Acculturative stress is associated with trajectory of anxiety symptoms during pregnancy in Mexican-American women

Experiences of discrimination during pregnancy predict altered neonatal hair cortisol at birth

OBJECTIVE

Prenatal glucocorticoids (e.g., cortisol) are a widely proposed prenatal programming mechanism, yet few studies directly measure fetal cortisol. Neonatal hair provides a non-invasive method to assess fetal cortisol. The current studies test the association between maternal exposure to discrimination and fetal cortisol, as measured in neonatal hair, in two cohorts.

METHODS

Study 1: Pregnant individuals (N = 65) and their neonates (61.8 % female) participated in study 1 between 2017 and 2021. Participants self-identified as Asian (6.2 %), Black (21.5 %), Latinx (35.4 %), Multiracial or Multiethnic (35.4 %), and Native Hawaiian or Pacific Islander (1.5 %). Experiences of discrimination were measured using the Everyday Discrimination Scale. Neonatal hair samples were collected close to birth (Mediandays=1.30, IQRdays=0.96-2.03).

RESULTS

Study 1: Higher experiences of everyday discrimination among pregnant individuals were associated with lower hair cortisol levels in neonates (r = -.28, p = .031).

METHODS

Study 2: Pregnant individuals of Mexican descent (N = 73) and their neonates (50.7 % female) participated in study 2 between 2017 and 2020. Participants reported on their exposure to experiences of discrimination using the Discrimination Stress Scale, and neonatal hair samples were collected shortly after birth (Mediandays=13.0, IQRdays=11-18).

RESULTS

Study 2: Those who had higher discrimination stress during pregnancy had neonates with higher cortisol than those with low discrimination (F(1,70)= 3.78, p = .03), but this relation did not remain significant after controlling for gestational age.

CONCLUSION

Across two cohorts, higher experiences of discrimination were associated with alterations in neonatal hair cortisol. Both higher and lower neonatal hair cortisol are linked to poorer neonatal development, indicating that experiences of discrimination might be a potential source of health disparities in the next generation.

Effects of sociocultural stressors on maternal responsivity and the infant behavioral and neuroendocrine response to stress in families of Mexican descent

Maternal stress is consistently linked to alterations in maternal behavior and infant neurodevelopmental outcomes. As the Latino population grows in the U.S., it is increasingly important to understand how culturally relevant factors affect this relationship. This study aimed to address the role of sociocultural stressors on maternal sensitivity and markers of infant emotional regulation and the neuroendocrine response to stress in mother/infant dyads of Mexican descent. Pregnant women of Mexican descent (n = 115) were recruited during early pregnancy and followed until their infants were 6 months old. Mothers completed measures of sociocultural stressors (acculturative stress and discrimination) at pre and postnatal time points. At 6 months, dyads underwent the Still Face procedure. Mothers were observed for behaviors exhibiting maternal responsivity, while negative vocalizations were observed in infants. Salivary cortisol was also collected from infants. Maternal responsivity was a salient risk factor for alterations in infant emotional regulation and cortisol activity. Postnatal experiences of discrimination were also negatively associated with infant negative affect. This work highlights maternal responsivity and points to a potential role for experiences of discrimination in the response to stress in the mother/child dyad that may have consequences for the development of emotional regulation in infants of Mexican descent.

The role of stress in perinatal depression and anxiety - A systematic review

Perinatal depression (PND) and anxiety affect around 20% of women, but available pharmacotherapy is not sufficiently effective in 20-60% of them, indicating a need for better understanding of these diseases. Since stress is a significant risk factor for PND, the aim was to examine the role of biological, environmental and psychological stress in PND and anxiety through a systematic literature search. Overall 210 studies were included, among which numerous rodent studies showed that perinatal stress induced depressive-like and anxious behavior, which was associated with HPA-axis alterations and morphological brain changes. Human studies indicated that the relationship between cortisol and perinatal depression/anxiety was not as clear and with many contradictions, although social and psychological stress were clearly positively associated with PND. Finally, oxytocin, synthetic neuroactive steroid and n-3 PUFA diet have been identified as potentially beneficial in the therapy of PND and anxiety, worth to be investigated in the future.

