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

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.

Predictive association between immigration status and chronic pain in the general population: results from the SwePain cohort

“…However, the majority of the earlier studies used a cross-sectional study design, making a direct comparison with our findings not fully relevant. Our results are partly in agreement with a recent population-based study in Germany, showing that although ‘migration background’ as per official statistics definition is not related with increased mental health problems, identification as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression [ 48 ]. A previous report investigating health-related quality of life outcomes have also documented important disparities between racial/ethnic groups related to the experience and management of pain [ 23 ].…”

Perceived Stress Scale (PSS-10) psychometric properties in migrants and native Germans

“…Self- and group- attribution as migrants are additional factors that may influence not only differences between migrants and native Germans, but also differences between first- and second-generation migrants. Nesterko et al [ 43 ] explored attribution as a migrant as a predicting factor of PTSD, depression and anxiety, finding that many second-generation migrants do not self-attribute as a migrant. These types of factors are likely to influence perceptions of discrimination and ultimately levels of perceived stress.…”