Mental Health of Latino Adolescent Who Migrate without a Parent: Understanding Risk and Identifying Resilience and Coping Strategies

没有父母陪伴的拉丁裔青少年的心理健康：了解风险并确定复原力和应对策略

• 批准号: 10585414
• 负责人: ROBERTO LEWIS-FERNANDEZ
• 金额: $ 72.08万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-09 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585414
• 关键词: Accounting; Acute; Adolescence; Adolescent; Adolescent Development; Adult; Adverse event; Affect; Age; Buffers; Chronic; Cognitive; Communities; Conflict (Psychology); Coping Skills; Data; Development; Dislocations; Economics; Effectiveness; Equation; European; Event; Exhibits; Exposure to; Food deprivation (experimental); Fostering; Future; Health; Health Status; Hunger; Infrastructure; Intervention; Latin America; Latin American; Latino; Life; Longitudinal Studies; Mental Depression; Mental Health; Methods; Migrant; Minor; Modeling; New York City; Outcome; Parents; Pattern; Phase; Pilot Projects; Post-Traumatic Stress Disorders; Process; Psychological Factors; Refugees; Reporting; Resources; Risk; Risk Factors; Social Network; Stress; Stressful Event; Substance Use Disorder; Symptoms; Teenagers; Testing; Textiles; Violence; Vulnerable Populations; Well in self; Work; Youth; cognitive capacity; cognitive function; community organizations; community setting; coping; depressive symptoms; deprivation; early adolescence; executive function; experience; follow-up; generalized anxiety; improved; improved outcome; innovation; migration; novel; novel strategies; physical conditioning; post-traumatic stress; psychologic; psychosocial; recruit; resilience; social; social factors; stressor

Exposure to food deprivation (e.g., hunger) and threat (violence) during mid-to-late adolescence (ages 15-19) can have a lasting impact on the mental and physical health of youth. However, the interplay—during this key developmental stage—of acute and chronic exposure to deprivation and threat with modifiable cognitive, psychological, and social factors is not well understood. Clarifying this interplay would help guide the creation of novel interventions that target specific, modifiable cognitive and social mechanisms during development. This is crucial for impacting youth at elevated risk for mental health problems because of markedly dislocating and stressful experiences, such as unaccompanied migration. Due to globalization, the number of unaccompanied minors is increasing dramatically, including in the US where 194,000 arrived from Latin America in October 2020- January 2022. Unaccompanied teen migrants are especially vulnerable to violence and hunger before, during, and after migration. Prior studies in refugee teens show increased risk of PTSD, depression, generalized anxiety, and substance use disorders. Post-resettlement stressors compound these risks. Threat and deprivation in early adolescence predict poor mental health and worsened cognitive capacity, especially executive functions, which continue to develop throughout adolescence. Importantly, not all youth who experience these adverse conditions develop mental health problems; thus, it is essential to identify which risk factors are particularly important and which coping strategies and community resources can buffer their effect. No study, to our knowledge, has examined the impact of all these factors in one comprehensive model among unaccompanied migrant youth. In partnership with community organizations in New York City, our pilot study (CAMINANDO) recruited 74 teens who migrated from Latin America as unaccompanied minors. We found poorer mental health (PTSD, generalized anxiety, depression) and executive functions were differentially associated with violence and hunger exposure. Initial qualitative data further suggest that supportive social networks post-resettlement help youths cope with the impact of migration. We propose CAMINANDO-Mental Health a parallel mixed-methods (QUANT- qual) longitudinal study (18-month follow-up) of 400 migrant youth (ages 16-19) that builds on the infrastructure of our pilot to: 1) examine the impact of exposure to threat and food deprivation (distinguishing acute from chronic exposures) on the mental health status of teens who migrated to the US as unaccompanied minors, and 2) assess how concurrent post-resettlement psychological (resilience, emotional well-being), cognitive (executive functions), and social (daily stressors, supports) factors affect mental health trajectories over 18 months in late adolescence. Our approach is innovative in that it: 1) includes concurrent potentially modifiable psychological, cognitive, and social factors in one model; 2) accounts for both acute and chronic food deprivation and threat; and 3) longitudinally examines the coping strategies and resource-use patterns of migrant teens in community settings. Study findings will inform strategies to improve outcomes for teens migrating as unaccompanied minors.

在青春期中后期(15-19岁)暴露于食物匮乏(如饥饿)和威胁(暴力) 会对年轻人的身心健康产生持久的影响。然而，在这个关键时期，相互作用 发育阶段--急性和长期暴露在剥夺和威胁下，认知能力可改变， 心理和社会因素还没有得到很好的理解。澄清这种相互作用将有助于指导创建 针对发展过程中特定的、可改变的认知和社会机制的新型干预措施。这是 对于影响青少年的心理健康问题的风险增加至关重要，因为明显的错位和 有压力的经历，例如无人陪伴的迁徙。由于全球化，无人陪伴的人数 未成年人正在急剧增加，包括在美国，2020年10月有19.4万人从拉丁美洲来到美国- 2022年1月。无人陪伴的青少年移民特别容易受到暴力和饥饿的伤害， 在迁徙之后。先前对难民青少年的研究表明，患创伤后应激障碍、抑郁症、广泛性焦虑、 和物质使用障碍。重新安置后的压力因素加剧了这些风险。早期的威胁和剥夺 青春期预示着心理健康状况不佳和认知能力恶化，特别是执行功能，这 在整个青春期都会继续发育。重要的是，并不是所有经历过这些不利情况的年轻人 出现心理健康问题；因此，确定哪些风险因素特别重要和 哪些应对策略和社区资源可以缓冲它们的影响。据我们所知，没有一项研究 在一个综合模型中审查了所有这些因素对无人陪伴的移徙青年的影响。 与纽约市的社区组织合作，我们的试点研究(Caminando)招募了74名 作为无人陪伴的未成年人从拉丁美洲移民过来的青少年。我们发现精神健康状况较差(PTSD， 广泛性焦虑、抑郁)和执行功能与暴力和饥饿有不同的联系 曝光。初步的质量数据进一步表明，重新安置后的支持性社会网络有助于年轻人 应对移民带来的影响。我们建议卡米南多-心理健康是一种平行的混合方法(QUANT- QUAL)对400名流动青年(16-19岁)进行的以基础设施为基础的纵向研究(为期18个月) 我们的试点的目的是：1)检查暴露于威胁和食物匮乏的影响(区分急性和慢性 暴露)作为无人陪伴的未成年人移民到美国的青少年的心理健康状况，以及2) 评估同时发生的重新安置后心理(韧性、情绪幸福感)、认知(执行力) 功能)和社会(日常应激源、支持)因素影响超过18个月的心理健康轨迹 青春期。我们的方法是创新的，因为它：1)包括同时的潜在可改变的心理， 认知和社会因素在一个模型中；2)解释了急性和慢性食物匮乏和威胁； 3)纵向考察社区流动青少年的应对策略和资源利用模式 设置。研究结果将为改善作为无人陪伴未成年人移徙的青少年的结果提供战略依据。