International Society for Traumatic Stress Studies

“One Scar Too Many:” The Association of Traumatic Events and Psychological Distress among Undocument

by Luz M. Garcini, Ph.D., MPH
The United States (U.S.) has been a primary destination for international migrants. Approximately 13% of the U.S. population is foreign born (U.S. Census Bureau, 2015), with a considerable proportion of these immigrants being undocumented (approximately 27%) and of Latinx/Hispanic descent (Pew Research Center, 2013). Also, there are approximately 4.5 million U.S.-born children whose parents are undocumented, and at least 9 million Latinxs living in “mixed-status” families, in which at least one family member is undocumented (Taylor, Lopez, Passel, & Motel, 2011).

Undocumented immigration to the U.S. often presents with multiple stressors and contextual challenges, which may increase risk for psychological distress and diminished mental health (Garcini et al., 2016). For instance, exposure to physical, verbal, psychological and/or sexual violence is widespread among undocumented immigrants (Garcini et al., 2016). Examples of common traumatic events experienced by these immigrants include human/drug trafficking, extortion, dangerous border crossing, witnessing the death of others while crossing, abandonment by crossing guides or “coyotes,” unsafe working conditions, separation from family and friends, limited access to healthcare, domestic violence, and deportation (Garcini et al., 2016; Infante, Idrovo, Sánchez-Domínguez, Vinhas, & González-Vázquez, 2012). These traumatic events can have serious and lasting impact on the mental health of these immigrants and their U.S.-born families (Delva et al., 2013). For instance, trauma can lead to disruption in family relations, interference in building supportive social networks, conflict and diminished performance at work/school, engagement in high-risk behavior (e.g., substance use) and ill health (Delva et al., 2013; Porche, Fortuna, Lin, & Alegria, 2011). Also, given their lack of access to health and human services programs (e.g., legal protection), undocumented immigrants are at high-risk of psychological distress associated with trauma (U.S. Department of Health and Human Services, 2012).

In this study, we aimed to measure the relationship between traumatic events, psychological distress and socio-demographic and immigration characteristics, including gender differences, among undocumented Mexican immigrants residing in high-risk neighborhoods. Therefore, we assessed the prevalence of psychological distress and traumatic events, as well as the association of psychological distress and traumatic events after controlling for relevant socio-demographic and immigration characteristics.

Our findings indicated that more than three-fourths of participants had a history of exposure to traumatic events. Nearly a third of participants reported having a history of at least six or more types of traumatic events. Men were more likely to report greater instances of material deprivation, war-like or violent conditions, confinement, extortion, robbery, witnessing violence of others and deportation. In contrast, women were more likely to experience domestic violence and rape. Nearly half of participants with a history of traumatic events had a high prevalence of clinically significant psychological distress. Participants with a history of domestic violence, physical injury, witnessing violence to others and injury to loved ones were more likely to have clinically significant levels of psychological distress. A surprising finding in our study was that not having a history of deportation was associated with clinically significant psychological distress. Although the opposite effect was expected, it is probable that once an undocumented immigrant is deported and finds a way to successfully return to the U.S., the distress associated with fear of deportation may subside given that the immigrant has learned that he/she can face and survive deportation if it reoccurs.

This study has some limitations. First, it is likely that there are differences in traumatic events and psychological distress among other undocumented immigrants living in other parts of the U.S. or from other countries of origin. Moreover, our sample was predominately female and on average participants had lived in the U.S. for more than 10 years. Thus, our data is most representative of undocumented Mexican women who have made the U.S. their home and most of which are living in mixed status families; where, some family members are U.S. citizens. Also, this study was cross-sectional; thus, causation cannot be inferred.

Our study makes a timely and significant contribution to inform the mental health of this community. Overall, the high prevalence of exposure to traumatic events and psychological distress highlight the need for the development and provision of culturally and contextually sensitive prevention and treatment interventions, as well as binational policy efforts to protect the human rights of this immigrant population. Debates on programs and policies pertaining to undocumented immigrants are complex and multifaceted, and divisiveness on immigration and welfare reform in the U.S. is long-standing. Undocumented immigrants represent an at-risk subgroup, for whom access to health and human services is limited, which have significant public health implications. Revisiting immigration policies to devise solutions grounded in evidence and advocating to support mechanisms aimed to protect the human rights of this immigrant population is essential to prevent the negative consequences of trauma for these immigrants and the broader communities in Mexico and the U.S.


