Eating disorder psychopathology: The role of attachment anxiety, attachment avoidance, and personality functioning.

OBJECTIVE: Although the relationship between insecure attachment patterns and eating disorder (ED) psychopathology has repeatedly been demonstrated, the underlying mechanisms of this association are not fully understood. Therefore, the current study aimed to examine personality functioning, defined as an impairment in self and interpersonal functioning, as a mediator between attachment insecurity and ED psychopathology. METHODS: In a representative population-based sample (N = 2508; age range 14-92 years) ED symptomatology, personality functioning, and attachment insecurity (anxiety and avoidance) were assessed. Besides descriptive uni-/bivariate analysis, path analysis was used to test a mediation model while controlling for the effects of age, gender, mental distress, and BMI. RESULTS: ED symptomatology was associated with lower levels of personality functioning (r = 0.22) and higher levels of attachment anxiety (r = 0.14) but did not correlate with attachment avoidance (r = 0.02). Path analysis revealed that personality functioning fully mediated the effect of attachment anxiety on ED symptomatology: The indirect effect via personality functioning (ß = 0.04, p < .001) accounted for 77% of the total effect. Fit indices were excellent. Sensitivity analyses revealed that the main results were mainly applicable to women and the middle age group. CONCLUSION: The present findings contribute to the growing body of research using dimensional conceptualizations of personality functioning, suggesting that it provides an informative, overarching framework for understanding and treating ED psychopathology. Findings indicate that underlying individual differences, e.g., with respect to insecure attachment configurations, have relevant implications for symptom manifestations. Potential clinical implications and avenues for future research are discussed.

Gender-specific associations of loneliness and suicidal ideation in a representative population sample: Young, lonely men are particularly at risk.

BACKGROUND: Loneliness has been related to negative physical and mental health outcomes including suicidal ideation (SI). However, it is not clear whether loneliness is equally important for SI in women and men and in individuals of all age groups. METHODS: Participants were a representative population sample (N=2,450) comprising the entire adult age range (18-95 years). Participants filled out established questionnaires (UCLA Three-Item Loneliness Scale, Beck Scale for Suicide Ideation, Patient Health Questionnaire-4). We tested a multiple linear regression model of SI (controlling for income, living alone, and mental distress) with interaction terms (loneliness x gender, loneliness x age, gender x age, loneliness x gender x age). We also investigated women and men separately. RESULTS: Women and men did not differ regarding mean levels of SI, but women reported more loneliness. Loneliness was related to SI regardless of participants' gender (ß=.410; p<.001). Gender-specific analyses showed that the association of loneliness and SI was especially strong among younger men (loneliness x age within the male sample: ß=-.149; p=.014). Living in a shared household was negatively associated with SI in men (ß=-.072; p=.019), but not in women. LIMITATIONS: The cross-sectional study design does not allow for interpretations regarding the direction of effects. CONCLUSIONS: Besides similarities, the study indicated gender-specific potential risk- and protective factors, i.e. age and living together with others. Young men who report loneliness could be at particularly high risk for suicidal ideation. Gender- and age-specific approaches can contribute to a more precise identification of vulnerable groups in the population.

Perceived Stress Scale (PSS-10) psychometric properties in migrants and native Germans.

BACKGROUND: With the increasing diversity of the German population, it is important to test the psychometric validity and reliability of the German version Perceived Stress Scale (PSS-10) specifically between German natives and residents with a migration background. METHODS: Using nationally representative data (N = 2527), this study conducted an Exploratory Factor Analysis (EFA) to determine the most appropriate factor structure, a Multi-Group Confirmatory Factor Analysis (MGCFA) to compare the validity of the two-factor structure and tested the PSS-10 measurement invariance between the German native and migrant sub-samples. Lastly, reliability of the PSS-10 was examined via Cronbach's alpha, omega and individual item analyses across the two sub-samples. RESULTS: The EFA results support a two-factor structure in the migrant sample. The MGCFA showed adequate model fit for both sub-samples and the PSS-10 is strict invariant between German natives and migrants. Cronbach's alpha and omega for Perceived Helplessness (PHS: factor 1) and Perceived Self-Efficacy (PSES: factor 2) demonstrate good internal consistency in both German and migrant sub-samples. CONCLUSIONS: The key conclusions are: (1) the German version PSS-10 is suitable for German residents with a migration background. (2) Despite good internal consistency for the total scale, the PSS-10 measures two aspects: (a) perceived helplessness and (b) perceived self-efficacy. Future research would profit from analyzing the two subscales separately, not only using the total score.

