The Correlates of Collective and Individual Trauma on Mental Health Outcomes Among Afghan Refugees: A Study of Sociodemographic Differences.

Following the U.S. military's departure from Afghanistan, a significant number of Afghan refugees have resettled in the United States, presenting complex mental health challenges exacerbated by extensive traumatic exposure. This demographic is particularly affected by collective trauma due to war, genocide, and the loss of homeland. However, detailed investigations into the correlations between collective trauma and mental health outcomes among Afghan refugees are limited. This study sought to explore the relationship between collective trauma and mental health outcomes within the Afghan refugee population in the United States, paying particular attention to the influence of sociodemographic factors. Identifying subgroups at greater risk allows for the development of more targeted mental health interventions. The study surveyed 173 Afghan refugees employing snowball sampling, utilizing a cross-sectional design. Data collection was facilitated through online and in-person surveys in English, Dari, and Pashto. Key measures included the Harvard Trauma Questionnaire for individual trauma experiences, the Historical Loss Scale for collective trauma, the Historical Loss Associated Symptoms Scale for collective trauma symptoms, the Afghan Symptom Checklist-22 for mental health symptoms, and the Post-Migration Living Difficulties Scale for post-migration stressors. Statistical analyses involved Pearson's correlation for variable associations, with nonparametric Mann-Whitney U and Kruskal-Wallis tests conducted to assess sociodemographic impacts due to data's non-normal distribution. The analysis revealed significant variations in collective trauma and mental health outcomes across subgroups. Afghan women, minoritized ethnic groups, those who experienced extended displacement, and refugees with uncertain visa statuses reported higher collective trauma levels and worse mental health outcomes. Statistical significance was noted in the correlations between collective trauma and mental health symptoms (r = .53, p < .01) and between post-migration difficulties and mental health (r = .33, p < .01). The disparities in mental health outcomes based on sociodemographic characteristics were significant, with nonparametric tests showing clear distinctions across different groups (Kruskal-Wallis H = 14.76, p < .05 for trauma experience by visa status). This study emphasizes the critical need for mental health interventions that account for the complex experiences of collective trauma among Afghan refugees, especially among identified subgroups. Tailoring mental health services to address the specific needs highlighted through disaggregated data can enhance support for Afghan refugees in the United States. This research contributes to a deeper understanding of the relationship between collective trauma and refugee mental health, advocating for nuanced care strategies in resettlement environments.

Ecological Factors of Telemental Healthcare Utilization Among Adolescents with Increased Substance Use During the COVID-19 Pandemic: The Moderating Effect of Gender.

Background: Adolescent substance use is often associated with concurrent mental health problems (e.g., depression, suicide attempts, parental emotional and physical abuse, not feeling close to people at school, and lower virtual connectedness) at multiple ecological levels. Objective: This study examined whether such risk factors among adolescents were associated with the use of telemental healthcare (TMHC) and whether gender moderated these associations. Methods: Data were drawn from the Adolescent Behaviors and Experiences Survey, collected by the U.S. Centers for Disease Control and Prevention from January to June 2021. A hierarchical multiple logistic regression analysis was conducted using a national sample of 1,460 students in Grades 9-12 in the United States who reported having used more alcohol and/or drugs during the pandemic than before it started. Results: The results showed that only 15.3% of students sought TMHC. Students reporting increased substance use during the pandemic were more likely to use TMHC if they experienced more severe mental health problems (e.g., suicide attempts) compared to other ecological factors, such as issues with their family, school, or community. Analysis of the moderating effect showed that the closer male students felt to people at school, the more likely they were to seek TMHC, whereas the opposite was true for female students. Conclusions: The findings highlighted that feeling close to people at school is an important aspect of understanding the help-seeking behavior of female and male adolescent substance users.

Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination.

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.

The hidden minority: Discrimination and mental health among international students in the US during the COVID-19 pandemic.

