The Role of Acculturative Stress on the Mental Health of Immigrant Youth: A Scoping Literature Review.

Acculturation after settlement has been identified as a risk factor affecting the mental health of immigrant youth. Increasing rates of immigration and expanding populations of immigrant youth mean that addressing their mental is a priority. Acculturative stress is the stress-response resulting from the effects of multiple stressors that result from the need to acculturate. Among youth within the developmental stages of late adolescence and emerging adulthood, increased sensitivity to stress, and developmental demands, impact their mental health. The effects of acculturative stress place an additional burden on the mental health of immigrant youth. This scoping review examined existing literature that investigated a variety of relationships between acculturative stress and youth mental health. A comprehensive search strategy that focused on studies involving youth, mainly aged between 15-24, with a proximal history of international migration, published between 2012-2022, resulted in a collection of fifty-three studies. This review examined significant relationships between acculturative stress and major depression, anxiety disorders, eating disorders, substance misuse, behavioural problems and poor psychological wellbeing. This scoping review was truly explorative as it included youth from immigrant minorities, had no geographical limits, and included various study designs. Acculturative stress continues to be an important contributor to the mental health of youth who have a proximal history of international migration. This review provided an exploration of the state of research, identified the importance of the settlement context, and provided recommendations for the direction of future studies, supportive policies, and practice considerations, related to the mental health of immigrant youth.

Factors associated with acculturative stress among international medical students in an Egyptian university.

BACKGROUND: International students frequently face difficulties that are specific to the typical college experience, in addition to facing other factors of acculturative stress, including cultural differences, language barriers, and comfortability in accommodation. AIM: The study aims to measure the prevalence of acculturative stress among first-year international students enrolled at Faculty of Medicine in an Egyptian University and aims to reveal the factors that are associated with acculturative stress in these students. METHODOLOGY: A cross-sectional study was conducted on 422 international students in the academic year 2021-2022, using the Acculturative Stress Scale for International Students (ASSIS). The factors associated with acculturative stress were examined using the following criteria: comfort in accommodation, student adjustment to college, language proficiency, and academic pressure. RESULTS: This study showed that 28.7% of the international students were "above the warning sign" of acculturative stress (above 109). The major stressors of acculturative stress among international students were the non-specific concerns, homesickness, and perceived discrimination, while the least reported stressors were fear and guilt. International students who scored in the "above the warning sign" in the (ASSIS) were mostly females (35.3%) and non-Arab students (37.8%). Having a friend or a family member living in Egypt significantly reduced the level of acculturative stress. Moreover, the ASSIS total score showed a negative correlation with the scores for overall language proficiency, comfort in accommodation, academic adjustment, and student adjustment to college. CONCLUSION: Acculturative stress among the studied groups is influenced by several factors, including nationality, English and Arabic language proficiency, academic adjustment, and comfort of living. That being said, the most significant stressor is the country of origin, which is defined in terms of nationality or language proficiency. Consequently, resources that ensure the sustainability and growth of international students throughout their educational process must be made available to a multicultural environment in order to support and retain those students. CLINICAL TRIAL NUMBER: Not applicable.

The impact of acculturative stress on internalizing problems among racially and ethnically minoritized adolescents and young adults in the U.S.: A systematic review and meta-analysis.