Recalled parental rearing behavior in adult women and men with depressive and anxiety symptoms: Findings from a community study.

Objectives: Addressing the lack of population-based data, the purpose of this representative study was to assess sex- and age-specific associations of maternal and paternal rearing behavior with depressiveness and anxiety controlling for sociodemographic and somatic variables. Methods: 8,175 subjects participating in a population-based study completed standardized questionnaires measuring Recalled Parental Rearing Behavior and distress. Results: Women recalled their fathers as more controlling and warmer, and their mothers as more rejecting than men. Comparisons between age groups (≤ 60 vs. > 60 years) revealed that younger participants recalled more parental control and emotional warmth. In addition to sociodemographic and somatic risk factors, paternal rejection and maternal control were associated with depressiveness and anxiety both for women and men (OR 1.58-1.96; OR 1.37-1.66). Maternal warmth was negatively related to distress (OR 0.66-0.69). Conclusions: Findings suggested sex- and age-specific differences in recalled maternal and paternal rearing behavior. The current results highlighted the important role of recalled parental rearing behavior besides sociodemographic factors and somatic diseases for the occurrence of depression and anxiety symptoms across the age groups.

Sex-dependent associations of low birth weight and suicidal ideation in adulthood: a community-based cohort study.

Low birth weight (LBW; < 2,500 g) has been identified as a risk factor for adverse mental health outcomes over the life span. However, little is known about the association of LBW and suicidal ideation in middle and late adulthood. We investigated N = 8,278 participants of a representative community cohort: 3,849 men (46.5%) and 4,429 women (53.5%) (35-74 years of age). We assessed standardized measures of mental distress, sociodemographics, health behavior, and somatic factors (based on an extensive medical assessment). Controlling for these confounders, we examined the relationship of birth weight and suicidal ideation in logistic regression models. As men and women differ with regard to their susceptibility to suicidal ideation and behavior, we tested sex-dependent effects. LBW was reported by 458 participants (5.5%). In men, LBW was associated with a higher likelihood of reporting suicidal ideation (OR 2.92, 95% CI 1.58-5.12). In women, there was no such relationship. The findings underscore the interrelatedness of the physical and psychological domain, the role of early adversity in suicidal ideation, and they identify a vulnerable group whose numbers are expected to grow. They also indicate other risk factors for suicidal ideation in the community (mental distress, lack of social support, and health risk behavior).

The relationship between acculturation and mental health of 1st generation immigrant youth in a representative school survey: does gender matter?

BACKGROUND: Although gender plays a pivotal role in the psychological adaptation of immigrant youth, its association with acculturation strategy and mental health among 1st generation immigrant adolescents are still scarce and inconsistent. Therefore, the purpose of the current study was to investigate gender-related differences in acculturation patterns and their association with mental health (internalizing and externalizing problems). METHODS: Self-reported data of immigrant adolescents (N = 440) aged between 12 and 19 years (M = 16.2; SD = 1.6) was collected in a representative German school survey. Fifty-one percent of the sample were female (n = 224). Almost half of the sample was born in the Former Soviet Union, followed by Poland (9.3%). Sociodemographic variables, acculturation strategies, and internalizing as well as externalizing problems were assessed by questionnaires. RESULTS: Confirmatory factor analysis supported the four- dimensional model of acculturation styles (assimilation, integration, separation and marginalization). Whereas girls more often showed an integration pattern, boys scored higher on the separation and marginalization scale. After adjusting for age and educational level, regression analyses revealed for both gender that marginalization was associated with more internalizing problems. Separation was related to more externalizing problems. CONCLUSION: 1st generation adolescents experiencing a lack of belongingness to German society, socio-economic and educational disadvantages might be particularly vulnerable to mental distress. Findings are discussed in terms of gender-related differential socialization processes in context of immigration.

The association between recalled parental rearing behavior and depressiveness: a comparison between 1st immigrants and non-immigrants in the population-based Gutenberg Health Study.

