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Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Post-Traumatic Stress Disorder | Research article

Mental health among immigrants in Germany – the impact of self-attribution and attribution by others as an immigrant

Authors: Yuriy Nesterko, Michael Friedrich, Elmar Brähler, Andreas Hinz, Heide Glaesmer

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

In Germany, the term ‘migration background’ has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’.

Methods

In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors.

Results

A total of 10.7% of respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety.

Conclusions

It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.
Literature
1.
go back to reference Nesterko Y, Braehler E, Grande G, Glaesmer H. Life satisfaction and health-related quality of life in immigrants and native-born Germans: the role of immigration-related factors. Qual Life Res. 2013;22:1005–13.CrossRef Nesterko Y, Braehler E, Grande G, Glaesmer H. Life satisfaction and health-related quality of life in immigrants and native-born Germans: the role of immigration-related factors. Qual Life Res. 2013;22:1005–13.CrossRef
2.
go back to reference Bhugra D, Gupta S, Schouler-Ocak M, Graeff-Calliess I, Deakin NA, Qureshi A, et al. EPA guidance mental health care of migrants. Eur Psychiatry. 2014;29:107–15.CrossRef Bhugra D, Gupta S, Schouler-Ocak M, Graeff-Calliess I, Deakin NA, Qureshi A, et al. EPA guidance mental health care of migrants. Eur Psychiatry. 2014;29:107–15.CrossRef
3.
go back to reference Glaesmer H, Witting U, Braehler E, Martin A, Mewes R, Rief W. Health care utilization of first and second generation immigrants and the native population – a population based study in Germany. Int J Public Health. 2011;56:541–8.CrossRef Glaesmer H, Witting U, Braehler E, Martin A, Mewes R, Rief W. Health care utilization of first and second generation immigrants and the native population – a population based study in Germany. Int J Public Health. 2011;56:541–8.CrossRef
4.
go back to reference Bhugra D. Migration and mental health. Acta Psychiatr Scand. 2004;109:243–58.CrossRef Bhugra D. Migration and mental health. Acta Psychiatr Scand. 2004;109:243–58.CrossRef
5.
go back to reference Lorant V, Van Oyen H, Thomas I. Contextual factors and immigrants’ health status: double jeopardy. Health Place. 2008;14:678–92.CrossRef Lorant V, Van Oyen H, Thomas I. Contextual factors and immigrants’ health status: double jeopardy. Health Place. 2008;14:678–92.CrossRef
6.
go back to reference Beutel ME, Jünger C, Klein EM, Wild P, Lackner KJ, Blettner M, et al. Depression, anxiety and suicidal ideation among 1(st) and 2(nd) generation migrants - results from the Gutenberg health study. BMC Psychiatry. 2016;16:288.CrossRef Beutel ME, Jünger C, Klein EM, Wild P, Lackner KJ, Blettner M, et al. Depression, anxiety and suicidal ideation among 1(st) and 2(nd) generation migrants - results from the Gutenberg health study. BMC Psychiatry. 2016;16:288.CrossRef
7.
go back to reference Glaesmer H, Wittig U, Brähler E, Martin A, Mewes R, Rief W. Sind Migranten häufiger von psychischen Störungen betroffen? Eine Untersuchung an einer repräsentativen Stichprobe der deutschen Allgemeinbevölkerung [are migrants more susceptible to mental disorders? An evaluation of a representative sample of the German general population]. Psychiatr Prax. 2009;36:16–22.CrossRef Glaesmer H, Wittig U, Brähler E, Martin A, Mewes R, Rief W. Sind Migranten häufiger von psychischen Störungen betroffen? Eine Untersuchung an einer repräsentativen Stichprobe der deutschen Allgemeinbevölkerung [are migrants more susceptible to mental disorders? An evaluation of a representative sample of the German general population]. Psychiatr Prax. 2009;36:16–22.CrossRef
8.
go back to reference Dinesen C, Nielsen SS, Mortensen LH, Krasnik A. Inequality in self-rated health among immigrants, their descendants and ethnic Danes: examining the role of socioeconomic position. Int J Public Health. 2011;56:503–14.CrossRef Dinesen C, Nielsen SS, Mortensen LH, Krasnik A. Inequality in self-rated health among immigrants, their descendants and ethnic Danes: examining the role of socioeconomic position. Int J Public Health. 2011;56:503–14.CrossRef
9.
go back to reference Janssen-Kallenberg H, Schulz H, Kluge U, Strehle J, Wittchen HU, Wolfradt U, et al. Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds. BMC Psychiatry. 2017;17:264.CrossRef Janssen-Kallenberg H, Schulz H, Kluge U, Strehle J, Wittchen HU, Wolfradt U, et al. Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds. BMC Psychiatry. 2017;17:264.CrossRef
11.
