Generational Differences in Psychosocial Adaptation and Predictors of Psychological Distress in a Population of Recent Vietnamese Immigrants

While first-wave Vietnamese immigrants adapted well to life in the United States, subsequent immigrants have had greater adjustment difficulties, including more evidence of psychological distress. This study aimed to analyze psychosocial adaptation differences among three generations of recent Vietnamese immigrants, as well as to examine predictors of mental distress in the sample as a whole. A community sample of 184 recent Vietnamese immigrants, categorized as either elderly, middle-aged, or young adults, was assessed for levels of psychological distress, including depression, anxiety, and PTSD, as well as family conflict, dissatisfaction with life in the U.S., acculturation and biculturalism, social support, coping, and premigratory stressors. Young Vietnamese adults were most acculturated, most bicultural, and reported themselves as healthiest and least depressed. They were most often working, least often on welfare, and had the highest family income. However, they also reported most dissatisfaction with their current lives in the U.S. and most family conflict. Regression analysis explaining approximately one-quarter of the variance in mental distress implicated current dissatisfaction with and lack of adjustment to life in the United States, as well as greater acculturation and increased family conflict. Although young adults scored significantly higher than other generations on most of the risk factors for psychological distress, they appeared to be buffered against poorer mental health outcomes by factors of generation and perceived positive overall well-being. In terms of testing a predictive model of psychological distress, this study found current adjustment factors significantly more important in determining mental health outcomes than premigratory stressors such as war-related traumas.     

Plasma lipids and other cardiovascular risk factors in Costa Rican adolescents.

This study assessed plasma lipids and other cardiovascular risk factors in adolescents in a developing Latin American country and compared those risk factors to those of adolescents in the United States of America, where the risk of heart disease is high. In a cross-sectional study, data were collected from September 1998 to April 1999 on 161 Costa Rican adolescents between the ages of 12 and 20. A general questionnaire was used to collect demographic, smoking, socioeconomic, and women's health data. Anthropometric measurements, blood pressure, and a fasting blood sample were taken. The Costa Rican males had lower levels of total cholesterol than did the Costa Rican females (mean +/- standard error of the mean (SEM), 149 +/- 6.5 mg/dL vs. 158 +/- 6.3 mg/dL). This was mainly due to lower high-density lipoprotein (HDL) cholesterol in males than in females (mean +/- SEM, 38 +/- 2.0 mg/dL vs. 44 +/- 2.4 mg/dL). As compared to the United States, adolescents in this study had lower levels of total cholesterol, largely due to lower HDL cholesterol. Both genders of Costa Ricans had levels of low-density lipoprotein (LDL) cholesterol that were similar to those of counterpart groups in the United States. Costa Rican male and female adolescents had higher LDL/HDL ratios than did their United States counterparts. Therefore, as compared to the United States, Costa Rican adolescents have an adverse lipid profile as demonstrated by a higher LDL/HDL ratio. Overweight prevalence in Costa Rica was 13%, approaching the 15% overall level of the United States.     

Prenatal Care Use Among Selected Asian American Groups

OBJECTIVES: This study examined the predictors of 3 patterns of prenatal care use (no care, late initiation of care, and inadequate use after early initiation) for 4 Asian American ethnic groups in the United States. METHODS: Single live births to US resident mothers of Chinese, Japanese, Korean, and Vietnamese ancestry (n = 273 604) were selected from the 1992-1996 US natality files. Logistic regression was used to analyze the effects of maternal characteristics on the 3 use measures. RESULTS: Korean Americans and Vietnamese Americans had the lowest levels of prenatal care use. Young or single motherhood, high parity for age, and low educational attainment were the main risk factors for low use. CONCLUSIONS: Considerable variability exists in prenatal care use among Asian American ethnic groups.     

