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Trauma and Acculturative Stress
Abstract and Figures
There are a substantial number of immigrant youth living in the United States (USA), and there has been a recent media coverage documenting a rise in illegal entry by immigrants into the United States. Both legal and clandestine entries into the United States present various trauma risk factors for youth whose families seek the promise of a fruitful future in America. This chapter examines the various types of traumatic experiences immigrant youth may encounter, prevalent treatment approaches, and practical, community-based applications of treatment programs utilized by the Early Life Stress and Pediatric Anxiety Program at Stanford University. By investigating trauma before, during, and after migration, clinicians can achieve a greater depth of understanding on how to develop new treatment approaches and how to adapt existing psychotherapeutic models. Through an exploration of the psychosocial stressors immigrant youth face, various risk and resiliency factors during different phases of the migration process, potential comorbidities, and existing treatment models, we arrive at specific treatments and cultural adaptation recommendations.
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... The health needs of migrant population are tremendous because of their suboptimal living conditions, lack of vaccination in certain cases, crowded living places, minimal health care services and insurance, rejection and stigma from certain countries, language barriers in certain cases, cultural differences, and several other factors that could negatively affect their health and survival [13][14][15][16]. Of the migrant population, children, unaccompanied minors, pregnant women, and elderly people remain the most vulnerable categories that require continuous healthcare provision [17,18]. Another important health dimension of the migrant population is adaptation to the culture of host countries in addition to overcoming the psychological trauma of war and difficult journey to safer places [18][19][20][21]. ...
... Of the migrant population, children, unaccompanied minors, pregnant women, and elderly people remain the most vulnerable categories that require continuous healthcare provision [17,18]. Another important health dimension of the migrant population is adaptation to the culture of host countries in addition to overcoming the psychological trauma of war and difficult journey to safer places [18][19][20][21]. The provision of health to migrants requires research activity that shed lights on health problems faced by migrants in their new living environment in order to develop appropriate health services that meet their health needs. ...
Background:
In the past few decades Arab countries had witnessed several intra-regional conflicts and civil wars that led to the creation of millions of refugees and migrants. Assessment of research activity is an indicator of national and international efforts to improve the health of those millions of war victims. Therefore, the aim of this study was to analyze published literature in international Arab migrants.
Methods:
Literature in international Arab migrants published during the past three decades (1988-2017) was retrieved using Scopus database. A bibliometric analysis methodology was implemented on the retrieved data. Author keywords were mapped using VOSviewer program.
Results:
In total, 1186 documents were retrieved. More than half (658; 55.5%) were published in the last five years (2013-2017). Retrieved documents received an average of 8.6 citations per document and an h-index of 45. The most frequently encountered author keywords were refugees and mental health-related terms. Three countries in the Middle East; Jordan, Lebanon, and Turkey, were among the most active countries. In total, 765 (63.7%) documents were about refugees, 421 (35.5%) were about migrant workers, 30 (2.5%) were about asylum seekers, and 7 (0.6%) were about trafficked and smuggled people. When data were analyzed for the nationality of migrants being investigated, 288 (24.3%) documents were about Syrians, 214 (18.0%) were about Somali, 222 (18.7%) were about Arab or Middle Eastern in general, and 147 (12.4%) were about Palestinians. The American University of Beirut ranked first with 45 (2.4%) publications. The most active journal in publishing research in this field was Journal of Immigrant and Minority Health (35; 3.0%) followed by Journal of Refugee Studies (23, 1.9%), The Lancet (19, 1.6%) and BMC Public Health (16, 1.3%). Publications from Jordan and Lebanon had the highest percentage of international research collaboration.
Conclusion:
Research in international Arab migrants showed a dramatic increase in the last few years mostly due to the Syrian war. Both mental health and Syrian refugees dominated the literature of international Arab migrants. Research in infectious diseases was relatively low. Research on non-refugee migrants such as workers, trafficked victims, and asylum seekers was also relatively low.
... Caregivers may expect or wish for their children to retain strong cultural ties to their home country while simultaneously relying on children as cultural and language brokers (Marsiglia et al., 2018). These stressors can exacerbate the psychological effects of existing traumas (Rettger et al., 2016). ...
