Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born?

School bullying among refugee and non-refugee adolescent students in Lebanon

BACKGROUND

School bullying is a significant issue affecting adolescents globally. This study explores the prevalence and predictors of bullying among refugee and non-refugee adolescents in Lebanon, focusing on sociodemographic, protective, and risk factors.

OBJECTIVE

To assess the prevalence and types of bullying and identify significant predictors, including sociodemographic variables, protective factors, and risk factors.

PARTICIPANTS AND SETTING

A cross-sectional survey was conducted with 1906 adolescents aged 12-17 from 32 public schools in Lebanon.

METHODS

Logistic regression analysis was used with sequential blocks to evaluate predictors of bullying: (a) sociodemographic variables (age, gender, refugee vs. non-refugee status); (b) protective factors (prosocial behavior, social-emotional assets, and school environment); (c) risk factors (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship issues).

RESULTS

The overall bullying rate was 56.3 %, with verbal bullying being the most common. Significant predictors included younger age (Odds Ratio [OR] = 1.35, p < 0.01), male gender (OR = 1.48, p < 0.01), and a negative school environment (OR = 1.62, p < 0.01). Syrian refugee students were more likely to be victims (OR = 2.03, p < 0.01), while Lebanese students were more frequently identified as perpetrators (OR = 1.78, p < 0.01). Protective factors were associated with lower bullying rates, whereas risk factors such as conduct problems and peer relationship difficulties were linked to higher bullying involvement.

CONCLUSIONS

The study reveals a high prevalence of bullying and underscores the need for comprehensive anti-bullying strategies. Addressing both protective and risk factors is crucial for creating a safer, more inclusive educational environment for all students.

Victimization, immigration status, and psychosocial well-being: A representative study among finnish adolescents

BACKGROUND

Immigrant adolescents seem to be at risk for victimization and being victimized in adolescence is related to risk factors regarding mental health.

OBJECTIVE

This study compared the frequency and type of victimization experiences among immigrant and native Finnish adolescents and tested whether these experiences mediate the relationship between immigration status and psychosocial well-being. Additionally, willingness to disclose victimization experiences in anonymous questionnaires was compared between the groups.

PARTICIPANTS AND SETTING

In this computer-based study a population-based sample of 5607 Finnish adolescents was used (Mage = 15.23, SDage = 0.42, Range 15 to 16 years; 49.8 % girls, 48.5 % boys), of which 11.7 % were immigrants. Twelve lifetime victimization experiences were assessed, and psychosocial well-being was measured with Strengths and Difficulties Questionnaire.

METHODS

Descriptive statistics, crosstabulation and t-tests were used to report victimization experiences and participants' willingness to share them in an anonymous questionnaire. The relationship between immigration status and psychosocial well-being was investigated with mediation analysis, victimization experiences as mediator.

RESULTS

Findings revealed that immigrant adolescents experienced more victimization, particularly in the form of property crimes, hate crimes, and physical and sexual abuse, than native adolescents. Victimization experiences were found to mediate the impact of immigration status on psychosocial well-being. Moreover, immigrant adolescents were less likely to disclose victimization experiences.

CONCLUSIONS

The results suggest a potential underestimation of the prevalence of victimization experiences in immigrant adolescents, which warrants further investigation. As these experiences play an important role in the relationship between immigrant status and psychosocial well-being, the findings endorse assessing adverse experiences, as well as safe disclosure when planning psychosocial support and treatment for immigrant adolescents.

Victimization experiences, internalizing problems and family bonds among adolescents from the UK: multi-group structural equation modeling using an intersectionality-informed approach

Adolescents from marginalized backgrounds are at increased risk for victimization experiences, which was shown for ethnic minorities and females. However, an intersectional approach has rarely been taken in research. Using the Understanding Society Youth Panel, multigroup structural equation models were conducted to identify cross-group variation among adolescents aged 10-15 years in the relation between victimization experiences (verbal, physical and cyberbullying, discrimination) and internalizing problems (loneliness, emotional problems, life satisfaction), along with a mediating effect of family bonds (family support, parental communication). The groups white male (n = 280), white female (n = 280), Black, Asian and minority ethnic (BAME) male (n = 219) and BAME female (n = 279) were included in the analyses. Across all groups, victimization experiences were negatively associated with family bonds. Only among BAME male adolescents, experiences of victimization were related to more internalizing problems. No mediating effects of family bonds on the relation between victimization and internalizing problems were identified in any group. The results support an intersectionality-informed approach and the necessity of implementing preventative anti-bullying and family strengthening interventions among adolescents.

Generational Immigration Status Modifies the Association Between Psychosocial Distress and Substance Use Among Alternative High School Students

PURPOSE

Alternative high schools (AHS) are designed to provide individualized education, more flexible scheduling, and smaller class sizes for students referred out of traditional high school. AHS students report higher levels of substance use (SU) and face disproportionately higher levels of trauma and toxic stress than their traditional high school peers. We sought to examine whether generational immigration (GenIm) status modifies the association of mental health and SU among AHS students using a longitudinal study of 1,060 Southern California AHS students.

METHODS

Subscales from the 21-item Depression Anxiety Stress Scale were administered. Effect modification was examined by GenIm status defined as first generation (born outside of the United States), second generation (born in the United States with a parent born outside the United States), or third generation (born in the United States with US-born parent(s)). Main outcomes included the number of times different substances were used in the past year over a 3-year period.

RESULTS

Multilevel, negative binomial, covariate-adjusted latent growth curve models generated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of the time-varying association between depression, anxiety, or stress and the use of cigarettes, e-cigarettes, cigars, alcohol, or marijuana. Multiple-group models examined effect modification by GenIm status.

DISCUSSION

The link between mental health and SU was stronger among first- and second-generation students than third-generation students. For example, a one-unit increase in stress relative to the average stress of students from the same school was associated with an increase in the rate of e-cigarette use among first-generation (IRR = 2.03, 95% CI = 1.07-3.85), second-generation (IRR = 2.25, 95% CI = 1.86-2.72), and third-generation (IRR = 1.68, 95% CI = 1.31-2.16) students. Effective strategies tailored to subgroups of AHS students are needed to counter disparities between traditional and alternative school systems that may contribute to long-term trajectories of SU.