Psychological Distress of Ethnically Diverse Adult Caregivers in the California Health Interview Survey

This study examined factors associated with psychological distress for culturally diverse family caregivers using a population-based sample. Data were analyzed from the 6634 caregivers of adults (i.e. elderly as well as non-elderly) who self-reported as non-Hispanic White, Mexican, Chinese, or Vietnamese in the 2009 California Health Interview Survey. Simple and multiple regression analyses were conducted to assess the potential influence of race/ethnicity, caregiving context, and social contextual variables on psychological distress. Analyses that included moderators showed that while more education was associated with less distress for White caregivers, it was associated with more distress for Vietnamese and Chinese caregivers. Identifying the caregiving and contextual variables associated with psychological distress is critical for tailoring interventions towards those who need the most help—in this case, possibly less educated White caregivers and more educated Asian American caregivers.     

Association of language spoken at home with health and school issues among Asian American adolescents

The study examined the association of language spoken at home with the school and health risks and behaviors of Asian American adolescents. Using the United States component of the 1997-1998 World Health Organization Study of Health Behavior in School Children, bivariate and multiple logistic regression analyses were conducted of records for Asian children to explore the relationship between language spoken at home and outcome variables regarding health behaviors, psychosocial and school risk factors, and parental factors. Compared to those who usually speak English at home, adolescents who usually speak another language, or who speak two languages equally, face a greater risk for health risk factors, psychosocial and school risk factors, and parental risk factors. Not speaking English at home was associated with higher health risks, including not wearing seat belts and bicycle helmets; higher psychosocial and school risk factors, including feeling that they do not belong at school, difficulty making new friends, and lacking confidence; and higher parental risks, including reporting that parents were not ready to help them or willing to talk to teachers. Adolescents less acculturated to the United States experience a variety of physical and psychosocial risks. School-based interventions such as early identification and outreach, needs assessment, and counseling and support services should be provided to immigrant students and their families.     

Psychoecological Model of Alcohol Use in Mexican American Adolescents

In this study, we proposed and tested a structural model based on Bronfenbrenner’s ecological systems theory in order to further understand alcohol use among Hispanic adolescents, who are at greater risk of alcohol use than adolescents of other racial/ethnic groups. Family cohesion, school connectedness, and peer influence were conceptualized as three primary process factors, while psychological distress was used as a mediating factor and Mexican culture orientation as a cultural factor. The sample comprised 444 Mexican American adolescents (aged 16–20) living along the U.S./Mexico border. The proposed model explained 33 % of the variance in alcohol use. Most of the hypothesized relationships in the proposed model were supported: (a) low family cohesion had significant indirect effects mediated through psychological distress, poor school connectedness, and negative peer influence; (b) poor school connectedness had significant indirect effects mediated through psychological distress and negative peer influence; (c) psychological distress had a significant direct effect as well as a significant indirect effect mediated through negative peer influence; and (d) negative peer influence had the strongest direct effect. However, contrary to the hypothesis, Mexican culture orientation was not a protective factor, but rather had a significant positive relationship with negative peer influence. Lastly, it was found that gender, school status, Anglo cultural orientation, and severity of alcohol use did not have any moderating effects. Based on the collective findings, suggestions for primary prevention programs designed to reduce underage drinking among Mexican American youth were given.     

Cancer, Cancer Risk Factors, and Community-Based Cancer Control Trials in Vietnamese Americans

OBJECTIVES: The purpose of this paper is to describe the epidemiology of cancer in Vietnamese Americans and reviews some of the successful intervention strategies that have been accomplished in Northern California. FINDINGS: Preventable cancers are among the leading causes of death in Vietnamese Americans, who have higher than average rates of smoking and lower than average rates for breast and cervical cancer screening, and lower rates of hepatitis B vaccination. Community­based intervention trials have shown good success in reducing these risk factors. CONCLUSIONS: Despite successes, more work needs to be done. Continuing research and dissemination of successful intervention strategies will help improve the health of Vietnamese Americans, one of the fastest growing populations in the U.S.     

A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia.

PURPOSE: To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused policies. METHODS: Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use. RESULTS: More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use. CONCLUSIONS: Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.     