International students in the US occupy a precarious position at the intersection of immigration policy and global education mobility, one made more challenging by the disparate impact of COVID-19 on college students' mental health. Few studies, however, have explored the pandemic's effects on mental well-being among the international student population in the US. Our study aims to provide initial empirical evidence on the mental health status of these students, with a specific focus on discrimination, loneliness, anxiety, and depression. We propose a mediation framework and estimate the mediating effects of loneliness and anxiety in the relationships between discrimination and depression in a sample of US-based international students (N = 103). We collected cross-sectional data from July to August 2020, using a 50-item online survey instrument with three open-ended questions. Mediation analyses using PROCESS Macro were used to analyse quantitative data and thematic analysis was used to analyse qualitative data. Findings showed that higher levels of discrimination were significantly associated with higher levels of loneliness. Higher levels of loneliness were significantly associated with higher levels of anxiety, which in turn led to high levels of depressive symptoms. Our study contributes to understanding the needs and capacities of international students in the wake of COVID-19 and simultaneously provides pragmatic program and policy implications for inclusive higher education environments and the overall health and well-being of this crucial US student population.

Direct and Indirect Associations between Family Residential Mobility, Parent Functioning, and Adolescent Behavioral Health.

Residential mobility and caregiver social support are two key factors influencing adolescents' and their caregivers' health status. However, few studies have examined whether these factors vary across developmental periods. The present study therefore adopted a life course perspective to investigate the longitudinal effects of residential mobility and caregiver social support on a range of individual health outcomes (i.e., caregiver depression, adolescent internalizing problems, and adolescent externalizing problems) among families exposed to disadvantaged social and economic conditions. Data were obtained from the Longitudinal Studies in Child Abuse and Neglect, and 425 children and their caregivers who completed the age 12, 14, 16, and 18 interviews were included in this study. Structural equation modeling was conducted to test the measurement and structural models. The results showed that greater residential mobility was significantly associated with higher levels of caregiver depression, which in turn led to more adolescent internalizing and externalizing problems. Alternatively, higher levels of caregiver social support mitigated the levels of caregiver depression, which in turn resulted in fewer adolescent internalizing and externalizing problems. Highly mobile children and their caregivers were found to be vulnerable to several negative health outcomes and in high need of mental and behavioral health support and services. These findings inform important policy and practice implications on social support for mobile caregivers to address their children's behavioral problems.

Effects of Church Attendance Vs. Private Religious Activities on Suicidal Ideation: A Study of Rural US College Students.

To examine how religiosity and depression directly/indirectly affect suicidal ideation in White and African American rural college students. The data from 272 rural college students were used to test the moderated mediation model using PROCESS macro. Students with higher church attendance and/or private religious activities had lower depressive symptoms, which in turn significantly alleviated their suicidal ideation. There was no significant racial group difference in the direct/indirect effects. The college students who did not engage in religious meetings and private religious activities were inclined to have depressive symptoms and a higher risk of suicidal ideation.

Sexually Transmitted Diseases Among College Students in Sierra Leone: A Life Course Ecological Analysis.

Applying life course theory, this study examined the direct and indirect effects of adverse childhood experiences (ACEs) on the risk of contracting sexually transmitted diseases (STDs), mediated by early sexual activity (first sexual experience before age 15), number of lifetime sex partners, and mental health problems. The link between ACEs and mental health on college students' sexual risk is still understudied. Using cross-sectional data from a sample of 327 college students in Sierra Leone, this study tested the hypothesized mediation model using structural equation modeling analysis. The results showed that ACEs significantly increased sexual risks. Specifically, ACEs increased the risk of early initiation of sexual activity and the number of lifetime sex partners, which in turn increased the risk of STDs. Furthermore, ACEs significantly predicted negative mental health and were significantly associated with an increased risk of STDs. Effective future intervention strategies should include health education programs to address the lifelong effects of ACEs and mental health treatment.

Acculturative stress and binge drinking among international students in the United States: Resilience and vulnerability approaches.

Objective: While international students frequently face behavioral health risks due to the stress of adjusting to new cultures, many demonstrate effective coping skills that minimize negative outcomes. The current study tested the mediating effects of resilience and mental health on the relationship between acculturative stress and binge drinking. Participants: International students (N = 322) in the United States. Methods: A cross-sectional design using both online and paper-based survey was implemented. Structural equation modeling was conducted to test the hypothesized mediation model. Results: The results showed good model fit, with resilience mediating the relationship between acculturative stress and binge drinking in the conceptual model. Conclusions: Behavioral health problems and needs of international students are prevalent themes in social work practice; this study, therefore, has practical implications for U.S. colleges and universities as they make decisions about programs and services.

