A prospective longitudinal study of depression, perceived stress, and perceived control in resettled Syrian refugees' mental health and psychosocial adaptation.

This prospective study examined the psychosocial adaptation of a community sample of newly resettled Syrian refugees in Canada (N = 235). Specifically, depressive symptoms, perceived stress, and perceived control were collected in Arabic at baseline and 1-year follow-up. Two theory-informed, cross-lagged panel models demonstrated that higher baseline depressive symptoms predicted lower perceived self-efficacy and lower perceived control at 1-year follow-up. Similarly, baseline depressive symptoms were concurrently correlated with higher perceived helplessness, lower perceived self-efficacy, and lower perceived control. Secondary regression analyses further demonstrated that baseline depressive symptoms predicted lower perceived social support and higher anxiety symptoms, though neither were assessed at baseline. Empirical results identify a potentially broad, precipitating, and persistent effect of depressive symptoms on Syrian refugees' psychosocial resources and adaptation post-migration, which is consistent with both the transactional model of stress and coping and the self-efficacy theory of depression, respectively. Clinically, the study results highlight the importance of early screening for depressive symptoms among refugee newcomers within a culturally and trauma-informed, integrated health setting. Furthermore, this study underscores the value and need for theoretically guided longitudinal studies to advance future research on refugee mental health and psychosocial adaptation.

Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review.

Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments. A search in CINAHL, MEDLINE, PSYCINFO, EMBASE, SOCINDEX and SCOPUS following (Arksey and O'Malley in Int J Soc Res Methodol 8:19-32, 2005) guidelines found 44 papers and 41 unique interventions/assessment tools. Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS' accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted.

Assessing Virtual Mental Health Access for Refugees during the COVID-19 Pandemic Using the Levesque Client-Centered Framework: What Have We Learned and How Will We Plan for the Future?

During the COVID-19 pandemic, mental health services rapidly transitioned to virtual care. Although such services can improve access for underserved populations, they may also present unique challenges, especially for refugee newcomers. This study examined the multidimensional nature of access to virtual mental health (VMH) care for refugee newcomers during the COVID-19 pandemic, using Levesque et al.'s Client-Centered Framework for Assessing Access to Health Care. One hundred and eight structured and semi structured interviews were conducted in four Canadian provinces (8 community leaders, 37 newcomer clients, 63 mental health or service providers or managers). Deductive qualitative analysis, based on the Client-Centered Framework, identified several overarching themes: challenges due to the cost and complexity of using technology; comfort for VMH outside clinical settings; sustainability post-COVID-19; and communication and the therapeutic alliance. Mental health organizations, community organizations, and service providers can improve access to (virtual) mental health care for refugee newcomers by addressing cultural and structural barriers, tailoring services, and offering choice and flexibility to newcomers.

Self-Esteem, Resilience, Social Support, and Acculturative Stress as Predictors of Loneliness in Chinese Internal Migrant Children: A Model-Testing Longitudinal Study.

The present study examined the risk and protective factors of loneliness among Chinese internal migrant children (CIMC) in Beijing, China, including self-esteem, resilience, social support, and acculturative stress. Longitudinal survey data were collected from a large sample of 4th, 5th, and 6th grade CIMC from three schools in Beijing, at four time points (N = 862 at T1 to N = 837 at T4) over a 20-month period. Grounded in the Cultural and Contextual Model of Coping and the Acculturation Theory, two predictor models of loneliness were tested with path analysis. The results yielded the following: a) the two predictor models fit the data well; b) CIMC's T1 self-esteem and T1 resilience protected them against loneliness at T4; and c) CIMC's T2 social support seeking was a significant mediator between self-esteem and loneliness, and between resilience and loneliness; and d) similarly, CIMC's T3 acculturative stress was a significant mediator between self-esteem and loneliness, and between resilience and loneliness. The study's results highlight the merit and importance of implementing theoretically-guided, model-testing research grounded in a prospective research design, to help advance CIMC research. Implications for future research on and practical support for CIMC are discussed.

Recovery from Anorexia Nervosa in contemporary Taiwan: A multiple-case qualitative investigation from a cultural-contextual perspective.

Grounded in a cultural and contextual perspective, the current study examined the lived experiences and the recovery pathways of three Taiwanese women diagnosed with various subtypes of anorexia nervosa, at varying stages of their recovery. Specifically, using a multiple-case qualitative method, this study explored the complex, dynamic interactions of sociocultural factors and forces (i.e., cultural, familial, and societal influences) that impinge upon the three Taiwanese female participants in relation to living with anorexia nervosa in contemporary Taiwan. Data were collected based on in-depth, semi-structured interviews with the participants and relevant written materials and journal entries provided by these participants. The data were first analyzed within each case and then again across all cases. Accordingly, we present the results of the study by illustrating each participant's story and narrative of struggling with and recovering from anorexia. We then describe three main culturally-related themes that emerged from the cross-case analysis, which pertain specifically to the recovery process of the participants under the East-West 'biculturalism' in Taiwan: 1) anorexia as a function of the conflictual bicultural self; 2) recovery as a pathway towards an integrated bicultural self; and 3) the paradoxical roles of Chinese cultural heritage in anorexia and recovery. Findings of the study highlight the role of local cultural factors/forces, including Chinese familism, Confucianism, filial piety, face-saving, gender role prescriptions, biculturalism, Westernization, and self-relation-coordination, in affecting and shaping Taiwanese women's struggling with anorexia. Implications and recommendations for future research and clinical interventions are discussed.

