about the relationship between acculturative stress and youth behaviors, and provides recommendations for developing future interventions with Latinx youth to prevent the onset of internalizing and externalizing behaviors.

Respondent Driven Sampling for Immigrant Populations: A Health Survey of Foreign-Born Korean Americans

This study examined feasibility and methodological utilities of respondent driven sampling (RDS) for Korean immigrants. We conducted the Health and Life Study of Koreans (HLSK), a Web-based RDS study targeting foreign-born Korean Americans. Through chain referrals, n = 638 participated. Geographic coverage and estimates of HLSK were compared to foreignborn Korean samples in the American Community Survey and the California Health Interview Survey as benchmarks. Compared to the benchmarks, HLSK fared well on the geographic coverage, household type and size, employment and health insurance but over-captured those who were younger, more recent immigrants, with higher education and with disability. Existing RDS-specific estimators were largely ineffective. Conclusions. RDS may serve as a cost-effective tool for recruiting recent immigrants, a harder-to-recruit subgroup within minorities. However, recruitment noncooperation posed operational challenges, a critical gap in the literature. This leaves RDS yet to be a reliable methodology.

Family function and eating behaviours among Hispanic/Latino youth: results from the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth)

OBJECTIVE

To elucidate mechanisms across family function, home environment and eating behaviours within sociocultural context among Hispanic youth.

DESIGN

Two models tested via path analysis (youth fruit and vegetable (FV) consumption; empty energy consumption) using data from the Study of Latino Youth (2011-2013).

SETTING

Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA.

PARTICIPANTS

Youth (8-16-year-olds), n 1466.

RESULTS

Youth ate 2·4 servings of FV per d and received 27 % of total energy from empty energies. Perceiving higher acculturative stress was indirectly associated with lower FV consumption via a pathway of low family function and family support for FV (β = -0·013, P < 0·001) and via lower family closeness and family support (β = -0·004, P = 0·004). Being >12-year-olds was indirectly associated with lower FV consumption via lower family closeness and family support (β = -0·006, P < 0·001). Household food security was indirectly associated with greater FV consumption via family closeness and family support (β = 0·005, P = 0·003). In contrast, perceiving higher acculturative stress was indirectly associated with higher empty energy consumption (via family closeness and family support: β = 0·003, P = 0·028 and via low family function and low family support: β = 0·008, P = 0·05). Being older was associated with higher consumption of empty energies via family closeness (related to family support: β = 0·04, P = 0·016; parenting strategies for eating: β = 0·002, P = 0·049).

CONCLUSIONS

Findings suggest pathways of influence across demographic and sociocultural context, family dynamics and home environment. The directionality of these associations needs confirmation using longitudinal data.

Climate of Fear: Provider Perceptions of Latinx Immigrant Service Utilization

Latinx immigrants endure stressors throughout the immigration process that detrimentally impact their health and wellbeing. Yet, they also face substantial barriers to accessing and utilizing services. These barriers might be heightened under the Trump administration, which has implemented policies facilitating increased immigration enforcement and punitive immigration practices. This study utilizes data collected from providers who serve Latinx immigrants in the border state of Texas to better understand current immigrant service utilization behaviors. Individual interviews and focus groups were conducted shortly after the last presidential election to inquire about recruitment, retention, program completion, and resources to address key client risk factors. Applying grounded theory analysis strategies, interviews, and focus group recordings were coded for key themes. Data demonstrated central concerns held by providers serving immigrants, and especially those who are undocumented or in mixed-status families. Concerns were related to the following three themes: (1) undocumented immigrant stressors, (2) limited resources for undocumented immigrants, and (3) service utilization barriers. Lack of services for undocumented immigrants and fear related to service utilization were prominent subthemes. These findings extend our knowledge of stressors and barriers of access and utilization for immigrants during this time period of increased immigration enforcement which have valuable implications for practice and future research. Providers can take concrete actions to educate immigrants, regardless of documentation status, on how their clients' identities will be protected. In addition, intentional trust-building strategies are essential to help overcome fear of utilizing services. Future research should ascertain perspectives of immigrant families, as this study drew perspectives only from providers.

