Association of Family Member Detention or Deportation With Latino or Latina Adolescents' Later Risks of Suicidal Ideation, Alcohol Use, and Externalizing Problems
Association of Family Member Detention or Deportation With Latino or Latina Adolescents' Later Risks of Suicidal Ideation, Alcohol Use, and Externalizing Problems
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DOI：
10.1001/jamapediatrics.2020.0014
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发表时间：
2020-05-01
期刊：
影响因子：
26.1
通讯作者：
Little, Todd D.
中科院分区：
文献类型：
--
作者：
Roche, Kathleen M.;White, Rebecca M. B.;Little, Todd D.
自2017年初以来的政策变化导致拉丁美洲或拉丁裔移民被优先驱逐出境和拘留的人数大幅增加。包括美国儿科学会、美国医学协会和儿童发展研究学会在内的专业组织对驱逐出境和拘留对拉丁裔或拉丁裔青年可能造成的不可逆转的心理健康影响表示担忧。目的探讨家庭成员滞留或驱逐出境与拉美裔青少年后期心理健康问题和危险行为的关系。设计，设置和参与者调查数据收集于2018年2月14日至4月26日，2018年9月17日至2019年1月13日，并在6个月的随访中，从格鲁吉亚亚特兰大郊区的中学随机选择了547名拉丁裔或拉丁裔青少年。在结构方程模型框架内使用多变量、多变量逻辑模型分析前瞻性数据。模型研究了家庭成员在过去12个月内被拘留或驱逐出境如何与自杀意念，酒精使用和临床外化症状的后期变化相关，并控制了最初的心理健康和风险行为。去年家庭成员被拘留或驱逐出境。主要结局和测量：过去6个月内自杀意念的随访报告，自上次调查以来的饮酒情况，以及过去6个月内外部症状的临床水平。结果共有547名青少年（303名女孩;平均[SD]年龄，12.8 [1.0]岁）参加了这项前瞻性调查。应答率为65.2%（547的839）中接触的父母和95.3%（547的574）中接触的青少年的父母提供的许可。6个月随访留存率为81.5%（446/547）。共有136名青少年（24.9%）的家庭成员在前一年被拘留或驱逐出境。家庭成员拘留或驱逐出境与自杀意念的几率较高有关（38/136 [27.9%] vs 66/411 [16.1%];校正比值比，2.37; 95% CI，1.06-5.29），饮酒（25/136 [18.4%] vs 30/411 [7.3%];校正比值比，2.98; 95%CI，1.26-7.04），临床外化行为，（31/136 [22.8%] vs 47/411 [11.4%];校正比值比，2.76; 95% CI，1.11-6.84），控制基线变量。结论和相关性-这项研究表明，最近的移民政策的变化可能与危害拉丁美洲或拉丁裔青少年的健康的关键结果。由于95%的美国拉丁裔或拉丁裔青少年是公民，与家庭成员拘留或驱逐出境有关的精神健康受损和风险行为引起了人们对当前移民政策与美国拉丁裔和拉丁裔青少年精神健康相关性的关注。这项调查研究探讨了家庭成员拘留或驱逐出境是否与拉丁裔或拉丁裔青少年后期的精神健康问题和风险相关问题：在拉丁美洲或拉丁美洲青少年中，家庭成员的拘留或驱逐是否与后来的自杀意念、饮酒和临床上显著的外化行为有关？在这项对547名11至16岁的拉丁裔或拉丁裔青少年的调查研究中，在过去12个月内发生的家庭成员拘留或驱逐出境与过去6个月内自杀意念的几率显着增加，自上次调查以来饮酒，以及6个月随访调查中的外部症状的临床水平，控制青少年的初始心理健康和危险行为。当前的移民政策可能与威胁拉丁美洲人或拉丁美洲青少年健康的结果风险增加有关。
Importance Policy changes since early 2017 have resulted in a substantial expansion of Latino or Latina immigrants prioritized for deportation and detention. Professional organizations, including the American Academy of Pediatrics, American Medical Association, and Society for Research in Child Development, have raised concerns about the potentially irreversible mental health effects of deportations and detentions on Latino or Latina youths. Objective To examine how family member detention or deportation is associated with Latino or Latina adolescents' later mental health problems and risk behaviors. Design, Setting, and Participants Survey data were collected between February 14 and April 26, 2018, and between September 17, 2018, and January 13, 2019, and at a 6-month follow-up from 547 Latino or Latina adolescents who were randomly selected from grade and sex strata in middle schools in a suburban Atlanta, Georgia, school district. Prospective data were analyzed using multivariable, multivariate logistic models within a structural equation modeling framework. Models examined how family member detention or deportation within the prior 12 months was associated with later changes in suicidal ideation, alcohol use, and clinical externalizing symptoms, controlling for initial mental health and risk behaviors. Exposure Past-year family member detention or deportation. Main Outcomes and Measures Follow-up reports of suicidal ideation in the past 6 months, alcohol use since the prior survey, and clinical level of externalizing symptoms in the past 6 months. Results A total of 547 adolescents (303 girls; mean [SD] age, 12.8 [1.0] years) participated in this prospective survey. Response rates were 65.2% (547 of 839) among contacted parents and 95.3% (547 of 574) among contacted adolescents whose parents provided permission. The 6-month follow-up retention rate was 81.5% (446 of 547). A total of 136 adolescents (24.9%) had a family member detained or deported in the prior year. Family member detention or deportation was associated with higher odds of suicidal ideation (38 of 136 [27.9%] vs 66 of 411 [16.1%]; adjusted odds ratio, 2.37; 95% CI, 1.06-5.29), alcohol use (25 of 136 [18.4%] vs 30 of 411 [7.3%]; adjusted odds ratio, 2.98; 95% CI, 1.26-7.04), and clinical externalizing behaviors (31 of 136 [22.8%] vs 47 of 411 [11.4%]; adjusted odds ratio, 2.76; 95% CI, 1.11-6.84) at follow-up, controlling for baseline variables. Conclusion and Relevance This study suggests that recent immigration policy changes may be associated with critical outcomes jeopardizing the health of Latino or Latina adolescents. Since 95% of US Latino or Latina adolescents are citizens, compromised mental health and risk behavior tied to family member detention or deportation raises concerns regarding the association of current immigration policies with the mental health of Latino and Latina adolescents in the United States.This survey study examines whether family member detention or deportation is associated with Latino or Latina adolescents' later mental health problems and risk behaviors.Question Is the detention or deportation of a family member associated with later suicidal ideation, alcohol use, and clinically significant externalizing behaviors among Latino or Latina adolescents? Findings In this survey study of 547 Latino or Latina adolescents aged 11 to 16 years, family member detention or deportation occurring during the prior 12 months was associated with significantly higher odds of suicidal ideation in the past 6 months, alcohol use since the prior survey, and a clinical level of externalizing symptoms at the 6-month follow-up survey, controlling for adolescents' initial mental health and risk behaviors. Meaning Current immigration policies may be associated with increased risks for outcomes threatening the health of Latino or Latina adolescents.