Assessment of Suicide Risk and Cultural Considerations in Forcibly Displaced Migrant Youth

Migrant youth who face forced displacement from their home countries have an emergent mental health burden, placing them at increased suicide risk. As such, it is crucial for pediatric providers to include suicide screening and assessment in their care for this population. Migrant families seek safety but, in many cases, encounter adverse events and psychosocial inequities in the migration journey and in the host community. Factors such as trauma, acculturative stress, and intersectionality influence suicide risk in migrants. Summative traumatic events contribute to the mental health load and worsen suicidal outcomes in migrant youth. Acculturative stress can lead to social marginalization in the host country, further adding to the existing mental health burden. Finally, intersectionality encompasses complex sociocultural influences, which shape the development of cultural identity in migrant youth and influence suicide risk. By examining these factors, the author advances cultural considerations in screening and assessment for suicide risk in migrant youth through evidence-based tools in pediatric clinical practice. Barriers to access to mental health services, stigma, and distrust of the health care system within the host community are also addressed. The author establishes recommendations for early suicide screening and prevention within this population through trauma-informed care, active advocacy, and cultural sensitivity.

The Effect of Psychoeducation on Attitudes toward Violence and Risky Behaviors among Refugee Adolescents

This study was conducted to examine the effect of psychoeducation on attitudes toward violence and risky behaviors among refugee adolescents. This was a randomized controlled experimental study conducted with refugee adolescents (n = 101) studying in a high school in southern Turkey. After psychoeducation, it was determined that there was a significant decrease in the prevalence of antisocial behaviors, alcohol use, suicidal thoughts, unhealthy eating habits, and school dropout thoughts among adolescents according to the subdimensions of the risky behavior scale. Psychoeducation was found to be effective in reducing attitudes toward violence and preventing risky behaviors among refugee adolescents.

Immigration background as a risk factor of chronic pain and high-impact chronic pain in children and adolescents living in Spain: differences as a function of age

ABSTRACT

The number of people immigrating from one country to another is increasing worldwide. Research has shown that immigration background is associated with chronic pain (CP) and pain disability in adults. However, research in this issue in children and adolescents has yielded inconsistent results. The aims of this study were to examine (1) the association between immigration background, CP, high-impact chronic pain (HICP) in a community sample of children and adolescents; and (2) the extent these associations differed as a function of sex and age. Participants of this cross-sectional study were 1115 school children and adolescents (mean age = 11.67; 56% girls). Participants were asked to provide sociodemographic information and respond to a survey including measures of pain (location, extension, frequency, intensity, and interference). Results showed that having an immigration background was associated with a greater prevalence of CP (OR = 1.91, p <.001) and HICP (OR = 2.55, p <. 01). Furthermore, the association between immigration background and CP was higher in children (OR = 6.92, p <.001) and younger adolescents (OR = 1.66, p <.05) than in older adolescents. Children and adolescents with an immigration background are at higher risk for having CP -especially younger children- and HICP. More resources should be allocated in the prevention of CP and HICP in children and adolescents with an immigration background.

From struggle to strength in African and Middle Eastern newcomers' integration stories to Canada: A participatory health equity research study

BACKGROUND AND OBJECTIVES

Newcomers (immigrants, refugees, and international students) face many personal, gender, cultural, environmental and health system barriers when integrating into a new society. These struggles can affect their health and social care, reducing access to mental health care. This study explores the lived experiences of African and Middle Eastern newcomers to Ontario, Canada. An understanding of newcomer integration challenges, successes and social justice issues is needed to improve health equity and social services.

METHODS

In this qualitative study, we used a participatory research approach to collect stories reflecting participants' integration perspectives and experiences. Beginning with our immigrant community network, we used snowball sampling to recruit newcomers, ages 18 to 30, originating from Africa or the Middle East. We used qualitative narrative analysis to interpret stories, identifying context themes, integrating related barriers and facilitators, and resolutions and learnings. We shared our findings and sought final feedback from our participants.

FINDINGS

A total of 18 newcomers, 78% female and approximately half post-secondary students, participated in the study. Participants described an unknown and intimidating migration context, with periods of loneliness and isolation aggravated by cold winter conditions and unfamiliar language and culture. Amidst the struggles, the support of friends and family, along with engaging in schoolwork, exploring new learning opportunities, and participating in community services, all facilitated integration and forged new resilience.

CONCLUSIONS

Community building, friendships, and local services emerged as key elements for future immigrant service research. Utilizing a participatory health research approach allowed us to respond to the call for social justice-oriented research that helps to generate scientific knowledge for promoting culturally adaptive health care and access for marginalized populations.

Upholding the Human Rights and Well-Being of Refugee Children Through Effective Clinical Care

Refugee children are often exposed to adversities and traumatic experiences that can harm the mental health and well-being of refugee children. These include human trafficking and exploitation and dangers in detention centers and refugee camps. All these adverse events can be traumatic and contribute to poor mental health, including posttraumatic stress, anxiety, depression, and substance use disorders. Therefore, the assessment of refugee children and adolescents should include screening and identification for these experiences, provision of evidence-based trauma treatment, and social supports to promote their well-being and thriving.

Social determinants of health of racial and ethnic minority adolescents: An integrative literature review

Integration of adolescents with diverse cultural backgrounds into the country of residence is associated with some form of rejection and discrimination, predisposing them to undesirable health outcomes. In this regard, the aim of this study was to identify the social determinants of the health of racial and ethnic minority adolescents. In this integrative literature review, PubMed, EMBASE, Cochrane Library, and CINAHL databases were searched from 2016 to 2021 and studies were selected according to the PRISMA 2020 guidelines. Health status was limited to health outcomes according to the definition proposed by the World Health Organization and Healthy People 2020. The social determinants of health were classified according to the research framework of the National Institute on Minority Health and Health Disparities. Six types of health status were identified: self-rated health, obesity and overweight, global self-worth, emotional well-being, anthropometric measurement, and psychosocial adjustment. The social determinants of health were at the individual and interpersonal level, and the domains included the biological (gender, illness experience), psychological (acculturative stress), and sociocultural environment (e.g., socioeconomic status, parents' educational level, household death due to violence). Therefore, future research must prioritize their sociocultural environments to reduce the negative impact of discrimination and sociocultural and structural differences on racial and ethnic minority adolescents.

Empowering Students against Ethnic Bullying: Review and Recommendations of Innovative School Programs

Despite research on anti-bullying interventions, there is no systemic approach or resources for teachers to address ethnic and race-related bullying in schools. In this article, we selectively reviewed theories and programs to help teachers identify and address ethnic bullying in their classrooms. We provide recommendations for workshops (e.g., cultural awareness training, empathy-building activities, bystander intervention, and stigma-based intervention). These anti-ethnic bullying workshops should promote understanding of different cultures, strengthen empathy for those who are different, encourage bystanders to take action, and reduce stigma and stereotypes. Through the sharing of diverse perspectives, expertise, and experiences, we hope this article can cultivate interactive dialogues and collaborations between educators and researchers to effectively address ethnic and race-related bullying.

