Meta-Analysis of Acculturation and Suicide-Related Outcomes: A Test of the Immigrant Paradox.

OBJECTIVE: This meta-analysis aimed to systematically test the relation between acculturation and suicide-related outcomes among immigrants, with attention to key methodological (i.e., measure of suicide-related outcome, measure of acculturation) and demographic (i.e., race, gender, age, geographic region, publication year) moderators. METHOD: We conducted a meta-analysis of 72 independent samples from 50 studies (38 peer-reviewed articles, 12 dissertations) representing more than 1.4 million immigrants. Participants' age ranged from 11.20 to 74.70 years (M = 29.96, SD = 15.07). Random effects models were used for both main and moderation analyses. RESULTS: We found significant positive associations between acculturation and suicidal ideation, but not suicide attempts and deaths. We also found a significant and positive effect of acculturation on suicide-related outcomes when acculturation was measured by psychological scales, but not by generation status, length of residence in the host country, and proficiency in the host country's language. More acculturated Latinx immigrants were at higher risk for suicide-related outcomes, whereas a reverse pattern was found among Asian immigrants. Meta-regressions revealed that the moderating effects of participants' age and publication year were also significant. CONCLUSION: Our results show partial support for the immigrant paradox but suggest that the relation between acculturation and suicide-related outcomes is complex and multifaceted. We discuss the implications of our findings and recommendations for research and prevention.

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.

The Impact of 9/11 and the War on Terror on Arab and Muslim Children and Families.

PURPOSE OF REVIEW: There is a growing body of work that documents the impact of 9/11 and the war on terror on Arab and Muslim children and families. This review is designed to provide a brief overview and suggest new ways to better understand this understudied population. RECENT FINDINGS: Several studies show anti-Arab and anti-Muslim sentiments at its highest levels since 9/11. There is strong evidence that Arab and Muslim children and families experience some of the highest levels of discrimination, and as a result, they report higher levels of mental health symptoms. Given the limited data, we need future studies (a) to focus on populations outside of the USA and Europe; (b) to use longitudinal designs; (c) to pay attention to within group variations by race, gender, social class, and immigration status; and (d) to use culturally validated instruments.

Acculturative Stress and Mental Health: Implications for Immigrant-Origin Youth.

"In this article, the authors provide an overview of the current global and US debates on immigration as a key developmental context for immigrant-origin youth. Relying on a conceptual framework that highlights both risk and protective factors, the authors provide evidence from their longitudinal study that empirically links acculturative stress to key mental health outcomes during adolescence. They conclude with a discussion of clinical implications of their work with an emphasis on what is needed to meet the growing mental health needs of immigrant youth."

The Longitudinal Relation between Daily Hassles and Depressive Symptoms among Unaccompanied Refugees in Norway.

The aim of the present longitudinal study is to understand the longitudinal relation between depressive symptoms and daily hassles (i.e., general and acculturation hassles) in a high-risk population of unaccompanied refugees. We investigated the validity of three stress-mental health models: the stress exposure model, the stress generation model, and the reciprocal model. Data were collected from 918 unaccompanied refugees in Norway in three waves. Of the initial sample, the majority (82.1%) were male (M age = 19.01 years, SD = 2.54 years). The data were analyzed with auto-regressive cross-lagged modeling and latent growth curve modeling. The results supported the stress exposure model for the relation between depressive symptoms and acculturation hassles, indicating that acculturation hassles predicted the subsequent levels of depressive symptoms rather than vice versa. On the other hand, the reciprocal model was supported for the relation between depressive symptoms and general hassles indicating a bidirectional, mutual relation. Unconditional latent growth models further showed that depression level remained unchanged over time, while levels of acculturation and general hassles decreased. The implications for clinical practice and immigration policy are discussed.

Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles.

OBJECTIVES: This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma. DESIGN: The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway. RESULTS: Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression. CONCLUSION: The findings underscore the importance of current life conditions for unaccompanied refugees' mental health.

Discrimination-related stress effects on the development of internalizing symptoms among Latino adolescents.

This three-wave longitudinal study of 173 Latino adolescents (M = 16.16 years, SD = 0.65) is designed to understand the role of discrimination-related stress in mental health trajectories during middle to late adolescence with attention to differences due to immigration status. The results of the growth curve analysis showed that anxious-depressed, withdrawn-depressed, and somatic complaints significantly decreased over time. Furthermore, although discrimination-related stress was found to be significantly related to the trajectories of three types of mental health symptoms, the results revealed that immigration status moderated these relations such that discrimination-related stress was significantly related to these outcomes for Latino youth whose parents were born in the United States, while this relation was not significant for Latino children of immigrants.

The role of collective self-esteem on anxious-depressed symptoms for Asian and Latino children of immigrants.

We conducted a 3-wave, longitudinal study to examine the role of ethnic collective self-esteem and United States (U.S.) collective self-esteem on anxious-depressed symptoms over time among Asian and Latino immigrant-origin adolescents (n = 171). Growth curve analysis revealed that anxious-depressed symptoms first decreased between 10th and 11th grade and then increased over time for both groups. Additionally higher levels of ethnic collective self-esteem were associated with lower levels of anxious-depressed symptoms only for Asian adolescents. There was a differing pattern for U.S. collective self-esteem such that for Latino adolescents, higher U.S. collective self-esteem was associated with higher anxious-depressed symptoms, whereas for Asian adolescents there was an inverse relationship with anxious-depressed symptoms. The results expand the literature on ethnic and U.S. collective self-esteem and their link to mental health. Implications of the findings for research in general, and for counseling immigrant youth and families in particular, are discussed.

Mediators of the relationship between acculturative stress and internalization symptoms for immigrant origin youth.