Due to demographic changes of the U.S. population in the past few decades, more attention has been placed on understanding the sociocultural factors that have an impact on the mental health of racially and ethnically minoritized (REM) groups. One factor that has gained increased attention in recent years is acculturative stress. Acculturative stress is associated with negative mental health outcomes, such as depression, anxiety, psychological distress, and suicide ideation (SI). However, the magnitude of this association remains unclear. A systematic review and meta-analysis were conducted to provide a comprehensive review of the impact of acculturative stress on depression, anxiety, psychological distress, and SI among REM youth. We also aimed to explore whether sociodemographic variables (i.e., race/ethnicity, generational status, sex/gender, and age) moderate the relationships between acculturative stress and mental health outcomes. Forty-six peer-reviewed articles examining the link between acculturative stress and internalizing problems among REM youth in the U.S. (mean age range: 13-29) met inclusion criteria and were included in this systematic review and meta-analysis. A positive relationship of moderate size between acculturative stress and depression, anxiety, psychological distress, and SI was found. Moderation analyses also revealed that the impact of acculturative stress on depression may be greater among those who are older and for first-generation immigrants. Similarly, its impact on anxiety may also be more pronounced for first-generation immigrants. Results also suggested that the impact of acculturative stress on depression and psychological distress may be greater among men compared to women. These findings highlight the importance of making sure clinicians assess for acculturative stress when working with REM youth, as well as factors that may be contributing to an individual's acculturative stress level.

Acculturation, acculturative stress, and tobacco/nicotine use of Latin American immigrants.

OBJECTIVE: US Hispanics have several health disparities, greater tobacco/nicotine-related illnesses, lower access to smoking cessation, and lower rates of cessation. Understanding cultural constructs linked to tobacco/nicotine use may provide a greater understanding of future cultural adaptations of cessation interventions. This study used a multidimensional acculturation framework, with cultural practices, identity, and values, to test links between measures of acculturation stress, multidimensional acculturation (language-based enculturation and acculturation, cultural identity, familism), and tobacco/nicotine use, and interactions with gender. DESIGN: Participants were 391 adult Latin American immigrants (69% women); 12% self-reported tobacco/nicotine use in the past six months. RESULTS: Path analysis showed acculturative stress, ß = .16, and acculturation, ß = .20, were positively related to tobacco/nicotine use. Enculturation, familism, and Hispanic cultural identity were not related to tobacco/nicotine use. There were no significant acculturation by enculturation or gender interactions, but women were less likely to use tobacco/nicotine than men, ß = -.36. CONCLUSION: Findings suggest that tobacco/nicotine cessation interventions for Latino immigrants may be enhanced with an emphasis on the mitigation of acculturative stress, attention to the adoption of US cultural practices, and gender. Future research should examine specific sources of acculturative stress or social norms related to tobacco/nicotine use.

Age of migration and common mental disorders among migrants in early adulthood: a Norwegian registry study.

BACKGROUND: Younger age of migration is associated with higher risk of psychotic disorders but the relationship between age of migration and common mental disorders is less clear. This study investigates the association between age of migration and diagnosed common mental disorders among migrants living in Norway. METHODS: Using national Norwegian register data from 2008 to 2019, we compared the odds of a common mental disorder diagnosis in healthcare services during early adulthood among non-migrants, descendants and migrants with different ages of migration and lengths of stay. We also investigated differences in the relationship for different migrant groups and for men and women. RESULTS: Descendants and childhood migrants with ≥ 19 years in Norway had higher odds of common mental disorders than non-migrants, while those migrating during adolescence with ≥ 19 years in Norway had similar odds. Those migrating during emerging and early adulthood had lower odds. Overall among migrants, the relationship between age of migration and common mental disorders was more pronounced for migrants < 19 years in Norway than ≥ 19 years and for non-refugees compared with refugees, especially men. CONCLUSIONS: Descendants and childhood migrants with long stays may have higher odds of common mental disorders due to the associated stress of growing up in a bicultural context compared with non-migrants. Age of migration has a negative association with diagnosed common mental disorders but much of this effect may attenuate over time. The effect appears weaker for refugees, and particularly refugee men, which may reflect higher levels of pre-migration trauma and stress associated with the asylum-seeking period for those arriving as adults. At the same time, migrants, especially those arriving as adults, experience barriers to care. This could also explain the particularly low odds of diagnosed common mental disorders among adult migrants, especially those with shorter stays.

Determining the role of acculturative stress in predicting mental health service use among Latinx immigrants.