Objectives: This article explores the stages where trauma is experienced (123s) and its physiopsychological impact (affect, behavior, and cognitions [ABCs]) in unaccompanied Latinx Minors through the analysis of a composite case study. Unaccompanied Latinx Minors represent a unique and growing population in the United States that warrants careful consideration from a trauma-informed and resilience-based framework. Method: A detailed case study was implemented, triangulating caregiver and client therapy records to illustrate the framework of stages of trauma exposure (123s) and physiopsychological impact (ABCs). Results: Latinx children often encounter various potentially traumatic experiences and adverse childhood experiences at the following stages (123s): (1) Preimmigration; (2) During immigration; and (3) Postimmigration. The extended traumas experienced by immigrant youth may easily constitute toxic stress. Moreover, once in the destination country, youth may lack coping resources or encounter stressful circumstances that prolong or exacerbate the impact of previous traumas. This continuous physiological hyperarousal can also result in changes in brain neurobiology, which further compounds the experience of other symptoms (Krupnik, 2021). These potentially complex trauma responses may manifest for these children through ABCs. The cumulative impact of these incidents may have significant effects on minors’ A. Affective, B. Behavioral, and C. Cognitive functioning. Conclusions: Relevant clinical implications and policy recommendations for addressing the multifaceted needs of unaccompanied Latinx minors.
... We posit that MBAs are well-suited to address trauma in Latinx immigrants caused in part by systemic oppression, immigration journeys, and the resettlement process (Rettger et al., 2016). There is evidence to support the use of several MBAs for individuals with complex PTSD as useful for a variety of trauma-related symptoms (e.g., avoidance, affect dysregulation, behavioral dysregulation, attention dysregulation, dissociation, and identity disturbance), including mindfulness-based stress reduction (MBSR; Polusny et al., 2015), mindfulness-based cognitive therapy (MBCT; King et al., 2013), and compassion meditation (Hinton et al., 2013;Kearney et al., 2013), among others. ...
Objectives
This article represents a call to action for the mindfulness field to be more diverse and inclusive of Latinx individuals. Building a diverse and inclusive science around mindfulness-based approaches (MBAs) that considers important group-level cultural and contextual information is an important public health challenge in need of innovative solutions.
Methods
We describe ways that the Latinx population is poised to benefit from MBAs. We further elucidate challenges, describe potential solutions, and outline a research agenda that may hold promise for building a more inclusive mindfulness movement.
Results
Our recommendations center around developing nuanced cultural adaptations to MBAs, engaging Latinx individuals in research, increasing the rigor of scientific studies pertaining to Latinx individuals, relying on implementation science to develop innovative methods for disseminating MBAs to Latinx individuals, developing training and certification mechanisms to increase diversity and representation of Latinx mindfulness teachers, and creating mechanisms for the oversight of MBAs within this group.
Conclusions
There has been a lack of inclusivity of Latinx individuals in the field of MBAs with regards to research studies, barriers to access for economically disadvantaged groups, and lack of diversity in its workforce. Considering the recognition of adverse social drivers of health that generate chronic stress and health disparities, the Latinx population is especially poised to benefit greatly from MBAs. A diverse and inclusive mindfulness science holds promise to enhance the effectiveness, acceptability, feasibility, and wide-scale dissemination and implementation of MBAs.
... It is seen that conditions which effect psychological trauma are formed by pre-migration, during the migration and post-migration risk factors. Perceived discrimination and bullying are among the post-migration risk factors; they effect perceptions of subjective health and well-being (Rettger et al, 2016). It is declared that migrated children are faced with peer bullying more than the native children (Maynard et al, 2017;Alivernini et al, 2017). ...
According to the data of UNHCR, there have been 25.9 million refugees in the world, and more than half are children who are under 18 years old. Turkey has accepted 3.7 million Syrian individual under temporary protection. 43.6% of Syrian refugees in Turkey are under 18 years old. According to the data of UNICEF in January 2019, 645 thousand children are registered to the school, however 400 thousand are still out of school system. It is seen that conditions which effect psychological trauma are formed by pre-migration, during the migration and post-migration risk factors. Perceived discrimination and bullying are among the post-migration risk factors; they effect perceptions of subjective health and well-being (Rettger et al, 2016). It is declared that migrated children are faced with peer bullying more than the native children (Maynard et al, 2017; Alivernini et al, 2017). Whereas the children who are obliged to migrate need a safe school environment, having goals about future, learning the language of the new country beside a supportive family life (Pieloch et al, 2016). Method is review related with the given former research results above. Science Direct, Springer Link, ProQuest, BMJ Online Journals, EBSCOhost, JSTOR, Taylor&Francis, Wiley Online Library, ULAKBİM-TR Dizin are used as database. It is considered that migrated children who are faced with peer bullying will have benefit from a holistic approach which is included family and school (both teachers and students) to have academic needs and gain resilience. These arrangements would be helpful to increase the feelings of hope and being safe.
