T here is growing interest in psychosocial trauma and chronic pain (CP). Numerous retrospective studies link trauma or posttraumatic stress disorder (PTSD) to CP,
Unemployment is associated with poor health among refugees and immigrants; however, the degree to which discrimination in employment contributes to poor health remains unclear because of methodological limitations. This cross-sectional study aims to investigate factors associated with perceived discrimination, ethnicity and migration status, and their implication on health (self-rated health & depression). Perceived discrimination was investigated in 273 Iraqi skilled-workers, refugees and immigrants, who are members of a professional scientific organization. It was hypothesized that unemployment, ethnicity (Arab), and migration status (refugee) would be associated with perceived discrimination. Additionally, it was hypothesized that participants who endorse discrimination are more likely to report poor health. Results reveal that more individuals who were unemployed (46.4%), reported perceived discrimination (X2(1, N=273) =6.63, p<.05), however, when linear regression modeling was applied, age [OR=1.36], gender [OR=2.13], and ethnicity [OR=2.15], not migration status became significant predictors of discrimination. With respect to health, age [OR=2.25], length of residency [OR.93], language skills [OR=3.00], and perception of discrimination [OR=2.12] were predictors of SRH, while ethnicity [OR=3.93], age [OR=1.39], and discrimination [OR=3.26] were significant predictors of depression. Notably, perceived discrimination was a predictor in both health variables. In conclusion, there appears to be a link between discrimination and health in a homogenous refugee and immigrant sample.
Background Psychological war trauma among displaced refugees is an established risk factor for mental health disorders, especially post-traumatic stress disorder (PTSD). Persons with traumainduced disorders have heightened neuroplastic restructuring of limbic brain circuits (e.g., amygdala and hippocampus), which are critical factors in the pathophysiology of PTSD. Civilians in war are exposed to both psychological trauma and environmental hazards, such as metals. Little is known about the possible mental health impact from such environmental exposures, alone or in combination with trauma. It is of special interest to determine whether war exposures contribute to dysfunctional neuroplasticity; that is, an adverse outcome from sustained stress contributing to mental health disorders. The current study examined Middle Eastern refugees in the United States to determine the relationships among pre-displacement trauma and environmental exposures, brain derived neurotrophic growth factor (BDNF) and nerve growth factor (NGF)-two neurotrophins reported to mediate neuroplasticity responses to stress-related exposures-and mental health. Methods Middle Eastern refugees (n = 64; 33 men, 31 women) from Syria (n = 40) or Iraq (n = 24) were assessed 1 month after arrival to Michigan, US. Participants were interviewed in Arabic using a semi-structured survey to assess pre-displacement trauma and environmental exposure, PTSD, depression, anxiety, and self-rated mental health. Whole blood was collected, and concentrations of six heavy metals as well as BDNF and NGF levels were determined. Because these two neurotrophins have similar functions in neuroplasticity, we
Little is known about how the overall employment conditions in a country impact the likelihood of employment of newly arrived refugees. In the current study, we compare employment and determinant of employment of highly educated Middle Eastern refugees to Michigan that arrived before and after the 2007 recession. We also look at self-reported barriers to employment. Results show that the general downturn of the economy made it substantially more difficult to secure employment, even for well-educated refugees. Thus, before the economic downturn, 22.9 % of refugees were unemployed as compared to 55.1 % once the recession had set in (p < 0.01). There were also substantially more self-reported barriers to employment after the economic downturn. The study points to the importance of understanding both individual characteristics and the general employment conditions in the new host country when studying variation in refugee employment success.
Refugees experience distress from premigration trauma, often exacerbated by postmigration difficulties. To develop effective interventions, risk factors for mental health symptoms need to be determined. Male Iraqi refugees (N = 53) to the United States provided background information and reported predisplacement trauma and psychological health within 1 month of their arrival. An inflammatory biomarker-C-reactive protein (CRP) was assessed approximately 1.5 years after arrival, and a contextual factor-acculturation-and psychological health were assessed 2 years after arrival. We tested whether acculturation and CRP were associated with posttraumatic stress disorder (PTSD) and depression symptoms at the 2-year follow-up, controlling for baseline symptoms, age, body mass index, and predisplacement trauma. Acculturation was inversely related to depression, and CRP was positively related to both PTSD and depression at the 2-year follow-up. Interventions targeting acculturation could help reduce the development of depression symptoms in refugees. The role of CRP in the development of PTSD and depression symptoms warrants further research.
There is little research on risk and protective factors for Arab American women's mental health, particularly the role played by religiosity and religious affiliation. This study examined two stress-related risk factorschildhood adversity and racism-and three religious protective factors-religious support, positive religious coping, and organized religious participation-and their relationships with psychological symptoms (Brief Symptom Inventory-18) among 123 Arab American women (aged 18-34) who were either Muslim (n = 68; 55%) or Christian (n = 55; 45%). Main analyses examined the associations of risk and protective factors to symptoms and whether each religious protective factors moderated the association of risk factors with psychological symptoms. Exploratory analyses compared Muslim and Christian women and tested religious affiliation as a moderator of the association of risk and protective factors to symptoms. In the whole sample, childhood adversity (r = .37) and racism (r = .34) were associated with greater symptoms, whereas religious support (r = −.20) and positive religious coping (r = −.18) were associated with lower symptoms. Organized religious participation and positive religious coping buffered the relationship of racism with symptoms. Although Muslim and Christian women did not differ on most variables, racism was a stronger risk factor for symptoms among Muslims (r = .47) than Christians (r = .12). In conclusion, stressful life experiences and religiosity relate to psychological health in Arab American women. Racism is a particularly strong risk factor, although buffered by religious participation and coping. Efforts to combat racism and support religious practice are encouraged.
Emotional processing interventions for trauma and psychological conflicts are underutilized. Lack of adequate training in emotional processing techniques and therapists’ lack of confidence in utilizing such interventions are barriers to implementation. We developed and tested an experiential training to improve trainees’ performance in a set of transtheoretical emotional processing skills: eliciting patient disclosure of difficult experiences, responding to defenses against disclosure, and eliciting adaptive emotions. Mental health trainees (N = 102) were randomized to experiential or standard training, both of which presented a 1-hr individual session administered remotely. Before and after training and at 5-week follow-up, trainees were videorecorded as they responded to videos of challenging therapy situations, and responses were coded for demonstrated skill. Trainees also completed measures of therapeutic self-efficacy, anxiety, and depression at baseline and follow-up. Repeated-measures analysis of variance indicated all three skills increased from pre- to posttraining for both conditions, which were maintained at follow-up. Importantly, experiential training led to greater improvements than standard training in the skills of eliciting disclosure (η2 = .05, p = .03), responding to defenses (η2 = .04, p = .05), and encouraging adaptive emotions (η2 = .23, p < .001) at posttraining, and the training benefits for eliciting disclosure were maintained at follow-up. Both conditions led to improved self-efficacy. Trainees’ anxiety decreased in the standard training, but not in the experiential. One session of experiential training improved trainees’ emotional processing therapy skills more than didactic training, although more training and practice likely are needed to yield longer lasting skills.
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