Health Status of Kanaka Maoli (Indigenous Hawaiians)

PURPOSE OF THE PAPER: To summarize the current health status of Kanaka Maoli (indigenous Hawaiians) with historical background, underlying factors responsible for the Kanaka Maoli health plight and recommendations. METHODS: The author reviewed the available literature and some not readily available, unpublished information. PRINCIPAL FINDINGS: Kanaka Maoli continue to have the worst health and socio­economic indicators of the various ethnic groups in their home islands of Ka Pae'aina (Hawai'i). Cardiovascular disorders, cancer, diabetes, obstructive lung disease, maternal and infant health and mental distress are the prominent maladies. Tobacco smoking, high­fat diet, alcohol drinking, hyperlipidemia and obesity are the major lifestyle risk factors. Societal factors, such as depopulation, foreign transmigration, colonial exploitation, coercive assimilation, cultural conflict and racism persist. Since 1990, Kanaka Maoli communities have established five island­wide Native Hawaiian Health Care Systems to improve availability, accessibility, and acceptability of health services to their people, but with inadequate resources. CONCLUSIONS: Under present conditions, while the future may bring some amelioration of Kanaka Maoli ill health, the price will be progressive acculturation and loss of Kanaka Maoli identity. Accordingly, recommendations include augmented revitalization of the traditional culture, effective recontrol by the Kanaka Maoli of their lives and natural resources and thus, improved total health. KEY WORDS: Pacific Islander Americans, Kanaka Maoli, Hawaiians, Indigenous Health, Culture, Ethnicity, Racism, Colonialism, Sovereignty     

Pre-migration Trauma Exposure and Psychological Distress for Asian American Immigrants: Linking the Pre- and Post-migration Contexts

Drawing on the life course perspective and the assumptive world theory, this paper examines whether pre-migration trauma exposure is associated with psychological distress through post-migration perceived discrimination for Asian American immigrants. The study is based on cross-sectional data from the National Latino and Asian American Study (N = 1639). Structural equation model is used to estimate the relationship between pre-migration trauma, post-migration perceived discrimination, and psychological distress. Additional models are estimated to explore possible variations across ethnic groups as well as across different types of pre-migration trauma experience. Pre-migration trauma exposure is associated with higher levels of psychological distress, both directly and indirectly through higher level of perceived discrimination, even after controlling for demographic/acculturative factors and post-migration trauma exposure. This pattern holds for the following sub-types of pre-migration trauma: political trauma, crime victimization, physical violence, accidental trauma, and relational trauma. Multi-group analyses show that this pattern holds for all Asian immigrant subgroups except the Vietnamese. Studies of immigrant mental health primarily focus on post-migration stressors. Few studies have considered the link between pre- and post-migration contexts in assessing mental health outcomes. The study illustrates the usefulness of bridging the pre- and post-migration context in identifying the mental health risks along the immigrant life course.     

Alcohol Consumption and Psychological Distress in Adolescents: A Multi-Country Study

PurposeTo examine the association between alcohol use and psychological distress among adolescents in a range of developing countries.MethodsSecondary data analysis of the Global School-Based Student Health Survey was conducted using nationally representative data from 12 developing countries: Botswana, Grenada, Indonesia, Kenya, Myanmar, the Philippines, Saint Lucia, Saint Vincent and the Grenadines, the Seychelles, Thailand, Trinidad and Tobago, and Uganda. The surveys were conducted between 2003 and 2008 and involved 32,001 adolescents primarily aged 13–15 years. We used multivariate logistic regression analysis to determine the association between alcohol use and psychological distress.ResultsThe prevalence of past 30-day alcohol use and lifetime drunkenness varied widely across countries, as did the occurrence of psychological distress (anxiety-induced sleeplessness and/or depression). The risk of psychological distress was significantly higher among adolescents when using alcohol in all countries except Myanmar. In nine of the 12 countries, past 30-day alcohol use was associated with psychological distress, while students who had been drunk at least once in their lifetime had an increased risk of experiencing psychological distress in 11 of the study countries.ConclusionsThe high prevalence of alcohol use among adolescents and the strength of the association with psychological distress present a major public health challenge in developing countries. The urgent need to reduce adolescent alcohol use necessitates the implementation of context- and culture-specific strategies that reduce the physical availability of alcohol.     

Does Acculturation Influence Physical Activity in Japanese American Older Adults?