Migrant and Refugee Youth's Sexual and Reproductive Health and Rights: A Scoping Review to Inform Policies and Programs

Objectives: Migrants and refugee youth (MRY) in Western nations are less likely to participate in sexual reproductive health (SRH) services. Consequently, MRY are more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. A scoping review was conducted to examine MRY's understanding of and the implications for inclusive sexual and reproductive health and rights (SRHR) programs and policies. Methods: A systematic search of literature across seven academic databases was conducted. Data were extracted following Partners for Dignity and Rights' Human Rights Assessment framework and analysed using the thematic-synthesis method. Results: 38 literature (peer-reviewed, 24 and grey, 14) were considered eligible for inclusion. The findings highlighted significant barriers and the under-implementation of SRHR support and services by MRY. Key policy implications include a need for programs to support MRY's SRHR education, diversity, equity and inclusiveness and privacy protections. Conclusion: The review shows that the emerging evidence on MRY SRHR suggests gaps in practices for resourcing policies and programs that promote sustainable SRH for vulnerable populations. Policies for MRY's SRHR should prioritise programs that focus on diversity, equity and inclusion with targeted education and community resourcing strategies for sustainability.

Psychosocial Predictors of Suicidal Thoughts and Behaviors in Mexican-Origin Youths: An 8-Year Prospective Cohort Study

Suicide is the second leading cause of death for youths in the United States. More Latino adolescents report suicidal thoughts and/or behaviors (STBs) than youths of most other ethnic communities. Yet few studies have examined multiple psychosocial predictors of STBs in Latino youths using multiyear longitudinal designs. In this study, we evaluated the progression of STBs in 674 Mexican-origin youths (50% female) from fifth grade (10 years old) to 12th grade (17 years old) and identified psychosocial predictors of changes in STBs across this period. Latent growth curve models revealed that being female and later-generation status were associated with increasing prevalence in STBs across adolescence. Family conflict and peer conflict predicted increased STBs, whereas greater familism predicted less STBs. Thus, interpersonal relationships and cultural values contribute to the development of STBs in Mexican-origin youths and may be key levers for decreasing suicidality in this understudied but rapidly growing portion of the U.S. adolescent population.

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.

Effectiveness of Promotive and Preventive Psychosocial Interventions on Improving the Mental Health of Finnish-Born and Immigrant Adolescents

Background: Schools are considered natural environments in which to enhance students’ social–emotional skills and mental health in general, but they can be especially important for students with refugee and immigrant backgrounds. The current study tested the effectiveness of two school-based interventions in enhancing the mental health and wellbeing of adolescents of native, refugee, and immigrant backgrounds. It further analyzed the role of age, gender, daily stressors, and discrimination in affecting the interventions’ effectiveness. Methods: A three-arm cluster RCT with parallel assignment was applied among the 16 schools. Schools were randomized to three conditions of two active interventions and a waiting-list control condition. Students (n = 1974) filled in an online questionnaire at baseline before the interventions, after the interventions, and at follow-up an average of 9 months after the interventions. The effectiveness criteria were internalizing and externalizing problems, resilience, and prosocial behavior. Results: Interventions were generally not effective in decreasing mental health problems and increasing psychosocial resources. The expected positive intervention effects were dependent on students’ age and gender and exposure to socioeconomic daily stressors. Conclusion: Interventions enhancing teacher awareness and peer relationships at school should be carefully tailored according to the strengths and vulnerabilities of participating students, especially their daily stress exposure, but also age and gender.

An Analysis of Admissions to a Refugee Child Mental Health Unit in the Context of the COVID-19 Pandemic

BACKGROUND

To examine the admissions to a refugee child outpatient mental health unit in the COVID-19 pandemic and to compare them with the pre-pandemic period.

METHODS

This retrospective observational study, planned through the hospital information system and patient files, included the 1-year number of outpatient unit admissions, sociodemographic, and clinical data.

RESULTS

Before the COVID-19 pandemic (March 2019-February 2020), a total of 2322 patients (local and refugee) applied to the same unit, and 236 (10.1%) of these patients were refugees. Since the commencement of the COVID-19 pandemic in Turkey (March 2020-February 2021), 1209 patients applied, and 10.4% (n = 126) of them were refugees. While 19.66 ± 6.31 refugees applied per month in the pre-pandemic period, this number decreased to 10.50 ± 5.31 during the pandemic period (p = 0.01). During the pandemic period, there was a significant decrease in the number of female refugee patient admissions. In addition, while admissions for external disorders increased significantly during the pandemic period (x² = 13.99, p = 0.001), admissions for internal disorders decreased significantly (x² = 4.54, p = 0.03).

CONCLUSIONS

The decrease in the mental health unit demands with the pandemic may lead to negative consequences in the long term. To determine mental health and psychological needs of patients during the outbreak will greatly contribute to the pandemic management process.

Suicide ideation and psychosocial distress among refugee adolescents in Bidibidi settlement in West Nile, Uganda

This study investigated the factors associated with suicidal ideation and psychological distress among Sudanese refugees (aged 10–19 years) in Bidibidi refugee settlement, Yumbe district, Uganda. The analysis is based on cross-sectional data collected as part of the implementation of a project on sexual and reproductive health in Bidibidi refugee settlement. Data were collected from 284 South Sudanese adolescents in July 2020. We estimated the prevalence of psychological distress and suicidal ideation, and their associated profiles. Odds ratios and their 95% Confidence Intervals based on a logistic regression model were used to assess the effect of different potential factors on the risk profiles for suicidal ideation and psychological distress. The prevalence of psychological distress (on KS-6 scale) was estimated to be 12.3% (95%CI: 8.7, 16.7%). The risk for psychological distress is low among male adolescents (AOR = 0.51; 95%CI: 0.23, 1.02), older adolescents, (AOR = 0.12; 95%CI: 0.04, 0.40), and adolescents with a friend or family members they can confide in (AOR = 0.33; 95%CI: 0.11, 0.96). Both suicidal ideation and psychological distress are very high among the female adolescents. Familial and individual interventions can be potentially useful for female adolescents who have a high risk of suicide and psychological distress.

Physical trauma and injury: A multi-center study comparing local residents and refugees in Lebanon

Background

Refugees are susceptible to various types of injury mechanisms associated with their dire living conditions and settlements. This study aims to compare and characterize the emergency department admissions due to physical trauma and injuries among local residents and refugees in greater Beirut.

Methods

This epidemiological study analyzes injury incidence and characteristics of patients presenting to Emergency Departments of 5 sentinel hospitals between 2017 and 2019. Using the WHO Injury Surveillance Guidelines and Pan-Asia Trauma Outcomes Study form, an injury data surveillance form was designed and used in hospital settings to collect data on injuries. Chi-square test analysis was performed to compare differences in injury characteristics between local residents and refugees. Regression models were constructed to assess the effect of being a refugee on the characteristics of injuries and outcomes of interest.

