Article

Immigration, Suicidal Ideation and Deliberate Self-Injury in the Boston Youth Survey 2006

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Abstract

The prevalence and immigration-related correlates of deliberate self-injury (DSI) and suicidal ideation (SI) were estimated in a sample of Boston public high school students in 2006. Compared with U.S.-born youth, immigrant youth were not at increased risk for DSI or SI, even if they had experienced discrimination due to their ancestry. By contrast, U.S.-born youth who reported having been discriminated against because of their ancestry had an increased risk of deliberate self-injury (odds ratio [OR] = 3.1, 95% confidence interval [CI] = 1.6-5.9) and suicidal ideation (OR = 2.1, 95% CI = 1.2-3.8). The combination of being U.S.-born and experiencing ancestry-based discrimination identifies youth at increased risk for suicidal behavior.

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... Most studies did not use robust controls to limit the risk of bias whenever possible and relied on convenience sampling methods instead. Of the final score given to the studies, 5 had a score of "fair" [38,[40][41][42]48] and 12 had a score of "poor" [39,[43][44][45][46][47][49][50][51][52][53][54]. None of the studies obtained a "good" score. ...
... Twelve studies reported data on suicidal ideation, all of which collected data from surveys of relevant population groups [39][40][41][42][43]46,47,[49][50][51]53]. Eight of these 12 studies compared the results of migrants with non-migrants with mixed findings [39,41,42,46,47,49,50,53]. ...
... Twelve studies reported data on suicidal ideation, all of which collected data from surveys of relevant population groups [39][40][41][42][43]46,47,[49][50][51]53]. Eight of these 12 studies compared the results of migrants with non-migrants with mixed findings [39,41,42,46,47,49,50,53]. ...
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... The empirical evidence indicates that depression is correlated with many other variables of interest to this study, including stigmatization related to mental health (Link et al., 2001;Corrigan, 2007). The reasons for the high incidence of depression among racialized women students may include racism process stigmatization IHTP, 1(2), 288-307, 2021 CC BY-NC-ND 4.0 associated with acculturation (Link et al., 2001;Walsemann, et al., 2011); experience of racial discrimination (Borges et al., 2011;Joseph, 2015); and gender role conflict (Good & Wood, 1995). ...
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... Differences also occur by generational status and time spent in the United States (Almeida, Johnson, Matsumoto, & Godette, 2012;Borges et al., 2011;Cook, Alegría, Lin, & Guo, 2009). These findings point toward the importance of acculturation in Latina/o mental health research. ...
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Post-1965 immigration to the United States has given rise to a vigorous literature focused on adult newcomers. There is, however, a growing new second generation whose prospects of adaptation cannot be gleaned from the experience of their parents or from that of children of European immigrants arriving at the turn of the century. We present data on the contemporary second generation and review the challenges that it confronts in seeking adaptation to American society. The concept of segmented assimilation is introduced to describe the diverse possible outcomes of this process of adaptation. The concept of modes of incorporation is used for developing a typology of vulnerability and resources affecting such outcomes. Empirical case studies illustrate the theory and highlight consequences of the different contextual situations facing today's second generation.
Article
This study sought to determine the association between nearly lethal suicide attempts and exposure to the suicidal behavior of parents, relatives, friends, or acquaintances and to accounts of suicide in the media. The authors conducted a population-based case-control study in Houston, Texas, from November 1992 through July 1995. They interviewed 153 victims of attempted suicide aged 13--34 years who had been treated at emergency departments in Houston and a random sample of 513 control subjects. After controlling for potentially confounding variables, the authors found that exposure to the suicidal behavior of a parent (adjusted OR = 1.5; 95% CI: 0.6, 3.6; p = 0.42) or a nonparent relative (adjusted OR = 1.2; 95% CI: 0.7, 2.0; p = 0.55) was not significantly associated with nearly lethal suicide attempts. Both exposure to the suicidal behavior of a friend or acquaintance (adjusted OR = 0.6; 95% CI: 0.4, 1.0; p = 0.05) and exposure to accounts of suicidal behavior in the media (adjusted OR = 0.2; 95% CI: 0.1, 0.3; p = 0.00) were associated with a lower risk of nearly lethal suicide attempts. Exposure to accounts of suicidal behavior in the media and, to a lesser extent, exposure to the suicidal behavior of friends or acquaintances may be protective for nearly lethal suicide attempts, but further research is needed to better understand the mechanisms underlying these findings.