Trauma, Post-Migration Stress, and Mental Health: A Comparative Analysis of Refugees and Immigrants in the United States

Numerous studies describe mental health effects of pre-migration trauma and post-resettlement stress among refugees, yet less research examines these associations with non-refugee immigrants. Additionally, few studies assess the prevalence and impact of traumatic experiences after settlement in a new country. Using a U.S.-based representative sample of Asian (n = 1637) and Latino (n = 1620) refugees and immigrants, we investigated how traumatic events prior to and after migration, and post-migration stressors, are associated with mental illness and distress. Pre-migration trauma posed risk across a broad range of psychological outcomes for Asian refugees and Latino immigrants. Deleterious effects of post-migration trauma were notable for both groups of refugees and immigrants. Discrimination, acculturative stress, and family conflict increased risk for disorder and distress across groups in complex ways. Findings highlight the importance of examining trauma and stress at pre- and post-migration phases across migrant populations, including those not labeled as refugees.

Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States

IMPORTANCE

An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space.

OBJECTIVES

To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois.

DESIGN, SETTING, AND PARTICIPANTS

In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n = 71 901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsupervised algorithms used to reduce dimensions of multivariate data). The SDOH indices were used to estimate age-adjusted mortality rates in Chicago (n = 789 census tracts with approximately 7.5 million persons) with a spatial regression for the same period, while controlling for violent crime.

MAIN OUTCOMES AND MEASURES

Fifteen variables, measured as a 5-year mean, were selected to characterize SDOH as small-area variations for demographic characteristics of vulnerable groups, economic status, social and neighborhood characteristics, and housing and transportation availability at the census-tract level. This SDOH data matrix was reduced to 4 indices reflecting advantage, isolation, opportunity, and mixed immigrant cohesion and accessibility, which were then clustered into 7 distinct multidimensional neighborhood typologies. The association between SDOH indices and premature mortality (defined as death before age 75 years) in Chicago was measured by years of potential life lost and aggregated to a 5-year mean. Data analyses were conducted between July 1, 2018, and August 30, 2019.

RESULTS

Among the 71 901 census tracts examined across the continental United States, a median (interquartile range) of 27.2% (47.1%) of residents had minority status, 12.1% (7.5%) had disabilities, 22.9% (7.6%) were 18 years and younger, and 13.6% (8.1%) were 65 years and older. Among the 789 census tracts examined in Chicago, a median (interquartile range) of 80.4% (56.3%) of residents had minority status, 10.2% (8.2%) had disabilities, 23.2% (10.9%) were 18 years and younger, and 9.5% (7.1%) were 65 years and older. Four SDOH indices accounted for 71% of the variance across all census tracts in the continental United States in 2014. The SDOH neighborhood typology of extreme poverty, which is of greatest concern to health care practitioners and policy advocates, comprised only 9.6% of all census tracts across the continental United States but characterized small areas of known public health crises. An association was observed between all SDOH indices and age-adjusted premature mortality rates in Chicago (R2 = 0.63; P < .001), even after accounting for violent crime and spatial structures.

CONCLUSIONS AND RELEVANCE

The modeling of SDOH as multivariate indices rather than as a singular deprivation index may better capture the complexity and spatial heterogeneity underlying SDOH. During a time of increased attention to SDOH, this analysis may provide actionable information for key stakeholders with respect to the focus of interventions.

Longitudinal associations between marianismo beliefs and acculturative stress among Latina immigrants during initial years in the United States