Results

A total of 4847 injuries (3933 local residents and 914 refugees) were reported. 87.4% of the total injuries among refugees were sustained by the younger age groups 0-45 years compared to 68.8% among local residents. The most prevalent injury mechanism was fall (39.4%) for locals and road traffic injury (31.5%) for refugees. The most injured body part was extremities for both populations (78.2% and 80.1%). Injuries mostly occurred at home or its vicinity (garden or inside the camp) for both populations (29.3% and 23.1%). Refugees sustained a higher proportion of injuries at work (6%) compared to locals (1.3%). On multivariate analysis, refugee status was associated with higher odds of having an injury due to a stab/gunshot (odds ratio (OR) = 3.392, 95% confidence interval (CI) = 2.605-4.416), having a concussion injury (OR = 1.718, 95% CI = 1.151-2.565), and being injured at work (OR = 4.147, 95% CI = 2.74-6.278). Refugee status was associated with increased odds of leaving the hospital with injury-related disability (OR = 2.271, 95% CI = 1.891-2.728)]

Conclusions

Injury remains a major public health problem among resident and refugee communities in Beirut, Lebanon. Refugees face several injury-related vulnerabilities, which adversely affect their treatment outcomes and long-term disabilities. The high prevalence of occupational and violence-related injuries among refugees necessitates the introduction of targeted occupational safety and financial security interventions, aiming at reducing injuries while enhancing social justice among residents.

Attitudinal Acceptance of Intimate Partner Violence and Mental Health Outcomes for Female Survivors in Sub-Saharan Africa

While current literature evidences a strong association between gender-based violence exposure and adverse mental health outcomes, few studies have explored how attitudinal acceptance of intimate partner violence (IPV) might impact this relationship. This analysis employed data from 13–24-year-old females as part of the Violence Against Children Surveys in Nigeria, Uganda, and Malawi. Mental health status, defined by the Kessler Screening Scale for Psychological Distress, and suicide ideation served as outcome measures. Predictors of interest included lifetime experiences of IPV and attitudinal acceptance of IPV. Country-stratified logistic and ordinary least squares regressions were used to predict outcomes and included interactions between violence exposure and attitudinal acceptance of IPV. Violence exposure was associated with increased symptoms of mental distress and increased suicide ideation in all countries. Among those who experienced IPV, exhibiting attitudinal acceptance of IPV was associated with improved mental health in Nigeria and Malawi. IPV tolerance conferred lower odds of suicide ideation following IPV exposure in Nigeria. The findings suggest that programs aiming to reduce attitudinal acceptance of IPV must consider how these changes may interact with women’s exposure to IPV.

Fifteen-year trends in self-reported racism and link with health and well-being of African Canadian adolescents: a secondary data analysis

BACKGROUND

We assessed the prevalence and trends in racial discrimination among African Canadian adolescents in British Columbia. The association between racial discrimination and self-rated health, access to mental health services, substance use, suicidal thoughts and attempts, experience of extreme stress, among others were examined within the 2018 dataset.

METHODS

Secondary analysis used the data collected from African Canadian adolescents (n = 2448) as part of the British Columbia Adolescent Health Surveys (2003-2018). We examined whether racial discrimination increased, decreased, or remained stable over time. We evaluated experiences of racial discrimination for all adolescents, and then disaggregated analyses for boys, girls, immigrant, and Canadian-born African adolescents. We used Rao-Scott's adjusted chi-square to test differences in racial discrimination and adjusted logistic regressions to test trends across survey years, widening or narrowing gaps in racial discrimination, as well as the link to health outcomes.

RESULTS

Racial discrimination was significantly different across the survey years (Adjusted F = 4.60, p < .01), with the highest percentage of adolescents reporting past year racial discrimination in 2018 (29.9%) and the lowest percentage in 2013 (21.3%). Girls and immigrant African Canadian adolescents were more likely to have experienced racial discrimination. However, girls and Canadian-born adolescents had the highest odds of reporting racial discrimination in 2018 compared to 2003, AOR = 1.85, and 1.58, respectively. The findings reveal significant differences in the experiences of racial discrimination for boys and girls, as well as for immigrant and Canadian-born African adolescents. Significant differences were noted in the link between racial discrimination and self-rated health and engaging in behaviours that might expose them to health risks. The worst negative health outcomes were found for boys and immigrant African Canadian adolescents.

CONCLUSION

The study suggests that more than 1 in 4 African Canadian adolescents in British Columbia report racial discrimination, which is an increasing trend in recent years. Those who reported racial discrimination also had the worst adverse health outcomes. There is a need for more public health action to reduce racism, create awareness about the negative health impacts, and provide better support for African Canadian adolescents.

Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

Background

Gender inequality varies across countries and is associated with poor outcomes including violence against women and depression. Little is known about the relationship of source county gender inequality and poor health outcomes in female immigrants.

Methods

We used administrative databases to conduct a cohort study of 299,228 female immigrants ages 6–29 years becoming permanent residence in Ontario, Canada between 2003 and 2017 and followed up to March 31, 2020 for severe presentations of suffering assault, and selected mental health disorders (mood or anxiety, self-harm) as measured by hospital visits or death. Poisson regression examined the influence of source-country Gender Inequality Index (GII) quartile (Q) accounting for individual and country level characteristics.

Results

Immigrants from countries with the highest gender inequality (GII Q4) accounted for 40% of the sample, of whom 83% were from South Asia (SA) or Sub-Saharan Africa (SSA). The overall rate of assault was 10.9/10,000 person years (PY) while the rate of the poor mental health outcome was 77.5/10,000 PY. Both GII Q2 (Incident Rate Ratio (IRR): 1.48, 95% Confidence Interval (CI): 1.08, 2.01) and GII Q4 (IRR: 1.58, 95%CI: 1.08, 2.31) were significantly associated with experiencing assault but not with poor mental health. For females from countries with the highest gender inequality, there were significant regional differences in rates of assault, with SSA migrants experiencing high rates compared with those from SA. Relative to economic immigrants, refugees were at increased risk of sustaining assaults (IRR: 2.96, 95%CI: 2.32, 3.76) and poor mental health (IRR: 1.73, 95%CI: 1.50, 2.01). Higher educational attainment (bachelor’s degree or higher) at immigration was protective (assaults IRR: 0.64, 95%CI: 0.51, 0.80; poor mental health IRR: 0.69, 95% CI: 0.60, 0.80).

Conclusion

Source country gender inequality is not consistently associated with post-migration violence against women or severe depression, anxiety and self-harm in Ontario, Canada. Community-based research and intervention to address the documented socio-demographic disparities in outcomes of female immigrants is needed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10720-0.