Using a classification tree modeling approach to predict cigarette use among adolescents in the United States.

Objective: The purpose of this study was to screen pertinent variables to identify ordered relations that provide easily interpretable and accurate predictions of the probability of cigarette use among adolescents using a classification tree modeling approach. Methods: This cross-sectional study included a national sample of 3717 U.S. adolescents aged between 12 and 20 years old from the 2016 National Survey on Drug Use and Health. Results: The results indicated that age was the most influential variable, followed by depression, race/ethnicity, family income, gender, and alcohol abuse and dependence. Additionally, several interaction emerged that identified higher and lower cigarette use profiles: youth who were between 18 and 20 years old and self-identified as non-Hispanic White, Native American/Alaska Native, and "Other" racial/ethnic group and African American, Asian, and Latinx adolescents, with depressive symptoms were at higher risk of cigarette use; while youth who reported lower family incomes, were 16-17 years old, who identified as African American, Asian, and Latinx, were also likely to report lower use of cigarettes when they reported lower depressive symptom scores. Discussion: These results are discussed relative to practice implications.

Peer victimization, depression, and sexual risk behaviors among high school youth in the United States: a gender-based approach.

BACKGROUND AND OBJECTIVES: Little research has examined how different types of peer victimization (i.e. school bullying, cyber-bullying, and physical and sexual dating violence) predict sexual risk behaviors and how depression may mediate the relationship of such behaviors with types of peer victimization. Few works have investigated gender differences in these direct and indirect associations as well. This study, therefore, examined gender differences in the direct and indirect associations among four types of peer victimization, depression, and sexual risk behaviors in United States (US) high school students. MATERIALS AND METHODS: Data were drawn from the 2015 Youth Risk Behavior System Survey, collected by the U.S. Centers for Disease Control and Prevention. A multigroup path analysis was conducted using a national sample of high school students who reported having ever engaged in sexual intercourse (n = 5,288). RESULTS: All the peer victimization variables positively predicted depressive symptoms for both females and males. The direct effects of physical and sexual dating violence were associated with increased sexual risk behaviors for females and males. However, school-bullying victimization did not significantly predict sexual risk behaviors for either gender. Cyber-bullying victimization significantly predicted increased sexual risk behaviors for males only. Among indirect effects, depression positively mediated the relationship between cyber-bullying victimization and sexual risk behaviors for males only. CONCLUSIONS: Our findings suggest that male adolescents who are victimized may actually be at higher risk of negative outcomes compared to their female adolescent peers. This study highlights the need to pay attention to male victims who may be ashamed to self-identify and difficult to detect in cyber-bullying.

Multiple Forms of Early Violent Socialization and the Acceptance of Interpersonal Violence Among Chinese College Students.

Early violent socialization has consistently been associated with individuals' attitudes toward interpersonal violence in adulthood. However, how particular types of violent socialization during childhood differently influence individuals' acceptance of interpersonal violence remains unclear. The current study examined the effect of multiple types of violent socialization on acceptance of interpersonal violence among Chinese college students in Hong Kong (N = 794). The findings of hierarchical multiple regression analyses indicated that verbal advice regarding and witnessed experience with violence during childhood predict the acceptance of violence. In contrast, childhood experience of being a violence victim was not significantly associated with the acceptance of violence. In addition, gender moderates the relationship between verbal advice toward violence and acceptance of violence. Therefore, educational interventions related to the impact of multiple forms of violent socialization on attitudes toward violence that create a safe and stable environment for children may be beneficial for parents, teachers, and practitioners who work closely with children. The results may be also useful in informing colleges, universities, and professional practitioners as they make decisions about social awareness programs for college students to help change their attitudes toward violence.

The Gendered Self of Chinese Lesbians: Self-Esteem as a Mediator Between Gender Roles and Depression.

