Family Cohesion and its Relationship to Psychological Distress among Latino Groups

Family-level moderators of daily associations between discrimination and distress among Mexican-origin youth

The current study evaluated cultural values and family processes that may moderate associations between daily racial-ethnic discrimination and distress among Mexican-origin youth. Integrating micro-time (daily diary) and macro-time (longitudinal survey) research design features, we examined familism, family cohesion, and ethnic-racial socialization from youth-, mother-, and father- reports as potential buffers of daily associations between youth racial-ethnic discrimination and youth distress (negative affect and anger). The analytic sample, drawn from the Seguimos Avanzando study, included 317 Mexican-origin adolescents (Mage = 13.5 years) and their parents, recruited from the Midwestern United States. Results indicated that youth-reported familism and family cohesion significantly buffered daily associations between youth racial-ethnic discrimination and youth distress. In contrast, parent-reported familism and family cohesion and some aspects of ethnic-racial socialization exacerbated the discrimination to distress link. The implications of these results are discussed to inform efforts supporting the healthy development of Mexican-origin youth and their families.

A home environment-moderated model of the influence of ergonomics on individual work performance among Filipino nurse educators working from home during the COVID-19 pandemic: An interaction moderation analysis using structural equation model

AIM

To determine the influence of ergonomics on individual work performance of nurse educators working at home during the COVID-19 pandemic and to develop a model of the moderating effect of home environment.

DESIGN

Cross-sectional, predictive-correlational design.

METHODS

Utilizing interaction moderation and structural equation modeling, 214 consecutively-selected educators from nursing schools in the Greater Manila Area, Philippines completed a four-part online survey.

RESULTS

Physical, cognitive, and organizational ergonomics positively influenced individual work performance. Home environment had a linear, positive moderation on the effects of physical and cognitive ergonomics on individual work performance but had a negative moderating effect with organizational ergonomics.

CONCLUSION

The moderated model underscored the positive effects of ergonomics and the moderating effect of home environment on the individual work performance of nurse educators working at home during the COVID-19 pandemic, and this knowledge can be used in developing appropriate programs, strategies, and policies.

IMPACT

The moderated model highlights the need for policies and programs, training and education, and organizational evaluation geared towards promoting healthy workplace and work-life balance among nurse educators transitioning to remote work and online teaching.

PATIENT OR PUBLIC CONTRIBUTION

Eligible participants contributed in the data collection with the survey responses.

Yearly and Daily Discrimination-Related Stressors and Mexican Youth's Mental Health and Sleep: Insights From the First Wave of a Three-Wave Family Study

OBJECTIVE

Research is needed to examine discrimination-related stressors and their social and psychological shaping of mental health and sleep outcomes of Latinx youth. The background, design, and methodology of a longitudinal study of Mexican families in Indiana and the initial findings of associations between discrimination-related stressors and youth mental health and sleep outcomes are presented.

METHOD

Initiating wave 1 of a 3-wave (yearly) longitudinal study, investigators surveyed an ethnically homogeneous sample of 344 Mexican-origin adolescents (ages 12-15) and their primary caregivers, assessing risks and protective factors for mental health and sleep outcomes. Youth also completed a one-time 21-day daily diary after wave 1. Self-reported measures of youth mental health, sleep, and discrimination across wave 1 and the daily diary were evaluated to compare the cross-sectional (wave 1) and daily associations between discrimination and youth mental health and sleep outcomes.

RESULTS

Of youth, 88.1% reported at least one incident of lifetime discrimination. Almost one-third had elevated depressive symptoms, 44.5% had probable generalized anxiety disorder, and 50.9% had poor sleep quality. Between-youth correlations at wave 1 and in the daily diary were consistent in that perceived racial discrimination was positively correlated with worse mental health and poorer sleep quality. Smaller within-youth correlations were observed in the daily diary, but there was striking variability in the effect of discrimination across youth.

CONCLUSION

The present results illustrate the powerful methods of combining yearly and daily time data to investigate how and for whom discrimination-related stressors lead to adverse outcomes.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

CLINICAL TRIAL REGISTRATION INFORMATION

Seguimos Avanzando - Latino Youth Coping With Discrimination; https://clinicaltrials.gov/; NCT04875208.