Posttraumatic stress among trauma-exposed Hispanic/Latinx adults: relations to mental health

Latinx persons are exposed to higher rates of traumatic events and conditional risks for developing posttraumatic stress disorder (PTSD) symptoms and comorbid mental health symptoms compared to other minority groups. The study evaluated PTSD symptom severity for global and specific cluster severity relating to co-occurring anxiety, social anxiety, depression, and suicidal ideation among 326 Latinx adults who endorsed trauma exposure. Results indicated that global PTSD symptom severity was significantly related to greater social anxiety, anxious arousal, depression, and suicidal ideation symptoms. PTSD arousal and reactivity symptom cluster had the strongest relation to anxious arousal, social anxiety, and depression, whereas negative alterations in cognitions and mood symptoms had the strongest association with social anxiety, depression, and suicidal ideation. The findings suggest that global PTSD symptom severity, alongside arousal and reactivity and negative alterations in cognitions and mood, are related to a range of concurrent negative mental health symptoms among trauma exposed Latinx young adults.

Neural activation to infant cry among Latina and non-Latina White mothers

Cultural neuroscience is an emerging framework positing that culture (for example, values, beliefs, practices, and modes of emotional expression) critically informs socialization goals and desired behaviors, which are perhaps accompanied by differential patterns of brain activation. Using fMRI, the current study examines brain activation to infant cry stimuli and matched white noise among 50 first-time biological mothers identifying as Latina or White in the United States. Results showed that brain activation to infant cries in the right posterior insula, left cerebellum, and left auditory were higher for White mothers compared to Latina mothers, p's < .05. White mothers showed greater activation to cry sounds compared to white noise in the right dorsolateral prefrontal cortex, left somatosensory, right and left premotor cortices, p's < .05, whereas Latina mothers did not. These brain regions are involved in motor planning, movement, sensory processing, and social information processing. It is important to note that mothers in the two groups did not show differences in stress and behavioral parenting measures. Therefore, Latina and White mothers differentially recruiting brain regions related to infant parenting behaviors indicates the potential role of cultural context in shaping patterns of neural activation. Our exploratory analysis suggests that this difference might be due to greater pre-parenting exposure among Latina mothers to children compared to White mothers. Taken together, although our data did not completely explain the differences in brain activation between groups, findings suggest potential culture-related influences in brain activation occurring in the postpartum period.

What is prenatal stress? A scoping review of how prenatal stress is defined and measured within the context of food insecurity, housing instability, and immigration in the United States

BACKGROUND

Stress during pregnancy can lead to significant adverse outcomes for maternal mental health. Early evaluation of prenatal stress can help identify treatment needs and appropriate interventions. Disparities in the social determinants of health can contribute to stress, but what constitutes stress during pregnancy within the social determinants of health framework is poorly understood.

OBJECTIVE

To scope how prenatal stress is defined and measured among pregnant people exposed to three prominent social stressors in the United States: insecurity pertaining to food, housing, and immigration.

ELIGIBILITY CRITERIA

We included all studies that focused on stress during pregnancy in the context of food insecurity, housing instability, and immigration, given their recent policy focus due to the COVID-19 pandemic and ongoing political discourse, in addition to their importance in American College of Obstetricians and Gynecologists (ACOG's) social determinants of health screening tool.

SOURCES OF EVIDENCE

We searched PubMed, Scopus, and Web of Science for articles published between January 2012 and January 2022.

CHARTING METHODS

Using a piloted charting tool, we extracted relevant study information from the selected articles and analyzed the content pertaining to stress.