The present study examines the generational differences in the relation between acculturative stress and internalizing symptoms (i.e., anxiety and depression) with a sample of 304 urban residing first- and second-generation immigrant adolescents. In addition, the role of perceptions of social support-a critical element to healthy immigrant adolescent adaptation-is explored as a mediator of this relation. Results indicate that first-generation adolescents report more acculturative stress and internalizing symptoms than do second generation. Employing a moderated mediation framework (Preacher, Rucker, & Hayes, 2007), we find that perceptions of both emotional and academic social support mediate the relation between acculturative stress and internalizing symptoms for the first generation but not for the second. Our findings serve to expand the discourse of the "immigrant paradox" (García Coll & Marks, 2011).

The role of acculturative stress on mental health symptoms for immigrant adolescents: a longitudinal investigation.

Immigrant-origin adolescents represent the fastest growing segment of youth population in the United States, and in many urban schools they represent the majority of students. In this 3-wave longitudinal study, we explored trajectories of internalizing mental health symptoms (depression, anxiety, and somatic symptoms). The participants included 332 urban-residing first-and second-generation immigrant adolescents (44% male). Participants were recruited in 10th grade (Mage = 16.20 years, SD = 1.19), and 2 additional waves of data were gathered in 12-month intervals. Both generational and racial/ethnic background of the participants reflected the general demographics of urban centers in the United States. With individual growth curve modeling, the results show significant decline in internalizing mental health problems during the high school years. At the same time, greater exposure to acculturative stress predicted significantly more withdrawn, somatic, and anxious/depressed symptoms. Gender and generation status differences in internalizing mental health problems were also identified.

Exploring dual identification among Muslim-American emerging adults: a mixed methods study.

This mixed methods study explored dual identification among Muslim-American emerging adults of immigrant origin. A closer look was taken at the relationship between American and Muslim identifications and how this relationship was influenced by experiences of discrimination, acculturative and religious practices, and whether it varied by gender. Data were gathered from 97 Muslim Americans (ages 18-25) who completed a survey and produced identity maps, a pictorial representation of hyphenated identities. The findings showed that young people found a way of allowing their Muslim and American identities to co-exist, and only a small minority of the participants seemed to experience identity conflict. While religiosity was the only predictor of Muslim identification, young peoples' identification with mainstream United States culture was predicted by discrimination-related stress and acculturative practices. Gender moderated the relationship between Muslim and American identities in both survey measures and identity maps.

The Brookline Early Education Project: a 25-year follow-up study of a family-centered early health and development intervention.

BACKGROUND: Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn. OBJECTIVE: Outcome studies of BEEP and comparison children during kindergarten and second grade demonstrated the program's effectiveness during the early school years. The goal of this follow-up study was to test the hypotheses that BEEP participants, in comparison with their peers, would have higher levels of educational attainment, higher incomes, and more positive health behaviors, mental health, and health efficacy during the young adult period. METHODS: Participants were young adults who were enrolled in the BEEP project from 1973 to 1978. Comparison subjects were young adults in Boston and Brookline who did not participate in BEEP but were matched to the BEEP group with respect to age, ethnicity, mother's educational level, and neighborhood (during youth). A total of 169 children were enrolled originally in BEEP and monitored through second grade. The follow-up sample included a total of 120 young adults who had participated in BEEP as children. The sample differed from the original BEEP sample in having a slightly larger proportion of college-educated mothers and a slightly smaller proportion of urban families but otherwise resembled the original BEEP sample. The demographic features of the BEEP and comparison samples were similar. The young adults were asked to complete a survey that focused on the major domains of educational/functional outcomes and health/well-being. The study used a quasi-experimental causal-comparative design involving quantitative analyses of differences between the BEEP program and comparison groups, stratified according to community. Hypotheses were tested with analysis of variance and multivariate analysis of variance techniques. Analyses of the hypotheses included the main effects of group (BEEP versus comparison sample) and community (suburban versus urban location), as well as their interaction. RESULTS: Young adults from the suburban community had higher levels of educational attainment than did those in the urban group, with little difference between the suburban BEEP and comparison groups. In the urban group, participation in the BEEP program was associated with completing >1 additional year of schooling. Fewer BEEP young adults reported having a low income (less than 20000 dollars); the income differences were accounted for largely by the urban participants. The percentage of subjects with private health insurance was significantly lower in the urban group overall, but the BEEP urban group had higher rates of private insurance than did the comparison group. More than 80% of both suburban samples reported being in very good or excellent health; the 2 urban groups had significantly lower ratings, with 64% of the BEEP group and only 41.67% of the comparison group reaching this standard. Overall, suburban participants reported more positive health behaviors, more perceived competence, and less depression. Among the urban samples, however, participation in BEEP was associated with higher levels of health efficacy, more positive health behaviors, and less depression than their peers. CONCLUSIONS: No previous study has focused as extensively on health-related outcomes of early education programs. BEEP participants living in urban communities had advantages over their peers in educational attainment, income, health, and well-being. The educational advantages found for BEEP participants in the early years of schooling included executive skills such as planning, organizing, and completing school-related tasks. It is likely that these early advantages in executive function extended beyond education-related tasks to other activities as participants became responsible for their own lives. The long-term benefits revealed in this study are consistent with the findings of previous long-term studies that indicated that participants in high-quality intervention programs are less likely to cost taxpayers money for health, educational, and public assistance services. The BEEP program appears to have somewhat blunted differences between the urban and suburban groups. The results of this study add to the growing body of findings that indicate that long-term benefits occur as the result of well-designed, intensive, comprehensive early education. The health benefits add a unique and important extension to the findings of other studies.