Article
Epidemiological data show high rates of suicide attempts among adolescent Latinas. Few studies have addressed the psychosocial, cultural and family correlates of suicide attempts among this age group of a rapidly growing population. The authors studied 31 adolescent Hispanic females who were receiving mental health services; 14 girls had attempted suicide in the previous five years and 17 had never attempted suicide. The two groups of girls did not differ significantly with respect to demographic profiles, levels of depression, family type, acculturation, or self-esteem. However, as hypothesized, the mutuality between girls and their mothers was lower among suicide attempters. Maladaptive coping skills of withdrawal and wishful thinking were more commonly used by attempters, and non-attempters used emotional regulation and problem-solving more frequently. Findings are discussed within the context of the empirical and theoretical literature and implications for practice are considered.
Article
A reexamination of ethnicity as a risk factor for adolescent suicidal behavior, focusing on whether Mexican American youths are at increased risk, was undertaken. Data from a sample of 4,175 African, European, and Mexican Americans, aged 11-17, are presented. We examined lifetime attempts and past year attempts, thoughts, and plans. Odds ratios, adjusting for covariates, indicate no differences between European and Mexican Americans on past year thoughts, plans, or attempts or lifetime attempts. Although some studies have reported Mexican American youths are at increased risk, we did not find any differences. Possible explanations for disparate results across studies are discussed, in particular methods effects.
Article
(1) To determine the relationship between acculturative stress, depressive symptoms, and suicidal ideation in a sample of immigrant and second-generation Latino-American adolescents, and (2) to determine the best predictors of acculturative stress and depressive symptoms. Subjects were 40 female and 30 male students from a bilingual program in a southern California high school. Measures used were the Short Acculturation Scale for Hispanics, the SAFE acculturative stress measure, the Family Assessment Device, the Reynolds Adolescent Depression Scale, the Suicidal Ideation Questionnaire-Junior, and an open-ended question measuring individual attitudes and expectations toward the future. A cross-sectional design was used. One fourth of the adolescents reported critical levels of depression and suicidal ideation, which were positively correlated with acculturative stress. Multiple regression analyses revealed that perceived family dysfunction and nonpositive "expectations for the future" were significant predictors of acculturative stress and depression. Results suggest that some acculturating Latino adolescents experience high levels of acculturative stress. These adolescents are also "at risk" for experiencing critical levels of depression and suicidal ideation. Findings highlight the importance of assessing the treating the depressed and potentially suicidal acculturating adolescent within a cultural context.
Article
Although immigrants are in better health than the U.S.-born population according to a variety of indicators, little research has investigated current foreign-born/U.S.-born differentials in suicide. A review of 32,928 California death certificates from 1970 to 1992 indicates that although foreign-born persons are consistently underrepresented in the suicide deaths of 15- to 34-year-olds (risk ratio = 0.60), any foreign-versus U.S.-born difference by ethnicity appears to be decreasing. Specifically, although Hispanics born outside the United States consistently are at significantly lower risk of suicide than U.S.-born Hispanics, the discrepancy between the two groups has diminished over time. And, in a comparable trend, non-Hispanic white persons born outside the United States were at higher risk of suicide than their U.S.-born counterparts until 1990, when their risk became similar. Black and Asian/other foreign- and U.S.-born persons have been at statistically similar risk since 1970. A man using a firearm at home was the typical pattern for both the foreign- and U.S.-born.