Cohesion and conflict for mothers during the pandemic: Results of the Portuguese version of the COVID-19 Household Environment Scale

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide event that has caused significant changes in the daily lives of individuals and families. The combined effect of the pandemic and the stress associated with major life cycle changes, such as the transition to parenthood, is yet to be understood. The aim of the current study was to validate the Portuguese version of the recently developed COVID-19 Household Environment Scale (CHES) and examine its psychometric properties in a sample of mothers who had given birth during the pandemic. The CHES is a self-report measure assessing the consequences of the COVID-19 pandemic in household cohesion and conflict and includes two sections. Section 1 contains 25 descriptive items pertaining to sociodemographic and household characteristics and COVID-19 stressors. Section 2 encompasses household cohesion and conflict, assessing any change in household experiences and activities following the onset of social distancing. The participants consisted of 342 mothers, aged between 19 and 50 years (M = 31.43; SD = 4.38). A confirmatory factor analysis supported the original CHES bifactor structure of household cohesion and conflict, which obtained an acceptable fit (CFI = 0.900, RMSEA = 0.065). Correlations between household cohesion and conflict and family cohesion and dyadic coping contributed to developing the construct validity of this scale. Furthermore, both CHES subscales demonstrated very good internal consistency. Further research is warranted to assess the CHES in other cultural contexts. This is a useful tool to assess change in family households due to the unprecedented adverse pandemic experience.

The protective effects of social support and family functioning on parenting stress among Hispanic/Latino/a American immigrant parents with traumatic life experiences: A mediation analysis

Despite high rates of traumatic experiences reported among Hispanic/Latino/a immigrants in the U.S., the effect of post-traumatic stress on parenting stress among Hispanic/Latino/a immigrant parents with young children has been overlooked. The present study tested the direct and indirect relationships of self-reported maternal post-traumatic stress symptoms on parenting stress, and the mediating role of protective factors among Hispanic/Latino/a mothers with young children. Baseline data collected from mothers participating in a community-based child-parent dyadic intervention were analyzed. Measures included the post-traumatic stress disorder (PTSD) Checklist, the Protective Factors Survey, and the Parenting Stress Index-Short Form (PSI). The sample included 80 mothers with a child between ages 0-6 years. About 75% of these mothers were migrants from Central America. A multivariate regression analysis showed that maternal post-traumatic stress symptoms predicted higher levels of PSI, and two protective factors (social support and family functioning/resilience) fully mediated the relationship between maternal post-traumatic stress symptoms and PSI. Higher social support and family functioning/resiliency may have protective effects on Hispanic/Latino/a mothers with post-traumatic stress, leading to lower levels of stress related to parenting. Findings underscore the importance of interventions that enhance access to social support and promote family functioning/resilience for Hispanic/Latino/a immigrant mothers with trauma histories to cope better with parenting stress.

Exploring Help-Seeking Predictors Among Colombian Victims of Intimate Partner Violence in Different Age Groups

This study examined the extent, source, and individual, microsystem, exosystem, and macrosystem-level (Heise's Ecological Model) predictors of help-seeking behaviors among women of different age groups in Colombia. Data on 12,915 married or cohabitating women who had experienced diverse forms of intimate partner violence (IPV) were obtained from the Colombia Demographic Health Survey 2015. More than half of the Colombian women who reported some form of IPV experience did not seek any help. Women aged 25-39 were less likely to seek help. Type of violence and experience of IPV and education were the strongest predictors of help-seeking among women in all age groups. Implications for research and programming are discussed.

"It's about being healthy"; a novel approach to the socio-ecological model using family perspectives within the Latinx community

BACKGROUND

The Latinx community is at risk for obesity, type 2 diabetes, and other chronic illnesses. Culturally appropriate, community facing physical activity (P.A.) and nutrition programs may provide the basis for families to improve their health status. Our objectives are as follows: 1. To investigate synergistic factors within this type of program that play a role in creating an environment for participants to learn and practice healthy behaviors. 2. To apply factors into a novel model of components that support health and wellness. 3. To design an intervention for future implementation and evaluation.

METHODS

A two-year P.A. and nutrition program, Families Inspired Together 4 Youth Empowered to Succeed (FIT 4 YES), took place in Milwaukee, WI. with Hispanic families from 2018 to 2020 through a community-academic partnership. A pair of interviewers spoke with families who provided insight into the impact of the program. A grounded theory qualitative approach to code the transcripts guided the team to identify overarching themes.

RESULTS

Twenty-four interviews were conducted. Common themes indicated that children had a stronger belief in their abilities and confidence in peer support. Parents noticed their children increasing self-directed healthy behaviors. All families grew in their implementation of health and wellness.

