Psychological distress among Chinese immigrants to the USA

Visa type and financial strain on depressive symptoms among Filipino migrants to the United States

Migrants have been theorized to be healthier than their non-migrant counterparts; however, there is limited examination of health selection using binational data and how selection occurs, particularly for mental health outcomes. This study examines the role of visa status and financial strain as critical factors for mental health selection among Filipino migrants to the U.S. and non-migrants who remain in the Philippines. We used the baseline data from the Health of Philippine Emigrants Study (HoPES; n = 1631) to compare depressive symptoms between non-migrants and migrants who were both surveyed prior to their departure to the U.S. We assessed depressive symptoms using linear regression by migration status, financial strain, and by visa categories including fiancée/marriage, unlimited family reunification, limited family reunification, and employment. Overall, all migrants reported lower depressive symptoms than non-migrants; however, depressive symptoms varied by visa type. Fiancée/marriage migrants had lower depressive symptoms than compared to limited family reunification migrants. Additionally, those who reported financial strain had higher depressive symptoms than those without any financial strain. We find that migrants were positively selected for mental health using a unique sample of Filipino migrants before they left for the U.S.

Psychological distress among immigrant women who divorced: Resilience as a mediator

PURPOSE

The purpose of this study was to investigate relationships among the demands of immigration, resilience, and psychological distress in divorced immigrant women, and determine the mediating effects of resilience on the relationship between demands of immigration and psychological distress.

DESIGN

The cross-sectional study included 117 women who had immigrated and married Taiwanese men but later got divorced.

METHODS

The Chinese health questionnaire-12 scale, the resilience scale-Chinese version, and the demands of immigration (DI) scale were used to measure in this study. A multiple regression and Sobel test were used to examine whether resilience mediated the relationship between demands of immigration and psychological distress.

FINDINGS

In this study, 47% of the divorced immigrant women were experiencing psychological distress, and 25.6% exhibited high levels of demands of immigration. Women with psychological distress had higher demand scores (t = 2.592, p = 0.011) and lower resilience scores (t = -3.965, p < 0.001) compared to women without psychological distress. The demands of immigration negatively predicted resilience (t = -3.050, p = 0.003). Finally, resilience mediated the association of demands of immigration with psychological distress (z = 2.497, p = 0.0125).

CONCLUSIONS

Relationships among the demands of immigration, resilience, and psychological distress in divorced immigrant women were demonstrated in this study. Resilience played an important role in the relationship between demands of immigration and psychological distress.

CLINICAL RELEVANCE

Tailored programs that foster resilience to reduce risks of demands of immigration and psychological distress in this vulnerable population should be developed.

Clustering of Social and Physical Pain Variables and Their Association With Mortality in Two Population-Based Cohorts

OBJECTIVE

Social pain and physical pain are related bidirectionally, but how these variables cluster in the population is unknown.

METHODS

This study included 2833 women from the Study of Women's Health Across the Nation (SWAN), a community-based cohort of middle-aged women, and 3972 women from the Pathways Study, a population-based cohort of women diagnosed with American Joint Committee on Cancer stages I-IV breast cancer diagnosed between 2005 and 2013. Women provided data on measures related to social pain (social network size, social support, loneliness, social well-being) and physical pain (sensitivity to pain, bodily pain) at study baseline. Analyzing each cohort separately, we used latent class analysis to evaluate social-physical pain clusters, logistic regression to evaluate predictors of categorization into clusters, and Cox proportional hazards models to evaluate associations of clusters with all-cause mortality. We also performed a meta-analysis to combine cohort mortality associations.

RESULTS

Each cluster analysis produced a "low social-physical pain" cluster (SWAN, 48.6%; Pathways, 35.2%) characterized by low social and pain symptoms, a "high social-physical pain" cluster (SWAN, 17.9%; Pathways, 17.9%) characterized by high symptoms, and a "low social/high physical pain" cluster of women with high pain and compromised social functioning but otherwise low social symptoms (SWAN, 33.5%; Pathways, 46.9%). In meta-analysis, categorization into the high social-physical pain cluster was associated with elevated mortality (adjusted hazard ratio = 1.34, 95% confidence interval = 1.05-1.71, Q statistic = 0.782), compared with those in the low social-physical pain cluster.

CONCLUSIONS

In two cohorts of women, latent class analysis produced similar sets of social-physical pain clusters, with the same proportion having both high social and pain symptoms; women in this cluster had elevated mortality.

A Biopsychosocial Framework to Examine Risk for Type 2 Diabetes in Asian Pacific Islander Immigrants

There is large disparity in the incidence of Type 2 diabetes (T2D) for Asian Pacific Islanders (APIs), one of the fastest growing minority populations in the United States. It is critical to examine biopsychosocial pathways and vulnerability factors that intensify risk for T2D in API. Increasing evidence links chronic stress to poor health outcomes and accelerated development and progression of diseases of aging, such as diabetes. Immigrant populations face unique life stressors, including the challenges associated with the process of adapting to a new environment, new language, and cultural differences. In addition, immigrants experience high levels of psychological distress related to changes of identity and values, loss of support, discrimination, and disempowerment. The purpose of this article is to propose a biopsychosocial framework to explicate potential mechanistic pathways that link cumulative life stress to risk for T2D in the API immigrant population. Unique to the proposed framework is the emphasis on inflammatory processes and accelerated cellular aging (telomere biology). A deeper understanding of biopsychosocial pathways can lead to tailored and targeted interventions to reduce the incidence of T2D in the API immigrant population.

Unemployment and Psychological Distress among Young People during the COVID-19 Pandemic: Psychological Resources and Risk Factors

In the wake of COVID-19, unemployment and its potential deleterious consequences have attracted renewed interest. We examined (1) the association between unemployment, occurring upon the coronavirus outbreak, and psychological distress among Israeli young people (20–35-years-old); (2) the associations between various psychological resources/risk factors and psychological distress; and (3) whether these resources and risk factors were moderators in the unemployment-psychological distress link. A real-time survey based on snowball sampling was conducted during the month of April 2020 (N = 390). We employed hierarchical linear models to explore associations between unemployment, psychological resources, risk factors, and psychological distress. Unemployment was independently associated with greater psychological distress. Perceived trust, optimism, and sense of mastery decreased psychological distress, whereas financial strain and loneliness during the crisis increased this distress. The effect of unemployment on psychological distress did not depend on participants’ resource and risk factor levels. Policymakers must develop and extend health initiatives aimed at alleviating the mental health consequences of COVID-19-related unemployment and promote labor market interventions to help young job seekers integrate into employment. These measures, which are in line with the UN sustainable development goals, should be seen as an important route to promote public health.

Psychological distress in older adults linked to immigrant status, dietary intake, and physical health conditions in the Canadian Longitudinal Study on Aging (CLSA)

BACKGROUND

Psychological distress increases mortality risk; there is little knowledge about its prevelance and contributory factors in older populations.

METHODS

Canadian Longitudinal Study on Aging baseline data (2010-2015) were analyzed to examine the relationship between Kessler's Psychological Distress Scale-K10 and immigrant status (recent/mid-term,<20 years; long-term, ≥20 years; Canadian-born). Covariates included socioeconomic and health-related variables. Stratified by sex, two series of multinomial logistic regression were used to calculate the likelihood of having mild distress (20 < K10 score ≤24) and moderate/severe distress (K10 score >24).

RESULTS

Respondents (n = 25,700) were mainly Canadian-born (82.8%), 45-65 years (59.3%), earning <C$100,000/year (58.2%), and had a post-secondary education (78.4%). For women, psychological distress was associated with being a recent/mid-term immigrant(OR=1.76, 99% CI 1.09-2.83), marital status (widowed/divorced/separated, OR=1.62, 99% CI 1.19-2.20), lower education level (<secondary school; OR = 1.95, 99% CI 1.32-2.88), lower intake of fruit and vegetable (≤ 2/day; OR=1.50, 99% CI 1.05-2.14), higher waist-to-height ratio (>cut-off; OR=1.32, 99% CI 1.02-1.70), and higher nutritional risk (ORs = 2.16-3.31, p's <0.001). For men, psychological distress was associated with under-nutrition (grip strength<cut-off, OR=1.57, 99% CI 1.14-2.16). For men and women, psychological distress was associated with age (>56 years, ORs=0.19-0.79, p's<0.01), lower income (≤C$149,000, ORs = 1.68-7.79, p's<0.01), multi-morbidities (ORs = 1.67-4.70, p's<0.01), chronic pain (ORs = 1.67-3.09, p's<0.001) and higher intake of chocolate (≥ 0.6 bar/week, ORs=1.61-2.23, p's<0.001).

LIMITATIONS

Cross-sectional design prohibits causal inferences.

CONCLUSIONS

Nutritional factors, immigration status, social, and health-related problems are strongly associated with psychological distress among midlife and older adults.

Citizenship as Privilege and Social Identity: Implications for Psychological Distress

Citizenship is both a system of privilege and a source of social identity. This study examines whether there are disparities in psychological distress between citizens and noncitizens, and whether these disparities may be explained by markers of social disadvantage (e.g., poverty, discrimination) or perceptions of success in the United States (i.e., subjective social status). We analyze data from the Asian subsample (n = 2,095) of the National Latino and Asian American Study. The data show that noncitizens report greater psychological distress compared with naturalized citizens and native-born citizens after accounting for sociodemographics (e.g., age, gender, Asian subgroup), socioeconomic characteristics (education, employment, income-to-poverty ratio), immigration (e.g., interview language, years in the United States, acculturative stress), health care visits, and everyday discrimination. Preliminary evidence suggests that subjective social status may explain some of the disparities between naturalized citizen and noncitizen Asian Americans.