PURPOSE: Despite the health benefits of physical activity, demographic and health factors as well as cultural backgrounds are thought to influence participation in physical activity. The aim of this study is to examine whether acculturation is associated with physical activity in a sample of Japanese American older adults living on the continental United States. METHODS: A survey was mailed to Japanese Americans identified from the mailing list of two community­based organizations. The survey included questions on physical activity, acculturation, demographics, health behaviors, and self­reported health status. Data were analyzed using bivariate and multiple regression techniques. FINDINGS: Acculturation was not a significant predictor of phsical activity in either community sample, or the pooled sample, after conrolling for other sociodemographic andhealth status variables. The models explained 23% to 2% of the variance in physical activity. Statistically significant predictors of physical activity included gender, work status, age, income, and health status. CONCLUSIONS: Our findings differ from studies of Japanese Americans in Hawaii and other racial/ethnic groups, suggesting that accultraion may have differential effects depending on the environment and the racial/ethnic group under study. KEY WORDS: Japanese American, physical activity, acculturation     

Predictors of HPV vaccine acceptability: a theory-informed, systematic review

OBJECTIVE: To inform future human papillomavirus (HPV) vaccination programs, we systematically reviewed studies of HPV-related beliefs and HPV vaccine acceptability, organizing the findings using health behavior theory and cervical cancer risk factors. METHODS: We searched Medline, CINAHL, and PsycINFO from 1995 to January, 2007 for studies of HPV beliefs and HPV vaccine acceptability among adolescents, young adults, and parents of adolescents in the United States. RESULTS: We identified 28 studies. Most were small, cross-sectional studies of parents and adults. Most parents reacted positively to the possibility of vaccinating their daughters against HPV. Vaccination acceptability was higher when people believed the vaccine was effective, a physician would recommend it, and HPV infection was likely. Cost and, for 6% to 12% of parents, concerns that vaccination would promote adolescent sexual behavior were barriers to vaccination. African American, Hispanic, and white respondents were equally accepting of the HPV vaccine. Parents with lower levels of education reported higher vaccine acceptability. Many studies inadequately reported on other variables associated with cervical cancer mortality. CONCLUSIONS: HPV vaccine programs in the United States should emphasize high vaccine effectiveness, the high likelihood of HPV infection, and physicians' recommendations, and address barriers to vaccination.     

Profile of Tuberculosis among Foreign-born Asians Residing in Los Angeles County, California, 1985­1994

PURPOSE. To present a profile of tuberculosis %lpar;TB) among foreign& shy;born Asians residing in Los Angeles County and priorities in eliminating TB. SUMMARY OF METHODS UTILIZED. The demographic and disease­related data were analyzed from a total of 3,364 TB cases among Asians, which were obtained over a 9­year period (1985& shy;1994) by the Los Angeles County Tuberculosis Control Program. Various sources were used to obtain the denominators needed to calculate case rates because no one source had all the information. The data were analyzed using the standard SAS statistical software system. PRINCIPAL FINDINGS. Ninety& shy;eight percent of Asians with TB were foreign& shy;born, and 91 percent of the foreign& shy;born with TB were born in countries with high endemic rates of TB (Vietnam, Philippines, South Korea and the People's Republic of China). The TB case rate of foreign& shy;born Asians increased linearly with increase in percent household income below poverty level. The relative risk of TB among newly arrived Vietnamese, Filipinos, Chinese from People's Republic of China and Koreans was 112.0, 91.0, 36.8 and 28.1 times higher than that of the overall U.S., respectively (risk). CONCLUSIONS. The current screening procedures identify large numbers of TB cases among newly arrived Asians who contribute significantly to the occurrence of TB in Los Angeles County. Better strategies should be developed to effectively reduce morbidity in foreign& shy;born Asians from countries with high endemic rates of TB. They include the development of a comprehensive, ethnic& shy;specific, culturally sensitive educational intervention campaign and readily accessible outreach clinics with culturally sensitive TB preventive therapy program. KEY WORDS. Asians, tuberculosis, immigrants, Filipinos, Koreans, Chiense, Vietnamese.     