Sexual minority women are at an elevated risk for depression compared to heterosexual women, yet less is known about how gender roles affect the mental health of sexual minority women. Existing studies examining the role of self-esteem in the relationship between gender roles and depression are scarce and have predominantly focused on heterosexual populations. Using a cross-sectional survey of Chinese lesbians in Hong Kong (N = 438), the study tested the direct and indirect effects of different types of gender roles (masculine, feminine, and androgynous) on depression through the mediating factor of self-esteem. We found that masculinity and androgyny were positively associated with self-esteem, while femininity was negatively associated with self-esteem. More importantly, self-esteem fully mediated the inverse relationship between masculinity and depression and that between androgyny and depression. The positive relationship between femininity and depression was also fully mediated by self-esteem. By examining different types of gender roles and incorporating gender roles, self-esteem, and depression into a unified framework, the research highlighted the particularly protective effect of androgyny, which had the strongest positive direct effect on self-esteem and indirect effect on depression through the mediation of self-esteem compared to the effects of other types of gender roles. Our results illuminate the importance of understanding how individual differences in gender roles relate to the mental health of sexual minority women in future research and interventions. Implications for interventions that help Chinese lesbians cope with gender expectations and improve their mental health are discussed.

Typologies of Peer Victimization, Depression, and Alcohol Use among High School Youth in the United States: Measuring Gender Differences.

Using the data from 2015 Youth Risk Behavior Surveillance System, our study explored gender differences in the typologies of peer victimization and alcohol use mediated by depression among adolescents. Results showed a significant association between peer victimization types with depression and alcohol use among both male and female students. Results also showed stark gender differences in school victimization, cyber-bullying victimization, sexual-dating violence, and depression on alcohol use. Findings provide implications for policies and programs that examine various forms of peer victimization, mental health, and alcohol use through a gendered lens, critical to acknowledging gendered differences in victimization and behavior of adolescents.

School-based HIV/AIDS education, risky sexual behaviors, and HIV testing among high school students in the United States.

This study assessed the practical value of HIV/AIDS education among at-risk adolescents in the United States. Data were drawn from the 2013 Youth Risk Behavior Surveillance System spanning students in grades 9-12 who have engaged in sexual intercourse. A multivariate hierarchical logistic regression analysis was employed to test: (1) the individual effects of school-based HIV/AIDS education and risky sexual behaviors on the probability of HIV testing and (2) the interaction effects to estimate the degree to which the education effect varied by specific risky sexual behavior. The results indicated that students who engaged in risky sexual activities and received HIV/AIDS education were more likely to test for HIV compared to those who did not receive HIV/AIDS education. The relationship between education and HIV testing also varied according to the number of recent sexual partners. The findings have policy and practice implications. Specifically, HIV/AIDS education that promotes HIV testing should be encouraged particularly with the high-risk student population.

The association between school bullying victimization and substance use among adolescents in Malawi: the mediating effect of loneliness.

Background and objectives Research has shown an increased prevalence of substance use among adolescents in countries in Sub-Saharan Africa. Peer affiliation, bullying, and psychological stress are significantly associated with substance use. This study empirically tested theoretical frameworks linking peer affiliation, bullying victimization, loneliness and substance use (specifically tobacco or alcohol use) among adolescents. Materials and methods Data were obtained from the 2009 Malawi Global School-based Health Survey (GSHS) with a representative sample of 2359 students aged 13-17 years in Malawi, Sub-Saharan Africa. Missing data were handled using multiple imputation. The study conducted path analyses using Mplus to test the conceptual models of tobacco use and alcohol use. Results The results showed that loneliness partially mediated the association between bullying victimization and tobacco use in the first model, as well as the relationship between bullying victimization and alcohol use in the second model. Results indicated statistically significant indirect paths from bullying victimization to tobacco use and alcohol use through the mediation of loneliness. However, peer affiliation did not directly predict bullying victimization in the two path models; it directly predicted tobacco use only. Conclusions These findings have important implications in early intervention for health practitioners in school and mental health settings to prevent feelings of loneliness and substance use among adolescents who have experience with bullying victimization but no experience with depression, alcohol use or tobacco use.

Aggression behavior and substance use among immigrant children: Mediating effect of antisocial attitudes.

