Mona M. Amer

Socio-demographic Differences in Acculturation and Mental Health for a Sample of 2nd Generation/Early Immigrant Arab Americans

This study examined socio-demographic differences in acculturation patterns among early immigrant and second-generation Arab Americans, using data from 120 participants who completed a Web-based study. Although sex, age, education, and income did not significantly relate to the acculturation process, respondents who were female and those who were married reported greater Arab ethnic identity and religiosity. Striking differences were found based on religious affiliation. Christian patterns of acculturation and mental health were consistent with acculturation theory. For Muslims, however, integration was not associated with better mental health, and religiosity was predictive of better family functioning and less depression. The results of this study suggest unique acculturation patterns for Christian and Muslim subgroups that can better inform future research and mental health service.

An Exploration of Cultural Identity Patterns and the Family Context among Arab Muslim Young Adults in America

While many studies have explored cultural adaptation and development and its correlates among adult Arab immigrants to the United States (U.S.), little empirical work has focused on Arab youth who were raised in the U.S., particularly Arab Muslim young adults. The present study explores cultural identity patterns and the sociodemographic and family contexts of 150 Arab Muslim American young adults ages 18–25 who completed an Internet study. The participants fell into three cultural identity groups: High Bicultural, Moderate Bicultural, and High Arab Cultural. Although all three groups demonstrated positive general family functioning, the Moderate Bicultural group was distinct in that they were less likely to be engaged or married, and they experienced less family support and more family acculturative stressors. The results highlight the importance of the family context in contributing to a stronger sense of cultural identity for young adults who fall at the intersection of Arab and American culture and Muslim faith.

Anxiety and depression in a post-September 11 sample of Arabs in the USA

ObjectiveScant research has examined the mental health of Arab Americans. This study aimed to determine the levels of anxiety and depression in a sample of Arab Americans and compare the rates to normative community samples and samples of other minority ethnic/racial groups.MethodsA non-probability sampling approach resulted in 601 adult Arab American respondents from 35 US states. Respondents completed anxiety and depression questionnaires at a form-based Internet site.ResultsOne-fourth of participants reported moderate to severe anxiety levels as measured by the Beck Anxiety Inventory (BAI), and one-half reported depression scores that met clinical caseness as assessed by the Center for Epidemiologic Studies-Depression Scale (CES-D). The present sample of Arab Americans reported significantly higher levels of anxiety and depression compared to standardization samples and community samples of four other minority groups.ConclusionsArab Americans may be at risk for anxiety and depression. Further studies should be conducted to replicate and validate these results, identify stressors that affect this population, and develop recommendations for clinical interventions.

Initial Development of the Brief Arab Religious Coping Scale (BARCS)

This project aimed to develop a brief and culturally sensitive measure of positive religious coping that could be useful in research with Arab Americans of both Christian and Muslim affiliations. In Study 1,62 items were generated based on previous religious coping measures and knowledge of religious practices in the Arab community. Seventy-six community respondents completed this pilot questionnaire. Based on Rasch rating scale analysis, 15 items were retained for the Brief Arab Religious Coping Scale (BARCS). In Study 2, the BARCS was completed by an Internet sample of 599 Arab Americans. The measure demonstrated excellent reliability and strong internal validity, although it did not correlate with acculturation stress and depression as expected. Limitations and suggestions for future research are discussed.

Psychological research with Muslim Americans in the age of Islamophobia: trends, challenges, and recommendations.

Like other minority groups in North America, Muslim Americans have been largely ignored in the psychological literature. The overwhelming pressures faced by this group, including surveillance, hate crimes, and institutional discrimination, stimulate an urgent need for psychologists to better understand and ensure the well-being of this population. This article reviews challenges in conducting research with Muslim Americans in order to offer recommendations for culturally sensitive approaches that can enhance the growth of future scholarship. We first contextualize this endeavor by assessing trends in psychological scholarship pertinent to Muslims in North America over the past two decades. A total of 559 relevant publications were identified through a PsycINFO database search. The 10 years post 9/11 saw a more than 900% increase in the annual number of publications, paralleling a national interest in the Muslim American community subsequent to the World Trade Center attacks. Researchers who conducted these studies faced numerous barriers, including unclear definition of the target sample, unavailability of culturally sensitive measures, sampling difficulties, and obstacles to participant recruitment. To navigate these challenges, we provide a framework for effective research design along the continuum of the research process from study conceptualization to dissemination of results. The challenges and recommendations are illustrated with examples from previous studies.

