Relative contributions of acculturation and psychopathological factors to cannabis use among adolescents from migrant parents

Issues around food in mixed families of adolescent girls with bulimia nervosa: A qualitative study with photo-elicitation

OBJECTIVES

Bulimia nervosa (BN) is a common psychiatric disorder among adolescent girls with potentially significant complications. Family relationships play a major role in the development and progression of this disorder. Studies in migrant populations suffering from eating disorders show contrasting results depending on the generation of migrants: first generation migrants have fewer eating disorders than the native population, while the prevalence of this disorder is more important than the latter among second and third generation migrants. In our clinical experience, we have frequently encountered so-called "mixed" families, which are families composed of one migrant parent and one non-migrant parent. Research focusing on this kind of family is scarce which is why we chose to explore their dynamic.

METHODS

This study explored the issues around food and family relationships of adolescent girls suffering from BN, a topic that, to date, has not yet been studied. Ten interviews were conducted with five adolescent girls with BN between the ages of 16 and 20 and their parents, using photo-elicitation to enrich the collected data.

RESULTS

The results were organized around two axes: (1) identity issues around food, that is the assimilation process described by both parents and adolescents concerning family meals and food habits, and how the adolescents struggle to manage this interbreeding; and (2) transmission issues with the consequences the migrant parent has to deal with to transmit his/her cultural identity with food while being far away from the homeland, and the difficulties between this parent and his/her child to share this heritage. Both issues, identity and transmission, appear to be central among these families.

CONCLUSIONS

Our results suggest a difficulty in mentalizing identity issues in adolescent girls; the function of appeasement around non-mentalized tensions was highlighted. In our opinion, in this particular context, BN acts as a means of expressing the difficulty of their mixed culture. This enables it to draw some clinical implications, especially using mentalization-based therapy which has already shown efficacy in adolescents with borderline personality disorder and ED.

Meta-Analysis on the Relation Between Acculturation and Alcohol Use Among Immigrant Youth

PURPOSE

We empirically examined the relation between acculturation and alcohol use in immigrant youth, with attention to demographic and methodological moderators.

METHODS

We identified 43 studies (38 empirical studies published in peer-reviewed journals and 6 dissertations) yielding 66 independent samples and 118 effect sizes. The total sample size was 61,851 immigrant youth from birth to 25 years of age (M = 937.14, standard deviation = 1,271.24) with a mean age of 15.50 years (standard deviation = 2.46).

RESULTS

The average effect size for the fixed effects model was .04 with a 95% confidence interval of .03-.05, which was significantly different from zero (p < .001). The average effect size for the random effects model was .05 with a 95% confidence interval of .02-.08, which was significantly different from zero (p = .002). Location of the study, age of participants, type of measurements used to assess acculturation and alcohol use, and publication year were significant moderators.

CONCLUSIONS

This meta-analytic review supported the immigrant paradox in which acculturation puts immigrant youth at risk for alcohol use. Several demographic and methodological factors also moderated this relation in a significant way. Important implications are discussed.

Immigrants, refugees and cannabis use

Immigration typically occurs from low- to high-income countries and regions. Unfortunately, these wealthier areas also have higher rates of cannabis use (e.g. European Union and the US). This systematic review aimed to summarize available studies on cannabis use among immigrants, refugees, and asylum seekers. In addition, evidence on the association between immigration and cannabis use was reviewed. The rates of cannabis use were lower among immigrants than natives. The risk and protective factors to cannabis use were quite similar to those of the native populations. The population at greatest risk for cannabis use were refugees, males, singles, non-religious, those with lower educational level, living in urban areas, with friends that use cannabis and/or other drugs. Cannabis use tend to increase over generations, and acculturation seems to play a pivotal role. First generation migrants report equal or lower consumption of cannabis when compared with the majority population with a subsequent increase in following generations, with a clear association with acculturation factors. A higher cannabis use was found among migrants with lower cultural congruity as well as a higher level of culture assimilation. This use seems to be unrelated to alcohol or illicit drugs consumption, but possibly associated with tobacco smoking.

Exploring problem use, discrimination, ethnic identity and social networks

Purpose

Possessing a strong ethnic identity and ethnic network are described in some epidemiological literature as moderating factors in the relation between perceived discrimination and varying types of substance use in people with a migration background (PMB). The purpose of this paper is to qualitatively explore problem use, discrimination, ethnic identity and social networks in a small purposive sample of users with a Turkish and Eastern European migration background in Ghent, Belgium.

Design/methodology/approach

The authors present data retrieved within the framework of a qualitative community-based participatory research study that primarily aims to understand the nature of substance use in PMB. In the secondary analysis, the authors focus on a sub-study examining substance use by people with a Turkish (n=55) and Eastern European (n=62) migration background and explore how individuals perceive discrimination, ethnic identity and (ethnic) social networks in 117 qualitative interviews.

