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.

暴露于食物匮乏（例如，饥饿）和威胁（暴力），在青春期中后期（15-19岁） 可以对青年的身心健康产生持久的影响。然而，在这个关键时刻， 发展阶段-急性和慢性暴露于剥夺和威胁， 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 新的干预措施，针对特定的，可修改的认知和社会机制在发展过程中。这是 对于影响处于精神健康问题高风险中的青年至关重要，因为他们明显错位， 有压力的经历，如无人陪伴的移徙。由于全球化， 未成年人的数量急剧增加，包括美国，2020年10月有194，000人从拉丁美洲抵达- 2022年1月。无人陪伴的青少年移徙者在移徙之前、期间、 迁移后。先前对难民青少年的研究表明，创伤后应激障碍、抑郁症、广泛性焦虑症的风险增加， 和物质使用障碍。重新安置后的压力因素加剧了这些风险。儿童早期受到的威胁和剥夺 青春期预示着心理健康状况不佳，认知能力恶化，特别是执行功能， 在整个青少年时期继续发展。重要的是，并非所有经历这些不利条件的年轻人 发展心理健康问题;因此，必须确定哪些风险因素特别重要， 哪些应对策略和社区资源可以缓冲其影响。据我们所知， 在一个综合模型中，研究了所有这些因素对孤身移徙青年的影响。 在与纽约市的社区组织合作下，我们的试点研究（CAMINANDO）招募了74名 无人陪伴的未成年人从拉丁美洲移民。我们发现精神健康状况较差（创伤后应激障碍， 广泛性焦虑、抑郁）和执行功能与暴力和饥饿有不同的相关性 exposure.初步定性数据进一步表明，安置后的支持性社交网络可以帮助年轻人 科普移民的影响。我们提出了CAMINANDO-心理健康的并行混合方法（QUANT- 对400名移民青年（16-19岁）进行的纵向研究（18个月随访）， 我们的试点：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）关于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） 评估重新安置后的心理（复原力、情感健康）、认知（执行） 功能）和社会（日常压力源，支持）因素影响心理健康轨迹超过18个月， 青春期我们的方法是创新的，因为它：1）包括并发的潜在修改的心理， 认知和社会因素; 2）解释急性和慢性食物剥夺和威胁; 3）纵向考察流动青少年在社区中的应对策略和资源使用模式 设置.研究结果将为改善作为孤身未成年人移徙的青少年的结果的战略提供信息。