BACKGROUND: Studies in immigrant youth have suggested differences in parenting patterns by immigration status. Knowledge of variation in recalled parenting pattern and its distinctive impact on mental health in adult immigrants, however, is limited. Therefore, the purpose of the current study was to investigate similarities and differences in recalled maternal and paternal rearing behavior and its association with depressiveness in adult 1st generation immigrants compared to non-immigrants. METHODS: Seven hundred and forty-three 1st generation immigrants (M = 57.4, SD = 10.1 years) and 6518 non-immigrants (M = 60.3, SD = 10.7 years) participated in a population-based study. Regarding countries of origin, the largest subgroups were immigrants from Eastern-Europe, Former-SU, and Arabic-Islamic countries. All participants completed the ultra-short version of The Recalled Parental Rearing Behavior-questionnaire and the PHQ-9 assessing depressiveness. Multiple linear regressions with depressiveness as outcome variable were analyzed separately for each facet of parental rearing behavior adjusting for socio-demographic and migration-related variables. RESULTS: In addition to differences in depressiveness and socioeconomic status, 1st generation immigrants recalled both their mothers and fathers as more controlling and overprotecting than non-immigrants. Parental emotional warmth was negatively associated with depressiveness across all groups. The relationship between parental control, respectively parental rejection and depressiveness, however, varied in direction and severity between the groups. CONCLUSION: The results support the notion that parental warmth is a universal protective factor against depressiveness, whereas the impact of parental control on mental health might be more culturally influenced. Analyses point to the importance of considering the unique contribution of fathers' rearing behavior on mental health, particularly in immigrant samples.

What's past is prologue: Recalled parenting styles are associated with childhood cancer survivors' mental health outcomes more than 25 years after diagnosis.

BACKGROUND: With the increased survival rates of childhood cancer, long-term survivors' well-being over the life span has come into focus. A better understanding of the determinants of childhood cancer survivors' (CCS) mental health outcomes contributes to the identification of vulnerable individuals as well as to the development of evidence-based prevention and intervention efforts. It has been noted that psychosocial factors such as parental rearing behavior shape individual differences in mental health. There is also evidence that parents show altered parenting behavior in the face of childhood cancer, e. g. that they express more emotional support, but also more worries. However, little is known about the relevance of different parenting styles for CCS' mental health decades after diagnosis and treatment. METHODS: We examined the associations of recalled parenting styles and disease-related factors with lifetime diagnoses of depression and anxiety disorders in a German, registry-based sample of adult CCS (N = 948, 44.50% women) with survival times >25 years. We conducted logistic regression analyses of lifetime diagnoses of depression and anxiety disorders, respectively, on dimensions of recalled parental rearing behavior (measured with a validated German short version of the EMBU) controlling for relevant adjustment variables such as the presence of physical illnesses. RESULTS: Recalled parenting styles of both parents had statistically relevant associations with CCS' lifetime depression and anxiety diagnoses. Maternal emotional warmth was related to fewer lifetime diagnoses of depression and fewer lifetime diagnoses of anxiety. Memories of paternal control and overprotection were positively associated with lifetime diagnoses of anxiety. CONCLUSION: The results indicate that mental representations of one's caregivers are associated with psychological long-term outcomes. Thus, medical professionals should involve the parents and support them in accompanying their child through the difficult times of treatment and survivorship. Interventions aimed at fostering survivors' quality of life should consider the sustained relevance of early relationships.

Somatic Symptoms in the German General Population from 1975 to 2013.

The study determines how burden and patterns of somatic symptom reporting developed over almost four decades in the general German population. Additionally, we studied how socio-demographic factors affected the degree of somatic symptoms. Population-based samples representative for West Germany between 18 and 60 years of age were analyzed comparing three cross-sectional samples of 1975 (N = 1601), 1994 (N = 1416), and 2013 (N = 1290) by conducting a three-way analysis of variance (sex, age, survey). The prevalence rates for somatic symptoms in men and women were lower in the more recent surveys; this affected women most strongly. Exhaustion and musculoskeletal complaints remained leading symptoms (affecting 25%, resp. 11% of the men and 30%, resp. 19% of the women). There was a slight increase in women's prevalence of exhaustion from 1994 (15%) to 2013 (19%). As determined by stepwise multiple regression, somatic symptoms were consistently associated with female sex and higher age. In the 2013 survey, education became an additional negative predictor of somatic symptom load, while the impact of age and sex on somatic symptoms reporting decreased. Somatic symptoms remain a major burden in the general population. Findings are interpreted with regard to improved living and health care conditions, different cohort experiences, and more public health information.

Parenting in the face of serious illness: Childhood cancer survivors remember different rearing behavior than the general population.

