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S18 Z. Bromand et al. / European Psychiatry 27 (2012) / supplement n°2 / S17-S21 strain. However, to date, there are few studies to identify risk and protective factors in migrant populations in Europe. In the current study, we explored both risk factors (neuroticism, social strain) and protective factors (self- effi cacy, extraversion, and social support), associated with mental health status among Turkish women living in Germany. 1.1. Psychological factors in regard to mental disorders Personality traits [7,46], perceived self- effi cacy [43,49], social support, and social stress, especially resulting from violence within the family [4,21,34,38] are psychosocial contributors to the emergence of mental disorders. There has not been a comprehensive study about the relationship between social support, self- effi cacy, and personality factors among migrants of Turkish descent. Research on non- migrant populations points to a signifi cant correlation between personality traits and psychological complaints [13,16]. Personality traits can infl uence health in various ways, and together with behavior patterns, can either have a health- promoting or health- threatening effect. Several studies reveal a positive correlation between the personality trait, neuroticism, and anxiety and depression [21,34]. Likewise, neuroticism is a risk factor for cultural confl icts. In contrast, extraversion was found to be a major predictor of life satisfaction and less depression [28,41]. The present study focuses on these two dimensions of personality: neuroticism, and extraversion, as previous fi ndings suggest they are the best predictors of psychological functioning. Self- effi cacy is regarded as a central protective factor in dealing with psychological stress [18,48]. Self- effi cacy expectation refers to the belief that one can achieve goals with one´s own capability despite potential obstacles. Since people with higher self- effi cacy expectations are more confi dent about their own abilities and skills, they can deal with challenges more positively [5], and achieve success more frequently. Schwarzer [43] suggests that subjective behavior patterns are available as resources for various situations, and therefore self- efficacy can be seen as a generalised, temporally steady construct. The self- effi cacy expectation has been found to be an indicator for mental health, with low self- effi cacy associated with anxiety and depression [26,43]. Therefore, migrants with a higher self- effi cacy expectation could possibly, despite strain, integrate better in the host country, and have a lower risk of developing psychological problems. Social support has been found to be a protective factor in stressful situations [31]. The quality of interpersonal interactions has a crucial role in social support [31] and social support can be defi ned as general perceived or anticipated support, i.e. the subjective conviction about receiving support from one’s social network in case of need [30,45]. Interpersonal interactions can, as well, be experienced as burdening if one feels controlled, constrained, criticised or looked down on upon by others [45]. This can lead to confl icts within the family and increase social strain, which may have negative effects on mental health. Therefore we hypothesize a negative effect of social strain on the development of psychological problems amongst migrant women. To our knowledge, there have been no studies to date, which have systematically investigated the relationship between resilience (self- effi cacy, extraversion, social support), risk factors (neuroticism, social strain) and mental health in women with Turkish backgrounds living in Germany. We hypothesize that 1) resilience factors (self- effi cacy, extraversion, social support) would be negatively associated with mental distress and 2) risk factors such as neuroticism and social strain would correlate positively with mental distress. 2. Method 2.1. Participants Participants were recruited through direct contacts with family members, friends, hospital coworkers and women from Turkish community centers in Berlin. A total of 105 Turkish migrant women between 21 and 64 years of age living in Berlin were included. Mother- tongue Turkish clinical staff conducted interviews with participants to collect sociodemographic data. Participants completed paper pencil self- report psychological questionnaires in the presence of the mother- tongue Turkish clinical coworkers. 2.2. Setting The data was collected between April and October 2009. All participants answered the questionnaire in a setting of their own choice, at home, in the university clinical hospital, or in Turkish community centers. Written informed consent was obtained from all participants and the study was approved by the ethics committee of Charité University, Berlin, Germany. Respondents took an average of 120 minutes to complete the interview and questionnaires. Proofs 2.3. Measures 2.3.1. Socio demographic variables Data were collected on age, birthplace of the participants, their parents and grandparents, length of stay in Germany, residence status, reasons for migration, language ability, religious background and several indicators of socioeconomic status (SES) including education (i.e. none, elementary school or post- secondary education), total family income, partnership (i.e. single, steady relationship, married or separated), and employment status. Furthermore, all respondents were asked to report their own and their parents’ physical and mental health (e.g. cancer, diabetes, depression, alcohol addiction, and suicidal ideation or suicide attempts) and experience of trauma. 2.3.2. Translation procedures Several of the instruments (NEO- FFI, Social Strain questionnaire, Acculturation Scale) were fi rst translated from German to Turkish and then translated back. Translated questionnaires