Acculturative stress is commonly experienced among Latinx immigrants in the United States who may feel pressured to maintain their heritage cultural norms and beliefs and/or adopt norms and beliefs of the dominant culture. The present study examined longitudinal relations between acculturative stress and endorsement of traditional Latina gender role beliefs (i.e., marianismo). We determined strength of the relations and temporal precedence of acculturative stress and endorsement of marianismo across 3 time points during participants' initial 3 years in the United States using a random intercept cross-lagged panel model. Participants were 530 Latina young adult women (ages 18-23) recruited from Miami-Dade County, Florida. Results suggested that acculturative stress levels at Time 1 positively predicted endorsement of the Family Pillar belief at Time 2, but acculturative stress levels at Time 2 negatively predicted the Virtuous and Chaste and Subordinate to Others beliefs at Time 3. In terms of marianismo beliefs predicting acculturative stress levels over time, the Virtuous and Chaste belief at Time 1 positively predicted acculturative stress at Time 2, and the Silencing Self to Maintain Harmony belief at Time 2 positively predicted acculturative stress at Time 3. Findings suggest that the Family Pillar belief, or feeling responsibility for the family's unity, may be protective against acculturative stress over time. Endorsing certain gender role beliefs (i.e., Virtuous and Chaste, Subordinate to Others) may lead to greater acculturative stress, and Latina young adult women experiencing acculturative stress may alter their endorsement of marianismo beliefs in an attempt to resolve culturally conflicting stress experienced after immigration. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Immigration Stress among Recent Latino Immigrants: The Protective Role of Social Support and Religious Social Capital

Religious institutions can be a source of support for recent Latino immigrants struggling to adjust to a new culture. For undocumented immigrants, who are often marginalized from other formal institutions, they may symbolize a place of refuge and hope through supportive social networks that mitigate common challenges such as social isolation and other forms of immigration stress. This cross-sectional study examined the impact of religious social capital and social support on immigration stress among documented and undocumented recent Latino immigrants (N = 408). Religious social capital was associated with higher levels of social support, while social support was protective against immigration stress. Social support mediated associations between religious social capital and immigration stress, but only among undocumented immigrants. Findings suggest religious social capital may be a particularly useful resource for undocumented immigrants, aiding in the provision of social support and in decreasing levels of immigration stress. Future research directions and implications for culturally tailored service delivery are presented.

Life Quality of University Students From Immigrant Families in the United States

The numbers of university students from immigrant families have been increasing in the United States, yet little research exists on factors influencing their life quality. Self-report data were collected from 2,210 students from one university in California. Direct effects of four contextual stressors (i.e., ethnic discrimination, parent-child cultural conflict, family disengagement, and family financial stress) were examined in relation to life quality. Also, the potential moderating and mediating role of perceived stress was examined, as well as the potential moderating role of students' generational status. The results provided strong support for mediation, showing contextual stressors influenced students' life quality through their perceived stress. Some evidence was found for moderation, showing the complex role of perceived stress. Generational status did not play a moderating role.

Alcohol use Exacerbates Acculturative Stress Among Recently Immigrated, Young Adult Latinas

Associations between theorized sociocultural factors and acculturative stress were examined among Latina immigrants (aged 18-23 years) during their initial months in the US. Participants' quantity of alcohol use was hypothesized to be linked with more acculturative stress. Using respondent-driven sampling, 530 Latinas who recently immigrated to Miami-Dade County, Florida, were recruited from community activities, Latino health fairs, advertisements at community agencies, and online postings. A path analysis revealed associations between acculturative stress and more time in the US and greater commitment to ethnic identity. Marianismo gender role beliefs differentially related with acculturative stress. Quantity of alcohol use moderated the positive association between time in US and acculturative stress, such that women in the US for less time who drank more alcohol experienced higher levels of acculturative stress than their peers. Findings suggest quantity of alcohol use may exacerbate acculturative stress during some Latina young adult immigrants' initial months in the US.

Alcohol Use Severity Among Adult Hispanic Immigrants: Examining the Roles of Family Cohesion, Social Support, and Gender

BACKGROUND

This study examined (a) the direct association of family cohesion on alcohol use severity among adult Hispanic immigrants; (b) the indirect association of family cohesion on alcohol use severity via social support; and (c) if gender moderates the direct and indirect associations between family cohesion and alcohol use severity.

METHOD

Mediation and moderation analyses were conducted on a cross-sectional sample of 411 (men = 222, women = 189) participants from Miami-Dade, Florida.

RESULTS

Findings indicate that higher family cohesion was directly associated with higher social support and lower alcohol use severity. Higher social support was also directly associated with lower alcohol use severity. Additionally, family cohesion had an indirect association with alcohol use severity via social support. Moderation analyses indicated that gender moderated the direct association between family cohesion and alcohol use severity, but did not moderate the indirect association.

