The effect of minority status and social context on the development of depression and anxiety: a longitudinal study of Puerto Rican descent youth

Abstract

Few longitudinal studies have explored to date whether minority status in disadvantaged neighborhoods conveys risk for negative mental health outcomes, and the mechanisms possibly leading to such risk. We investigated how minority status influences four developmental mental health outcomes in an ethnically homogeneous sample of Puerto Rican youth. We tested models of risk for major depressive disorder (MDD) and generalized anxiety disorder (GAD), depressive and anxiety symptoms (DAS), and psychological distress, as Puerto Rican youth (aged 5-13 years) transitioned to early adulthood (15-29 years) in two sites, one where they grew up as a majority (the island of Puerto Rico), and another where they were part of a minority group (South Bronx, New York). At baseline, a stratified sample of 2,491 Puerto Rican youth participated from the two sites. After baseline assessment (Wave 1), each youth participant and one caregiver were assessed annually for two years, for a total of three time points (Waves 1-3). From April 2013 to August 2017, participants were contacted for a Wave 4 interview, and a total of 2,004 young people aged 15 to 29 years participated in the assessment (response rate adjusted for eligibility = 82.8%). Using a quasi-experimental design, we assessed impacts of minority status on MDD, GAD, DAS and psychological distress. Via mediation analyses, we explored potential mechanisms underlying the observed relationships. Data from 1,863 Puerto Rican youth (after exclusion of those with MDD or GAD during Waves 1-3) indicated links between minority status and higher rates of lifetime and past-year GAD, DAS and past 30-day psychological distress at Wave 4, and a marginal trend for MDD, even after adjustments. Childhood social support and peer relationships partially explained the differences, as did intercultural conflict, neighborhood discrimination, and unfair treatment in young adulthood. The experience of growing up as a minority, as defined by context, seemingly elevates psychiatric risks, with differences in social relationships and increased social stress as mediators of this relationship. Our findings suggest that interventions at the neighborhood context rather than at the individual level might be important levers to reduce risks for the development of mood disorders in minority youth.

Development, Psychopathology, and Ethnicity II: Psychiatric Disorders Among Young Adults

“…However, the prevalence among BYS young men from PR (8.2%) was almost five times higher. 30 Among adults, two studies conducted in the 1990s 53,54 agreed with the National Latino and Asian American Study, conducted 17 years ago, which also showed women having a higher prevalence of lifetime (19.8%) and past-year (10.8%) MDD than men (10.9% and 6.4%, respectively). 55 In the BYS, prevalence of lifetime MDD was 15.0% for men from SBx and 13.3% for men from PR.…”

“…A recent BYS article focused on MDD and anxiety disorders in young adulthood points to the relevance of sociocultural processes for understanding the early development of psychopathology among youths. 30 Earlier BYS work focused on childhood and early adolescence, together with existing literature, identified the importance of sociocultural risk and protective factors. For example, higher parental acculturation and experiences of discrimination and cultural stress in children have been related to greater symptoms and poor outcomes.…”

“…29 A recent analysis examined a subsample of participants in young adulthood and found elevated rates of generalized anxiety disorder (GAD) and major depressive disorder (MDD) (marginal) among participants living in SBx compared with those living in PR. 30 However, this analysis aimed to identify specific sociocultural mechanisms related to increased risk and did not generate estimates of psychiatric disorders for the full sample. Also, it did not focus specifically on gender differences or on the developmental course of psychiatric disorders.…”

Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

“…The rate of suicidal ideation found in our sample is quite impressive, compared with the 3% found in a previous epidemiological study carried out in Italy [98]. Several factors may contribute to the increased rate of suicidal ideation in the Italian general population, including uncertainty about the future, loneliness, physical distancing, unemployment, economic recession and interpersonal violence [99]. All these risk factors should be taken into account in the implementation of actions aiming to prevent suicide [100][101][102].…”

Developmental Psychopathology and Ethnicity I: The Young Adulthood Assessment of the Boricua Youth Study

“…Youths in SBx, however, growing up as part of an ethnic minority group, are likely to face ethnic discrimination throughout life, an experience likely related to psychopathology. 14,15 Rates of people living with human immunodeficiency virus/acquired immunodeficiency syndrome were 10 times higher than the U.S. average in SBx in 2017, 16 5 times more than the total PR population and over 2 times higher than the population in San Juan, PR. [16][17][18] Rates of sexually transmitted infections in SBx ranged from 3 to 7 times higher than the rates for people living in PR in 2016.…”