were then scrutinized independently by three highly competent bilingual coworkers (i.e., a psychologist, a social worker, and a graduate student of psychology) and were adjusted in a consensus conference supervised by the principal investigator of the study. 2.3.3. General health (GHQ- 28) The general health questionnaire (GHQ- 28) presents a valid and reliable instrument across cultures. It assesses the recent subjective psychological state along four subscales: (a) psychosomatic symptoms, (b) anxiety and insomnia, (c) social dysfunction, and (d) severe depression [20]. Each subscale contains seven items on a four- point Likert scoring system. Total scores for the GHQ in our sample ranged from 0 to 84. The lower the score, the better the psychological well- being of the subjects. The internal reliability of the Turkish version of GHQ- 28 was found to be highly reliable (Cronbachs α = .82 - .93). 2.3.4. The General Self- Effi cacy Scale (GSE) The GSE is based on Bandura`s self- effi cacy theory [5]. Self- effi cacy is an optimistic self- belief that one can achieve his or her goals or perform a novel or diffi cult task with his or her own capability despite potential obstacles. The GSE is a 10- item scale with a four- point Likert scale type format ranging from [1] “Not at all true” to [4] “Exactly true” and with a total range from 10 to 41 [27]. The scale is designed for adult populations and is available in 27 languages. The internal reliability of GSE from the 23 nations including Turkey ranged between .76 and .90, with the majority in the high .80s. 2.3.5. Berlin Social Support Scales (BSSS) The Berlin Social Support Scales (BSSS) is a multi- dimensional self- report inventory [44] designed to measure various dimensions of social support (perceived available support, need for support, support seeking, actually received support, provided support). In the current study, we only used the subjectively perceived social support as a robust trait, which contains 12 items. Responses ranged from 1 (strongly disagree) to 4 (strongly agree). The internal reliability for the original BSSS version is .83 and for the Turkish translated version .91. 2.3.6. Social Strain (F- SOZU) Social Strain is a subscale of the German Social Support Questionnaire F- SOZU [45]. The 12- item subscale assesses excessive demands, overprotection and rejection. Examples are “I feel rejected by important people” or “I wish others would not interfere too much with my life”. The items are rated on a Likert scale from 1 (totally disagree) to 5 (totally agree). The internal reliability for the German Social Support Questionnaire F- SOZU is between .81 and .93 and for the Turkish translated version .89. Z. Bromand et al. / European Psychiatry 27 (2012) / supplement n°2 / S17-S21 S19 2.3.7. NEO- Five Factor Inventory (NEO- FFI) The NEO Five- Factor inventory (NEO- FFI) is a shortened version of the NEO PI- R designed to measure five stable domains of personality (Neuroticism, Extroversion, Openness, Agreeableness, and Conscientiousness) [12]. In the current study, all subjects completed only two dimensions (extraversion and neuroticism) from a German version of NEO- FFI [8]. High scores on extraversion represent individual differences in the tendency to experience warmth, gregariousness and assertiveness. Neuroticism is characterized by anxiety, hostility and depression. The (NEO- FFI) is a 60- item self- report inventory, which measures on a fi ve- point Likert- scale (from “strong approval” to “strong disapproval”). The measurement was also translated and back- translated into the Turkish language (Neuroticism, Cronbachs α =.51 for translated version; Extraversion, Cronbachs α = .58 for translated version). 2.4. Data analysis All the analyses were conducted in SPSS/PC version 18.0. Descriptive statistics of the frequencies and means of the demographic variables of the study were computed. Missing data were replaced by the mean of nearby points. (chi 2 ) tests were performed for categorical data. Interrelations between psychosocial variables were assessed using simple Pearson correlation. 3. Results 3.1. Participant characteristics Proofs A total of 105 respondents with a Turkish background participated in the study. Participants’ mean age was 36.01 years (SD 9.11; range 21 to 64 years). Most subjects were married (54.9%), born in Turkey (66.7%) and migrated to Germany for social reasons (family reunion/marriage) (78%). Only 26% of the subjects had a full- time job and more than 72% of them had relatively low household net income with less than 2000 € per month (Table 1). 3.2. Predictors of mental health resilience and vulnerability factors In all participants, social strain (Pearson’s r=.26*, p
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Page 45 and 46: generating a model of the self with
Page 47 and 48: Acknowledgements This work was supp
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Page 61 and 62: 1. Introduction The number of immig
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Acknowledgments We are very gratefu
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cross- cultural mental health train
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3.3.2. German experiences Despite t
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[31] Mösko M, Gil- Martinez F, Sch
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2. Psychosocial care as a necessary
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* First Rank Symptoms according to
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Epilogue A. Kleinman Esther and Syd
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