CONCLUSIONS

Some potential clinical implications may be that strengthening family cohesion may enhance levels of social support, and in turn, lower alcohol use severity among adult Hispanic immigrants. Furthermore, strengthening family cohesion may be especially beneficial to men in efforts to lower levels of alcohol use severity.

Characteristics and outcome of minority group patients in methadone maintenance treatment

Abstract Minority status is associated with mental and physical morbidity, substance dependence, and poor outcomes. To compare characteristics and treatment outcomes between patients from two minority groups in Israel (Christians and Muslims) and patients from the majority population (Jews) in methadone maintenance treatment (MMT), we prospectively studied all patients admitted to our clinic between 1993 and 2012 and followed up until 2013; 655 Jews, 67 Christians, and 37 Muslims. Christian patients differed from Jews and Muslims by younger age at admission to MMT, greater prevalence of drug injectors, and a higher proportion of Hepatitis-C and HIV sera positive. Muslims had comparatively less education and a lower proportion of females. The three groups had similar rates of one-year retention (75.9%) and opiate abstinence (68.1%). They also did not differ in long-term retention (up to 20 years): Muslims 5.5 years (95%CI 3.6-7.4), Christians 7.5 years (95%CI 6-9.1), and Jews 7.6 years (95%CI 7-8.2, p = .3). The Hepatitis-C incidence, however, was higher among the 21 admitted Hepatitis-C seronegative minorities (5.0/100 person years) than the 207 Hepatitis-C seronegative non-minority patients (1.7/100 person years, p=0.03). All groups had good treatment outcomes, except for Hepatitis-C seroconversion, which necessitates a specific preventive intervention among the minority groups.

Documenting legal status: a systematic review of measurement of undocumented status in health research

Background

Undocumented status is rarely measured in health research, yet it influences the lives and well-being of immigrants. The growing body of research on undocumented status and health shows the need to assess the measurement of this legal status. We discuss the definition of undocumented status, conduct a systematic review of the methodological approaches currently taken to measure undocumented status of immigrants in the USA, and discuss recommendations for advancement of measurement methods.

Methods

We conducted a systematic review of 61 studies indexed in PubMed, conducted in the USA, and published from 2004 to 2014. We categorized each of the studies’ data source and type, measurement type, and information for classifying undocumented participants. Studies used self-reported or proxy measures of legal status.

Results

Information to classify undocumented participants included self-reported status, possession of a Social Security number, possession of health insurance or institutional resources, concern about deportation, and participant characteristics. Findings show it is feasible to collect self-reported measures of undocumented status.

Conclusions

We recommend that researchers collect self-reported measures of undocumented status whenever possible and limit the use of proxy measures. Validated and standardized measures are needed for within and across country measurement. Authors should provide methodological information about measurement in publications. Finally, individuals who are undocumented should be included in the development of these methodologies.

Trial registration

This systematic review is not registered.

Immigration Stress and Alcohol Use Severity Among Recently Immigrated Hispanic Adults: Examining Moderating Effects of Gender, Immigration Status, and Social Support

OBJECTIVE

Identifying and understanding determinants of alcohol use behavior among Hispanic immigrants is an increasingly significant public health concern. Although prior research has examined associations of cultural stressors with alcohol use among Hispanics, few studies have tested these associations among recent adult immigrants. As such, this study aimed to examine (a) the association of immigration stress on alcohol use severity among recently immigrated Hispanic adults (≤ 1 year in the United States) and (b) the moderating effects of gender, immigration status, and social support.

METHOD

A hierarchical multiple regression and moderation analyses were conducted on a sample of 527 participants in South Florida.

RESULTS

Results indicated that, after controlling for demographic variables, preimmigration drinking behavior, and dimensions of social support, the association of higher immigration stress with higher alcohol use severity was statistically significant. Moderation analyses indicated that immigration stress had a statistically significant association with alcohol use severity among men, but not women. Also, dimensions of social support consistently reduced the deleterious effect of immigration stress on alcohol use severity.