Article
17.7% in 1999), as compared to African American youth (7.3% in 1997 and 6.7% in 1999, 14.3% in 1997 and 11.7% in 1999, respectively) and European American youth (6.3% in 1997 and 7.3% in 1999, 12.5% in 1997 and 12.4% in 1999, respectively). During 1999, 19.9% of Latino youth seriously considered attempting suicide as compared to 15.3% of African American and 17.6% of European American youths(CDC, 1999). No significant ethnic differences were reported for serious suicide attempts that resulted in injury, poisoning, overdose, or treatment by a professional. This article reviews the scientific literature related to suicidal behavior among Latino youth. We start by discussing the conceptualization of culture, and how culture may influence behavior and psychopathology, in particular, suicidal behavior. Next, we critically review the available literature that discusses rates of suicidal behavior, risk, and protective factors associated with this behavior among Latino youth. This literature is then discussed in terms of its implications for prevention. Finally, we conclude with a discussion of directions for future research.
Article
This report describes ethnic and gender differences in suicide ideation among two large samples of middle school students in New Mexico (n = 2,140) and Texas (n = 1,302). Students completed a self-administered questionnaire on suicide ideation and psychosocial risk factors. Mexican Americans in both samples reported significantly higher prevalence of suicide ideation than did their European American counterparts. Mexican Americans were 1.8 times more likely to have high suicide ideation than European Americans. The suicide ideation risk for Mexican Americans remained unchanged in both samples after adjusting for gender, age, family structure, depression, low social support, and self-esteem. This study indicates that ethnicity plays an important role in suicidal ideation, but the mechanism remains unclear.
Article
The purpose of this study is to test specifically which social influences and which problem behaviors predict drinking among a sample of African-American and Caribbean-American black adolescents residing in New York City. A total of 3212 African-American or Caribbean-American seventh graders completed questionnaires assessing their alcohol use, demographic characteristics, social influences to drink, and other behavioral measures. Logistic regression analyses examined predictors for the overall black sample and separately for each of the two black groups. The predictors of alcohol initiation were virtually identical for both groups (father's drinking, siblings' drinking, friends' drinking, peer drinking, and smoking) with the exception of marijuana use. Although there were some common predictors of alcohol consumption for the two groups (siblings' drinking, friends' drinking, and smoking), some factors only influenced alcohol consumption for African-Americans (father's drinking and marijuana use) and others only did so for Caribbean-Americans (deviance and absenteeism). These findings highlight the importance of examining the etiology of alcohol use for different black groups.
Article
To examine the link between victimization at school and health risk behaviors using representative data comparing lesbian, gay, and bisexual (LGB) youths and heterosexual youths. Data from the 1995 Youth Risk Behavior Survey taken in Massachusetts and Vermont were examined. This sample included 9188 9th through 12th grade students; 315 of these students were identified as LGB. Analyses of variance were used to examine health risk behaviors by sexual orientation by gender by victimization level. The combined effect of LGB status and high levels of at-school victimization was associated with the highest levels of health risk behaviors. LGB youths reporting high levels of at-school victimization reported higher levels of substance use, suicidality, and sexual risk behaviors than heterosexual peers reporting high levels of at-school victimization. Also, LGB youths reporting low levels of at-school victimization reported levels of substance use, suicidality, and sexual-risk behaviors that were similar to heterosexual peers who reported low at-school victimization. The findings provide evidence that differences in health risks among LGB youth are mediated by victimization at school. Such victimization of LGB youth is associated with health risk behaviors.
Article
There exist no national prevalence data on specific DSM-IV Axis I psychiatric disorders among foreign-born and US-born Mexican Americans and non-Hispanic whites. To present nationally representative data on the prevalence of DSM-IV lifetime psychiatric disorders among foreign-born and US-born Mexican Americans and non-Hispanic whites. Face-to-face survey conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. The United States and District of Columbia, including Alaska and Hawaii. Household and group-quarters residents, aged 18 years and older (n = 43 093). Prevalence of DSM-IV substance use disorders and mood and anxiety disorders. With few exceptions, foreign-born Mexican Americans and foreign-born non-Hispanic whites were at significantly lower risk (P<.05) of DSM-IV substance use and mood and anxiety disorders compared with their US-born counterparts. Although the risk of specific psychiatric disorders was similar between foreign-born Mexican Americans and foreign-born non-Hispanic whites, US-born Mexican Americans were at significantly lower risk (P<.05) of psychiatric morbidity than US-born non-Hispanic whites. Data favoring foreign-born Mexican Americans with respect to mental health may extend to foreign-born non-Hispanic whites. Future research among foreign-born and US-born Mexican Americans and the foreign-born and US-born of other origins and descents is needed to understand what appears to be the protective effects of culture and the deleterious effects of acculturation on psychiatric morbidity in the United States.