go back to reference Schenk L, Bau AM, Borde T, Butler J, Lampert H, Neuhauser O, et al. Mindestindikatorensatz zur Erfassung des Migrationsstatus. Empfehlungen für die epidemiologische praxis [a basic set of indicators for mapping migrant status. Recommendations for epidemiological practice]. Bundesgesundheitsbla. 2006;49:853–60.CrossRef Schenk L, Bau AM, Borde T, Butler J, Lampert H, Neuhauser O, et al. Mindestindikatorensatz zur Erfassung des Migrationsstatus. Empfehlungen für die epidemiologische praxis [a basic set of indicators for mapping migrant status. Recommendations for epidemiological practice]. Bundesgesundheitsbla. 2006;49:853–60.CrossRef
12.
go back to reference Nesterko Y, Glaesmer H. Warum fragen wir nicht direkter nach? Eine analyse zur objektiven und subjektiven Erfassung des Migrationshintergrundes [why don’t we ask directly? An analysis of the subjective perspective on migration background]. Psychol Rundsch. 2019;70:101–8.CrossRef Nesterko Y, Glaesmer H. Warum fragen wir nicht direkter nach? Eine analyse zur objektiven und subjektiven Erfassung des Migrationshintergrundes [why don’t we ask directly? An analysis of the subjective perspective on migration background]. Psychol Rundsch. 2019;70:101–8.CrossRef
13.
go back to reference Wengler A. Ungleiche Gesundheit [Unequal Health]. Campus Verlag: Frankfurt am Main; 2013. Wengler A. Ungleiche Gesundheit [Unequal Health]. Campus Verlag: Frankfurt am Main; 2013.
14.
go back to reference Bhopal R. Glossary of terms relating to ethnicity and race: for reflection and debate. J Epidemiol Community Health. 2004;58:441–5.CrossRef Bhopal R. Glossary of terms relating to ethnicity and race: for reflection and debate. J Epidemiol Community Health. 2004;58:441–5.CrossRef
15.
go back to reference Igel U, Braehler E, Grande G. Der Einfluss von Diskriminierungserfahrungen auf die Gesundheit von MigrantInnen [The influence of perceived discrimination on health in migrants]. Psychiatr Prax. 2010;37:183–90.CrossRef Igel U, Braehler E, Grande G. Der Einfluss von Diskriminierungserfahrungen auf die Gesundheit von MigrantInnen [The influence of perceived discrimination on health in migrants]. Psychiatr Prax. 2010;37:183–90.CrossRef
16.
go back to reference Arellano-Morales L, Roesch SC, Gallo LC, Emory KT, Gonzalez P, Penedo FJ, et al. Prevalence and correlates of perceived ethnic discrimination in the Hispanic community health study/study of Latinos sociocultural ancillary study. J Latina/o Psychol. 2015;3:160–76.CrossRef Arellano-Morales L, Roesch SC, Gallo LC, Emory KT, Gonzalez P, Penedo FJ, et al. Prevalence and correlates of perceived ethnic discrimination in the Hispanic community health study/study of Latinos sociocultural ancillary study. J Latina/o Psychol. 2015;3:160–76.CrossRef
17.
go back to reference Ng IFS, Lee SY, Wong WKF, Chou KL. Effects of perceived discrimination on the quality of life among new mainland Chinese immigrants to Hong Kong: a longitudinal study. Soc Indic Res. 2015;120:817–34.CrossRef Ng IFS, Lee SY, Wong WKF, Chou KL. Effects of perceived discrimination on the quality of life among new mainland Chinese immigrants to Hong Kong: a longitudinal study. Soc Indic Res. 2015;120:817–34.CrossRef
18.
go back to reference Buchanan ZE, Abu-Rayya HM, Kashima E, Paxton SJ, Sam DL. Perceived discrimination, language proficiencies, and adaption: comparisons between refugee and non-refugee immigrant youth in Australia. Int J Intercult Relat. 2018;63:105–12.CrossRef Buchanan ZE, Abu-Rayya HM, Kashima E, Paxton SJ, Sam DL. Perceived discrimination, language proficiencies, and adaption: comparisons between refugee and non-refugee immigrant youth in Australia. Int J Intercult Relat. 2018;63:105–12.CrossRef
19.
go back to reference Escovar EL, Craske M, Roy-Byrne P, Stein MB, Sullivan G, Sherbourne CD, et al. Cultural influences on mental health symptoms in a primary care sample of Latinx patients. J Anxiety Disord. 2018;55:39–47.CrossRef Escovar EL, Craske M, Roy-Byrne P, Stein MB, Sullivan G, Sherbourne CD, et al. Cultural influences on mental health symptoms in a primary care sample of Latinx patients. J Anxiety Disord. 2018;55:39–47.CrossRef
20.
go back to reference Schmitt MT, Branscombe NR, Postmes T, Garcia A. The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull. 2014;140:921–48.CrossRef Schmitt MT, Branscombe NR, Postmes T, Garcia A. The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull. 2014;140:921–48.CrossRef
21.
go back to reference Crabtree JW, Haslam SA, Postmes T, Haslam C. Mental health support groups, stigma and self-esteem: positive and negative implications of group identification. Aust J Soc Issues. 2010;66:553–69.CrossRef Crabtree JW, Haslam SA, Postmes T, Haslam C. Mental health support groups, stigma and self-esteem: positive and negative implications of group identification. Aust J Soc Issues. 2010;66:553–69.CrossRef
22.