Findings

Almost all the respondents in this study reported perceived (inter-)ethnic discrimination. The authors establish that problem users in this study have a complex but albeit weak sense of ethnic identity nor do they have a strong ethnic network. This, in combination with perceived discrimination, is a risk factor for continued problem substance use and may hamper recovery related to problem use.

Originality/value

This article intends to lay the groundwork for future research that should focus more on longitudinally studying the intertwined relation between problem use, discrimination, ethnic identity and especially social instead of solely ethnic networks, their complex nature as well as their relation to recovery processes among persons with a migration background.

Interpersonal dysfunction in personality disorders: A meta-analytic review

Personality disorders are defined in the current psychiatric diagnostic system as pervasive, inflexible, and stable patterns of thinking, feeling, behaving, and interacting with others. Questions regarding the validity and reliability of the current personality disorder diagnoses prompted a reconceptualization of personality pathology in the most recent edition of the psychiatric diagnostic manual, in an appendix of emerging models for future study. To evaluate the construct and discriminant validity of the current personality disorder diagnoses, we conducted a quantitative synthesis of the existing empirical research on associations between personality disorders and interpersonal functioning, defined using the interpersonal circumplex model (comprising orthogonal dimensions of agency and communion), as well as functioning in specific relationship domains (parent-child, family, peer, romantic). A comprehensive literature search yielded 127 published and unpublished studies, comprising 2,579 effect sizes. Average effect sizes from 120 separate meta-analyses, corrected for sampling error and measurement unreliability, and aggregated using a random-effects model, indicated that each personality disorder showed a distinct profile of interpersonal style consistent with its characteristic pattern of symptomatic dysfunction; specific relationship domains affected and strength of associations varied for each personality disorder. Overall, results support the construct and discriminant validity of the personality disorders in the current diagnostic manual, as well as the proposed conceptualization that disturbances in self and interpersonal functioning constitute the core of personality pathology. Importantly, however, contradicting both the current and proposed conceptualizations, there was not evidence for pervasive dysfunction across interpersonal situations and relationships. (PsycINFO Database Record

UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis

BACKGROUND

Impulsivity is often included as a risk factor in models of adolescent marijuana use behaviors; however, the magnitude of the association between impulsivity and marijuana use behaviors is variable across studies. The present study reviewed existent literature to 1) quantify the relationship between separable impulsivity-related traits and both marijuana use and negative marijuana consequences and 2) quantify the size of the effect of gender on these relationships.

METHOD

Thirty-eight studies (41 independent samples) were meta-analyzed using a random effects model to examine the relationship between impulsivity traits and marijuana use behaviors.

RESULTS

Marijuana use was significantly related to all impulsivity-related traits except lack of perseverance (r's ranging from 0.13-0.23, p's<0.01). Negative marijuana consequences were only significantly related to sensation seeking, lack of planning, and positive urgency (r's ranging from 0.37-0.39, p's<0.01). Effects were small for marijuana use, but medium for negative marijuana consequences. Gender was not a significant moderator of any relationships.

CONCLUSIONS

Impulsivity-related traits had more robust relationships with negative marijuana consequences than marijuana use, suggesting impulsivity-related traits are important in differentiating adolescents most likely to experience negative consequences from marijuana use. Few relationships examined gender and many of the impulsivity-related traits, other than sensation seeking. Data and trends suggest a more multi-dimensional approach to marijuana use and consequences is warranted.

Discrimination and Ethnic Identity as Predictors of Substance Use and Delinquency Among Immigrant Adolescents From the FSU and Ethiopia in Israel

The current study explores perceived discrimination and ethnic identity as predictors of delinquency and substance use among adolescent immigrants in Israel. Theoretically, the study draws from strain theory, immigration-related theories of ethnic identity formation in adolescence, bi-dimensional theories of acculturation, and the rejection-identification model. The study involved 250 adolescents, 140 from the Former Soviet Union (FSU) and 110 from Ethiopia, aged 15 to 18 years ( M = 16.7 years). Adolescents were assessed on substance use (cigarettes, marijuana, binge drinking, drunkenness), delinquent behavior, parental relationships (support, limit setting), perceived discrimination, host identity (Jewish Israeli), and ethnic identity (Russian/Ethiopian). Results from structural equation modeling showed that delinquency was predicted directly by greater discrimination, a weaker ethnic (Russian/Ethiopian) identity, and greater substance (alcohol and cigarette) use. Higher levels of parental limit setting and lower levels of parental support predicted higher levels of substance use, but only predicted delinquency indirectly through their impact on substance use. Findings support the hypotheses that perceived discrimination and a weaker ethnic identity predict involvement in delinquency and partially support a hypothesis that higher levels of a positive host identity are related to lower levels of substance use and delinquency among immigrant adolescents. A perceived lack of equal opportunities may lead to stress, anger, and frustration toward society leading to delinquent behavior, whereas difficulties in consolidating a positive cultural identity may lead the young adolescent to fill a void through substance use.