Delva, J., Horner, P., Martinez, R., Sanders, L., Lopez, W. D., & Doering-White, J. (2013). Mental health problems of children of undocumented parents in the United States: A hidden crisis. Journal of Community Positive Practices, 13(3), 25-35.

Garcini, L. M., Murray, K., Zhoe, A., Klonoff, E. A., Myers, M., & Elder, J. P. (2016). Mental Health of Undocumented Immigrants in the United States: A Systematic Review of Methodology and Findings. Journal of Immigrant and Refugee Studies, 14(1), 1-25.

Infante, C., Idrovo, A. J., Sánchez-Domínguez, M. S., Vinhas, S., & González-Vázquez, T. (2012). Violence committed against migrants in transit: Experiences on the northern Mexican border. Journal of Immigrant and Minority Health, 14,3, 449-459. doi:10.1007/s10903-011-9489-

Pew Research Center (2013). A nation of immigrants: A portrait of the 40 million, including 11 million unauthorized. Washington, DC: January. Retrieved October 12, 2013, from

Porche, M. V., Fortuna, L. R., Lin, J., & Alegria, M. (2011). Childhood trauma and psychiatric disorders as correlates of school dropout in a national sample of young adults. Child development, 82(3), 982-998.

U.S. Census Bureau (2015). U.S. Census Bureau, 2015 American Community Survey 1-Year Estimates Retrieved October 14, 2015 from

U.S. Department of Health and Human Services (2012). Immigrants’ access to health and human services programs. Retrieved November 10, 2016 from

Taylor, P., Lopez, M. H., Passel, J. S., Motel, S. (2011, December 1). Unauthorized immigrants: Length of residency, patterns of parenthood. Retrieved October 10, 2013, from

Discussion Questions

  1. How can traumatic events affect the mental health of undocumented Latinx immigrants?
  2. With the current socio-political climate, how can we increase access and utilization of mental health services among undocumented Latinx immigrants?

Reference Article

Garcini, L. M., Peña, J. M., Gutierrez, A. P., Fagundes, C. P., Lemus, H., Lindsay, S. and Klonoff, E. A. (2017), “One Scar Too Many:” The Associations Between Traumatic Events and Psychological Distress Among Undocumented Mexican Immigrants. JOURNAL OF TRAUMATIC STRESS, 30: 453–462. doi:10.1002/jts.22216

Author Biography

Dr. Luz María Garcini, PhD., MPH is originally from Mexico and completed her undergraduate work at the University of Houston. After her time at the University of Houston, Dr. Garcini completed an MA degree in clinical psychology at the University of Houston-Clear Lake, as well as a one-year clinical internship at the University of Texas Medical Branch (UTMB) where she became interested in the development and implementation of health interventions for the underserved. After working in multiple community-based settings with diverse immigrant populations, she attended the SDSU/UCSD Joint Doctoral Program (JDP) in Clinical Psychology where she worked on a combined degree in clinical psychology (PhD) and Epidemiology (MPH). Her research at the JDP involved extensive binational collaboration with Mexico, and her dissertation focused on the use of Respondent Driven Sampling (RDS) to study the health and well-being of undocumented Mexican immigrants and deportees. Currently, Dr. Garcini is a post-doctoral fellow at Rice University working on the study of loss and physiological dysregulation among underserved populations. Her primary interests include informing methodology to study socially disadvantaged populations, as well as translational research to inform health and public policy for the underserved.  Additionally, Dr. Garcini is a Ford fellow, and she is highly committed to activities supporting increased representation and retention of minorities in the health and social sciences. Dr. Garcini has received numerous awards including recently the 2016 American Psychological Association Distinguished Graduate Student Award in Professional Psychology and the 2017 Art Nezu Outstanding Dissertation Award.


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