go back to reference Greenaway KH, Haslam SA, Cruwys T, Branscombe NR, Ysseldyk R, Heldreth C. From “we” to “me”: group identification enhances perceived personal control with consequences for health and well-being. J Pers Soc Psychol. 2015;109:53–74.CrossRef Greenaway KH, Haslam SA, Cruwys T, Branscombe NR, Ysseldyk R, Heldreth C. From “we” to “me”: group identification enhances perceived personal control with consequences for health and well-being. J Pers Soc Psychol. 2015;109:53–74.CrossRef
23.
go back to reference Eccleston CP, Major BN. Attributions to discrimination and self-esteem: the role of group identification and appraisals. Group Process Intergroup Relat. 2006;9:147–62.CrossRef Eccleston CP, Major BN. Attributions to discrimination and self-esteem: the role of group identification and appraisals. Group Process Intergroup Relat. 2006;9:147–62.CrossRef
24.
go back to reference Hinz A, Weis J, Brähler E, Mehnert A. Fatigue in the general population: German normative values of the EORTC QLQ-FA12. Qual Life Res. 2018;27:2681–9.CrossRef Hinz A, Weis J, Brähler E, Mehnert A. Fatigue in the general population: German normative values of the EORTC QLQ-FA12. Qual Life Res. 2018;27:2681–9.CrossRef
26.
go back to reference Loewe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the patient health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122:86–95.CrossRef Loewe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the patient health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122:86–95.CrossRef
27.
go back to reference Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD checklist for DSM-5 (PCL-5). National Center for PTSD: Boston; 2013. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD checklist for DSM-5 (PCL-5). National Center for PTSD: Boston; 2013.
28.
go back to reference Bayram N, Thorburn D, Demirhan H, Bilgel N. Quality of life among Turkish immigrants in Sweden. Qual Life Res. 2007;16:1319–33.CrossRef Bayram N, Thorburn D, Demirhan H, Bilgel N. Quality of life among Turkish immigrants in Sweden. Qual Life Res. 2007;16:1319–33.CrossRef
29.
go back to reference Koochek A, Montazeri A, Johansson S, Sundquist J. Health-related quality of life and migration: a cross-sectional study on elderly Iranians in Sweden. Health Qual Life Outcomes. 2007;5:60.CrossRef Koochek A, Montazeri A, Johansson S, Sundquist J. Health-related quality of life and migration: a cross-sectional study on elderly Iranians in Sweden. Health Qual Life Outcomes. 2007;5:60.CrossRef
30.
go back to reference Bischoff A, Wanner P. The self-reported health of immigrant groups in Switzerland. J Immigr Minor Health. 2008;10:325–35.CrossRef Bischoff A, Wanner P. The self-reported health of immigrant groups in Switzerland. J Immigr Minor Health. 2008;10:325–35.CrossRef
31.
go back to reference Leão TS, Sundquist J, Johansson SE, Sundquist K. The influence of age at migration and length of residence on self-rated health among Swedish immigrants: a cross-sectional study. Ethn Health. 2009;14:93–105.CrossRef Leão TS, Sundquist J, Johansson SE, Sundquist K. The influence of age at migration and length of residence on self-rated health among Swedish immigrants: a cross-sectional study. Ethn Health. 2009;14:93–105.CrossRef
32.
go back to reference Virta E, Sam DL, Westin C. Adolescents with Turkish background in Norway and Sweden: a comparative study of their psychological adaptation. Scand J Psychol. 2004;45:15–25.CrossRef Virta E, Sam DL, Westin C. Adolescents with Turkish background in Norway and Sweden: a comparative study of their psychological adaptation. Scand J Psychol. 2004;45:15–25.CrossRef
33.
go back to reference Neto F, Barros J. Satisfaction with life among adolescents from Portuguese immigrant families in Switzerland. Swiss J Psychol. 2007;66:215–23.CrossRef Neto F, Barros J. Satisfaction with life among adolescents from Portuguese immigrant families in Switzerland. Swiss J Psychol. 2007;66:215–23.CrossRef
34.
go back to reference Verkuyten M. Life satisfaction among ethnic minorities: the role of discrimination and group identification. Soc Indic Res. 2008;89:391–404.CrossRef Verkuyten M. Life satisfaction among ethnic minorities: the role of discrimination and group identification. Soc Indic Res. 2008;89:391–404.CrossRef
35.
go back to reference Vieno A, Santinello M, Lenzi M, Baldassari D, Mirandola M. Health status in immigrants and native early adolescents in Italy. J Community Health. 2009;34:181–7.CrossRef Vieno A, Santinello M, Lenzi M, Baldassari D, Mirandola M. Health status in immigrants and native early adolescents in Italy. J Community Health. 2009;34:181–7.CrossRef
Metadata
Title
Mental health among immigrants in Germany – the impact of self-attribution and attribution by others as an immigrant
Authors
Yuriy Nesterko
Michael Friedrich
Elmar Brähler
Andreas Hinz
Heide Glaesmer
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-8060-y

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