The mediating role of cultural coping behaviours on the relationships between academic stress and positive psychosocial well-being outcomes.

While culture's effect on the coping process has long been acknowledged in the stress-coping literature conceptually, empirical evidence and attempts to discern the specific relationship between culture and coping remain very scarce. Against this backdrop, the present study applied the Cultural Transactional Theory (Chun, Moos, & Cronkite, 2006) to examine the mediating role of cultural coping behaviours (Collective, Engagement and Avoidance Coping) on the relationship between academic stress (AS) and two positive psychosocial well-being outcome measures: Collective Self-esteem (CSE) and Subjective Well-being (SWB). Responses from a sample of undergraduate students in Canada (N = 328) were analysed to test a theory-driven, hypothesised model of coping using structural equation modelling (SEM). As hypothesised, the SEM results showed that: (a) the proposed cultural coping model fit the data well; (b) Engagement Coping and Collective Coping partially mediated the association between AS and the outcomes and (c) the path relationships among the constructs were in the hypothesised directions. A set of preliminary exploratory analyses indicated that Collective Coping was most strongly endorsed by the African/Black and the Middle Eastern cultural groups as compared to other ethnic groups. Implications of the study's findings for future research and practice concerning culture, stress, and coping are discussed.

Coping, acculturation, and psychological adaptation among migrants: a theoretical and empirical review and synthesis of the literature.

Given the continuous, dynamic demographic changes internationally due to intensive worldwide migration and globalization, the need to more fully understand how migrants adapt and cope with acculturation experiences in their new host cultural environment is imperative and timely. However, a comprehensive review of what we currently know about the relationship between coping behavior and acculturation experience for individuals undergoing cultural changes has not yet been undertaken. Hence, the current article aims to compile, review, and examine cumulative cross-cultural psychological research that sheds light on the relationships among coping, acculturation, and psychological and mental health outcomes for migrants. To this end, this present article reviews prevailing literature pertaining to: (a) the stress and coping conceptual perspective of acculturation; (b) four theoretical models of coping, acculturation and cultural adaptation; (c) differential coping pattern among diverse acculturating migrant groups; and (d) the relationship between coping variabilities and acculturation levels among migrants. In terms of theoretical understanding, this review points to the relative strengths and limitations associated with each of the four theoretical models on coping-acculturation-adaptation. These theories and the empirical studies reviewed in this article further highlight the central role of coping behaviors/strategies in the acculturation process and outcome for migrants and ethnic populations, both conceptually and functionally. Moreover, the review shows that across studies culturally preferred coping patterns exist among acculturating migrants and migrant groups and vary with migrants' acculturation levels. Implications and limitations of the existing literature for coping, acculturation, and psychological adaptation research are discussed and recommendations for future research are put forth.

Collectivism and coping: current theories, evidence, and measurements of collective coping.

A burgeoning body of cultural coping research has begun to identify the prevalence and the functional importance of collective coping behaviors among culturally diverse populations in North America and internationally. These emerging findings are highly significant as they evidence culture's impacts on the stress-coping process via collectivistic values and orientation. They provide a critical counterpoint to the prevailing Western, individualistic stress and coping paradigm. However, current research and understanding about collective coping appear to be piecemeal and not well integrated. To address this issue, this review attempts to comprehensively survey, summarize, and evaluate existing research related to collective coping and its implications for coping research with culturally diverse populations from multiple domains. Specifically, this paper reviews relevant research and knowledge on collective coping in terms of: (a) operational definitions; (b) theories; (c) empirical evidence based on studies of specific cultural groups and broad cultural values/dimensions; (d) measurements; and (e) implications for future cultural coping research. Overall, collective coping behaviors are conceived as a product of the communal/relational norms and values of a cultural group across studies. They also encompass a wide array of stress responses ranging from value-driven to interpersonally based to culturally conditioned emotional/cognitive to religion- and spirituality-grounded coping strategies. In addition, this review highlights: (a) the relevance and the potential of cultural coping theories to guide future collective coping research; (b) growing evidence for the prominence of collective coping behaviors particularly among Asian nationals, Asian Americans/Canadians and African Americans/Canadians; (c) preference for collective coping behaviors as a function of collectivism and interdependent cultural value and orientation; and (d) six cultural coping scales. This study brings to light the present theoretical and methodological contributions as well as limitations of this body of literature and the implications it holds for future coping research.

Depression and its psychosocial correlates among older Asian immigrants in North America: a critical review of two decades' research.

OBJECTIVE: This article critically reviews two decades of empirically based depression studies on older Asian immigrants (OAIs) in North America published in English. The Psychosocial Model of Late-Life Depression is proposed as the conceptual roadmap to help interpret the findings across studies. METHODS: Using multiple bibliographic databases, this review systematically summarized and evaluated findings in 24 studies in terms of: (a) the prevalence and severity of depression; (b) demographic, psychosocial, cultural, and health risk factors of depression; and (c) methodological approaches and designs. RESULTS: The results showed that depression is prevalent among OAIs and is linked to gender, recency of immigration, English proficiency, acculturation, service barriers, health status, relationship with children and family, and social support. However, considerable variability in the results, the sample sizes, and the use of measurements were also found across studies. DISCUSSION: Recommendations for future research and the provision of clinical and community services are discussed within the psychosocial model.