CONCLUSION

This study adds to the scarce literature on cultural stressors and alcohol use among recent Hispanic immigrants. Findings suggest that it may be important to design gender-specific interventions and that increasing levels of social support may offset the effects of immigration stress on alcohol use.

Addressing Acculturative Stress in Psychotherapy: A Case Study of a Latino Man Overcoming Cultural Conflicts and Stress Related to Language Use

To foster engagement in treatment and improve therapeutic outcomes for immigrant clients, it is important for therapists to integrate cultural values and to recognize the psychological stressors faced as immigrants learn to adapt and assimilate changes associated with moving to a new country. This case study describes the integration of cultural values when working with immigrant Latino clients who are at an increased risk of experiencing acculturative stress as a result of moving to the United States and having limited English knowledge. The integration of cultural values of familismo and personalismo are also discussed as it related to case conceptualization and treatment process. Finally, the current case provides information about conducting therapy in two languages and transitioning from Spanish to English as part of acculturation process while also addressing multifaceted aspects involved when working with Latino clients.

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants' Adolescent Children

First, discrimination was conceptualized as a major source of stress for immigrants' adolescent children. Next, such children's emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity's possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991-2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians' self-esteem was also low, compared to other groups'. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups' emotional health.

Social support and networks: cardiovascular responses following recall on immigration stress among Chinese Americans

Social support has been shown to act as a buffer for cardiovascular responses to stress. However, little is known about how social support and networks are related to cardiovascular responses to immigration stress recall. The current study evaluated the impact of structural and functional support on cardiovascular reaction following immigrant stress recall provocation as well as the moderation effect of interdependent self-construal among first-generation Chinese immigrants. One hundred fifty Chinese immigrants were recruited in the New York Chinatown area. Participants completed questionnaires assessing their levels of social support and networks, and interdependent self-construal. Following adaptation, participants recalled a recent post-immigration stress-provoking situation. Cardiovascular measures were taken during adaptation, stressor task, and recovery period. Hierarchical multiple regression analysis was performed. Social network size and type, as well as perceived emotional support were positively predictive of systolic blood pressure (SBP) reactivity changes. Instrumental support seeking was a positive predictor of SBP and diastolic blood pressure (DBP) reactivity. The moderation effect between instrumental support seeking and interdependent self-construal were significantly predictive of DBP reactivity and recovery, suggesting that perceptions about themselves in relation to others is a crucial factor for determining whether support seeking is beneficial or not. Social support was not a direct buffer on cardiovascular responses to stress among Chinese immigrants. Chinese values of interdependence and collectivism may partly explain the disconfirming results. Still, when interdependent self-construal was taken into account, Chinese immigrants who had less interdependent self-construal, but solicited more instrumental support, had faster adaptation to stress over the long term.

Family functioning, resilience, and depression among North Korean refugees

North Korean refugees in South Korea are at high risk of depression, but there are few studies exploring protective factors in this population. We hypothesized that family functioning (family adaptability and cohesion) and resilience would protect North Korean refugees from developing depressive symptoms. A subsample of 304 adult North Korean refugees drawn from the cross-sectional 2010 Nationwide Survey of Domestic Violence in South Korea was analyzed. Approximately 44% of respondents were identified as having depression, using scores on the Center for Epidemiological Studies Depression scale. In models capturing the full spectrum of depressive symptoms (continuous), family cohesion was significantly associated with depression, and the relationship was partially mediated by resilience. In models predicting clinical depression (dichotomous), resilience fully mediated the relationship between family cohesion and clinical depression. In contrast, family adaptability was not associated with depression or resilience in this sample. These findings suggest that assessing and enhancing family cohesion and resilience may be essential for professionals working with refugees, and that refugees without family support may be at particularly high risk for depression.

The contribution of stress, cultural factors, and sexual identity on the substance abuse, violence, HIV, and depression syndemic among Hispanic men

OBJECTIVES

The purpose of this study was to confirm the substance abuse, violence, HIV, and depression syndemic among Hispanic men, and to test whether stress and sociocultural factors, including acculturation, family support, and sexual orientation, predict this syndemic.