OBJECTIVES: Acculturative stress is an important factor that affects health for Latinx immigrants in the US, with multiple studies identifying a link between depression and acculturative stress in this population. However, far fewer studies have examined the specific role and relationship of acculturative stress on mental health service use in this population. Through the lens of Yang's 2016 Model of Immigrant Health Service Use, this study aimed to examine the role of acculturative stress in predicting mental health service use in a sample of Latinx immigrants in the Southeast US. DESIGN: We conducted a secondary data analysis from a longitudinal study of Latinx immigrant health (n = 391). RESULTS: Our study found that while total acculturative stress was not significantly associated with mental health service use in this sample, parenting stress was a significant predictor of mental health service use in the past six months when controlling for covariates (OR: 1.043, 95% CI [1.009, 1.078]). Additionally, important Predisposing and Need for Healthcare factors were significantly associated with mental health service use, specifically: males were less likely to utilize mental health services than females (OR: 0.401, 95% CI [0.166-0.968]), English language acculturation was positively associated with mental health service use (OR: 1.953, 95% CI [1.130, 3.377]), and depression was positively associated with mental health service use (OR: 1.107, 95% CI [1.027, 1.194]). CONCLUSION: These findings support the need for more culturally sensitive mental health services, and the need to develop strategies to engage males and less acculturated individuals in mental health services to promote health equity among Latinx immigrants.

Effects of sociocultural stressors on maternal responsivity and the infant behavioral and neuroendocrine response to stress in families of Mexican descent.

Maternal stress is consistently linked to alterations in maternal behavior and infant neurodevelopmental outcomes. As the Latino population grows in the U.S., it is increasingly important to understand how culturally relevant factors affect this relationship. This study aimed to address the role of sociocultural stressors on maternal sensitivity and markers of infant emotional regulation and the neuroendocrine response to stress in mother/infant dyads of Mexican descent. Pregnant women of Mexican descent (n = 115) were recruited during early pregnancy and followed until their infants were 6 months old. Mothers completed measures of sociocultural stressors (acculturative stress and discrimination) at pre and postnatal time points. At 6 months, dyads underwent the Still Face procedure. Mothers were observed for behaviors exhibiting maternal responsivity, while negative vocalizations were observed in infants. Salivary cortisol was also collected from infants. Maternal responsivity was a salient risk factor for alterations in infant emotional regulation and cortisol activity. Postnatal experiences of discrimination were also negatively associated with infant negative affect. This work highlights maternal responsivity and points to a potential role for experiences of discrimination in the response to stress in the mother/child dyad that may have consequences for the development of emotional regulation in infants of Mexican descent.

Gender-Specific Patterns of Relations among Acculturative Stress, Family Processes, and Prosocial Behaviors in Latinx Youth.

The present study was designed to examine the direct and indirect relations between acculturative stress and Latinx youth prosocial tendencies. In addition, we considered family conflict, parental support, and parental psychological control as explanatory mechanisms. Participants included 306 (53.8% female, Mage = 15.50, SD = .42; range = 14 to 18) Latinx adolescents and their parents (87.9% mothers). The majority of adolescents were born in the U.S. (n = 206, 68.0%; average time in U.S. = 10 years) and identified as a Mexican heritage group member (n = 248, 81.0%). Findings differed by youth gender and suggest that for boys, parental support (but not psychological control) serves as underlying mechanism in the effects of acculturative stress and family conflict on youth's prosocial behaviors. Contrastingly, for girls, parental support (but not psychological control) serves as underlying mechanism in the negative effects of family conflict (but not acculturative stress) on youth's prosocial behaviors. The findings are discussed in the context of the need for integrative theories that account for cultural, family and gender-related socialization mechanisms to better understand prosocial behaviors among Latinx youth.

Evaluating the interactive impact of acculturative stress and anxiety sensitivity on behavioral health outcomes among Latinx during a period of high COVID-19 impact.

