Migrant and refugee children commonly experience traumatic events and stressful conditions along their migration journeys. Migration-related trauma can have persisting effects on children's mental health. Developmental neuroscience suggests neural mechanisms that connect these experiences to mental health conditions such as post-traumatic stress disorder. This research review, focused on migrant families emigrating from Mexico, Central America, and Haiti and bound for the United States, first overviews the nature of trauma exposure faced by migrant families and next delineates potential neurobiological mechanisms underlying the effects of migration-related trauma on youth mental health. Finally, detailed policy recommendations relate to (1) providing mental health care, (2) addressing chronic stressors in the context of daily life, and (3) preventing migration-related trauma.
- Award ID(s):
- 1849379
- NSF-PAR ID:
- 10334684
- Editor(s):
- Boon-Peng, Hoh
- Date Published:
- Journal Name:
- PLOS ONE
- Volume:
- 17
- Issue:
- 4
- ISSN:
- 1932-6203
- Page Range / eLocation ID:
- e0266509
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Abstract Children make up over half of the world's migrants and refugees and face a multitude of traumatic experiences prior to, during, and following migration. Here, we focus on migrant children emigrating from Mexico and Central America to the United States and review trauma related to migration, as well as its implications for the mental health of migrant and refugee children. We then draw upon the early adversity literature to highlight potential behavioral and neurobiological sequalae of migration‐related trauma exposure, focusing on attachment, emotion regulation, and fear learning and extinction as transdiagnostic mechanisms underlying the development of internalizing and externalizing symptomatology following early‐life adversity. This review underscores the need for interdisciplinary efforts to both mitigate the effects of trauma faced by migrant and refugee youth emigrating from Mexico and Central America and, of primary importance, to prevent child exposure to trauma in the context of migration. Thus, we conclude by outlining policy recommendations aimed at improving the mental health of migrant and refugee youth.
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null (Ed.)Stress is known to affect health throughout life and into future generations, but the underlying molecular mechanisms are unknown. We tested the hypothesis that maternal psychosocial stress influences DNA methylation (DNAm), which in turn impacts newborn health outcomes. Specifically, we analyzed DNAm at individual, regional, and genome-wide levels to test for associations with maternal stress and newborn birth weight. Maternal venous blood and newborn cord blood (n = 24 and 22, respectively) were assayed for methylation at ∼450,000 CpG sites. Methylation was analyzed by examining CpG sites individually in an epigenome-wide association study (EWAS), as regional groups using variably methylated region (VMR) analysis in maternal blood only, and through the epigenome-wide measures using genome-wide mean methylation (GMM), Horvath's epigenetic clock, and mitotic age. These methylation measures were tested for association with three measures of maternal stress (maternal war trauma, chronic stress, and experience of sexual violence) and one health outcome (newborn birth weight). We observed that maternal experiences of war trauma, chronic stress, and sexual assault were each associated with decreased newborn birth weight (p < 1.95 × 10-7 in all cases). Testing individual CpG sites using EWAS, we observed no associations between DNAm and any measure of maternal stress or newborn birth weight in either maternal or cord blood, after Bonferroni multiple testing correction. However, the top-ranked CpG site in maternal blood that associated with maternal chronic stress and sexual violence before multiple testing correction is located near the SPON1 gene. Testing at a regional level, we found increased methylation of a VMR in maternal blood near SPON1 that was associated with chronic stress and sexual violence after Bonferroni multiple testing correction (p = 1.95 × 10-7 and 8.3 × 10-6, respectively). At the epigenomic level, cord blood GMM was associated with significantly higher levels of war trauma (p = 0.025) and was suggestively associated with sexual violence (p = 0.053). The other two epigenome-wide measures were not associated with maternal stress or newborn birth weight in either tissue type. Despite our small sample size, we identified associations even after conservative multiple testing correction. Specifically, we found associations between DNAm and the three measures of maternal stress across both tissues; specifically, a VMR in maternal blood and GMM in cord blood were both associated with different measures of maternal stress. The association of cord blood GMM, but not maternal blood GMM, with maternal stress may suggest different responses to stress in mother and newborn. It is noteworthy that we found associations only when CpG sites were analyzed in aggregate, either as VMRs or as a broad summary measure of GMM.more » « less
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Abstract Objectives The COVID‐19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors—a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post‐apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID‐19) pandemic (ca. 2020–2021).
Materials and Methods Data came from 88 adults who participated in a follow‐up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID‐19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID‐19 stress was calculated to evaluate the potential effect of stress sensitization.
Results Fifty‐six percent of adults exhibited moderate‐to‐severe PTSD symptoms. Greater childhood adversity and higher COVID‐19 psychosocial stress independently predicted worse post‐traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non‐significantly worse PTSD symptoms from COVID‐19 psychosocial stress.
Discussion These results highlight the deleterious mental health effects of both childhood trauma and COVID‐19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.
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Background Even before the onset of the COVID-19 pandemic, children and adolescents were experiencing a mental health crisis, partly due to a lack of quality mental health services. The rate of suicide for Black youth has increased by 80%. By 2025, the health care system will be short of 225,000 therapists, further exacerbating the current crisis. Therefore, it is of utmost importance for providers, schools, youth mental health, and pediatric medical providers to integrate innovation in digital mental health to identify problems proactively and rapidly for effective collaboration with other health care providers. Such approaches can help identify robust, reproducible, and generalizable predictors and digital biomarkers of treatment response in psychiatry. Among the multitude of digital innovations to identify a biomarker for psychiatric diseases currently, as part of the macrolevel digital health transformation, speech stands out as an attractive candidate with features such as affordability, noninvasive, and nonintrusive. Objective The protocol aims to develop speech-emotion recognition algorithms leveraging artificial intelligence/machine learning, which can establish a link between trauma, stress, and voice types, including disrupting speech-based characteristics, and detect clinically relevant emotional distress and functional impairments in children and adolescents. Methods Informed by theoretical foundations (the Theory of Psychological Trauma Biomarkers and Archetypal Voice Categories), we developed our methodology to focus on 5 emotions: anger, happiness, fear, neutral, and sadness. Participants will be recruited from 2 local mental health centers that serve urban youths. Speech samples, along with responses to the Symptom and Functioning Severity Scale, Patient Health Questionnaire 9, and Adverse Childhood Experiences scales, will be collected using an Android mobile app. Our model development pipeline is informed by Gaussian mixture model (GMM), recurrent neural network, and long short-term memory. Results We tested our model with a public data set. The GMM with 128 clusters showed an evenly distributed accuracy across all 5 emotions. Using utterance-level features, GMM achieved an accuracy of 79.15% overall, while frame selection increased accuracy to 85.35%. This demonstrates that GMM is a robust model for emotion classification of all 5 emotions and that emotion frame selection enhances accuracy, which is significant for scientific evaluation. Recruitment and data collection for the study were initiated in August 2021 and are currently underway. The study results are likely to be available and published in 2024. Conclusions This study contributes to the literature as it addresses the need for speech-focused digital health tools to detect clinically relevant emotional distress and functional impairments in children and adolescents. The preliminary results show that our algorithm has the potential to improve outcomes. The findings will contribute to the broader digital health transformation. International Registered Report Identifier (IRRID) DERR1-10.2196/46970more » « less
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1371/journal.pone.0266509