This chapter focuses on children in mixed-status families. The authors provide demographic data and the definition of a mixed-status family, then outline the challenges experienced by these families. The authors delineate developmental, educational, and psychological risk factors for these children. Intervention and advocacy initiatives in which school counselors can engage are examined. Authors provide practical solutions, suggestions for future research, a glossary of terms, and further readings. Finally, each topic discussed includes application strategies for school counselors.
The debates on the mental health benefits associated with immigration are mixed. On the one hand, immigrants are provided with more opportunities not available in their home countries. On the other hand, they are far away from home and may have been exposed to traumatic experiences on their journeys to the receiving country. Even after settling down in the receiving country, most continue to face legal battles associated with their immigration status, as shown in this study. This study examined the risk and protective factors associated with the mental health conditions in a sample of 39 immigrants and refugees seeking legal services on the US-Mexico border. Participants were recruited from a southwestern community agency serving the region’s immigrant population over the past three decades. Negative mental health states including stress, sadness, and anxiety were frequently reported by the participants. Six themes were identified as significantly related to the participants’ adjustment in the US: (1) political turmoil and safety issues; (2) economic hardship and extreme poverty; (3) trauma before and after resettlement; (4) immigration status; (5) family relational strain; and (6) identity struggle and acculturation. Overall, results demonstrate the complexity of issues pertaining to cross-country migration, cultural sensitivities, and mental health.
Unaccompanied migrant youth enter the United States daily to escape violence, political oppression, extreme poverty, and chronic instability in their native countries, or as victims of human trafficking. While some research has investigated why they leave their home countries, very little is known about what happens to them after they begin the process of community integration. The research reported in this article sought to understand how sponsors of children with no postrelease services access and use community services during their first year of integration into a new U.S. community. Findings highlight the need for a nuanced understanding of family reunification and community integration as dynamic, ongoing processes rather than onetime events, and for services to support such integration.
This chapter emphasizes the importance of paying special attention to the family context for immigrant youth. Some key considerations for immigrant families, including separation and reunification, cultural and language brokering, acculturative gaps, and family conflict, are described. Case vignettes are used to illuminate these experiences, in order to bring empirical findings to life and reflect the kinds of circumstances which practitioners may encounter in their work with immigrant families.
Keywords: Separation and reunification Cultural and language brokering Acculturative gaps Family conflict Family interventions Prevention Family strengths
Cognitive-behavioral therapy (CBT) successfully treats a number of different emotional troubles youth experience. Though effectiveness studies with immigrant youth remain limited, the literature in existence reveals promising results for the treatment of immigrant youth with CBT. Modular CBT is a comprehensive treatment protocol specifically designed to flexibly address a variety of symptom clusters as well as attend to contextual psychosocial factors. In order to be potent, clinicians who practice must remain faithful to the cognitive-behavioral model and ground all interventions in the theoretical underpinnings. Case conceptualization represents the fundamental process that must be executed in order to understand the patient’s particular presentation, identify crucial targets of treatment, and guide interventions along the way. This chapter thoroughly defines and illustrates content and process factors that comprise competent CBT for immigrant youth. Confabulated clinical examples are included throughout to depict in detail the ways that CBT is mildly modified to address cultural factors salient to practice with immigrant youth.
It was once assumed that the bedrock concepts of psychology held true for all the world’s peoples. More recently, post-modern approaches to research have expanded on these Western models, building a psychology that takes into account the sociopolitical, historical, religious, ecological, and other indigenous factors that make every culture, as well as every person as agents of their own actions.
Indigenous and Cultural Psychology surveys psychological and behavioral phenomena in native context in various developing and developed countries, with particular focus on Asia. An international team of 28 experts clarifies culture-specific concepts (such as paternalism and the Japanese concept of amae), models integrative methods of study, and dispels typical misconceptions about the field and its goals. The results reflect culturally sound frames of reference while remaining rigorous, systematic, and verifiable. These approaches provide a basis for the discovery of true psychological universals.