As a multi-systemic disease, COVID-19 infection engendered a rise in co-occurring mental and physical health symptoms, particularly affecting the Latinx population. The current work sought to evaluate the main and interactive influence of acculturative stress and anxiety sensitivity in terms of mental and physical health symptoms among 181 Latinx persons (30.4% female, Mage = 34.1 years, SD = 8.20). Data were collected during a period of high COVID-19 impact (2020-2021) and analyses included five separate, two-step hierarchical regressions that were conducted for each of the criterion variables: (1) fear of coronavirus; (2) somatic symptoms; (3) fatigue severity; (4) anxiety symptoms; and (5) depression symptoms. For all analyses, step 1 covariates included years living in the U.S. COVID-19 impact, gender identity, education, and work life distress and home life distress. Results revealed an interactive effect of anxiety sensitivity and acculturative stress on COVID-19 fear, unique main effects for both anxiety sensitivity and acculturative stress on COVID-19 related fear and somatic symptoms, and main effects for anxiety sensitivity alone in relation to fatigue severity, anxiety, and depression. Overall, this study represents an initial investigation of the associations between acculturative stress, anxiety sensitivity, and a range of salient COVID-19 related outcomes among Latinx persons.

Exploring acculturative stress and family dynamics in African immigrant students in the US: implications for mental health.

OBJECTIVES: African immigrants represent a rapidly growing immigrant group in the US, yet relatively little is known about influences on the health of this group. This is a particularly important oversight since adaptation to life in the United States can have deleterious effects on health due to the stress associated with immigrant and minority status as well as separation from family abroad. The present study explores how African immigrants experience acculturative stress - the stress-inducing elements of life as an immigrant - and the mental health implications of these experiences in light of home country values and conceptions of health. DESIGN: Semi-structured, in-depth interviews were conducted with a purposive sample of sub-Saharan African immigrant students attending a metropolitan university in the northeastern United States (N = 26). Data were analyzed thematically using NVivo 12. RESULTS: African immigrant students first experience acculturative stress through schools and neighborhoods where they encounter othering processes, including discrimination and racism. Family responsibilities to loved ones in the US and Africa also represent a source of stress that contributes to feelings of isolation and depression experienced while managing college responsibilities. Since these emotional and mental states are not within the purview of how health is viewed in their home countries, many suffer and may not get the care they need to effectively manage their mental health. CONCLUSION: Findings emphasize shared experiences of navigating cultural dynamics, family pressures, and discrimination that contribute to the stress experienced by African immigrants. Findings also underscore the need for the development of culturally sensitive interventions in university settings so that African immigrant students can be upwardly mobile and healthy in the long-term.

Maternal stressors and maternal bonding among immigrant and Refugee Arab Americans resettled in the United States.

Maternal bonding with the infant and child is essential for the growth and development of the child, and for establishing the relationship between them. The effect of maternal acculturative stress, trauma, and depressive symptoms on maternal bonding has been established in nonimmigrant populations, but not in immigrant and refugee populations. In this study, we aimed to (1) examine the relationships among maternal psychosocial stress (acculturative stress, posttraumatic stress), depressive symptoms, and maternal bonding, and (2) examine whether maternal depression is a mediator of the relationship between maternal psychosocial stress and maternal bonding among a sample of Arab American immigrant and refugee mothers. Using a cross-sectional design, we recruited 78 immigrant and refugee Arab American mothers. Acculturative stress was correlated with posttraumatic stress (ρ = 0.56, p < 0.001), depressive symptoms (ρ = 0.48, p < 0.001), and bonding impairment (ρ = 0.39, p < 0.001). Posttraumatic stress and depressive symptoms were also correlated with maternal bonding impairment (ρ = 0.39, and 0.52, respectively, p < 0.001 for both). The effect of maternal psychosocial stress on maternal bonding was mediated by depressive symptoms. We concluded that higher levels of acculturative stress and posttraumatic stress were associated with higher levels of depressive symptoms and impairment of maternal bonding. Additionally, maternal depressive symptoms mediated the relationship between maternal stress and bonding. Assessing the stressors and depressive symptoms of immigrant and refugee mothers is key to avoiding negative effects on child outcomes.