Psychological adjustment of obese youth presenting for weight management treatment

OBJECTIVE: To determine the prevalence of psychological maladjustment in clinic-based treatment-seeking obese children and adolescents (BMI > or = 95th percentile) and the degree to which maternal, demographic, and youth factors correlate to the youths' psychological adjustment. RESEARCH METHODS AND PROCEDURES: Anthropometrics, demographics (race, sex, insurance status), measures of youth psychological adjustment (self- and mother-report; Behavior Assessment System for Children), and maternal self-report of psychological distress (Symptom Checklist 90-Revised) were collected from 121 obese children and adolescents (55% white, 45% black) and their mothers. RESULTS: Approximately one-third of youths self-reported some psychological maladjustment, but two-thirds of youth were described by their mothers as experiencing some degree of psychological maladjustment. Adjustment difficulties were specific to social functioning, low self-esteem, and internalizing symptoms. Forty-one percent of mothers of child participants and 56% of mothers of adolescent participants reported clinically significant psychological distress. Youth self-report and mother-report of youths' psychological difficulties were often most strongly associated with mothers' level of psychological distress and/or family socioeconomic status rather than to youth characteristics (e.g., percent overweight, race). DISCUSSION: Psychological maladjustment levels among obese youth and their mothers were higher in this clinic-based sample than in treatment research-based samples. Present correlate findings extended to obese adolescents and reaffirm a potent association between youth self-report of their own psychological adjustment and their mother's level of psychological distress. Demographic characteristics and youth weight status were not consistent correlates of youths' psychological functioning. Findings have implications for the translation of empirically supported pediatric obesity interventions to clinic-based treatment samples.     

Psychosocial Distress and Alcohol Use as Factors in Adolescent Sexual Behavior Among Sub-Saharan African Adolescents

BACKGROUND: This study examines the relationship between sexual behavior, alcohol use, and indicators of psychosocial distress (mental health) of adolescents in 6 sub-Saharan African countries using the Global School-based Student Health Survey (GSHS).
METHODS: The sample consisted of 22,949 adolescents from Botswana, Kenya, Namibia, Uganda, Zambia, and Zimbabwe who participated in 2003 or 2004 GSHS surveys. Statistical analysis was conducted to determine whether sexual behaviors increased with levels of psychosocial distress and alcohol use.
RESULTS: Sexual behaviors (having sex or having sex with 2 or more people) were associated with both psychosocial distress and alcohol use. Odds ratios showed that both boys and girls reporting psychosocial distress and alcohol use were at higher risk for having sex. Results also indicated that the likelihood of sexual behaviors increased when there was an increase in the number of psychosocial indicators and frequency of alcohol consumption.
CONCLUSION: The results of this study are consistent with those conducted in the United States suggesting that sexual behavior, psychosocial distress, and substance use are interconnected. These findings highlight the need for school health education and health services in sub-Saharan Africa, specifically the efforts to reduce psychosocial distress and prevent substance use in efforts to prevent the spread of human immunodeficiency virus and other sexually transmitted infections.     

Peer Reviewed: Association of Race/Ethnicity,Socioeconomic Status,Acculturation, and Environmental Factors with Risk of Overweight Among Adolescents in California, 2003

Introduction

Little has been published about racial/ethnic differences in the prevalence of overweight among adolescents that accounts in detail for socioeconomic status, acculturation, and behavioral and environmental factors. Increased understanding of factors associated with overweight can provide a rational basis for developing interventions to address the obesity epidemic in the United States.

Methods

Using a cross-sectional analysis of data from adolescents who participated in the California Health Interview Survey 2003, we estimated the prevalence of overweight and at risk of overweight, combined as a single measure (AROW, body mass index ≥85th percentile). We used logistic regression models to examine associations between AROW and risk factors.

