Acculturation and post-migration psychological symptoms among Iraqi refugees: A path analysis.

Refugees frequently experience symptoms of posttraumatic stress and depression, which impede their acculturation in the new host country where they are resettling. There are few longitudinal studies investigating predictors of mental health and acculturation during the early postmigration period. We conducted a longitudinal study of 298 Iraqi refugees, assessing them upon arrival to the U.S. and 1 year after migration. Premigration trauma was associated with increased PTSD and depressive symptoms at baseline, and with decreased acculturation 1 year later. Resilience was associated with depressive symptoms at 1-year follow-up, but not with other resettlement outcomes (PTSD symptoms, English-language skills, or acculturation). PTSD and depressive symptoms at baseline predicted the same symptoms at 1-year follow-up, but not any other resettlement outcomes. The number of chronic diseases at baseline predicted worse PTSD and depressive symptoms, acculturation, and English language skills at 1-year follow up. Postmigratory exposure to daily stressors and less social support predicted worse 1-year outcomes. Results suggest that interventions that aim to improve mental health and promote acculturation among refugees should assess their history of trauma, chronic disorders, and psychological symptoms soon after migration, and promptly provide opportunities for social support. (PsycINFO Database Record

Kidnapping and Mental Health in Iraqi Refugees: The Role of Resilience.

Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms.

Self-rated Health and Medical Conditions in Refugees and Immigrants from the Same Country of Origin.

BACKGROUND: Research suggests that refugees are at an increased risk for poor health outcomes as compared to immigrants. However, prior studies have compared refugees and immigrants from different countries and have failed to isolate specific war-related factors. OBJECTIVE: To compare health outcomes and their determinants in refugees and immigrants from the same country of origin. METHODS: A cross-sectional study based on a convenient sample and on self-report participants were conducted at Southeast Michigan during the period September to December 2009. A validated survey was used to examine refugees (n = 75) and immigrants (n = 65) from Iraq. The survey covered socioeconomics, lifestyle, violence exposure, self-rated health, and number of medical conditions (high blood pressure, fatigue, and backache, shortness of breath, gastrointestinal disorders, skin problems, and musculoskeletal problems). Group differences and predictors of health outcomes were assessed. RESULTS: Refugees reported significantly more violence exposure than immigrants (p < 0.001). There were no significant differences in self-rated health or medical disorders between groups; however, violence exposure was the main predictor of health outcomes in refugees, whereas age was the main predictor in immigrants. Other predictors also varied by migratory group. CONCLUSION: Even though migration status did not directly influence health outcomes, results suggest that factors associated with migration status, e.g., violence exposure and age, do impact health. Future studies need to more carefully define and control for country-specific variables.

Specific trauma subtypes improve the predictive validity of the Harvard Trauma Questionnaire in Iraqi refugees.

Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

Immigrant Arab Americans and alcohol use: longitudinal study.

English proficiency is associated with alcohol use in some immigrants groups, but little is known about its association among Arab Americans. Ethnographic work suggests gender, religion, education, and age influence prevalence of alcohol use among Arab Americans. Two years prospective study of recent Iraqi refugees and non-Iraqi Arab immigrants in Michigan using bilingual surveys and interviewers. At Time 1, prevalence of lifetime alcohol use was 20.5 % with males, Christians, better educated, older, and those with greater proficiency in English more likely to report ever drank. At Time 2, lifetime prevalence of drinking had increased to 34.0 %. In analysis of male new drinkers, risk factors were Christian, older age and greater proficiency in English. This study confirms drinking among recent immigrant Arab Americans varies by subgroups and suggests English proficiency may contribute to the increase in prevalence over time.

Longitudinal determinants of energy levels in knowledge workers.

OBJECTIVE: Increasingly, workers in the service, welfare, and health care sectors suffer adverse effects (ie, depression, burnout, etc) of "low-energy syndromes." Less is known about energy-based outcomes among knowledge workers. This study aimed to identify determinants of self-rated energy in knowledge workers and examine how these determinants change over time. METHODS: In collaboration with a large union and employer federation, 317 knowledge workers in Sweden responded to the health and productivity survey three times. RESULTS: At each assessment, worry, satisfaction with eating habits, and work-effectiveness were predictive of energy levels; however, only work-effectiveness covaried with energy over time. CONCLUSIONS: This study suggests that perceived work-effectiveness is an important factor in preventing knowledge workers from experiencing "low-energy syndromes." Lifestyle factors also play a role. Therefore, multifaceted interventions for increasing energy are needed.

Latent constructs of the autobiographical memory questionnaire: a recollection-belief model of autobiographical experience.

Many researchers employ single-item scales of subjective experiences such as imagery and confidence to assess autobiographical memory. We tested the hypothesis that four latent constructs, recollection, belief, impact, and rehearsal, account for the variance in commonly used scales across four different types of autobiographical memory: earliest childhood memory, cue word memory of personal experience, highly vivid memory, and most stressful memory. Participants rated each memory on scales hypothesised to be indicators of one of four latent constructs. Multi-group confirmatory factor analyses and structural analyses confirmed the similarity of the latent constructs of recollection, belief, impact, and rehearsal, as well as the similarity of the structural relationships among those constructs across memory type. The observed pattern of mean differences between the varieties of autobiographical experiences was consistent with prior research and theory in the study of autobiographical memory.

Potency of naltrexone to reduce ethanol self-administration in rats is greater for subcutaneous versus intraperitoneal injection.

The opioid antagonist naltrexone (NTX) is used to treat alcohol dependence and may reduce alcohol consumption by selectively blocking opioid receptors. In rat experiments, discrepancy exists across studies regarding the potency of NTX to reduce ethanol consumption. One cause of this discrepancy may be the use of different routes of NTX administration (e.g., intraperitoneal vs. subcutaneous). The purpose of this study was to directly compare the effects of intraperitoneal and subcutaneous injections of NTX on ethanol self-administration. Rats pressed a lever for a sweetened ethanol solution (10% wt/vol in 0.1% saccharin) during 20 min daily sessions. One group received intraperitoneal injections of 1, 3, 10, and 30 mg/kg NTX before the sessions. Another group received subcutaneous injections of 0.03, 0.1, 0.3, and 1 mg/kg NTX before the sessions. The group that received subcutaneous NTX was also tested with a single intraperitoneal injection of 0.3 mg/kg NTX. Naltrexone significantly reduced ethanol self-administration, and NTX was more potent when administered via subcutaneous injection versus intraperitoneal injection. Ethanol intake (g/kg) was significantly reduced after subcutaneous injection of NTX 0.1 mg/kg and higher. In contrast, ethanol intake was significantly reduced after intraperitoneal injection of NTX 3 mg/kg and higher. A comparison of the NTX ED(50) values showed that subcutaneous NTX was approximately 30-fold more potent than intraperitoneal NTX. For the subcutaneous 0.3 mg/kg NTX dose, a detailed bin analysis showed that responding during the first 2 min after injection was similar to that during the first 2 min after a saline injection while responding after NTX decreased in subsequent bins. These findings suggest that researchers should carefully consider the route of NTX administration when discussing potency and selectivity of NTX's effects on ethanol-related behaviors in rats. These findings further support the notion that NTX acts by terminating responding early rather than reducing the initial responding.