Bias-motivated Victimization of Immigrant Students in Schools: Incidence, Impact, and Intervention

Background:

Bias-motivated victimization is common among school-age youth and is associated with negative academic and emotional consequences. Few studies have looked at the incidence of various forms of bias-motivated victimization for first- and second- generation immigrant-origin students even though these students represent an especially vulnerable population for experiencing bias.

Objective:

The present study investigated whether immigrant-origin students reported higher incidences of bias-motivated victimization relative to their nonimmigrant-origin peers. For students who experienced bias-motivated victimization, we examined the impact of these experiences on levels of distress and examined perceived social and community support between immigrant-origin and nonimmigrant-origin students.

Methods:

Participants completed the Youth Bias Victimization Questionnaire (YBVQ), a questionnaire designed to capture information about how often youth experience different types of bias-motivated victimization.

Results:

Approximately 60% of youth in the full sample reported experiencing one or more types of bias victimization in their lifetime and this rate was generally equivalent across immigrant- origin and nonimmigrant-origin participants. For those students who reported at least one lifetime event of bias victimization, immigrant-origin youth were more likely than nonimmigrant-origin youth to experience victimization related to peers’ perceptions of their country of origin or immigrant status. There were no significant differences in reported levels of distress or perceived social and community support between immigrant-origin and nonimmigrant-origin youth, regardless of whether they experienced bias-motivated victimization during their lifetime.

Conclusion:

Clinicians working in school settings should be aware of the high incidence of students who experience bias-motivated victimization and when indicated provide targeted intervention services to those negatively impacted by these experiences.

A Descriptive Study of Bullying Victimization Among Arab American Adolescents in Southeast Michigan Middle and High Schools

PURPOSE

This cross-sectional study examined the frequency of different forms of bullying victimization (verbal, physical, and social), predictors of victimization, and whether bullying is reported to an adult.

DESIGN AND METHODS

The study utilized a community sample of 150 Arab American adolescents, age 12 to 16 years. The Adolescent Peer Relations Instrument-Victimization Scale was used to determine the participant's experiences of victimization in the past year. The adolescents indicated where bullying occurred, why, and whether they reported the incidence to an adult.

RESULTS

Approximately 30% of the study sample reported that victimization occurred occasionally (once a month or more frequent). Classrooms and hallways were the most common locations where bullying had occurred. Country-of-origin and obesity were the most frequent reasons for victimization. Predictors varied among the different forms of victimization; however, cyber-victimization [OR = 24.5; 95% CI 5-119.5)], perceived problematic attire [OR = 8.4; 95% CI 2.2-31.9)], female gender [OR = 5.2; 95% CI 1.2-22.7)], and being overweight [OR = 0.14; 95% CI 0.01-2.6)] all predicted overall victimization.

CONCLUSIONS

Our findings provide a foundation for future research focusing on Arab American adolescents, an underrepresented population, more research is needed to understand the scope of bullying victimization among Arab American adolescents.

PRACTICE IMPLICATIONS

This study will inform future intervention research and practice to consider victimization and related factors among Arab American adolescents. Culturally sensitive and multilevel interventions are imperative to decrease bullying victimization among Arab American adolescents and prevent negative effects on their health and families.

Factors associated with cyber-victimization among immigrants and non-immigrants in Canada: a cross-sectional nationally-representative study

Objectives

There is a paucity of research on patterns of cyber-victimization in minority groups, including immigrants. This study aimed to identify individual, interpersonal and contextual characteristics associated with cyber-victimization among immigrants and non-immigrants.

Methods

We drew on nationally representative data from adolescents and adults in the Canadian General Social Survey on victimization (2014). We used multivariable logistic regression to identify potential factors associated with cyber-victimization in the last 12 months, stratified by immigrant status and sex.

Results

Among 27,425 survey respondents, the weighted prevalence of cyber-victimization in the last 12 months was 2.1% among immigrants and 2.3% among non-immigrants. Cyber-victimization rates differed significantly by sex among immigrants (2.8% for males vs. 1.4% for females), but not among non-immigrants (2.1% for males vs. 2.4% for females). While most other factors associated with cyber-victimization were similar for immigrants and non-immigrants, there were pronounced associations of past child maltreatment (adjusted prevalence odds ratio [aPOR] 4.85, 95% confidence interval [CI] 2.76, 8.52) and residence in an unwelcoming neighbourhood (aPOR 5.08, 95% CI 2.44, 10.55) with cyber-victimization among immigrants that were diminished or absent among non-immigrants. Additionally, sex-stratified analyses among immigrants showed cyber-victimization to be strongly associated with having a mental health condition (aPOR 3.50, 95% CI 1.36, 8.97) among immigrant males only, and with perceived discrimination (aPOR 4.08, 95% CI 1.65, 10.08), as well as being under 24 years old (aPOR 3.24, 95% CI 1.09, 9.60) among immigrant females.

Conclusions

Immigration status and sex were differentially associated with cyber-victimization. Findings support the salience of a social-ecological perspective and gender-stratified analyses to better elucidate complex pathways linking cyber-victimization to potential gender-based health inequities among immigrants.

Bullying Experience among Adolescents with a Turkish Migration Background in Germany: Ethnic Class Composition, Integration, and Religiosity as Protective Factors?

Bullying is a worldwide problem that has serious effects on the mental health of both victims and perpetrators. Although bullying seems related to increasing globalization and migration, it has seldom been researched in this context. This exploratory study examined bullying experiences and related depressive symptoms among a sample of adolescents with a Turkish migration background in a German school context (N = 103, 56.7% female, M_Age = 16.17, SD_Age = 1.36). The study focuses on three migration-related variables as potentially salutogenic factors: Ethnic class composition, acculturation, and religiosity. While the ethnic class composition did not show any effect, an integration acculturation strategy and religiosity proved to be protective factors against bullying experience. The negative prediction of integration on depressive symptoms was not consistent throughout the multivariate analyses. The results are discussed against the background of new impulses for bullying intervention programs for this vulnerable group of adolescents from a Turkish migration background.