RESULTS

An initial search identified 1,023 articles, of which 24 met our inclusion criteria. None of the studies defined prenatal stress, and only one used the Prenatal Distress Questionnaire, a prenatal stress-specific tool to measure it. The Perceived Stress Scale was the most common instrument used in seven studies. Fifteen studies measured over 25 alternative exposures that researchers theorized were associated with stress, and 4 of the 15 studies did not explain the association between the measure and stress.

CONCLUSIONS

Our findings demonstrate a fundamental inconsistency in how prenatal stress is defined and measured in the context of social determinants of health, limiting the comparison of results across studies and the potential development of effective interventions to promote better maternal mental health.

The mastery lifestyle intervention to reduce biopsychosocial risks for pregnant Latinas and African Americans and their infants: protocol for a randomized controlled trial

BACKGROUND

Pregnant Mexican Americans (hereafter called Latinas) and Black/African American women are at increased risk for psychological distress, contributing to preterm birth and low birthweight; acculturative stress combined with perceived stress elevates depressive symptoms in Latinas. Based on our prior research using a psychoneuroimmunology framework, we identified psychological and neuroendocrine risk factors as predictors of preterm birth in Latina women that are also identified as risk factors for Black/African American women.

METHODS/DESIGN

In this prospective, randomized controlled trial with parallel group design we will explore psychosocial, neuroendocrine, and birth outcome effects of the Mastery Lifestyle Intervention (MLI). The MLI is a culturally relevant, manualized, psychosocial, group intervention integrating two cognitive behavioral therapies for both pregnant Latinas and Black/African American women (total n = 221). Study inclusion criteria are: women with current pregnancy at 14-20 weeks gestation, ability to read and speak English or Spanish, self-identify as Latina of Mexican heritage or Black/African American, 18-45 years old, born in the US or Mexico, and currently living in the US. Participants must receive Medicaid or other government-supported insurance, and meet screening criteria for anxiety, depressive symptoms, or stress. Participants are randomly assigned to either the intervention (MLI) or usual care group (UCG) in groups of 6-8 participants that occur over 6 consecutive weeks. Data are collected at 3 time points: enrollment (14-20 weeks gestation), following treatment (20-26 weeks), and 6 weeks after treatment (32-36 weeks gestation). Additional outcome, mediating, and moderating data are collected from the electronic health record during pregnancy and at birth. Analyses will primarily use generalized linear mixed modeling (GLMM) to evaluate the relationships between predictors and outcomes.

DISCUSSION

This RCT will test the efficacy of two combined third generation cognitive behavioral therapies (the MLI), given in a group format over 6 sessions, as compared to a usual prenatal care group, for both Latina and African American pregnant women. If efficacious, it may be provided as an adjunct to routine prenatal care and improve mental health, as well as babies being born too small and too soon.

TRIAL REGISTRATION

The trial was retrospectively registered at ClinicalTrials.gov . Bethesda (MD): National Library of Medicine. Identifier NCT05012072 , Reducing Pregnancy Risks: The Mastery Lifestyle Intervention (MLI); August 19, 2021. The trial is currently recruiting participants.

Associations between Self-Rated Health and Perinatal Depressive and Anxiety Symptoms among Latina Women

PURPOSE

The objective of this study was to determine whether decreases in or consistently low preconception to pregnancy self-rated health (SRH) were associated with perinatal depressive and anxiety symptoms among Latinas.

METHODS

This is a secondary data analysis of 153 perinatal Latinas. Three groups were created to capture SRH from preconception to pregnancy: a decline in ratings, consistently low, and good+ (i.e., good, very good, or excellent). SRH was measured using two questions about their perceived physical health before and during pregnancy. Depressive symptoms and anxiety symptoms were assessed in the third trimester and six weeks postpartum using the Edinburgh Postnatal Depression Scale and State-Trait Anxiety Inventory, respectively. Life stressors were assessed in pregnancy using a modified version of the Life Experiences Survey. Linear regressions tested the associations.

