Somatization and coping in ethnic minority recruits

Abstract

Introduction: Military service can have beneficial social effects on minorities. However, minoritygroups are also often at greater risk of somatizing psychological distress and coping maladaptively. In military trainingthis would result in lower mental health of minorities and contribute to higher drop-out rates. We thus examined ifrecruits with different ethnocultural backgrounds report different somatization levels and coping styles. Materials andMethods: Seven hundred and forty male recruits of the Swiss Armed Forces aged 18-26 took part in a cross-sectionalstudy during basic training. Participants filled out self-rating questionnaires covering sociodemographics, somatization(SCL-90-R), coping styles (INCOPE-2), and social support (F-SozU). The recruits' ethnic self-identification was usedto compare three groups: native Swiss (89%); Turkish or Balkan minority (5%); heterogeneous ethnic minority (6%).Group differences in somatization scores were tested with a Kruskal-Wallis test; group differences in coping styleswere tested with a multivariate ANCOVA, controlling for the level of social support experienced. Results: Recruitsfrom the heterogeneous ethnic minority group reported significantly greater levels of somatization than their nativeSwiss comrades. Coping styles did not differ between the three ethnic groups, but higher levels of social support wereassociated with better coping. Conclusion: Military doctors ought to place importance on the differential diagnosis ofmedically unexplained physical symptoms in ethnic minority recruits. This would contribute to minimize the risk ofmisdiagnosis. Military mental health professionals who counsel recruits reporting somatic symptoms are advised to besensitized to an ethnic minority status. Physical complaints could mask affective problems or be part of an adjustmentdisorder symptomatology.