METHOD

A cross-sectional survey was administered to 164 Hispanic men using standardized measures for Hispanic Stress (Cervantes, Padilla, & Salgado de Snyder, 1991), substance abuse (Kelly et al., 1994), violence (Peragallo et al., 2005), risk for HIV (González-Guarda, Peragallo, Urrutia, Vasquez, & Mitrani, 2008), and depression (Center for Epidemiologic Studies Scale, CES-D; Radloff, 1977).

RESULTS

Results from Structural Equation Modeling (SEM) supported the syndemic factor among Hispanic men. While family/cultural stress and homosexual identity were risk factors for the syndemic factor, family support was protective.

CONCLUSIONS

More longitudinal research is needed to identify influences on the syndemic factor among diverse Hispanic communities. Interventions that address stress and enhance family supports may show promise in addressing and preventing syndemics among Hispanic men. (PsycINFO Database Record

Intracultural accusations of assimilation and alcohol use severity among Hispanic emerging adults: Moderating effects of acculturation, enculturation, and gender

Individuals, including Hispanics, tend to drink most heavily during emerging adulthood (ages 18-25 years old). Research has suggested that intercultural stressors (e.g., ethnic discrimination) may increase levels of alcohol use among Hispanics. However, the relationship between intracultural stressors (e.g., accusations of assimilation-when Hispanics accuse a member of their heritage group of acculturating to U.S. culture) and alcohol use has been examined to a lesser extent. Accordingly, the present study aimed to (a) examine the association between family accusations of assimilation and alcohol use severity; and (b) examine if acculturation domains, enculturation domains, and gender moderated that association. A hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 181 Hispanic emerging adults. Results indicated that higher family accusations of assimilation were associated with higher levels of alcohol use severity (β = .18, p < .05), and all variables entered in the model accounted for ΔR2 = 15.1% of the variance of alcohol use severity. A moderation analysis indicated that higher family accusations of assimilation were associated with higher alcohol use severity among men, but not women. Of the four acculturation/enculturation domains, none had a moderation effect. However, there was a statistically significant three-way interaction among family accusations of assimilation, gender, and affective enculturation. This three-way interaction suggests that among men, higher family accusations of assimilation were associated with higher alcohol use severity at lower levels of affective enculturation. This study addresses a literature gap on intracultural stressors and substance use among Hispanics, and discusses recommendations for future research. (PsycINFO Database Record

Evaluating the Hispanic Paradox in the Context of Adolescent Risky Sexual Behavior: The Role of Parent Monitoring

OBJECTIVE

In the United States, Hispanic adolescents are at elevated risk for negative outcomes related to risky sexual behavior. To evaluate potential protective factors for this group, we examined the fit of the Hispanic Paradox for sexual behavior among high-risk youth and the moderating role of parent monitoring.

METHOD

We enrolled 323 justice-involved Hispanic youth (73% male; mean age 16 years), and measured generational status, parent monitoring (monitoring location, who children spend time with outside of school, family dinner frequency), and sexual risk behavior.

RESULTS

There were no main effects for generational status on sexual behavior. Parent monitoring of location moderated the relationship between generational status and sexual behavior, such that greater monitoring of location was associated with less risky sexual behavior, but only for youth second generation and above.

CONCLUSIONS

Rather than direct evidence supporting the Hispanic Paradox, we found a more nuanced relationship for generational status in this sample.

Development of the Stress of Immigration Survey: A Field Test Among Mexican Immigrant Women

The Stress of Immigration Survey (SOIS) is a screening tool used to assess immigration-related stress. The mixed methods approach included concept development, pretesting, field testing, and psychometric evaluation in a sample of 131 low-income women of Mexican descent. The 21-item SOIS screens for stress related to language, immigrant status, work issues, yearning for family and home country, and cultural dissonance. Mean scores ranged from 3.6 to 4.4 (a scale of 1-5, higher is more stress). Cronbach α values were more than 0.80 for all subscales. The SOIS may be a useful screening tool for detecting high levels of immigration-related stress in low-income Mexican immigrant women.

