For this reason, the healthy-migrant effect is also called the “acculturation paradox”: the more acculturated one is, the less healthy one becomes. One study of Turkish immigrants to Germany showed the effect to last for at least a generation. A subsequent 2004 study of Mexican immigrants to the United States showed that “[w]ith few exceptions, foreign-born Mexican Americans and foreign-born non-Hispanic whites were at significantly lower risk of DSM-IV substance-use and mood-anxiety disorders compared with their US-born counterparts.” These included alcohol and drug abuse, major depression, dysthymia, mania, hypomania, panic disorder, social and specific phobia, and generalized anxiety disorder. The longer they lived in the United States, the more they showed the particular damage to the mind that our particular culture wreaks. People who come to America eventually find themselves subject to our own culture-related syndromes, which the DSM-IV can easily recognize and categorize, as acculturation forces their internal worlds to conform to the external world, i.e., the American culture that the DSM-IV knows best.