Results

Twenty-nine percent of California adolescents were AROW. The prevalence of AROW differed significantly by sex and race. Boys were more likely than girls to be AROW (33% vs 25%). American Indians/Pacific Islanders/others (39%) were at highest risk, followed by Hispanics (37%), blacks (35%), whites (23%), and Asians (15%). For boys, older age, Hispanic or American Indian/Pacific Islander/other race/ethnicity, lower education of parents, and longer residence in the United States were significantly associated with AROW. For girls, Hispanic or black race/ethnicity, lower education of parents, and poor dietary habits were significantly associated with AROW.

Conclusion

The high prevalence of AROW among California adolescents in most racial/ethnic groups indicates the need for culturally specific and appropriate interventions to prevent and treat overweight.     

Spatio-Temporal Clustering of Adolescent Bereavement in the United States During the Extended Response to COVID-19: A Follow-Up Study

PurposeThis follow-up study investigated the spatio-temporal clustering of adolescent bereavement during the extended response to COVID-19 from October 2020–January 2022 in the continental United States.MethodsDeidentified and anonymized bereavement data from Crisis Text Line (CTL), a text-based crisis intervention service, and SaTScan cluster analysis were used to identify space-time clustering of bereavement among adolescents, aged 24 years and less, during the COVID-19 pandemic.ResultsClustering of bereavement conversations occurred during waves of high COVID-19 case and death counts, with the highest risk occurring in the Southeastern United States during the fall of 2020 (relative risk: 5.86, confidence interval: 3.48–8.24). Of the CTL texters who shared their demographic information, Indigenous American, Black, male, and female adolescents were more likely to seek help for bereavement when compared to the other CTL users.DiscussionFindings show an increased need for bereavement counseling resources during periods of high COVID-19 cases and deaths.     

Social Environments and Physical Aggression Among 21,107 Students in the United States and Canada

Background: Physical aggression is an important issue in North American populations. The importance of students’ social environments in the occurrence of physical aggression requires focused study. In this study, reports of physical aggression were examined in relation to social environment factors among national samples of students from Canada and the United States. Methods: Students in grades 6‐10 from the United States (n = 14,049) and Canada (n = 7058) who had participated in the Health Behaviour in School‐aged Children Survey (HBSC) were studied. Rates of students’ physical aggression were compared between the 2 countries. School, family, socioeconomic, and peer‐related factors were considered as potential risk factors. A simple social environment risk score was developed using the US data and was subsequently tested in the Canadian sample. Results: Risks for physical aggression were consistently higher among United States versus Canadian students, but the magnitude of these differences was modest. The relative odds of physical aggression increased with reported environmental risk. To illustrate, US boys in grades 6‐8 reporting the highest social environment risk score (5+) experienced a relative odds of physical aggression 4.02 (95% CI 2.7‐5.9) times higher than those reporting the lowest score (adjusted OR for risk scores 0 through 5+ was 1.00, 1.19, 2.10, 2.01, 3.71, and 4.02, respectively, p_trend < .001). Conclusions: Unexpectedly, rates of physical aggression and associations between social environments and students’ aggression were remarkably similar in Canada and the United States. Family, peer, and school social environments serve as risk or protective factors, with significant cumulative impact on physical aggression in both countries. Given the observed high rates and the many negative effects of aggression on long‐term health, school policies aimed at the reduction of such behavior remain a clear priority.     

Estimates of psychological distress among Vietnamese refugees: adolescents, unaccompanied minors and young adults

This study focuses on the assessment of psychological distress among three subgroups of Vietnamese refugee youth: adolescents, unaccompanied minors, and young adults. Using translated and backtranslated instruments, data was gathered in refugee camps in the Philippines in order to provide baseline measurement for future comparisons, as well as to begin to develop normative standards for these populations. A rationale for the choice of instruments (Vietnamese Depression Scale, Hopkins Symptom Checklist-25 and General Health Questionnaire) is offered and mean scores and percentages scoring above established clinical cut-offs are presented. Results indicate relatively high levels of depression and anxiety for the young adult group, although anxiety appeared high across all three groups. All three groups also scored poorly on self-reports of general health, with the young adults and unaccompanied minors being especially overrepresented in the clinical range. Significant method problems were noted regarding construct validity in the assessment of depression, and instructional set differences that may account for the relatively low intercorrelations between seemingly similar measures.