Changes in Family Cohesion and Acculturative Stress among Recent Latino Immigrants

Family relationships can serve as an important source of support during the acculturation process; yet, how the stress related to acculturation, or acculturative stress, may impact family functioning across time is not clear. Participants (n = 479), between the ages of 18-34 were recruited using respondent driven sampling methodology. Findings suggest family cohesion decreased over time; however, it decreased less for those reporting more acculturative stress. The implication is that for those Latino immigrants who struggle to adapt to their new host culture, family remains a source of support more so than for those who do not struggle as much.

Associations between positive parenting practices and child externalizing behavior in underserved Latino immigrant families

This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population.

Toward a Typology of Acculturative Stress

The objective of this study is to identify latent classes of Hispanic immigrants on the basis of acculturative stress and, in turn, examine the links between membership in acculturative stress classes and the prevalence of mental disorders. We use latent class analysis (LCA) and multinomial logistic regression with data from a population-based study of Hispanic immigrants in the United States ( n = 1,630). Classes were identified as “Low Acculturative Stress” (38.40%); “Social and Linguistic Stress” (32.27%); “Acculturative Stress, No Fear of Deportation” (20.06%); and “Acculturative Stress, Fear of Deportation” (9.26%). Members of the “Acculturative Stress, Fear of Deportation” class were significantly more likely than members of the “Low Acculturative Stress” class to meet criteria for generalized anxiety disorder (risk ratios [RR] = 3.55, 95% confidence interval [CI] [1.00, 12.56]). The present study represents an important step in the development of a typology of acculturative stress among Hispanic immigrants in the United States.

Duration of U.S. residence and suicidality among racial/ethnic minority immigrants

PURPOSE

The immigration experience embodies a range of factors including different cultural norms and expectations, which may be particularly important for groups who become racial/ethnic minorities when they migrate to the U.S. However, little is known about the correlates of mental health indicators among these groups. The primary and secondary aims were to determine the association between duration of U.S. residence and suicidality, and 12-month mood, anxiety, and substance use disorders, respectively, among racial/ethnic minority immigrants.

METHODS

Data were obtained from the National Survey of American Life and the National Latino and Asian American Survey. Multivariable logistic regression was used to determine the association between duration of US residence, and suicidality and 12-month psychopathology.

RESULTS

Among Afro-Caribbeans, there was a modest positive association between duration of U.S. residence and 12-month psychopathology (P linear trend = 0.016). Among Asians there was a modest positive association between duration of US residence and suicidal ideation and attempts (P linear trend = 0.018, 0.063, respectively). Among Latinos, there was a positive association between duration of US residence, and suicidal ideation, attempts and 12-month psychopathology (P linear trend = 0.001, 0.012, 0.002, respectively). Latinos who had been in the U.S. for >20 years had 2.6 times greater likelihood of suicidal ideation relative to those who had been in the U.S. for <5 years (95% CI 1.01-6.78).

CONCLUSIONS

The association between duration of US residence and suicidality and psychopathology varies across racial/ethnic minority groups. The results for Latino immigrants are broadly consistent with the goal-striving or acculturation stress hypothesis.

Perceived discrimination, family functioning, and depressive symptoms among immigrant women in Taiwan

This study examined the moderating effect of family functioning on the relationship between perceived discrimination and depressive symptoms in immigrant women. A total of 239 immigrant women were selected from four administrative regions in Central Taiwan. Questionnaires concerning perceived discrimination, family functioning (including family cohesion and family adaptability), depressive symptoms, and demographic characteristics were completed by either women themselves (N = 120) or their husbands (N = 119). The moderating effect of family functioning on the relationship between perceived discrimination and depression symptoms was analyzed using multiple regression analysis. Findings showed that a higher level of perceived discrimination among immigrant women is associated with more severe depressive symptoms. Family functioning serves as a moderator between the relationship of perceived discrimination and depressive symptoms, but the moderating effect of family adaptability was evident only in data reported by immigrant women. The results indicate that perceived discrimination has negative mental health implications, and also point to the importance of family functioning for depression. Findings suggest that providers should consider addressing immigrant women's mental health needs through declining their psychosocial distress at multiple ecological levels.