Premigration persecution, postmigration stressors and resources, and postmigration mental health: a study of severely traumatized U.S. Arab immigrant women.
Premigration persecution, postmigration stressors and resources, and postmigration mental health: a study of severely traumatized U.S. Arab immigrant women.
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DOI：
10.1177/1078390311408900
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发表时间：
2011-07-01
影响因子：
2
通讯作者：
Nickerson, David M
中科院分区：
文献类型：
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作者：
Norris, Anne E;Aroian, Karen J;Nickerson, David M
背景：就移民心理健康的风险而言，关于移民前创伤与移民后应激源和资源的重要性存在相互竞争的理论。目的：研究移民前创伤的类型、移民后应激源和移民后资源如何不同地预测遭受移民前创伤的阿拉伯移民妇女的创伤后应激障碍(PTSD)和严重抑郁障碍(MDD)症状。设计：描述性，使用多项Logistic回归来解释以下四组之一的成员：(A)仅PTSD(n=14)，(B)MDD(n=162)，(C)合并PTSD-MDD(n=148)和(D)亚临床症状(n=209)。结果：移民后相关应激源的参数估计(以移民[DI]的需求衡量)表明，DI得分的单位增加与与亚临床组相比处于共病状态的可能性增加近16倍，与仅与MDD组相比处于共病状态的可能性增加近2.5倍(p<；.05)。社会支持、年龄和移民前创伤类型的优势比介于0.95和1.95之间，并且仅在亚临床PTSD-MDD组和合并PTSD-MDD组之间存在差异(p<；0.05)。结论：移民后应激源对移民的心理健康结果有实质性影响。需要护理干预以减少与移民相关的压力源。考虑到在这个社区样本中观察到的高水平，筛查阿拉伯移民妇女的抑郁症和创伤后应激障碍很重要。
BACKGROUND: Competing theories exist regarding the importance of premigration trauma as compared with postmigration stressors and resources with respect to the risk to immigrant mental health.OBJECTIVE: To examine how type of premigration trauma, postmigration stressors, and postmigration resources differentially predict posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) symptomatology in Arab immigrant women who have been exposed to premigration trauma.DESIGN: Descriptive, using multinomial logistic regression to explain membership in one of four groups: (a) PTSD only (n = 14), (b) MDD (n = 162), (c) comorbid PTSD-MDD (n = 148), and (d) subclinical symptoms (n = 209).RESULTS: Parameter estimates for postimmigration-related stressors (as measured by the Demands of Immigration [DI]) indicated that a unit increase in DI scores was associated with a nearly 16-fold increase in the likelihood of being in the comorbid relative to the subclinical group, and a nearly 2.5-fold increase in the likelihood of being in the comorbid relative to the MDD-only group (p < .05). Odds ratios for social support, age, and type of premigration trauma ranged between 0.95 and 1.95 and only differentiated between subclinical and comorbid PTSD-MDD groups (p < .05).CONCLUSION: Postmigration stressors exert substantive effects on immigrant mental health outcomes. Nursing interventions are needed to reduce immigration-related stressors. Screening Arab immigrant women for depression and PTSD is important, given the high levels observed in this community-based sample.