CONCLUSIONS

Three main components of FIT 4 YES contributed to its success: opportunities for engagement, supportive relationships, and the interplay of components that emerged from the interviews. Effective programs could include these components to make their outcomes more cohesive within the family. A novel model emerged that builds on the social-ecological model that emphasizes the dynamic interactions between these main components. Additional research is needed to evaluate the long-term effects and response by the community.

Examining the Independent Association Between Acculturative Stress and Psychological Distress Among Mexican Immigrants in New York City: An Exploratory Study

Objective

This study examines the association between acculturative stress and psychological distress among Mexican immigrants living in New York City. It takes account factors such as language barriers, legal status, fear of deportation, and avoidance of social health and human services, and how these factors are implicated in the mental health status of the study population.

Design

Study draws from a community-based sample of Mexican American adults from the Social Network of Mexican Americans study recruited from a church-based community center in the Bronx, New York. Eighty Mexican immigrants were included in this analysis. Descriptive statistics were used to display participants' characteristics. Pearson correlation and multiple regressions were run to determine the relationship between acculturative stress and psychological distress, and also with each of the items from the acculturative stress scale. Both scales have been validated among Spanish-speaking Latino immigrants.

Results

A significant moderate positive relationship was found between acculturative stress and psychological distress. Within the acculturative stress scale, those items related to language discrimination, evasion of health services, and feeling guilty for leaving family/friends in home country had significant associations with increased psychological distress.

Conclusion

The findings support the need for interventions that account for the major stressors associated with being a Mexican immigrant in the United States to prevent psychological distress, especially given the anti-immigration policies.

Risky Sexual Behavior Among Mexican-Origin Emerging Adults in Los Angeles

This study examined the empirical link between substance use, and family, school, and contextual factors relevant to emerging adulthood and Mexican-origin emerging adults' sexual risk-taking behavior using a longitudinal design that followed the respondents from adolescence to emerging adulthood (n = 520). Overall, we found that engaging in one high-risk sexual behavior was associated with higher odds of engaging in another. While alcohol and substance use was associated with higher odds of engaging in risky sexual behavior, living with parents, having at least one parent who was a college graduate, sharing a higher level of parental closeness, being more bicultural, starting college, a new school, or classes, and feeling like an adult were associated with lower odds of engaging in sexual risk-taking behavior. Contrary to the study hypothesis, a higher level of family cohesion was associated with higher odds of such behavior. Lastly, male respondents tended to have more than 3 sexual partners but were less likely to not use condoms compared with their female counterparts.

The Relationship Between Latinxs' Acculturative Experiences and Mental and Behavioral Disorder in the National Latino and Asian American Study

Mental and behavioral disorders are among the leading contributors to disability among US-residing Latinxs. When treated as a homogeneous group, important disparities in the prevalence of such disorders among Latinx subgroups (e.g., by ethnic heritage) are obscured. However, Latinxs may also be characterized by their acculturative experiences while living in the USA, such as discrimination, neighborhood context and family conflict. Latent Profile Analysis with distal outcomes was used to estimate differences in psychiatric disorder prevalence across acculturative subgroups. Data from 2,541 Latinx participants (age 18 +) in the National Latino and Asian American Study (NLAAS) were used to estimate differences in the proportion of three categories of DSM-IV disorder: depressive, anxiety and substance use by four latent subgroups of Latinxs based on their acculturative experiences. Latinxs reporting more positive acculturative experiences had the lowest prevalence of all three disorders (14.8%, 13.6% and 7.1%, respectively). Those whose lives were characterized by high levels of family conflict and discrimination combined with low levels of social cohesion and neighborhood safety had the highest disorder prevalence (34.0%, 26.6% and 22.5%; all p < 0.01 compared to positive experiences subgroup). Latinxs with moderate levels of discrimination and conflict, along with those with high conflict and cohesion, were better off as compared to those with high negative experiences and low cohesion. These latent subgroups of Latinxs according to their acculturative experiences hold important implications for identifying high-risk groups for developing a psychiatric disorder. Findings also point to the protective role of family and neighborhood cohesion when facing high levels of adversity, which may inform prevention and intervention efforts.

Social relationships and their associations with affective symptoms of women with breast cancer: A scoping review

Background

Problems in affective and cognitive functioning are among the most common concurrent symptoms that breast cancer patients report. Social relationships may provide some explanations of the clinical variability in affective-cognitive symptoms. Evidence suggests that social relationships (functional and structural aspects) can be associated with patients’ affective-cognitive symptoms; however, such an association has not been well studied in the context of breast cancer.