OBJECTIVE: A child's cancer diagnosis and treatment affect the whole family. While it has been recognized that parents are an important resource for their children, little is known about the specifics of parenting in the face of serious illness. METHODS: We used the Recalled Parental Rearing Behavior Questionnaire in a register-based cohort of adult childhood cancer survivors (CCS) (N = 951) and a representative population sample of the same age range (N = 2042). The questionnaire assesses behavior of mothers and fathers with three scales (emotional warmth, rejection/punishment, and control/overprotection) by querying the (former) child. We compared the two groups using general linear models. With a hierarchical linear regression analysis, we tested associations of recalled rearing behavior with disease- and treatment-related factors. RESULTS: Compared with the general population, CCS remembered both parents as emotionally warmer, more overprotective, and less punishing/rejecting and less ambitious. The regression analysis showed that having received radiotherapy (ß = 0.092; P = .009) and chemotherapy (ß = 0.077; P = .027) was positively related to memories of maternal emotional warmth. CONCLUSIONS: CCS remembered parenting styles which are generally deemed more positive. The extent of recalled control and overprotection deviated from the population in different directions, suggesting that parenting in childhood cancer entails more complex adaptations than being affectionate and giving comfort. The results suggest an adaptation of parental behavior to particularly challenging treatments. They highlight potential vulnerability and resilience factors, some of which were sex-dependent.

The papain-like protease determines a virulence trait that varies among members of the SARS-coronavirus species.

SARS-coronavirus (CoV) is a zoonotic agent derived from rhinolophid bats, in which a plethora of SARS-related, conspecific viral lineages exist. Whereas the variability of virulence among reservoir-borne viruses is unknown, it is generally assumed that the emergence of epidemic viruses from animal reservoirs requires human adaptation. To understand the influence of a viral factor in relation to interspecies spillover, we studied the papain-like protease (PLP) of SARS-CoV. This key enzyme drives the early stages of infection as it cleaves the viral polyprotein, deubiquitinates viral and cellular proteins, and antagonizes the interferon (IFN) response. We identified a bat SARS-CoV PLP, which shared 86% amino acid identity with SARS-CoV PLP, and used reverse genetics to insert it into the SARS-CoV genome. The resulting virus replicated like SARS-CoV in Vero cells but was suppressed in IFN competent MA-104 (3.7-fold), Calu-3 (2.6-fold) and human airway epithelial cells (10.3-fold). Using ectopically-expressed PLP variants as well as full SARS-CoV infectious clones chimerized for PLP, we found that a protease-independent, anti-IFN function exists in SARS-CoV, but not in a SARS-related, bat-borne virus. This PLP-mediated anti-IFN difference was seen in primate, human as well as bat cells, thus independent of the host context. The results of this study revealed that coronavirus PLP confers a variable virulence trait among members of the species SARS-CoV, and that a SARS-CoV lineage with virulent PLPs may have pre-existed in the reservoir before onset of the epidemic.

Is assessment of depression equivalent for migrants of different cultural backgrounds? Results from the German population-based Gutenberg Health Study (GHS).

BACKGROUND: Bearing in mind the multicultural background of a national population, little is known about the measurement invariance across different cultures or ethnicities of frequently used screeners for depression. For this reason, the main objective of the current study is to assess the measurement invariance of the Patient Health Questionnaire (PHQ-9) across groups with different migration backgrounds. METHODS: We provided psychometric analyses (descriptive statistics at item and scale level, reliability analysis, exploratory [EFA] and confirmatory factor analyses [CFA]) comparing a native population with first- and second-generation migrants of the German population-based Gutenberg Health Study with N = 13,973 participants completing the PHQ-9. Furthermore, we conducted measurement invariance analyses among different groups of first-generation migrants. RESULTS: Comparing the native population with first- and second-generation migrants, a higher prevalence for mental distress was found for first generation. Although mean score patterns were similar for all groups, analyses of item loadings among first-generation migrants yielded some variance in patterns pointing out that certain items have a distinct impact on depression for specific groups. With regard to the factorial validity for all groups, EFA and CFA provided evidence for the proposed one latent factor structure of the PHQ-9. Depression assessed by the PHQ-9 turned out to be equivalent from a psychometric perspective across different groups stratified by their migration background. CONCLUSIONS: Overall, results of thorough scale and item analyses, especially multigroup confirmatory analyses, provided support that depression, assessed by the PHQ-9, can be considered as psychometrically equivalent across all analyzed groups.

