Abstract
Past research documents the heterogeneity in US immigrants, particularly in terms of racial and ethnic categories and specific ethnic subgroups. The present study builds on this research foundation by investigating heterogeneity in immigrants' experiences of adversity, both recent and during childhood, and associations with mental disorders. Data are drawn from 6,131 adult immigrants in the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Prevalence estimates for mental disorders and adversities were calculated overall and by gender. Latent class analysis was utilized to characterize patterns of self-reported experiences of childhood and recent adversities, and multinomial logistic regression established the statistical association between latent class membership and past-year mental disorder outcomes (substance use disorder only, mood/anxiety/trauma disorder only, co-occurring disorder, or no mental disorder). Neglect was the most commonly-reported childhood adversity among immigrant men and women. Prevalence of meeting criteria for a substance use disorder only, or a mood/anxiety/trauma disorder only, varied between men and women, yet no gender differences were observed in prevalence of co-occurring disorders. For latent class analyses, a five-class solution was selected based on fit indices and parsimony. Approximately 10.0% of the sample was categorized in the latent class characterized by severe childhood adversities, while 57.5% was classified in the latent class with low probabilities of reported adversities. The relative risk of meeting criteria for a past-year substance use disorder only (compared to no substance use or mood/anxiety/trauma disorder) was more than three times as high for members of the class with severe childhood adversities (RRR, 3.26; 95% CI, 2.08–5.10), as well as the class with recent employment/financial adversities (RRR, 3.82; 95% CI, 2.36–6.19), compared to the class with low adversities. The relative risk of past-year co-occurring disorders (compared to no disorder) was more than 12 times as high for those in the severe childhood adversities class (RRR, 12.21; 95% CI, 7.06–21.10), compared to the class with low adversities. Findings underscore the importance of considering both recent and childhood adversities when assessing and providing services for US immigrant groups.
Highlights
Mental disorders exact high societal, economic, and healthcare costs, contributing to lost productivity, disability, and mortality
As a means to more adequately address the mental health needs of immigrant populations in the United States (US), a deeper understanding is needed of the intricacies in the relationship between various adversities and mental health outcomes, including substance use disorders, mood/anxiety/trauma disorders, and co-occurring conditions
The present study aims to examine some of the heterogeneity in experiences of adversities and associated mental health outcomes in the diverse US adult immigrant population
Summary
Mental disorders exact high societal, economic, and healthcare costs, contributing to lost productivity, disability, and mortality. The present study, examines patterns in experiences of childhood and recent adversities among US immigrants, and the connection to mental health outcomes. Beyond the demographic differences between US-born and foreign-born populations, substantial demographic variation is observed within immigrant populations based on a variety of factors. The demographics of immigrant communities vary based on period of entry to the US, as patterns in immigrant-sending countries shift over time [8]. The varying journeys, circumstances precipitating migration, and contexts of reception in the US add to the diversity of US immigrants, and each of these factors may influence both access to resources and vulnerability to negative outcomes. An immigrant who arrived to the US as an infant may differ in many ways from an immigrant who arrived as an older adult; an immigrant who has lived in the US for a few years may have a very different experience from an immigrant who has resided in the US for decades
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