Health-compromising behaviors among a multi-ethnic sample of Canadian high school students: risk-enhancing effects of discrimination and acculturation

This article examines whether acculturation and experiences of discrimination help to explain observed ethnic disparities in rates of three health-compromising behaviors: interpersonal violence, drinking, and cannabis use. Data were drawn from a cross-sectional survey of 3,400 high school students from Toronto, Canada, sampled in 1998-2000. Multivariate ordinary least squares and logistic regression models tested for baseline differences in the health-compromising behaviors by ethnic identity. Subsequent models adjusted for control measures and introduced acculturation and discrimination measures. Results confirm that experiences of discrimination and acculturation are risk enhancing, whereas active cultural retention appears to protect ethnic youth from participation in health-compromising activities.

[Acculturation orientations and psychosocial adaptation among adolescents with immigrant background]

OBJECTIVE

The aim of the study was to explore the typology of adolescents with immigrant background based on the orientations of acculturation and to estimate the psychosocial adaptation of the various subtypes.

METHOD

A sample of 228 French high school students with an immigrant background completed a questionnaire assessing acculturation orientations (Immigrant Acculturation Scale; Barrette et al., 2004), antisocial behaviors, depressive symptoms and self-esteem. Cluster analysis based on acculturation orientations was performed using the k-means method.

RESULTS

Cluster analysis produced four distinct acculturation profiles: bicultural (31%), separated (28%), marginalized (21%), and assimilated-individualistic (20%). Adolescents in the separated and marginalized clusters, both characterized by rejection of the host culture, reported higher levels of antisocial behavior. Depressive symptoms and self-esteem did not differ between clusters.

DISCUSSION

Several hypotheses may explain the association between separation and delinquency. First, separation and rejection of the host culture may lead to rebellious behavior such as delinquency. Conversely, delinquent behavior may provoke rejection or discrimination by peers or school, or legal sanctions that induce a reciprocal process of rejection of the host culture and separation. The relationship between separation and antisocial behavior may be bidirectional, each one reinforcing the other, resulting in a negative spiral. This study confirms the interest of the study of the orientations of acculturation in the understanding of the antisocial behavior of adolescents with immigrant background.

Recent cannabis use among adolescent and young adult immigrants in the Netherlands--the roles of acculturation strategy and linguistic acculturation

BACKGROUND

The present study examined the relation between two different acculturation measures (i.e., linguistic acculturation and the acculturation strategies integration, separation and marginalization) and past year cannabis use. Additionally, we studied the mediating role of affiliation with cannabis-using peers.

METHOD

Data were utilized from i4culture, a Dutch study on immigrant adolescents and young adults aged 15-24 years. Participants belonged to the five largest immigrant populations in the Netherlands, living in or around the four major Dutch cities: Amsterdam, the Hague, Rotterdam, and Utrecht. In total, 771 adolescents and young adults (mean age 19.29, SD=2.61, 53.8% female) from Surinamese (n=210, 27.2%), Moroccan (n=209, 27.1%), Turkish (n=110, 14.3%), Antillean (n=109, 14.1%), and Asian (n=133, 17.3%) backgrounds participated. With questionnaires, past year cannabis use, acculturation strategy, linguistic acculturation, and affiliation with cannabis-using peers were assessed.

RESULTS

Using logistic regression analyses, we found no relation between acculturation strategy and past year cannabis use (OR=1.25, p=0.38 for separation vs integration and OR=0.86, p=0.50 for marginalization vs integration). Linguistic acculturation was positively related to cannabis use (OR=2.20, p<0.01). Affiliation with cannabis-using peers partly mediated this relation (OR=1.09, p<0.01).

CONCLUSIONS

Non-Western immigrant youngsters who speak the host culture's language at home are more likely to use cannabis than youngsters who speak their native language at home. The former group is more likely to affiliate with cannabis-using peers, which partly explains their increased risk of cannabis use.

The Roles of Family, Peer, School, and Attitudinal Factors in Cannabis Use Across Immigrant Generations of Youth

The objective of this study was to examine the associations of family, school, peer, and attitudinal factors with cannabis use among three immigrant generations of youth. The sample consisted of 3,134 students from the 2009 Ontario Student Drug Use and Health Survey, a provincewide survey of 7th- to 12th-grade students. Results indicate that the odds of using cannabis were lower among first-generation immigrant youth than among second as well as third and later generations. The immigrant generations were more similar than different in the significance of family, school, peers, and attitudinal factors on cannabis use. Parental education, however, was found to differ in its effect on cannabis use across generations. Findings suggest that factors that influence cannabis use may be similar across immigrant generations and that further research is needed on the effects of parental education and the mechanisms through which protection and risk to immigrant generations occur.