Declining Sexual Activity and Desire in Men-Findings From Representative German Surveys, 2005 and 2016.

BACKGROUND: Surveys have indicated an increase of sexual activity in aging men; recently, however, a decrease of sexual activity has been reported in young men. AIM: To assess (i) sexual activity and desire and their determinants across the age range in a population-based male sample and (ii) their changes over 11 years. METHODS: A representative survey of men (N = 1,095) 18 to 93 years old from 2016 was compared with a survey from 2005 (N = 1,106 men) with the same age range. Samples were drawn from the German population at random using standardized sampling procedures. Questions were filled out by participants in the presence of a trained interviewer. Sexual activity was compared using logistic regression with the factors survey (2005 vs 2016), living with a partner (yes vs no), and age. Frequency of sexual desire was compared using analysis of covariance with the factors survey (2005 vs 2016), living with a partner (yes vs no), and the covariate age. OUTCOMES: Sexual activity was assessed as having been intimate with someone in the past year; frequency of sexual desire was evaluated within the past 4 weeks. RESULTS: The great majority of men cohabiting with a partner in 2016 was sexually active and indicated sexual desire until 70 years of age; half did so at an older age. Across the age range, men living without a partner reported considerably less sexual activity and desire. Compared with 2005, fewer men reported living with a partner. The overall proportion of men reporting sexual activity deceased from 81% to 73% in 2016 and absent sexual desire increased from 8% to 13%. CLINICAL TRANSLATION: The findings highlight the relevance of living with a partner for sexual activity and desire. We advocate using a measure of sexual activity that encompasses many variants of intimate behavior. STRENGTHS AND LIMITATIONS: Large and methodologically comparable population-based samples were compared. However, interpretations are limited by the absence of longitudinal data. We did not assess the effect of having a partner living elsewhere. CONCLUSION: Sexual activity and desire decreased, especially in the young and middle-age groups. The decrease of men living with a partner contributed to this decreased sexual activity and desire. There was a generation effect, with younger and middle-age men living without a partner becoming less sexually active and experiencing less desire compared with the previous survey. The findings unveil changes in sexual activity and desire in a short time span. Beutel ME, Burghardt J, Tibubos AN, et al. Declining Sexual Activity and Desire in Men-Findings From Representative German Surveys, 2005 and 2016. J Sex Med 2018;15:750-756.

Expression of CLAVATA3 fusions indicates rapid intracellular processing and a role of ERAD.

The 12 amino acid peptide derived from the Arabidopsis soluble secretory protein CLAVATA3 (CLV3) acts at the cell surface in a signalling system that regulates the size of apical meristems. The subcellular pathway involved in releasing the peptide from its precursor is unknown. We show that a CLV3-GFP fusion expressed in transfected tobacco protoplasts or transgenic tobacco plants has very short intracellular half-life that cannot be extended by the secretory traffic inhibitors brefeldin A and wortmannin. The fusion is biologically active, since the incubation medium of protoplasts from CLV3-GFP-expressing tobacco contains the CLV3 peptide and inhibits root growth. The rapid disappearance of intact CLV3-GFP requires the signal peptide and is inhibited by the proteasome inhibitor MG132 or coexpression with a mutated CDC48 that inhibits endoplasmic reticulum-associated protein degradation (ERAD). The synthesis of CLV3-GFP is specifically supported by the endoplasmic reticulum chaperone endoplasmin in an in vivo assay. Our results indicate that processing of CLV3 starts intracellularly in an early compartment of the secretory pathway and that ERAD could play a regulatory or direct role in the active peptide synthesis.

Emotional and tangible social support in a German population-based sample: Development and validation of the Brief Social Support Scale (BS6).

Aim of the study was the development and validation of the psychometric properties of a six-item bi-factorial instrument for the assessment of social support (emotional and tangible support) with a population-based sample. A cross-sectional data set of N = 15,010 participants enrolled in the Gutenberg Health Study (GHS) in 2007-2012 was divided in two sub-samples. The GHS is a population-based, prospective, observational single-center cohort study in the Rhein-Main-Region in western Mid-Germany. The first sub-sample was used for scale development by performing an exploratory factor analysis. In order to test construct validity, confirmatory factor analyses were run to compare the extracted bi-factorial model with the one-factor solution. Reliability of the scales was indicated by calculating internal consistency. External validity was tested by investigating demographic characteristics health behavior, and distress using analysis of variance, Spearman and Pearson correlation analysis, and logistic regression analysis. Based on an exploratory factor analysis, a set of six items was extracted representing two independent factors. The two-factor structure of the Brief Social Support Scale (BS6) was confirmed by the results of the confirmatory factor analyses. Fit indices of the bi-factorial model were good and better compared to the one-factor solution. External validity was demonstrated for the BS6. The BS6 is a reliable and valid short scale that can be applied in social surveys due to its brevity to assess emotional and practical dimensions of social support.