Purpose

The purpose of this scoping review was to address the following question: What social relationships are associated with affective-cognitive symptoms of women with breast cancer?

Methods

This scoping review used the framework proposed by Arksey and O’Malley and PRISMA-Sc. Studies published by February 2022 were searched using four databases: MEDLINE (PubMed), Embase (Elsevier), PsycINFO (EBSCOhost), and Web of Science (Clarivate). All retrieved citations were independently screened and eligibility for inclusion was determined by study team members. Extracted data included research aims, design, sample, type and measures of social relationships (functional and structural), and the association between social relationships and affective-cognitive symptoms

Results

A total of 70 studies were included. Affective symptoms were positively associated with social support, family functioning, quality of relationships, social networks, and social integration, whereas the negative association was found with social constraints.

Conclusion

Our findings suggest positive social relationships may mitigate affective symptoms of women with breast cancer. Thus, health care providers need to educate patients about the importance of building solid social relationships and encourage them to participate in a supportive network of friends and family members.

We stick together! COVID-19 and psychological adjustment in youth residential care

BACKGROUND

Children and youth residential care institutions were forced to introduce adaptations to their regular functioning in order to respond to the COVID-19 pandemic challenges.

OBJECTIVE

The purpose of this study was to examine the effects of the lockdown on the adolescents' psychological adjustment and whether adolescents' perceived cohesion mitigated the increase of adolescents' psychological adjustment problems.

PARTICIPANTS

Participants were 243 adolescents aged 12 to 18 years, living in 21 different residential care institutions.

RESULTS

The results suggested a moderating role of cohesion on the stability of adolescents' emotional distress across time. Lower levels of cohesion were related with higher emotional distress stability across time. On the contrary, as cohesion increased, the association between adolescents' emotional distress at T0 and T1 decreased.

DISCUSSION

Results are discussed considering the mechanisms raised by the institutions to respond to the COVID-19 pandemic and minimize the negative effects on the psychological adjustment of adolescents living in residential care.

Family as a Bridge to Improve Meaning in Latinx Individuals Coping with Cancer

Background:

Family and meaning-making resources are culturally congruent and help support Latinx coping with cancer.

Objectives:

To explore Latinx advanced cancer patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer.

Methods:

A qualitative study was conducted. In-depth interviews were performed and transcripts were analyzed using the method from applied thematic analysis.

Setting/Subject:

Participants were patients with any advanced cancer diagnosis, recruited from Memorial Sloan Kettering Cancer Center (MSKCC), New York; Lincoln Medical Center (LMC), New York; and Ponce Health Science University (PHSU), Puerto Rico.

Measurements:

Sociodemographic and semistructured interview.

Results:

N = 24 in-depth interviews were completed by Latinx advanced cancer patients (Stage III and IV). When evaluating patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer, the team generated three categories: (1) family support, (2) family communication, and (3) include support for the family. Many patients reported the importance of family as a source of meaning and social support in the process of cancer diagnosis and treatment. They also reported communication as central to process information and planning. Also, participants describe their desire to incorporate family members into therapy and for encouraging them to seek counseling.

Conclusions:

Results highlight the need to include syntonic cultural values such as family and meaning for Latinx individuals coping with advanced cancer in psychological interventions.

Protective Factors against Self-Harm and Suicidality among Australian Indigenous Adolescents: A Strengths-Based Analysis of the Longitudinal Study of Indigenous Children

Background: Understanding and encouraging social and emotional well-being (SEWB) among Indigenous adolescents is vital in countering the impacts of colonisation and intergenerational trauma. As self-harm and suicidality are considered markers of poor SEWB among Indigenous communities, we aimed to identify the individual-level and community-level factors protecting Indigenous adolescents from self-harm and suicidality. Methods: Data came from Footprints in Time—The Longitudinal Study of Indigenous Children (waves 10 and 11), conducted among Indigenous families across Australia. A strengths-based analysis fitted multilevel logistic regression to explore associations with factors proposed as protective against self-reported self-harm and suicidality among Indigenous adolescents. Results: Our study cohort included 365 adolescents with complete data for the variables of interest. Adolescents had a mean (SD) age of 14.04 (0.45) years and a sex ratio of almost 1:1, and most were attending school (96.2%). Previous self-harm was reported by 8.2% (n = 30); previous suicidality was reported by 4.1% (n = 15). Individual-level factors protecting against self-harm and suicidality were being male, living in a cohesive family, and having low total Strengths and Difficulty Questionnaire scores (p < 0.05 for all). