Resilience, trauma, and hopelessness: protective or triggering factor for the development of psychopathology among migrants?

Trauma and mental health in young adults who arrived in France as unaccompanied and separated migrant children

OBJECTIVES

The mental health of unaccompanied and separated minors (UASC) has been widely studied but not their first years of adulthood, often characterised by uncertainty after leaving child protection. The aim of this study was to estimate the prevalence of psychiatric disorders using standardised and validated research instruments and examine the effect of exposure to trauma.

METHODS

One hundred and ten youth (92.7% male, median age 19.7 [18.1-22.8]) from Chambery, Montpellier and La Rochelle were recruited to a cross-sectional exploratory study. During a face-to-face interview, somatoform disorder, anxiety, and depression were assessed using the Patient Health Questionnaire (score≥10) and post-traumatic stress disorder (PTSD) with the PTSD Checklist for DSM-5 (score≥33). Traumatic life events were assessed using the Life Events Checklist.

RESULTS

Of the youth, 19.3% had a probable somatoform disorder, 17.6% anxiety, 28.7% depression, and 20% PTSD. The number of traumatic life events increased the risk of depression (multi-adjusted OR (95%CI): 1.56 (1.25-1.96)), PTSD (1.60 (1.23-2.08)), somatoform disorder (1.41 (1.10-1.82), and anxiety (1.33 (1.02-1.72)). Physical assault was the type of event positively associated with the most disorders (P≤0.01, except for anxiety), followed by witnessing sudden and violent death (P≤0.01 for depression and PTSD) and sexual assault (P=0.002 for PTSD).

CONCLUSION

Our study highlights the high prevalence of psychiatric disorders in young adults who arrived as UASC and the impact on their mental health of cumulative trauma and exposure to interpersonal and violent traumatic life events. A greater focus on their mental health with regular assessments is needed in order to provide rapid and adapted care.

A latent class analysis of hopelessness in relation to depression and trauma during the COVID-19 pandemic in China

BACKGROUND

Hopelessness is closely related to depression, trauma, and some organic diseases. Yet our understanding of the heterogeneity of hopelessness is limited. This study aimed to explore the heterogeneity of hopelessness, how it corresponds to the severity of depression, and the effect of traumatic experiences on it during COVID-19.

METHOD

The current study measures 28,360 Chinese college students (67.4 % of women) with the Beck Hopelessness Scale (BHS), Trauma Experience Questionnaire, and Patient Health Questionnaire-9 (PHQ-9). The method of latent class analysis (LCA) was used to identify different sub-groups of hopelessness with differences in emotion, motivation, and cognition. Logistic regression and analysis of variance were used to determine the characteristics of different sub-groups.

RESULTS

Three latent classes were identified: Negative affective cognition class (C1, N = 5940, 20.9 %), Negative thought cognition class (C2, N = 1358, 4.8 %), and Low hopelessness class (C3, N = 21,062, 74.3 %). Gender, only child or not, birthplace, family economic status, and grade are predictors of the latent category of hopelessness. There are significant differences in depression among different latent classes, and C1 > C2 > C3 (p < 0.001). Traumatic experience is a risk factor for the hopeless latent classes (OR > 1, P < 0.001).

LIMITATIONS

Research findings may not be applied to other populations and rely on subjective reports. Ignore the effects of other protective and risk factors. Lack of longitudinal research, unable to explore causality.

CONCLUSIONS

The current study provides evidence for the heterogeneity of hopelessness and informs targeted interventions for mental health problems (hopelessness) in college students.

Risk clustering and psychopathology from a multi-center cohort of Indian children, adolescents, and young adults

Developmental adversities early in life are associated with later psychopathology. Clustering may be a useful approach to group multiple diverse risks together and study their relation with psychopathology. To generate risk clusters of children, adolescents, and young adults, based on adverse environmental exposure and developmental characteristics, and to examine the association of risk clusters with manifest psychopathology. Participants (n = 8300) between 6 and 23 years were recruited from seven sites in India. We administered questionnaires to elicit history of previous exposure to adverse childhood environments, family history of psychiatric disorders in first-degree relatives, and a range of antenatal and postnatal adversities. We used these variables to generate risk clusters. Mini-International Neuropsychiatric Interview-5 was administered to evaluate manifest psychopathology. Two-step cluster analysis revealed two clusters designated as high-risk cluster (HRC) and low-risk cluster (LRC), comprising 4197 (50.5%) and 4103 (49.5%) participants, respectively. HRC had higher frequencies of family history of mental illness, antenatal and neonatal risk factors, developmental delays, history of migration, and exposure to adverse childhood experiences than LRC. There were significantly higher risks of any psychiatric disorder [Relative Risk (RR) = 2.0, 95% CI 1.8-2.3], externalizing (RR = 4.8, 95% CI 3.6-6.4) and internalizing disorders (RR = 2.6, 95% CI 2.2-2.9), and suicidality (2.3, 95% CI 1.8-2.8) in HRC. Social-environmental and developmental factors could classify Indian children, adolescents and young adults into homogeneous clusters at high or low risk of psychopathology. These biopsychosocial determinants of mental health may have practice, policy and research implications for people in low- and middle-income countries.

The dynamics of discrimination, resilience, and social support in the mental health of migrants with and without citizenship

Perceived discrimination has a significant negative impact on indices of mental health. One potential buffering factor in this is psychological resilience, which encompasses the ability to recover from or adapt successfully to adversity and use coping strategies, such as positive reappraisal of adverse events. This study examines the role of resilience as well as social support in buffering these effects in groups of migrants both with and without local residence permits. We conducted a non-experimental observational study with a cross-sectional design, collecting a variety of health variables in migrant groups in a naturalistic setting, during the COVID-19 period. The total sample consisted of 201 subjects, 88 of whom had a German residence title and 113 did not. These two groups were compared on the following variables of interest: social support, resilience, discrimination, and general mental health. There was no evidence for a difference in mental health between migrants with and without citizenship. However, our results suggested that migrants without citizenship reported less social support, less resilience, and more discrimination, which continued to have a distinct effect on mental health beyond resilience and social support. Psychological resilience mediated the link between social support and mental health, as well as being related to the perception of discrimination in the migrant group without citizenship. In conclusion, our models of migrants with and without citizenship showed that resilience specifically directly affected perceived discrimination in those without citizenship. The high levels of discrimination and lack of social support, particularly in the migrant group without citizenship, are concerning and suggest a focus for future interventions.

Migrants and Mental Health: Equal Rights but Different Needs

In 2020, the number of international migrants worldwide—people residing in a country other than their country of birth—reached almost 281 million [...]

Deconstructing resilience in patients at high risk for suicidal behavior

BACKGROUND

Resilience represents coping abilities to overcome exposure to psychopathological risk. In the context of risk factors for suicidal behavior, it is unknown if this attribute is deficient in suicide attempters, how it relates to other measures of risk, and where it may overlap with other risk factors associated with suicidal behavior.

METHODS

The present study examined the performance on the Connor-Davidson Resilience Scale (CD-RISC) in three groups of individuals with familial risk for both mood disorder and suicidal behavior, as well as a healthy comparison group. Other risk factors for suicidal behavior, such as depression severity, hopelessness, and lifetime impulsiveness were examined as well to determine if these mediated group differences in CD-RISC scores.

RESULTS

CD-RISC scores differed between groups, with lowest scores in the past attempter group. However, CD-RISC scores were strongly correlated with other common risk factors for suicide attempt, including hopelessness, subjective depression, and reasons for living, which together explained 68 % of the CD-RISC variance. Group differences in CD-RISC scores were eliminated when the model included these covariates.

LIMITATIONS

Sample sizes were modest, and depression severity was low overall and significantly higher in the past suicide attempter group.

CONCLUSIONS

The CD-RISC has demonstrated utility for predicting risk for depression, but appears to overlap with other known risk factors for suicidal behavior, especially hopelessness and subjective depression. Though it encapsulates variance from multiple risk factors in a single scale, it may not provide additional predictive power above and beyond these other risk factors for suicidal behavior.

Mental health in migrants contacting the mental health operational unit of the National Institute for Health, Migration and Poverty (NIHMP): preliminary data

Aim

Migration can lead to an increase in stress rates and can impact mental health, especially in certain migrant groups. Nonetheless, mental health needs and the importance of public health are not well captured in most studies using national samples. This study aimed to show the correlation between mental disorders, socio-demographic and cultural aspects among migrants.

Subject and methods

One hundred nineteen migrants, applying for assessment to the Mental Health Operational Unit of the National Institute for Health, Migration and Poverty (NIHMP) in Rome, were recruited.

Results

Migrants frequently reported mood disorders (mainly women). Men reported PTSD, somatization and adjustment disorders.

Conclusions

Over time, diverse factors may produce a decline in an initially healthy migrant status. The research unveils a new focus on the psychopathology of migrants accessing the NIHMP, with important implications for migrants’ mental health treatment and prevention.

Psychotherapists’ views on triggering factors for psychological disorders

Triggering factors play an important role in the development of psychological disorders. Practicing psychotherapists have valuable knowledge on psychological disorders and since their views on triggering factors have not been reported in the literature, triggers were addressed in this study from psychotherapists’ perspectives. The following three main issues were examined: definitions of triggers, examples of the most recurrent triggers and the idea of a common trigger for psychological disorders. Sixteen psychotherapists agreed to participate in the study. Semi-structured interviews were conducted in person and the data collected were analyzed using frame analysis. Frame analysis aims at representing the data through frames or groups that indicate different interpretations of the same topic. The results showed that the therapists provided three definitions of triggering factors. They most often defined triggers as events, occurrences or situations that explain the onset of psychological symptoms. The psychotherapists also provided examples of triggering factors: these were grouped into three frames, interpersonal, environmental and trauma. The therapists identified no single common trigger, although they discussed common categories and connections between different triggering factors. The findings indicate that triggering factors are complex and closely connected to personal vulnerabilities, as different events and circumstances act as triggers for different individuals. Future research could expand on these findings by examining the constituents of individual vulnerabilities.

Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis

Previous literature has shown that migrant workers manifested higher common mental issues (especially depressive symptom) compared to local workers due to stressors such as financial constraint and lack of access to healthcare. The aim of this systematic review and meta-analysis is to summarize the current body of evidence for the prevalence of depression and anxiety among migrant workers as well as exploring the risk factors and the availability of social support for migrant workers. Seven electronic databases, grey literature and Google Scholar were searched for studies from 2015 to 2021 related to mental health, social support and migrant workers. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Study heterogeneity was evaluated using I2 statistics. Random effects meta-analysis results were presented given heterogeneity among studies. The search returned 27 articles and only seven studies were included in meta-analysis, involving 44 365 migrant workers in 17 different countries. The overall prevalence of depression and anxiety among migrant workers was 38.99% (95% CI = 0.27, 0.51) and 27.31% (95% CI = 0.06, 0.58), respectively. Factors such as age, biological (health issue, family history of psychiatric disorder), individual (poor coping skills), occupational (workplace psychosocial stressors, poor working condition, salary and benefits issue, abuse), environmental (limited access towards healthcare, duration of residence, living condition) and social factor (limited social support) were associated with a mental health outcome in migrant workers. The availability of social support for migrant workers was mainly concentrated in emotional type of support. A high prevalence of depression and anxiety was found among migrant workers across the globe. This finding warrants a collective effort by different parties in providing assistance for migrant workers to promote their mental well-being.

Essential workers: Past month suicidal ideation and COVID-19 stress

OBJECTIVE

This study examined if essential workers (EW) reported higher past month suicidal ideation (SI) and coronavirus-19 (COVID-19) stress than non-EW, explored if the association between EW status and SI is indirect through COVID stress, and tested whether EW who identified as black, indigenous, and people of color (BIPOC) experienced more past month SI and COVID stress than white EW.

METHODS

Participants (N = 3500) were predominately white and female. COVID-19 was assessed with the COVID-19 subscale.