Loneliness in the general population: prevalence, determinants and relations to mental health.

BACKGROUND: While loneliness has been regarded as a risk to mental and physical health, there is a lack of current community data covering a broad age range. This study used a large and representative German adult sample to investigate loneliness. METHODS: Baseline data of the Gutenberg Health Study (GHS) collected between April 2007 and April 2012 (N = 15,010; 35-74 years), were analyzed. Recruitment for the community-based, prospective, observational cohort study was performed in equal strata for gender, residence and age decades. Measures were provided by self-report and interview. Loneliness was used as a predictor for distress (depression, generalized anxiety, and suicidal ideation) in logistic regression analyses adjusting for sociodemographic variables and mental distress. RESULTS: A total of 10.5% of participants reported some degree of loneliness (4.9% slight, 3.9% moderate and 1.7% severely distressed by loneliness). Loneliness declined across age groups. Loneliness was stronger in women, in participants without a partner, and in those living alone and without children. Controlling for demographic variables and other sources of distress loneliness was associated with depression (OR = 1.91), generalized anxiety (OR = 1.21) and suicidal ideation (OR = 1.35). Lonely participants also smoked more and visited physicians more frequently. CONCLUSIONS: The findings support the view that loneliness poses a significant health problem for a sizeable part of the population with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior and health care utilization.

Childhood adversities and distress - The role of resilience in a representative sample.

While adverse childhood experiences have been shown to contribute to adverse health outcomes in adulthood, specifically distress and somatic symptoms, few studies have examined their joint effects with resilient coping style on adult adjustment. Hence, we aim to determine the association between resilient coping and distress in participants with and without reported childhood adversities. A representative German community sample (N = 2508) between 14-92 years (1334 women; 1174 men) was examined by the short form of the Childhood Trauma Questionnaire, the Brief Resilience Coping Scale, standardized scales of distress and somatoform symptoms. Childhood adversity was associated with reduced adjustment, social support and resilience. It was also strongly associated with increased distress and somatoform complaints. Resilient coping was not only associated with lower distress, it also buffered the effects of childhood adversity on distress. Our study corroborates the buffering effect of resilience in a representative German sample. High trait resilient subjects show less distress and somatoform symptoms despite reported childhood adversities in comparison to those with low resilient coping abilities.

[Psychological Distress and Acceptance of Violence Legitimizing Masculinity Norms among Adolescents]. / Psychische Belastung und die Akzeptanz von gewaltlegitimierenden Männlichkeitsnormen bei Jugendlichen.

The proportion of adolescent migrants in Germany aged 15-20 years has risen to about 29.5% in 2014 according to Federal census statistics. The purpose of the current study was to describe and to compare the psychological strains of adolescent 1st and 2nd generation migrants with non-migrants in a representative school survey. Acceptance of violence legitimizing masculinity norms was explored and its correlation with psychological strain was analyzed. Self-reported data of psychological strain (internalizing and externalizing problems) and acceptance of violence legitimizing masculinity were gathered among 8 518 pupils aged 12-19 years across different school types. Among the surveyed adolescents, 27.6% reported a migration background (5.8% 1st generation migrants; 21.8% 2nd generation migrants). Particularly 1st generation migrants scored higher in internalizing and externalizing problems than 2nd generation migrants or non-migrants. The differences, however, were small. Adolescents with migration background suffered from educational disadvantage, especially 1st generation migrants. Male adolescents reported significantly higher acceptance of violence legitimizing masculinity norms than their female counterparts. Strong agreement with the measured concept of masculinity was found among pupils of lower secondary school and adolescents reported regularly tobacco and cannabis consumption. The acceptance of violence legitimizing masculinity norms was greater among migrants, particularly 1st generation migrants, than non-migrants. Overall, high acceptance of violence legitimizing masculinity norms was related to externalizing problems, which can be understood as dysfunctional coping mechanisms of social disadvantage and a lack of prospects.