Ethnic Bullying Victimization in Italy: The Role of Acculturation Orientation for Ethnic Minority Adolescents With Differing Citizenship Statuses

This study examines the role of acculturation orientation toward home and host countries in ethnic bullying victimization, by considering citizenship status and taking into account social withdrawal. Within a larger school project with middle and high school students, we analyzed data on 252 adolescents from immigrant backgrounds: 71 born abroad without Italian citizenship (Males = 71.4%; mean age = 13.98, SD = 1.7); 96 born in Italy to immigrant parents and without Italian citizenship (Males = 58.3%; mean age = 13.26, SD = 1.6); and 85 Italian citizens born in Italy with an immigrant parent (Males = 54.7%; mean age = 13.12, SD = 1.5). At the univariate level we found that the group of adolescents born abroad with foreign parents showed significantly higher levels of ethnic victimization compared to the group of adolescents born in Italy with an Italian parent. The latter also reported a significantly higher mean in Acculturation Orientation toward their Host Country (i.e., Italy) compared to the other two groups. Looking at the processes working within each group, we found differences in the patterns of association between acculturation orientation and ethnic bullying victimization. Specifically, we found a significant and positive association between acculturation orientation toward the home country and ethnic victimization in the two groups of adolescents born in Italy, while acculturation orientation toward the host country seems to be a protective factor only for adolescents with Italian citizenship. Acculturation orientation does not play any role in ethnic victimization for the first generation of immigrants, while for this group we found a stronger positive effect of Social Withdrawal. Citizenship status appears to be a good indicator of belonging to an ethnic minority group with a background of immigration: it seems to catch specific processes in ethnic bullying victimization.

Association of Immigrant and Refugee Status With Risk Factors for Exposure to Violent Assault Among Youths and Young Adults in Canada

IMPORTANCE

Immigrant populations continue to grow across Western countries. Such populations may face vulnerabilities that contribute to the risk of experiencing violent injury. Youths are at disproportionate risk compared with other age groups, and such violence may be preventable with appropriately targeted injury prevention strategies.

OBJECTIVE

To examine the association of immigrant or refugee status and immigration-related factors with the experience of assault.

DESIGN, SETTING, AND PARTICIPANTS

This population-based cohort study used linked health and administrative databases in Ontario, Canada, where health services are funded through a universal, single-payer health insurance plan. All youths and young adults aged 10 to 24 years (hereafter referred to as youths) residing in Ontario from January 1, 2008, to December 31, 2016, were eligible to participate. Data were analyzed from April 13, 2017, to January 6, 2020.

EXPOSURES

The main exposure was immigrant status. Secondary exposures were immigration-related factors, including visa class, time since immigration, and region and country of origin.

MAIN OUTCOMES AND MEASURES

The main outcome consisted of violent injuries requiring acute care (emergency department visit or hospitalization) or causing death. Poisson regression models were used to estimate rate ratios for injuries.

RESULTS

A total of 22 969 443 person-years were included in the analysis (51.3% male and 48.7% female participants). Compared with nonimmigrants, a greater proportion of immigrants lived in the lowest neighborhood income quintile (30.5% vs 18.2%) and urban areas (98.9% vs 87.7%). Among immigrants, 17.9% were refugees. Rates of violent injuries experienced were 549.0 (95% CI, 545.7-552.2) per 100 000 person-years in nonimmigrant youth, 225.0 (95% CI, 219.4-230.7) per 100 000 person-years in nonrefugee immigrant youth, and 525.4 (95% CI, 507.2-544.1) per 100 000 person-years in refugee immigrant youth. The rates of violent injury among nonrefugee and refugee immigrants were lower than among nonimmigrants (nonrefugee adjusted rate ratio [aRR], 0.41 [95% CI, 0.38-0.43]; refugee aRR, 0.82 [95% CI, 0.76-0.89]). Older age (oldest vs youngest aRR, 6.90 [95% CI, 6.53-7.29]), male sex (aRR, 2.60 [95% CI, 2.52-2.68]), and low neighborhood income (aRR, 2.42 [95% CI, 2.32-2.53]) were associated with violent injury risk. Rates of experiencing assault were lowest among South Asian (aRR, 0.33 [95% CI, 0.30-0.37]) and East Asian (aRR, 0.23 [95% CI, 0.19-0.26]) immigrants. Only Somali immigrants experienced higher assault rates (712.0 [95% CI, 639.3-805.3] per 100 000 person-years) compared with nonimmigrants. Most injuries (79.9%) were from being struck, followed by being cut (5.9%).

CONCLUSIONS AND RELEVANCE

The low rates of assault experienced by immigrants, including refugees, compared with nonimmigrants suggests that Canadian immigrant settlement supports and cultural factors may be protective against the risk of experiencing assault.

Factors Related to Depressive Symptoms Among Multicultural Adolescents in Korea

This study aimed to compare related factors of depressive symptoms among multicultural adolescents in South Korea. Cross-sectional data were collected from 1,325 students studying in ninth grade (mean age: 14.97 ± 0.36 years) who had one Korean parent and one foreign-born parent. The score of depressive symptoms among girls (1.777 ± 0.550) was higher than boys (1.647 ± 0.512). The regression model-including demographic, psychological, and social factors-explained 38.3% of depressive symptoms among boys and 27.9% among girls. Body image satisfaction was the most powerful factor related to depressive symptoms in both boys and girls. Gender-differentiated factors identified in this study such as demographic, psychological, and social factors need to be studied while planning gender-tailored intervention programs to help relieve depressive symptoms among multicultural adolescents.

Promoting Civic Engagement and Social Inclusion Interventions for Minors Involved with Crimes

The juvenile justice system in Italy is aimed at avoiding detention, thanks to alternative measures and strategies for social inclusion. Nevertheless, for two groups of minors – those involved in organised crime and migrants – social inclusion and other alternative forms of punishment are not easily applied because these minors often lack social networks. Migrant minors are at risk of becoming offenders because they arrive in the host country without a real migration plan and without educational or work opportunities. Psychosocial literature about migrant minors has also examined the relationship between the difficulties migrants face and their possible involvement in deviant groups. This is a crucial topic that must be explored carefully and without stigmatising minors. Young migrants under criminal proceedings are vulnerable in two ways: because they are minors and unable to fulfil their needs and because they are non-citizens, a status which may marginalise them within the social context. Accordingly, in previous research, we implemented proactive interventions in four European countries (Italy, Romania, Germany, and Spain) to promote social inclusion and prevent minors from engaging in violent behaviour. In this chapter, we use interviews and focus groups to explore how justice system professionals and stakeholders in Italy describe the deviant career of young people at risk of radicalisation. We also provide evidence for the importance of social inclusion interventions as a means of preventing violent radicalisation. Finally, we argue for professional development training so that practitioners in the juvenile justice system can develop innovative ways of promoting social inclusion.

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.

Acculturative stress and emotional eating in Latino adolescents

PURPOSE

Despite data that suggest Latino adolescents experience acculturative stress (i.e., feeling overwhelmed by conflicting cultural practices, language problems, and ethnic self-consciousness) and endorse elevated levels of emotional eating, there has been an absence of research examining the relations between acculturative stress and emotional eating in this population. The purpose of the present study was to (1) examine the associations between acculturative stress, emotional eating, and change in BMIz scores in Latino adolescents over a 3-month period, and (2) compare Latino and non-Latino adolescents on measures of acculturative stress, emotional eating, and body mass index (BMI).