RESULTS

EWs reported higher past month ideation and COVID-19 stress than non-EWs. EWs who identified as BIPOC reported higher past month ideation and higher fears about economic consequences and compulsive checking and reassurance seeking subscales compared to White EWs.

CONCLUSION

EWs experience higher rates of SI and stress than non-EW; and BIPOC EWs experience higher SI and stress than White EWs. Accessibility of support should be a priority for this group at high risk for both the physical and emotional burden of COVID-19.

Predictors of Psychological Distress and Resilience in the Post-COVID-19 Era

Background

The COVID-19 global pandemic has had profound effects on mental health and wellbeing. The present study examined trends in distress and recovery in the aftermath of COVID-19 in China. Predictors that might increase risks or provide protections again distress were explored.

Method

Participants were recruited using social media during the COVID-19 pandemic to complete a baseline and 6-week follow-up survey (N = 241). The change patterns of PTSD symptoms from baseline to follow-up were characterized using latent class growth analysis (LCGA). A repeated-measures ANOVA was conducted to explore the differences in the depressive symptoms across trajectory groups. Multinominal logistic regression was performed to investigate potential predictors of the outcome trajectories.

Results

Four longitudinal outcome trajectories were identified: chronic (PTSD symptoms remained high; 14.9%), resilient (symptoms remained low; 43.2%), recovered (symptoms decreased from symptomatic levels to asymptomatic; 19.5%), and delayed (symptoms increased from asymptomatic levels to symptomatic; 22.4%). Hopelessness and maladaptive coping strategies were unique predictors of distress and resilience as well as longer-term trajectories.

Conclusion

Individuals evidenced four outcome trajectories of distress in the aftermath of COVID-19 in China. Despite the uncertainty and high levels of stress related to the pandemic, the majority of the sample demonstrated resilience and recovery. It is essential to identify individuals at risk for chronic and delayed distress in order to build resilience.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10036-8.

Aggression and Non-Suicidal Self-Injury among Depressed Youths: The Mediating Effect of Resilience

Background

The global spread of COVID-19 not only exerted an enormous impact on the public in different countries but also aggravated depression among youths. The aggressive tendencies of depressed individuals can harm their body and life and threaten those of others. The aggressive and non-suicidal self-injurious behaviors of depressed youths may seriously affect their physical and psychological health if not identified and mediated promptly.

Method

A total of 875 young respondents (including college students, community youths, migrant workers, and so on) from three provinces in China were surveyed in 2020 using a depression scale, non-suicidal self-injury scale, aggression scale, and resilience scale.

Results

Depression, non-suicidal self-injury, and aggression are significantly higher among the members of the depression group compared with the members of the healthy control group (P<0.001), and the resilience of the members of the former group is remarkably lower than that of the members of the latter group (P<0.001). Aggression among the depressed youths exhibits a significant positive correlation with non-suicidal self-injury (r= 0.43, P<0.01), whereas aggression (r= -0.18, P<0.05) and non-suicidal self-injury (r= -0.20, P<0.05) demonstrates significant negative correlations with resilience. The resilience of the youths in the depression group plays a partial mediating role in the relationship between aggression and non-suicidal self-injury.

Conclusion

The more aggressive the behaviors of the depressed youths, the more serious their non-suicidal self-injurious symptoms. Furthermore, resilience plays a partial mediating role in the relationship between aggression and non-suicidal self-injury.

Psychosocial stressors among Ghanaians in rural and urban Ghana and Ghanaian migrants in Europe

Psychosocial stressors have significant health and socio-economic impacts on individuals. We examined the prevalence and correlates of psychosocial stressors among non-migrant and migrant Ghanaians as there is limited research in these populations. The study was cross-sectional and quantitative in design. A majority of the study participants had experienced stress, discrimination and negative life events. Increased age, female sex, strong social support and high sense of mastery were associated with lower odds of experiencing psychosocial stressors in both populations. Interventions should be multi-level in design, focusing on the correlates which significantly influence the experience of psychosocial stressors.