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

项目总结/摘要 创伤后痛苦不成比例地影响在美国寻求庇护的拉丁裔移民， 在本国遭受创伤的比例以及寻求庇护者在寻求庇护过程中持续遭受的创伤 体验.这项拟议中的研究将收集400名无证拉丁裔移民成年人的纵向数据 在美国寻求庇护，以研究创伤暴露在各个阶段-之前，嵌入在 寻求庇护的经历，而在美国定居-同时和前瞻性地影响 创伤后痛苦和生活质量通过炎症的生物途径。协同 已建立的社区合作伙伴，参与者将被招募从移民营地/庇护所两侧， 墨西哥-美国边境一年后收集的随访数据，预计整个样本将 在美国等待进一步的移民法庭听证会，将评估创伤暴露和歧视 在美国定居期间，创伤后痛苦和生活质量使用炎症假说 持续的创伤后痛苦（Gill等人，作为一个概念框架，拟议的研究包括 最先进的生物标记物和混合方法，以提供有关机制的新信息， 在各个领域和各个层面上加强健康风险的基础和复原力。具体目标1是同时和 前瞻性地评估寻求庇护之前和寻求庇护过程中创伤暴露的影响 移民创伤后的痛苦和生活质量。具体目标2是同时和前瞻性地 评估寻求庇护经历之前和寻求庇护经历中的创伤暴露对 移民的生物（免疫）功能，测试炎症作为健康差距的机制。具体目标 三是确定社会文化和个人环境领域内的因素（在个人/人际 第二个层次），目标2中确定的缓和联系。具体目标4是评估（迁移后）创伤 在美国定居时的暴露和歧视预期会影响创伤后应激反应和 生活获得的知识将（1）推动关于多领域，多层次因素如何影响 影响弱势群体的健康，目标是减少现有的差距;（2）告知 制定对文化和背景敏感的干预措施;（3）为宣传和政策工作提供信息。这是 第一个前瞻性的纵向研究，使用多领域，多层次的方法，包括生物学，以确定 在美国寻求庇护的拉丁裔移民的健康风险和弹性机制。 评估不同阶段的创伤暴露-在寻求庇护之前，在寻求庇护过程中， 在美国定居期间，与健康结果的差异有关。此外，我们探索新的来源， 移民的潜在创伤，包括家庭分离，拘留和墨西哥的移民经历。通过 创新性地研究了这一人群在生物水平上的恢复力，这项研究迈出了第一步， 开发新的治疗方法，以解决创伤后痛苦和生活质量的差异。

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.