METHODS

The sample comprised 168 Latino (mean age 13.69 years; SD 0.88) and 278 non-Latino (mean age 13.68 years; SD 0.79) middle and high school students. Participants completed the Emotional Eating Scale for Children and Adolescents (EES-C), the Social, Attitudinal, Familial, and Environmental Acculturative Stress Scale for Children (SAFE-C), and a demographic questionnaire. Participants had their height and weight measured after completing the questionnaires and at a second-time point, approximately 3 months after time 1 measurements. Independent samples t tests and Cohen's d effect sizes were used to investigate whether there were differences between Latino adolescents and non-Latino adolescents. Pearson correlations were computed to examine associations between acculturative stress, emotional eating, and change in BMIz scores in the Latino sample.

RESULTS

Latino adolescents endorsed significantly higher acculturative stress on the SAFE-C compared to non-Latino adolescents (Latino mean 30.81; non-Latino mean 25.64; p < 0.001; Cohen's d effect size = 0.35). In the Latino sample, acculturative stress was associated with higher levels of emotional eating. Latino and non-Latino adolescents endorsed similar levels of emotional eating.

CONCLUSIONS

The present findings provide preliminary evidence that acculturative stress may serve as a risk factor for emotional eating among Latino adolescents. Future obesity prevention and intervention programs developed for Latino adolescents may benefit from addressing acculturative stress, particularly among more recent Latino immigrants.

LEVEL OF EVIDENCE

Level 3, case-control analytic study.

"I Just Kept It to Myself": The Shaping of Latina Suicidality Through Gendered Oppression, Silence, and Violence

Suicide is a critical issue among Latina youth. In this study, we use family case analysis to explore how gendered oppression, silencing, and violence shape suicidal behaviors among a sample of Latina daughters (n = 10), and their parents. For comparison, we include family narratives from Latina adolescents with no histories of suicide attempts (n = 10). Results suggest how secrets and silence, as indicative of gendered oppression, may catalyze a suicide attempt. The risks are particularly salient when daughter and mother both have experienced violence that conflicts with gendered cultural scripts. Findings highlight the importance of parental engagement and exploration of histories of violence in the treatment of Latina suicide attempters. Future research should incorporate the risk factors of gendered oppression and violence to better understand the development of suicidality among Latina women.

HEIA tools: inclusion of migrants in health policy in Canada

This paper introduces the Migrant Populations Equity Extension for Ontario's Health Equity Impact Assessment (HEIA) initiatives. It provides a mechanism to address the needs of migrant populations, within a program and policy framework. Validation of an equity extension framework using community leaders and health practitioners engaged in HEIA workshops across Ontario. Participants assessed migrants' health needs and discussed how to integrate these needs into health policy. The Migrant Populations Equity Extension's framework assists decision makers assess relevant populations, collaborate with immigrant communities, improve policy development and mitigate unintended negative impacts of policy initiatives. The tool framework aims to build stakeholder capacity and improve their ability to conduct HEIAs while including migrant populations. The workshops engaged participants in equity discussions, enhanced their knowledge of migrant policy development and promoted HEIA tools in health decision-making. Prior to these workshops, many participants were unaware of the HEIA tool. The workshops informed the validation of the equity extension and support materials for training staff in government and public health. Ongoing research on policy implementation would be valuable. Public health practitioners and migrant communities can use the equity extension's framework to support decision-making processes and address health inequities. This framework may improve policy development and reduce health inequities for Ontario's diverse migrant populations. Many countries are now using health impact assessment and health equity frameworks. This migration population equity extension is an internationally unique framework that engages migrant communities.

Educational Environments with Cultural and Religious Diversity: Psychometric Analysis of the Cyberbullying Scale

The objective of this research is to adapt and validate a useful instrument to diagnose cyberbullying, provoked by intolerance towards cultural and religious diversity, identifying the profile of the aggressor and the victim. The study was carried out using the Delphi technique, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). The selected sample was composed of 1478 adolescents, all students from Compulsory Secondary Education of Spain. The instrument items were extracted from relevant scales on the topic. The initial questionnaire was composed of 52 items and three underlying constructs. After validation with EFA (n = 723), the structure was checked, and the model was later corroborated with CFA (n = 755) through structural equations (RMSEA = 0.05, CFI = 0.826, TLI = 0.805). The reliability and internal consistency of the instrument were also tested, with values for all dimensions being higher than 0.8. It is concluded that this new questionnaire has 38 items and three dimensions. It has an acceptable validity and reliability, and can be used to diagnose cyberbullying caused by the non-acceptance of cultural and religious diversity in Compulsory Secondary Education students.

Conceptualizing sexual and gender-based violence in European asylum reception centers

Background

Sexual and gender based violence (SGBV) is a major public health problem and a violation of human rights. Refugees, asylum seekers and migrants are exposed to a constant risk for both victimization and perpetration. Yet, in the context of European asylum reception centers (EARF) professionals are also considered to be at risk. Our study explores the conceptualization of SGBV that residents and professionals have in this specific context. Further, we intent to identify key socio-demographic characteristics that are associated with SGBV conceptualization for both groups.

Methods

We developed a cross-sectional study using the Senperforto project database. Semi-structured interviews were conducted with residents (n = 398) and professionals (n = 202) at EARF. A principal component analysis (PCA) was conducted to variables related with knowledge on SGBV. Chi-square test and Fisher’s exact test were applied to understand if significant statistical association exists with socio-demographic characteristics (significant level 0.5%).

Results

The majority of residents were male (64.6%), aged from 19 to 29 years (41.4%) and single (66.8%); for professionals the majority were women (56.2%), aged from 30 to 39 years (42.3%) and married (56.8%). PCA for residents resulted in 14 dimensions of SGBV representing 83.56% of the total variance of the data, while for professionals it resulted in 17 dimensions that represent 86.92% of the total variance of the data. For both groups differences in SGBV conceptualization were found according to host country, sex, age and marital status. Specific for residents we found differences according to the time of arrival to Europe/host country and type of accommodation, while for professionals differences were found according to legal status and education skills.

Conclusion

Residents and professionals described different conceptualization of SGBV, with specific types of SGBV not being recognized as a violent act. Primary preventive strategies in EARF should focus on reducing SGBV conceptualization discrepancies, taking into account socio-demographic characteristics.