Article
This study examined the risk of lifetime substance use disorders and mood and anxiety disorders between Island-born Puerto Ricans, foreign-born Cuban Americans, and foreign-born non-Latino whites and their U.S.-born counterparts. Data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093) were used to derive lifetime prevalence rates of specific DSM-IV psychiatric disorders by subethnicity and nativity group. Logistic regression models were constructed to detect variation in the odds of each psychiatric disorder across groups. A protective effect of foreign-born nativity in risk for psychiatric disorders was present for all groups but varied according to the assessed disorder. For non-Latino whites, the effect was observed for most specific psychiatric disorders, whereas, for Puerto Ricans and Cuban Americans, the effect was only evident for specific substance use disorders. The protective effect of nativity against psychiatric morbidity found in other studies among Mexican Americans and non-Latino whites does not entirely generalize to Puerto Ricans and Cuban Americans and may not generalize to individuals of other origins. The results of this study are discussed in terms of potential mechanisms involved in variations in the risk of specific psychiatric disorders among groups defined by nativity and race-ethnicity and the importance of identifying specific cultural components that may serve as risk and protective factors of psychiatric morbidity.
Article
Problem: Priority health-risk behaviors, which contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. Reporting period covered: October 2004-January 2006. Description of the system: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults, including behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infections; unhealthy dietary behaviors; and physical inactivity. In addition, the YRBSS monitors general health status and the prevalence of overweight and asthma. YRBSS includes a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education and health agencies. This report summarizes results from the national survey, 40 state surveys, and 21 local surveys conducted among students in grades 9-12 during October 2004-January 2006. Results: In the United States, 71% of all deaths among persons aged 10-24 years result from four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2005 national Youth Risk Behavior Survey (YRBS) indicated that, during the 30 days preceding the survey, many high school students engaged in behaviors that increased their likelihood of death from these four causes: 9.9% had driven a car or other vehicle when they had been drinking alcohol; 18.5% had carried a weapon; 43.3% had drunk alcohol; and 20.2% had used marijuana. In addition, during the 12 months preceding the survey, 35.9% of high school students had been in a physical fight and 8.4% had attempted suicide. Substantial morbidity and social problems among youth also result from unintended pregnancies and STDs, including HIV infection. During 2005, a total of 46.8% of high school students had ever had sexual intercourse; 37.2% of sexually active high school students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Among adults aged >/=25 years, 61% of all deaths result from two causes: cardiovascular disease and cancer. Results from the 2005 national YRBS indicated that risk behaviors associated with these two causes of death were initiated during adolescence. During 2005, a total of 23.0% of high school students had smoked cigarettes during the 30 days preceding the survey; 79.9% had not eaten >/=5 times/day of fruits and vegetables during the 7 days preceding the survey; 67.0% did not attend physical education classes daily; and 13.1% were overweight. Interpretation: Since 1991, the prevalence of many health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of mortality and morbidity. The prevalence of many health-risk behaviors varies across cities and states. Public health action: YRBS data are used to measure progress toward achieving 15 national health objectives for Healthy People 2010 and three of the 10 leading health indicators, to assess trends in priority health-risk behaviors among high school students, and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth.
Article
To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (<25 years), depression, a history of substance abuse treatment, a history of forced sex, gender-based discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender persons. In addition, increasing societal acceptance of the transgender community and decreasing gender-based prejudice may help prevent suicide in this highly stigmatized population.