In 2010, approximately one out of four youths in the United States were immigrant children. Hispanics and Asians comprised the largest groups (58% and 16%), respectively. Today, the Hispanic population is the largest ethnic minority in the United States (15%) and is a majority of the U.S. foreign-born population (47%). While immigration is a positive process for most immigrants, resettlement into a new country has challenges, including acculturation adjustments. Youth engage in risky behaviors such as substance use and antisocial behaviors. For immigrant youth with limited supportive opportunities, however, the acculturation process can be difficult. Stress, alienation, and stigma often manifest and cause behavioral problems, including aggression. This pilot study examines the mediating effect of antisocial attitudes using sociocultural, developmental, and environmental factors to understand Hispanic youth problem behaviors. We sampled 136 youths, ages 6-12, from predominantly Hispanic elementary schools in the southwestern United States to ascertain the role of aggression and antisocial behavior in substance use attitudes. The results show significant differences in aggression, antisocial attitudes, and substance use according to (1) age, (2) years in the United States, (3) English level, and (4) relationship with mother. Aggression significantly predicted antisocial attitudes and substance use, with antisocial attitudes having a mediating effect on the relationship between aggression and substance use. In developing social service programs to prevent substance use among children from immigrant families, social work educators and practitioners may consider addressing the role of aggression in Hispanic adolescents' future behavior.

Ecological Factors of Being Bullied Among Adolescents: a Classification and Regression Tree Approach.

Being bullied is a well-recognized trauma for adolescents. Bullying can best be understood through an ecological framework since bullying or being bullied involves risk factors at multiple contextual levels. The purpose of the study was to identify the risk and protective factors that best differentiate groups along with the outcome variable of interest (being bullied) using Classification and Regression Tree (CART) analysis. The study used the Health Behavior in School-Aged Children (HBSC) data collected from a nationally representative sample of students in grades six through ten during the 2005-2006 school years. This study identified that for adolescents 12 and younger, lower parental support is a critical risk factor associated with bullying and among those 13 to 14 with lower parent support, adolescent with higher academic pressure reported experiencing more bullying. For the older group of adolescents (aged 15 and older), school related factors were identified to increase the risk level of being bullied. There was a critical age (15 years old) for implementing victimization interventions to reduce the damage from being bullied. Service providers working with adolescents aged 14 and less should focus more on family-oriented intervention and those working with adolescents aged 15 and more should offer peer- or school-related interventions.

Functional ability of cytoskeletal ß-actin regulator to drive constitutive and ubiquitous expression of a fluorescent reporter throughout the life cycle of transgenic marine medaka Oryzias dancena.

Marine medaka Oryzias dancena, a candidate model organism, represents many attractive merits as a material for experimental transgenesis and/or heterologous expression assay particularly in the field of ecotoxicology and developmental biology. In this study, cytoskeletal ß-actin gene was characterized from O. dancena and the functional capability of its promoter to drive constitutive expression of foreign reporter protein was evaluated. The O. dancena ß-actin gene possessed a conserved genomic organization of vertebrate major cytoplasmic actin genes and the bioinformatic analysis of its 5'-upstream regulatory region predicted various transcription factor binding motifs. Heterologous expression assay using a red fluorescent protein (RFP) reporter construct driven by the O. dancena ß-actin regulator resulted in stunningly bright expression of red fluorescence signals in not only microinjected embryos but also grown-up transgenic adults. Although founder transgenics exhibited mosaic patterns of RFP expression, transgenic offspring in subsequent generations displayed a vivid and uniform expression of RFP continually from embryos to adults. Based on the blot hybridization assays, two transgenic lines established in this study were proven to possess high copy numbers of transgene integrants (approximately 240 and 34 copies, respectively), and the transgenic genotype in both lines could successfully be passed stably up to three generations, although the rate of transgene transmission in one of the two transgenic lines was significantly lower than expected Mendelian ratio. Significant red fluorescence color could be ubiquitously observable in all the tissues or organs of the transgenics. Quantitative real-time RT-PCR represented that the expression pattern of transgene under the regulation of ß-actin promoter would resemble, in overall, the regulation of endogenous ß-actin gene in adult tissues, although putative mechanism for competitive or independent regulation between transgene and endogenous gene could also be found in several tissues. Results from this study undoubtedly indicate that the O. dancena ß-actin promoter would be powerful enough to fluorescently visualize most cell types in vivo throughout its whole lifespan. This study could be a useful start point for a variety of transgenic experiments with this species concerning the constitutive expression of living fluorescent color reporters and other foreign proteins.