Arab Refugees: Trauma, Resilience, and Recovery

This chapter provides a brief introduction to the history of Arab refugees in the USA, an analysis of the traumatic stressors that different gender and age groups encounter pre- and post-refuge, and the effects of these stressors on their well-being. Further, it explores the resilience and protective factors of Arab refugees. Resilience and protective factors are used in this chapter to indicate internal and external factors that the evidence shows are associated with “good” outcome in spite of adversities (e.g., Luthar et al., Child Development 71(3):543–562, 2000). The development-based traumatology framework that highlights the etiology of refugees’ cumulative trauma is discussed (Kira, Traumatology 16(4):128–141, 2010). Also, two models of therapeutic interventions for Arab refugees are introduced: individual therapy that includes the transdiagnostic and complex trauma approaches that are mostly uni-systemic, and the ecological multi-systemic approaches. Finally, community outreach and advocacy are discussed as part of the recommended ecological model of recovery.

Racial-ethnic differences in access, diagnosis, and outcomes in public-sector inpatient mental health treatment.

This study investigated inequities in access, diagnosis, and treatment for African Americans and Hispanic Americans receiving treatment in northeast, public sector, inpatient mental health settings as part of a Department of Mental Health and Addiction Services Health Disparities Initiative. Data from 1,484 adults were obtained through a random extract of patients admitted to state inpatient facilities between 2002 and 2005. After controlling for demographic variables and symptom severity, logistic and linear regression showed that Hispanic Americans were significantly more likely to enter inpatient care through crisis/emergency sources and were significantly less likely to self-refer or come to inpatient care through other sources (e.g., family, outpatient). After admission, Hispanic Americans were more likely to be diagnosed with other psychotic disorders (e.g., schizoaffective disorder, delusional disorder), were less likely to receive an Axis II diagnosis at discharge, and had a shorter length of stay than non-Hispanic White Americans. African Americans were more likely than other groups to be diagnosed with schizophrenia, drug-related, and Cluster B diagnoses (discharge only), and they were less likely to be diagnosed with mood disorders and other nonpsychotic disorders. Although African Americans were more likely than other groups to come to inpatient units from numerous routes, including self-referral and referral from other sources (e.g., family, outpatient), they were more likely to terminate treatment against medical advice and displayed shorter length of stay despite receiving ratings of greater symptom severity at discharge. These findings highlight the need for policies, programs, and system interventions designed to eliminate disparities and improve the quality and cultural responsiveness of behavioral health services.

Racial-Ethnic Differences in Referral Source, Diagnosis, and Length of Stay in Inpatient Substance Abuse Treatment

OBJECTIVE Racial-ethnic differences in referral source, diagnosis, and length of stay in substance abuse treatment were examined. METHODS Data from 495 African Americans, 492 Hispanics, and 497 non-Hispanic whites were analyzed. RESULTS Hispanics were less likely than whites to be referred by crisis services; African Americans were more likely than other groups to be referred from criminal justice settings. At admission Hispanics and African Americans were more likely to have a drug use disorder, and whites were more likely to have an alcohol use disorder. Both African Americans and Hispanics were more likely than whites to have a cluster B personality disorder diagnosis at discharge. African Americans had longer stays than other groups. CONCLUSIONS The findings could be used to design interventions to reduce disparities in inpatient substance abuse treatment.

Arab American Acculturation and Ethnic Identity Across the Lifespan: Sociodemographic Correlates and Psychological Outcomes

This chapter provides a comprehensive overview of acculturation patterns and their psychological correlates among Arab Americans across the lifespan. First, Arab American racial and ethnic identifications are analyzed within the historical context of three waves of immigration to the USA. This history provides a backdrop to the diversity of present-day acculturation orientations, which are influenced by factors such as generation status, length of residence in the USA, religion, and discrimination. The chapter reviews the mental health correlates of these acculturation orientations, as well as protective factors such as family, ethnic identity, and religiosity that have been found to promote resilience and reduce acculturative stress. Unique acculturation experiences are discussed for youth, women, and the elderly. In addition to identifying gaps in the literature, the chapter offers a critique of Arab American acculturation research to date, including limitations in conceptualizations and methodologies. Notwithstanding these limitations, recommendations are offered for using existing and future research to inform community-based programming.

Evaluation of the CES-D Scale factor structure in a sample of second-generation Arab-Americans

Very few studies have examined the psychometric properties of mental health measures for use with the immigrant Arab American population, and fewer still have evaluated measures for use with the second generation. The present study evaluated the reliability and factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D). A total of 119 second-generation Americans of Arab descent completed the instrument on a Website. Cronbachs alpha was high, at .90. Principle components factor analysis yielded a three-factor solution in which emotional and physiological symptoms overlapped in one factor. These results are consistent with many other studies of ethnic minority immigrants, which report that affective and somatic symptoms were not experienced as separate. They are also consistent with research on the somatization of depression among Arabs living in the Middle East. However, the results challenge assumptions that as a result of the acculturation process, children of immigrants will experience depression more similar to the mainstream population rather than immigrants. Additionally, more than 40% of participants reported scores above the cut-off for clinically significant depression. Further research is needed to determine a more accurate cut-off score and identify the causes for the high self-reported depression.