RESULTS

Women with consistently low (i.e., fair or poor) SRH reported significantly more prenatal depressive symptoms than women who reported consistently good+ SRH. Women who reported a decline in SRH to fair or poor reported more prenatal anxiety symptoms but decreased postpartum anxiety symptoms than women who reported consistently good+ ratings. Life stressors were positively associated with prenatal depressive and anxiety symptoms.

CONCLUSIONS

Healthcare practitioners should assess changes in SRH ratings to identify risks for prenatal depressive and anxiety symptoms among Latinas, who have elevated rates of depressive and anxiety symptoms compared to non-Hispanic White women. Policymakers should provide healthcare providers with mental health resources to support at-risk Latinas during the prenatal period.

Limited English proficiency in the labor and delivery unit

PURPOSE OF REVIEW

Limited English proficiency (LEP) impacts patient access to safe and comprehensive care during the antepartum, intrapartum, and postpartum periods. In this review, we explore disparities in care delivery and outcomes that LEP women experience, and discuss the importance of providing language concordant care and using interpretation services appropriately.

RECENT FINDINGS

The number of individuals with LEP is steadily increasing in the United States. Pregnant women with LEP suffer disparities in obstetric care and are at risk for postpartum depression, breastfeeding difficulties, and substandard newborn care after neonatal ICU discharge because of insufficient education. Addressing these issues requires the implementation of language concordant care and education, along with the utilization of medically trained interpreters. Although further evidence is needed, the authors support these interventions to improve patient satisfaction, decrease medical errors, and curtail misdiagnoses.

SUMMARY

The pregnant woman with limited English proficiency is at risk of receiving suboptimal care and experiencing negative outcomes during the antepartum, intrapartum, and postpartum periods. The use of medically trained interpreters and the provision of language concordant care, through workforce diversification and the creation of forms and educational materials in diverse languages, can improve patient safety, outcomes, and quality of care.

Role of Race, Ethnicity, and Immigration in Perceived Stress and Depressive Symptomatology Trends During Pregnancy

Our goal was to examine the role of race, ethnicity, and immigration status on prenatal perceived stress and depressive symptomatology trends across pregnancy in a low-income, minority population of pregnant women in urban Los Angeles. Longitudinal data on 442 Hispanic and Black women were analyzed using mixed effects models with a random intercept for participant were employed to evaluate predictors of higher perceived stress levels and probable depression across pregnancy. Compared to U.S. born Hispanic women, Black women had higher perceived stress (β 2.24; 95% CI 0.41, 4.07) and higher odds of probable depression (OR 2.38; 95% CI 0.95, 5.95) while Hispanic immigrants with greater than 20 years of residency in the U.S. had higher odds of probable depression (OR 2.93; 95% CI 1.10, 7.79). Maternal mental health among Hispanic immigrants with longer U.S. residency and Black race warrants increased attention from public health and clinical agencies.

Acculturative stress, telomere length, and postpartum depression in Latinx mothers

Latinx mothers in the United States are highly vulnerable to psychosocial stressors, including discrimination and acculturative stress, which increase maternal health risks. Previous work in Latinx mothers indicates that prenatal discrimination influences epigenetic immune markers that may increase risk for postpartum depression. Discrimination and acculturative stress have also been linked to cellular aging, including telomere degradation, in Hispanic populations broadly, but not in this particularly vulnerable population. The present work addressed this gap in a sample of 150 Latinx mothers living in the United States (mean age 27.6 years). Psychosocial measures (including discrimination, stress, and mental health) and blood were collected at 24-32 weeks gestation. Psychosocial measures were re-evaluated at 4-6 weeks postpartum. First, we examined the relationship between maternal prenatal cultural stress (i.e., discrimination and acculturative stress) and telomere length (TL). Second, we tested whether TL predicted postpartum depression. Acculturative stress - but not discrimination - predicted shorter TL, especially among participants with high methylation of the FOXP3 promoter region. Further, shorter telomere measures during pregnancy predicted greater postpartum depression symptom severity. TL was not related to any sociodemographic characteristics such as age, income, country of origin, or years in the United States. These results highlight the uniquely impactful role of acculturative stress on Latinx maternal health and the potential interactive role of telomere length and epigenetic immune alterations in risk for maternal mental health concerns.

Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic

INTRODUCTION AND OBJECTIVES

Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic.

METHODS

The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as "pre-pandemic" (N = 128), between March 2020 and July 2020 as "early pandemic" (N = 38), and between August 2020 and November 2021 as "later pandemic" (N = 21). Average PIPES subscale scores were dichotomized into "higher" and "lower" groups (⩽median, >median) and logistic regression models were performed.

RESULTS

Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods.

CONCLUSION

Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.

Discrimination as a Moderator of the Effects of Acculturation and Cultural Values on Mental Health Among Pregnant and Postpartum Latina Women

It is important to consider how identity, culture, and social adversity influence maternal mental health among Latina women both because this community faces unique cultural stressors and also because factors that undermine women's mental health during pregnancy and postpartum could have injurious consequences that cascade across generations. This study uses data from a questionnaire administered to Latina pregnant and postpartum women in Southern California, examining cultural orientation, discrimination, and mental health. Results demonstrate mental health benefits for both American and Latino cultural orientations, but the latter's benefit of lower anxiety was only apparent with high discrimination. American and Latino cultural values systems had opposite relationships with depression, with the latter protective and also positively associated with happiness. More traditional gender roles values were associated with greater perceived stress and lower happiness. Different aspects of familism had opposite effects as obligation was associated with less anxiety and referent (defining oneself communally with kin) with more. Results suggest that social adversity and cultural identity and values influence maternal psychology. This study makes a unique contribution by integrating anthropological and biopsychosocial methods and theories towards addressing an issue of public-health importance.

Associations between religiosity and perinatal anxiety symptoms among women of Mexican descent

BACKGROUND

Over half of pregnant women experience anxiety symptoms, however perinatal mental health disparities exist. Women of Mexican descent exhibit higher levels of anxiety symptoms which may be linked to sociocultural stressors. However, little is known about culturally relevant factors that may protect against anxiety in this fast-growing population, such as religiosity, an important facet of Mexican culture.

METHODS

Pregnant women of Mexican descent (n = 197) were recruited from a local community clinic and followed into the postpartum period. Women completed surveys assessing religiosity, acculturation, acculturative stress, and anxiety symptoms.

RESULTS

Higher levels of religiosity were associated with lower levels of anxiety symptoms throughout pregnancy, but not postpartum (b = -1.01, p = .002). Additionally, religiosity significantly buffered the relationship between acculturative stress and anxiety symptoms during early (R² = .13, b = -.12, p = .041), mid- (R² = .19, b = -.19, p < .001) and late pregnancy (R² = .14, b = -.13, p = .023), and at six weeks postpartum (R² = .08, b = -.12, R² = .08, p = .016).

LIMITATIONS

The study was limited to women of Mexican descent and it is possible that other immigrant groups may exhibit different patterns of religiosity and anxiety symptoms.

CONCLUSIONS

These results suggest that religiosity may be protective against maternal anxiety among women of Mexican descent, which has important implications for culturally relevant perinatal interventions and treatments.

Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress

The purposes of this study were to investigate the trajectory groups of depressive symptoms and anxiety in women during pregnancy and to identify the factors associated with those groups. Participants were recruited from the outpatient clinic of a women's health hospital in Seoul, Korea. Pregnant women (n = 136) completed a survey questionnaire that included questions on depressive symptoms, anxiety, and pregnancy stress; additionally, their saliva was tested for cortisol hormone levels three times during their pregnancies. The group-based trajectory modeling approach was used to identify latent trajectory groups. Ordinal logistic regressions were used to explore the association of latent trajectory groups with sociodemographic factors and pregnancy stress. Three trajectory groups of depressive symptoms were identified: low-stable (70%), moderate-stable (25%), and increased (5%). Four trajectory groups of anxiety were identified: very low-stable (10%), low-stable (67%), moderate-stable (18%), and high-stable (5%). The only factor associated with both the depressive symptoms and anxiety trajectory groups was pregnancy stress (p < 0.001). Most participants showed stable emotional status; however, some participants experienced higher levels of depressive symptoms and anxiety related to higher pregnancy stress. These pregnant women may need additional care from healthcare providers to promote their wellbeing during pregnancy.

Biopsychosocial correlates of psychological distress in Latina mothers

BACKGROUND

Few studies have explored the relationship between psychological, psychosocial and biological factors among Latinas. An integrated understanding of how these factors associate with psychological distress is necessary for the development of culturally relevant screening tools and interventions. The study aim was to examine the relationships among (a) psychological distress symptoms, (b) psychosocial factors (discrimination, acculturation, acculturative stress, economic hardship), and (c) biological (DNA methylation of stress-related genes) factors among Latinas during pregnancy and postpartum period.

METHODS

A sample of 150 pregnant Latinas completed the Inventory of Depression and Anxiety Symptoms II (IDAS-II), psychosocial questionnaires (discrimination, acculturation, acculturative stress, economic hardship) before (24-32 weeks) and after gestation (4-6 weeks postpartum). Blood samples were collected between 24-32 weeks gestation. Correlations were determined between psychosocial and biological measures and psychological distress measures. Multivariable linear regression models were conducted to assess the relationships between IDAS and stressors.

RESULTS

Several correlations among psychosocial measures,DNA methylation factors and IDAS-II variables were identified. Among the psychosocial measures, everyday discrimination was the most strongly and consistently associated with IDAS-II. DNA methylation of NR3C1 affects the associations between psychological and psychosocial distress.

LIMITATIONS

We only assessed DNA methylation during pregnancy and focused on four HPA-related genes. Longitudinal assessment of DNA methylation and genome-wide analysis can provide a better picture of the role of methylation in psychological distress.

CONCLUSIONS

This work may assist clinicians and policy makers in effectively recognizing and preventing maternal mental health disparities based on discrimination and other psychosocial stressors in at-risk groups.

Acculturation and Postpartum Depression Among Immigrant Women of Arabic Descent

Acculturation has been related to risk of postpartum depression (PPD) among immigrant women globally. The purpose of this study was to examine the relationship between acculturation and PPD symptoms among U.S. immigrant women of Arabic descent. A cross-sectional study was conducted with 115 postpartum immigrant women of Arabic descent. Women completed questionnaires including measures of acculturation [attraction to Arabic culture (AArC), attraction to American culture (AAmC), marginalization] and PPD symptoms (Edinburgh Postnatal Depression Scale-EPDS) between 1 and 12 months postpartum. Twenty-five percent of women (n = 29) had EPDS scores ≥ 10 that represent PPD symptoms. Women with higher marginalization reported more PPD symptoms (r = .25, p = .008). None of the acculturation factors correlated with PPD symptoms after adjustment for maternal sociodemographic and health characteristics. Higher education (p = .001), lower gestational age at birth (p < .05), and antenatal anxiety (p < .05) were correlated with PPD symptoms in multivariate analyses. Health care providers should identify and assess immigrant women of Arabic descent for antenatal anxiety as this may identify women at risk for development of PPD symptoms. Future studies need to examine acculturation in relation to mental health among immigrant women of Arabic descent.

Pregnancy anxiety in expectant mothers predicts offspring negative affect: The moderating role of acculturation

BACKGROUND

Pregnancy anxiety predicts adverse developmental outcomes in offspring from infancy through late childhood, but studies have not examined associations with outcomes in early childhood, nor clarified ethnic or cultural variations in these processes.