Self-reported COVID-19 symptoms and perceived likelihood of suicide attempt among Latinx individuals who experience acculturative stress.

The impact of COVID-19 has led to a substantial economic and psychosocial burden on the Latinx population. However, few studies have evaluated how COVID-19 symptoms may exacerbate suicide risk indicators among Latinx persons, or the particular social determinants of health facilitating such detrimental effects. The present study examined the association between self-reported COVID-19 symptoms and suicide likelihood (i.e., self-reported perceived likelihood that one will attempt suicide in the future) among Latinx individuals within a timeframe involving high COVID-19 contagion before the onset of vaccine dissemination. Further, the possible moderating role of acculturative stress in the association between COVID-19 symptoms and suicide likelihood was examined. The sample included 200 Latinx participants (67.5% male, Mage = 34.67 years, SD = 9.15) who completed self-report measures on COVID-19 symptoms, suicide likelihood, acculturative stress, depressive symptoms, trauma symptoms, somatic symptoms, and general COVID-19 emotional impact. Findings indicated that self-reported COVID-19 symptoms were positively associated with suicide likelihood. Further, the association between COVID-19 symptoms and suicide likelihood was moderated by acculturative stress, such that the association was only statistically significant at mean or higher levels of acculturative stress but was not significant among participants with lower acculturative stress. The moderation effect was statistically significant after controlling for sociodemographic factors, depressive symptoms, trauma symptoms, somatic symptoms, and the general emotional impact of the COVID-19 pandemic. The current findings indicate that, among Latinx individuals, acculturative stress is a key social determinant of health for marked psychological distress in the context of the COVID-19 pandemic.

The effect of group art therapy on acculturative and academic stress of Chinese graduate students in South Korea.

Background: Research has shown that international students, specifically Chinese graduate students in South Korea, are vulnerable to stress and depression because of various factors. These include environmental changes, economic constraints, interpersonal difficulties, discrimination, and cultural conflict. Objective: This study investigates the effectiveness of group art therapy in reducing acculturative stress and academic stress among Chinese graduate students in South Korea. Method: Thirty participants were recruited and randomly assigned to the experimental (n = 15) and control groups (n = 15). The experimental group received eight 120-min sessions of group art therapy. Both groups were tested for acculturative stress (perceived discrimination, homesickness, perceived hate, fear, stress due to change/culture shock) and academic stress (schoolwork stress, future stress, social stress, living environment stress) before and after the art therapy intervention. Results were compared using the Mann-Whitney U test and the Wilcoxon signed-rank test. Results: The results showed that there was a significantly greater reduction in acculturative and academic stress in the experimental than the control group. Conclusion: Group art therapy can provide psychological and emotional support to international students studying abroad.

Changes in mental health symptoms and sociocultural factors across the COVID-19 pandemic in mothers of Mexican descent.

Latinos have been disproportionately affected by the COVID-19 pandemic in the US. Little is known about the lasting effects on mental health, particularly among mothers of young children, who historically report high levels of depression and anxiety. We examined if anxiety and depression symptoms worsened for mothers of Mexican descent across the pandemic and identified the role of sociocultural risk and protective factors on these changes. Mothers of Mexican descent (n = 141) with young children (ages 0-7) were administered surveys on mental health symptoms (anxiety and depression), stress-related sociocultural factors (perceived discrimination) before (pre-pandemic), within 3 months (early pandemic), and 18 months after the COVID-19 stay-at-home order (late pandemic). Another sociocultural factor, acculturative stress, was only measured pre-pandemic while during the later phase of the pandemic mothers reported their levels of loneliness, optimism, and coping styles. Repeated measures (RM) ANOVA demonstrated that depressive and anxiety symptoms as well as perceived discrimination increased from pre to early months of the COVID-19 pandemic and slightly lowered in late-COVID but did not return to pre-COVID levels. Two-way RM ANOVA showed that acculturative stress and perceived discrimination predicted worse mental health trajectories across the pandemic while moderations revealed that optimism buffered against, and avoidant coping increased the adverse effects of sociocultural factors on mental health. The effects of the COVID pandemic on mental health are lingering in mothers of young children; however, optimism may be a protective factor. The results also highlight the damaging effects of external factors, such as discrimination, on maternal mental health during times of crisis.

Cross-Cultural Validation of the Barcelona Immigration Stress Scale.

The concept of acculturative stress has been the subject of debate, resulting in contradictory arguments regarding its measurement. Many of the existing acculturative stress instruments have been developed for use with specific migrant groups. The objective of the current study is to revisit the psychometric properties of the Barcelona Immigration Stress Scale, an instrument aimed at measuring stress levels associated with the migration trajectory in any migrant group. Using a sample of 915 migrants who consulted in primary care, we carried out principal component and confirmatory factor analyses as well as item response theory analyses applied both to the entire sample and to different migratory groups separately. The new reduced version of the scale has very good psychometric properties both in general and applied to the Latino migratory group, the largest in the area where the study was carried out. Results were acceptable among sub-Saharan, North African, and Asian groups but not among Eastern Europeans. These results are discussed through the specificities of each migratory group and the limitations of psychometrics to capture the complexity of immigration-related and acculturative stress.

School and Bicultural Factors as Mediators between Immigrant Mothers' Acculturative Stress and Adolescents' Depression in Korea.

In Korea, marriages between Korean men and foreign women have surged since the late 1990s, resulting in public interest in the psychosocial adjustment of their children. This study examined the mediating effects of immigrant mothers' school involvement, adolescents' school adjustment, and bicultural acceptance on the relationship between the mothers' acculturative stress and adolescents' depression, as well as whether the structural relationships differed by the sex of adolescents. Data were collected from 1238 dyads of first-grade students (605 boys, 633 girls; age = 12.97 ± 0.35 years) in Korean middle schools and their immigrant mothers (age = 43.52 ± 5.13 years) who participated in the Multicultural Adolescents Panel Study. The structural equation modeling analysis revealed that mothers' acculturative stress was indirectly and positively related to adolescents' depression through (1) the serial mediations of mothers' school involvement and adolescents' school adjustment and (2) the individual mediation of adolescents' school adjustment. Furthermore, the multigroup analysis indicated that the relationships between adolescents' school adjustment and depression and between adolescents' bicultural acceptance and depression significantly differed between male and female adolescents. The study provides directions for schools and communities to increase immigrant mothers' school involvement and to facilitate their children's school adjustment and bicultural acceptance.

What do We Know About Acculturation? A Measurement Invariance Examination of Acculturation Domains Between Asian and Latinx Populations.

Objectives: Acculturation has emerged as a key variable in racial/ethnic minorities and immigrant research. Although findings generally conclude acculturation leads to adverse outcomes (e.g., risk behaviors), scholars often find contradicting results. This increased attention to the core definitional questions about what acculturation is and how it should be measured, specifically across different racial/ethnic groups. Methods: This study examined the measurement invariance using Multigroup Confirmatory Factor Analysis (MG-CFA) by comparing three common domains of acculturation measures across Asian and Hispanic populations (i.e., Ethnic Identification, Language Proficiency and Preference, and Acculturative Stress) using the National Latino and Asian American Study (NLAAS). Results: A total sample of 4,649 (nLatinx=2,554 and nAsian=2,095) was used. The results suggested that aspects of ethnic identification and acculturative stress measures significantly varied between groups. For example, Latinxs had higher factor loadings in certain Acculturative Stress items related to government and legal status. In contrast, Asians had higher factor loadings in an item related to Ethnic Identification. Conclusions: The results suggested that aspects of acculturation do not necessarily measure the same way across all populations; researchers/clinicians should consider racial/ethnic specific scales when using acculturation related measures. Future research should test universal acculturation scales across other ethnic subgroups and include more complex acculturation measures like cultural values and norms.