Among the topics featured:
• Scientific and philosophical bases of indigenous psychology
• Comparisons of indigenous, cultural, and cross-cultural psychologies
• Socialization, parent-child relationship, and family
• The private and public self: concepts from East Asia, Europe, and the Americas
• Interpersonal relationships: concepts from East Asia, Europe,, and the U.S.
• Factors promoting educational achievement and organizational effectiveness in Asia
• The growth and indigenization of psychology in developing and developed countries
• Are any values, attitudes, beliefs and traits universal? Cross-national comparisons
• The potential for indigenous psychology to lead to a global psychology
With this book, the editors have captured a growing field at a crucial stage in its evolution. Indigenous and Cultural Psychology benefits students and researchers on two levels, offering groundbreaking findings on understudied concepts, and signaling future directions in universal knowledge.
The startle reflex provides a revealing model for examining the ways in which evolved neurophysiology shapes personal experience and patterns of recurrent social interaction. In the most diverse cultural contexts, in societies widely separated by time and space, the inescapable physiology of the reflex both shapes the experience of startle and biases the social usages to which the reflex is put. This book describes ways in which the startle reflex is experienced, culturally elaborated, and socially used in a wide variety of times and places. It offers explanations both for the patterned commonalities found across cultural settings and for the differences engendered by diverse social environments. Boo! will intrigue readers in fields such as psychological anthropology, medical anthropology, general cultural anthropology, social psychology, cross-cultural psychiatry, evolutionary psychology, and human ethology.
This resource presents the findings of a Joint Presidential Task Force of the Society of Clinical Psychology (Division 12 of APA) and of the North American Society for Psychotherapy Research. This task force was charged with integrating two previous task force findings which addressed, respectively, Treatments That Work (Division 12, APA), and Relationships That Work (Division 29, APA). This online title transcends particular models of psychotherapy and treatment techniques and procedures, giving special attention to the empirical grounding of multiple contributors to change. The result is a series of over 60 principles for applying treatments to four problem areas: depression, anxiety disorders, personality disorders, and substance abuse disorders. It explains both principles that are common to many problem areas and those that are specific to different populations in a format that is designed to help the clinician optimize treatment planning.
Increasingly, research is focusing on the transportation and implementation of evidence-based psychosocial prevention programs into community care settings (Fixsen, Naoom, Blase, Friedman, and Wallace, 2005; Gewirtz and August, 2008). Questions for study include program adaptation for cultural and contextual relevance; recruitment and retention/engagement of participants, and the predictors of successful uptake in community social service settings. Within community settings, shelter and transitional/supportive housing sites serve among the highest risk families, whose stressors include significant rates of exposure to violence, substance abuse, mental illness, and child maltreatment. These stressors, coupled with extreme poverty and mobility, present barriers to children's and parents' access to mental health treatment and prevention resources. The availability of social services in most shelter and housing settings provides an opportunity to deliver evidence-based preventive interventions to highly stressed families. Developing strategies to transport evidence-based prevention interventions to these settings thus has significant potential to improve outcomes among vulnerable families. This paper presents data from the adaptation process of a group-based Oregon parent management training intervention: Parenting Through Change (Forgatch and DeGarmo, 1999). This preventive intervention was originally developed for predominantly white single mothers in the process of recent marital disruption. The program was adapted and implemented for culturally diverse groups of homeless single mothers with children who have been exposed to domestic violence. The curriculum was adapted using a community-based participatory approach. The adaptation group consisted of service providers representing community-based (predominantly shelter and housing) agencies, and university researchers. This article reviews the adaptation process, conducted in close collaboration with the program developer, the training of housing and shelter staff as group facilitators, and the implementation of the program in a shelter in a large metropolitan area. Group participation data indicated that program staff was extremely successful in recruiting and retaining women, with a 90% retention rate over the 14 weeks of the program and high participant satisfaction ratings. Participant characteristics, engagement, and satisfaction data are reported, together with data from a post intervention focus group highlighting perceived support and empowerment as key reasons for the high levels of group participation. Although often dismissed as places that can only provide "three hots and a cot", shelters may present key opportunities for the provision of empowerment-focused evidence-based prevention programs.
An open trial examines treatment using trauma systems therapy.