Article
Our understanding of the relationship between immigration and mental health can be advanced by comparing immigrants pre- and post-immigration with residents of the immigrants' home countries. DSM-IV anxiety and mood disorders were assessed using identical methods in representative samples of English-speaking Mexican immigrants to the US, a subsample of the US National Comorbidity Survey Replication (NCSR), and Mexicans, the Mexican National Comorbidity Survey (MNCS). Retrospective reports of age of onset of disorders and, in the immigrant sample, age of immigration were analyzed to study the associations of pre-existing mental disorders with immigration and of immigration with the subsequent onset and persistence of mental disorders. Pre-existing anxiety disorders predicted immigration (OR=3.0; 95% CI 1.2-7.4). Immigration predicted subsequent onset of anxiety (OR=1.9; 95% CI 0.9-3.9) and mood (OR=2.3; 95% CI 1.3-4.0) disorders and persistence of anxiety (OR=3.7 95% CI 1.2-11.2) disorders. The results are inconsistent with the "healthy immigrant" hypothesis (that mentally healthy people immigrate) and partly consistent with the "acculturation stress" hypothesis (i.e., that stresses of living in a foreign culture promote mental disorder). Replication and extension of these results in a larger bi-national sample using a single field staff are needed.
Article
Although previous research has consistently documented that immigrants to the United States have better mental health than US natives, little is known about why this difference occurs. DSM-IV anxiety, mood, impulse control, and substance use disorders were assessed in a nationally representative survey of the US household population, the National Comorbidity Survey Replication. Differences in risk for disorder between immigrants (N = 299) and 5124 natives (N = 5124) were examined using discrete time survival models. Differences were estimated by generation, age of immigration, and duration of residence in the United States. Immigrants had lower lifetime risk of disorder than natives (OR = 0.7; 95% CI, 0.5-0.9). Risk was equally large for natives who were children of immigrants as for natives of subsequent generations. For mood and impulse control disorders, risk equal to that of natives was also found among immigrants who arrived in the United States as children (12 years of age or younger). Immigrants had lower risk than natives prior to arrival in the United States, but there was a trend toward equalization of risk with longer duration of residence in the United States. Differences in risk for disorder emerge within a single generation following immigration, consistent with a strong effect of environmental factors on changes in risk among immigrant populations. This pattern is consistent with either of two causal processes, one involving early socialization in the United States and the other involving postmigration experiences among immigrants who arrive in the United States as adults.
Article
This study seeks to identify risk factors for psychiatric disorders that may explain differences in nativity effects among adult Latinos in the USA. We evaluate whether factors related to the processes of acculturation and enculturation, immigration factors, family stressors and supports, contextual factors, and social status in the US account for differences in 12-month prevalence of psychiatric disorders for eight subgroups of Latinos. We report results that differentiate Latino respondents by country of origin and age at immigration (whether they were US-born or arrived before age 6: In-US-as-Child [IUSC]; or whether they arrived after age 6: later-arrival immigrants [LAI]). After age and gender adjustments, LAI Mexicans and IUSC Cubans reported a significantly lower prevalence of depressive disorders than IUSC Mexicans. Once we adjust for differences in family stressors, contextual factors and social status factors, these differences are no longer significant. The risk for anxiety disorders appears no different for LAI compared to IUSC Latinos, after age and gender adjustments. For substance use disorders, family factors do not offset the elevated risk of early exposure to neighborhood disadvantage, but coming to the US after age 25 does offset it. Family conflict and burden were consistently related to the risk of mood disorders. Our findings suggest that successful adaptation into the US is a multidimensional process that includes maintenance of family harmony, integration in advantageous US neighborhoods, and positive perceptions of social standing. Our results uncover that nativity may be a less important independent risk factor for current psychiatric morbidity than originally thought.
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Nativity and DSM-IV psychiatric disorders among Puerto Ricans, Cuban Americans, and non-Latino Whites in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions
  • Alegria
Understanding differences in past year psychiatric disorders for Latinos living in the US
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