Perceptions of the Sense of Security, Belonging, and Acculturative Stress among International Students in China during COVID-19 Outbreak-An Empirical Analysis.

Understanding the cross-cultural adaptation of students studying in foreign countries by exploring acculturative stress factors is crucial to ensure the smooth academic performance of the students and, in turn, to enhance the global reputation of their universities. Therefore, it is an area of interest for the authorities (Ministry) and the corresponding management of universities. Using a random sample of 138 international students in China, descriptive and logistic regressions were conducted to assess the levels and influence of acculturative stress factors on cross-cultural adaptation, specifically on international students' sense of security and belonging during the COVID-19 pandemic outbreak. The results revealed that students were most concerned about homesickness, which obtained the highest mean score. The regression results indicated that the perception of fear and discrimination significantly impacted international students' sense of security. The perception of fear, guilt, and how long the student stayed in China also significantly affected the sense of belonging. We argue that the reflections provided herein are essential for universities to improve how they manage and handle international students to mitigate the effects of acculturative stress, particularly when additional stressful conditions are present, such as the COVID-19 pandemic.

Acculturation Experiences and Preterm Birth in Berlin: Does Acculturative Stress Contribute to Preterm Birth?

Acculturation and acculturative stress are potential risk factors for adverse perinatal outcomes. This study investigates whether and how acculturative stress affects preterm birth (PTB) in a sample of migrant women in Berlin. We interviewed 955 women who recently gave birth using standardized questionnaires (Frankfurt Acculturation Scale and Acculturative Stress Index). Multivariable logistic regression analyses assessed the effects of acculturation and acculturative stress on PTB. Women with migrant backgrounds did not have significantly higher PTB rates than German natives. First-generation migrants experienced higher acculturative stress levels than second-generation migrants, 38.8% vs. 13.2%. Acculturative stress could not be identified as a risk factor for PTB in our sample. These results need to be considered in the context of an international city and the wide use of antenatal care services in our population, which could be responsible for similarly good perinatal outcomes and highlights the potential of good access to perinatal care for vulnerable groups.

The spiral of disadvantage: Ethnolinguistic discrimination, acculturative stress and health in Nahua indigenous communities in Mexico.

OBJECTIVES: The aim of this study was to test the hypothesis that ethnic and ethnolinguistic discrimination, and Post-Traumatic Stress Disorder (PTSD) related to being Indigenous as well as different aspects of acculturative stress, are associated with poorer health and higher levels of depression among the Nahua Indigenous communities. MATERIALS AND METHODS: Our quantitative survey was carried out in four different regions inhabited by the Nahua people in Mexico. Self-rated health and depression, the symptoms of PTSD, two facets of acculturative stress and ethnolinguistic discrimination were assessed by questionnaires. The data were analyzed using binary logistic regression models. RESULTS: The symptoms of PTSD and acculturative stress experienced in the workplace were significantly associated with a higher risk of poor self-rated health, adjusted for various socio-demographic characteristics. Acculturative stress, discouragement of language use, language avoidance and ethnolinguistic discrimination were related to a higher risk of depression and PTSD. DISCUSSION: Our research implies that ethnic and linguistic discrimination, acculturative stress and the memory of harm linked to being Indigenous reflected in the symptoms of PTSD, are important predictors of poorer health and depression among Nahua groups in Mexico. These adverse effects could be significantly counteracted by effective dealing with stigmatization and discrimination against Indigenous people in Mexico and by replacing strong assimilation pressures with integrational approaches that respect ethnolinguistic diversity and reduce socioeconomic marginalization.