AIMS

(1) To examine differences in pregnancy anxiety and related concerns between non-Hispanic White women, Latina women who prefer to speak in English, and Latinas who prefer Spanish; (2) To test prospective associations between pregnancy anxiety and child negative affect and moderation by ethnicity and language preference, used as a proxy for acculturation.

STUDY DESIGN AND METHODS

This longitudinal study included 95 women (40 Non-Hispanic Whites, 31 Spanish-preference Latinas, and 24 English-preference Latinas). Language preference was provided at study entry. Pregnancy anxiety was assessed in the second and third trimesters of pregnancy with two standardized measures. Mothers reported child negative affect at age 4.

RESULTS

Spanish-preference Latinas had significantly more pregnancy-related anxiety about their health and safety in childbirth and concerning the medical system compared to English-preference Latinas and non-Hispanic White women. Adjusting for covariates, pregnancy anxiety in the second trimester, though not the third trimester, predicted significantly higher child negative affect in the full sample. A significant moderation effect indicated that the association was strongest among the lower acculturated Latinas, i.e., those who preferred Spanish.

CONCLUSION

These results document higher risk for offspring associated with pregnancy anxiety in the second trimester especially among less acculturated Latina women, and suggest the need for culturally-sensitive screening tools and interventions to improve outcomes for Latina mothers and their children.

Influence of Spousal Support on the Relationship between Acculturative Stress and Sense of Parenting Competence among Married Vietnamese Immigrant Women

PURPOSE

To identify the effects of spousal support on the relationship between acculturative stress and sense of parenting competence among married Vietnamese immigrant women.

METHODS

The sample for this study consisted of 175 married Vietnamese immigrant women in Gyeongsangnam-do. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlations, and hierarchical multiple regression with SPSS/WIN 23.0.

RESULTS

(a) sense of parenting competence was negatively correlated with acculturative stress, whereas a positive correlation was observed with spousal support; (b) spousal support mediated the relationship between acculturative stress and sense of parenting competence.

CONCLUSION

Results of the study suggest that spousal support decreases the negative effects of acculturative stress on sense of parenting competence. Therefore, we need to find ways to strengthen spousal support for married Vietnamese immigrant women.

Disparities in Anxiety and its Disorders

Much of the scientific work addressing the enigmas of anxiety and its disorders has been conducted among European Americans. This work has led to great progress into the nature of anxiety psychopathology, including etiologic, maintenance, and relapse processes. Moreover, evidenced-based treatments for anxiety and its disorders have arguably been among the best in the field of psychopathology for well over two decades. Yet, the progress thus far attained on the nature and treatment of anxiety disorders has not benefited all members of society equally. In fact, there are striking gaps of inequalities in anxiety disorder research and practice. The population in the United States (U.S.) and many parts of the industrialized world is rapidly changing in terms of diversity, and gaps between segments of society are growing in many instances (e.g., financial inequity). Health disparities in anxiety disorders are not a generic issue, but rather, reflect a systematic difference disproportionately affecting groups often not afforded a high social status ranking. We developed this Special Issue in the Journal of Anxiety Disorders to call attention to matters of inequality in anxiety disorders. The present special issue is designed to contextualize contemporary health disparity work on anxiety and its disorders. The special issue highlights three domains of study that are starting to guide research and practice in this arena, including sociocultural and contextual influences on anxiety and its disorders; intra-individual transdiagnostic mechanisms underpinning the expression and etiology/maintenance of anxiety psychopathology; and the close interconnection between anxiety processes and health status and health compromising behaviors. By covering a range of issues interconnected by their focus on understanding health disparity issues, it is hoped that this issue will: alert readers to the significance of this work at different levels of analysis; illustrate the many domains currently being explored via innovative approaches; and identify fecund areas for future systematic study.