Posttraumatic Distress and the Immigrant Experience: Individual and Interpersonal Risk and Resilience across Domains of Influence

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PROJECT SUMMARY/ABSTRACT Posttraumatic distress disproportionately affects Latinx immigrants seeking asylum in the U.S. due to high rates of trauma exposure in their home countries and continued trauma embedded in the asylum-seeking experience. The proposed study will collect longitudinal data from 400 undocumented Latinx immigrant adults seeking asylum in the U.S. to examine how trauma exposure at various stages— prior to, embedded in the asylum-seeking experience, and while settling in the U.S.— concurrently and prospectively influences risk for posttraumatic distress and quality of life via the biological pathway of inflammation. In collaboration with established community partners, participants will be recruited from immigrant camps/shelters on both sides of the Mexico-U.S. border. Follow-up data collected one year later, at which point the entire sample is expected to be in the U.S. awaiting further immigration court hearings, will assess trauma exposure and discrimination while settling in the U.S., posttraumatic distress, and quality of life. Using the inflammatory hypothesis of persistent posttraumatic distress (Gill et al., 2009) as a conceptual framework, the proposed study incorporates state-of-the-art biological markers and mixed methods to provide novel information about mechanisms that underlie health risk and foster resilience across domains and levels. Specific Aim 1 is to concurrently and prospectively evaluate the effect of trauma exposure prior to and embedded in the asylum-seeking experience on immigrants’ posttraumatic distress and quality of life. Specific Aim 2 is to concurrently and prospectively evaluate the effect of trauma exposure prior to and embedded in the asylum-seeking experience on immigrants’ biological (immune) function, testing inflammation as a mechanism of health disparity. Specific Aim 3 is to identify factors within the sociocultural and personal environment domains (at individual/interpersonal levels) that moderate links identified in Aim 2. Specific Aim 4 is to assess how (post-migration) trauma exposure and discrimination while settling in the U.S. prospectively affect posttraumatic stress and quality of life. Knowledge gained will (1) propel scientific evidence regarding how multi-domain, multi-level factors influence the health of vulnerable populations with the goal of reducing existing disparities; (2) inform the development of culture and context sensitive interventions; and (3) inform advocacy and policy efforts. This is the first prospective, longitudinal study to use a multi-domain, multi-level approach including biology to identify mechanisms of health risk and resilience among Latinx immigrants seeking asylum in the U.S. We innovate by assessing how trauma exposure at various stages— prior to, embedded in the asylum-seeking experience, and while settling in the U.S.— relates to disparities in health outcomes. Further, we probe new sources of potential trauma for migrants including family separation, detention, and migration experiences in Mexico. By innovatively studying resilience at the biological level in this population, this study takes the first steps towards the development of novel therapeutics to address disparities in posttraumatic distress and quality of life.