School factors and anxiety disorder among Hispanic youth: Results from the 2016 US National Survey on Children’s Health

Anxiety disorders continue to be a major mental health problem among Hispanic youth. A greater understanding of particular risk factors among this at-risk population may assist school health professionals in developing psychosocial interventions designed to mitigate this growing problem. The present study evaluated a variety of school factors related to anxiety among a national sample of Hispanic youth in the US. A secondary analysis of the 2016 National Children’s Health Survey was conducted. A total of 2,138 of Hispanic adolescents aged 12- to 17-years-old participated in the study. A sizeable percentage (10.9%) of Hispanic youth reported anxiety. Results from the final multivariate regression model indicated that bullying others or excluding them, being bullied or excluded by others, not doing all required homework, and school contact to parents about their child’s behavior were all significant risk factors for anxiety among Hispanic adolescents in the US. These risk factors should be considered when planning school health and psychology interventions for Hispanic adolescents in the US.

Relationships Between Mental Health, Skill Sets, and Violence Perpetration Among Adolescent Girls

This study examines relationships between emotional health, stress management skills, fight-avoidance skills, and two forms of violence perpetration among adolescent girls at high risk for violence involvement. Participants ( n = 253) were 13- to 17-year-old girls enrolled in a randomized controlled trial. The current study was completed with baseline data collected prior to the start of the intervention. Analyses examined self-report outcome measures of physical violence perpetration in the past 6 months (five-item scale, α = .79) and relational aggression perpetration in the past 30 days (six-item scale, α = .77). Independent variables included baseline measures of self-esteem (four-item scale, α = .89), emotional distress (six-item scale, α = .89), stress management skills (eight-item scale, α = .86), and fight avoidance skills (five-item scale, α = .70). Multivariate regression models predicted each form of violence perpetration controlling for age, race/ethnicity, violence victimization, and clustering of participants within clinics. Initial bivariate results showed that stress management skills and fight avoidance skills were inversely and significantly related to perpetration of both relational and physical violence. Emotional distress was related to significantly higher levels of both violence outcomes. In contrast, self-esteem was not significantly related to either violence outcome. Multivariate analyses revealed that stress management skills and fight avoidance skills were significantly protective against perpetration of both relational aggression and physical violence. In conclusion, findings suggest that clinicians providing services to adolescent girls involved in high risk behaviors assess and foster girls' development of stress management and fight avoidance skills to help reduce their risk of involvement in relational violence and physical fighting.

Children's Social Integration and Low Perception of Negative Relationships as Protectors Against Bullying and Cyberbullying

The aim was to investigate the factors associated with the diverse bullying forms suffered by a victim (relational, aggressive and cyberbullying) by considering the mediating role of the quality of coexistence in school: social integration and perception about relationships among peers. We evaluated data about 42 schools (79.5% public) in a sample of 3,407 students (47.6% boys and 52.4% girls) from the Primary Education. The mediational analyses indicated that, to predict all the bullying forms, a greater sense of social integration and a perception of low negative relationships were mediators, and social integration was the factor that most strongly correlated with bullying, especially relational bullying. We found that the number of good friends and negative relationships together predicted social integration, and the school type predicted negative relationships and number of good friends. The implications for education programs and policy are discussed.

[Suicidal thoughts and suicide attempts in adolescence among migrants]

Migration is an experience with a creative and dynamic potential, but it can also serve to further isolate people. Migrant adolescents and ethnic minorities with a migrant background are particularly vulnerable to suicidal ideation and suicidal behaviour. International studies show a significant prevalence of suicide attempts among migrants and their children. Intergenerational conflicts and the family environment, for example poor communication and lack of parental support, are risk factors for suicidal behaviour in migrant adolescents. The valorisation of the culture of origin could contribute to the feeling of 'cultural continuity' which is a protective factor of the suicidal risk.

Immigration, citizenship, and the mental health of adolescents

PURPOSE

To examine the reported mental health outcomes of adolescent foreign-born non-citizens and adolescent foreign-born U.S. citizens compared to adolescent U.S.-born citizens.

METHODS

Using the Strengths and Difficulties Questionnaire in the National Health Interview Survey, we compared mental health status of U.S.-born adolescent citizens to foreign-born citizens and non-citizens in the years 2010-2015, and examined how differences in emotional difficulty changed based on time spent in the U.S.

RESULTS

Results suggest that non-citizen adolescents experience better mental health outcomes than U.S.-born citizens. However, the mental health status of foreign-born citizens is indistinguishable from that of the U.S.-born, after accounting for basic socio-demographic characteristics. The prevalence of emotional difficulty experienced by immigrant adolescents increased with a family's duration in the U.S.

CONCLUSION

Our findings are consistent with a broader health advantage for the foreign-born, but we present new evidence that the mental health advantage of foreign-born adolescents exists only for non-citizens.

Psychological and psychosocial interventions for refugee children resettled in high-income countries

Large numbers of refugee children are arriving in high-income countries. The evidence to date suggests that they have mental health needs that are higher than for the general population and that these are exacerbated by the numbers of traumatic events they have experienced and the post-migration stressors they continue to be exposed to. The importance of a thorough and thoughtful assessment is discussed. Treatments of note are described for post-traumatic stress disorder, family functioning, general mental health problems and school environments. Future opportunities to operationalise outcome measures, develop multimodal interventions and utilise implementation science methodology are considered.

Primary Health Care Models Addressing Health Equity for Immigrants: A Systematic Scoping Review

To examine two healthcare models, specifically "Primary Medical Care" (PMC) and "Primary Health Care" (PHC) in the context of immigrant populations' health needs. We conducted a systematic scoping review of studies that examined primary care provided to immigrants. We categorized studies into two models, PMC and PHC. We used subjects of access barriers and preventive interventions to analyze the potential of PMC/PHC to address healthcare inequities. From 1385 articles, 39 relevant studies were identified. In the context of immigrant populations, the PMC model was found to be more oriented to implement strategies that improve quality of care of the acute and chronically ill, while PHC models focused more on health promotion and strategies to address cultural and access barriers to care, and preventive strategies to address social determinants of health. Primary Health Care models may be better equipped to address social determinants of health, and thus have more potential to reduce immigrant populations' health inequities.

Culture's Influence on Stressors, Parental Socialization, and Developmental Processes in the Mental Health of Children of Immigrants

Children of immigrants represent one in four children in the United States and will represent one in three children by 2050. Children of Asian and Latino immigrants together represent the majority of children of immigrants in the United States. Children of immigrants may be immigrants themselves, or they may have been born in the United States to foreign-born parents; their status may be legal or undocumented. We review transcultural and culture-specific factors that influence the various ways in which stressors are experienced; we also discuss the ways in which parental socialization and developmental processes function as risk factors or protective factors in their influence on the mental health of children of immigrants. Children of immigrants with elevated risk for mental health problems are more likely to be undocumented immigrants, refugees, or unaccompanied minors. We describe interventions and policies that show promise for reducing mental health problems among children of immigrants in the United States.