Acculturative stress and psychotic-like experiences among Asian and Latino immigrants to the United States

Abstract

Previous studies have shown variation in the prevalence and incidence of psychosis across immigrant groups, but the underlying mechanisms are not fully understood. Stress related to acculturation may increase risk for psychosis among immigrant groups. In this study we examine the association between acculturative stress and psychotic-like experiences in a sample of Latino- and Asian-American immigrants to the United States in the National Latino and Asian American Study (n = 2434). Acculturative stress was associated with visual and auditory hallucinations among Asians, but only with hearing voices among Latinos. Increased risk for psychotic-like experiences among Latinos was primarily associated with younger age of immigration. Acculturative stress appears to be a promising candidate mechanism explaining the relationship between immigration and psychosis, particularly among Asian Americans. Ethnic differences may reflect variability between groups that integrate more readily into the host culture and those that are subject to greater discrimination and environmental adversity.

Immigration and psychotic experiences in the United States: Another example of the epidemiological paradox?

“…This decline in health status may be attributable to the loss of traditional cultural practices from the country of origin and/or the acquisition cultural practices from the receiving society (Schwartz et al, 2010). The stressors of being an immigrant -such as being mistreated because of one's accent or limited English proficiency, being questioned about one's legal status, feeling guilt about leaving one's family in country of origin, being afraid of deportation, and so forth -appear to increase risk for psychotic experiences among Latino and Asian immigrants in the United States (DeVylder et al, 2013). Second generation immigrants may not be exposed to many of these stressors, but may still encounter discrimination, alienation, identity crises, and other stressful events, while relinquishing the protective attributes of their heritage culture (e.g.…”

“…We used sampling weights that corresponded with each survey to account for individual-level sampling factors including non-response and unequal probabilities of selection. We analyzed each sample separately because a number of problems arise from the CPES weights and psychosis screen when examining racial/ethnic groups across the combined data (DeVylder et al, 2013). Design-based analyses with Taylor series linearization were used to estimate standard errors that accounted for the complex multistage clustered design of each survey.…”

Psychotic experiences in the population: Association with functioning and mental distress

“…Psychotic experiences are far more common in the population than psychotic disorder (Cullen et al, 2014;Devylder et al, 2013;Laurens et al, 2012;Lin et al, 2011;Saha et al, 2011a). Among young people, these experiences most commonly occur in the form of auditory hallucinations, which may be frankly psychotic in nature or, more commonly, attenuated (that is, hallucinatory experiences with intact reality testing) (Kelleher et al, 2011).…”

Migration and psychosis in acute inpatient psychiatry

“…9 There is no evidence that genetics confer a greater risk of psychosis in certain immigrant populations. 10 Psychosocial factors in immigrants such as discrimination and social defeat, 8 social isolation, 11 familial dysfunction 10 and traumatic experience in home country 12 elevate the risk of psychosis. Immigrants who perceived high levels of discrimination and those whose culture and appearance differed significantly from the host population were at particular risk.…”

“…13 Acculturation, whereby an individual attempts adapting to a different culture, also contributes to the onset of psychosis in immigrants. 11 Some acculturative stressors include language barriers, differing cultural views and problems with legal residency status. 11 There are few Australian-based studies examining the association between migration and psychosis.…”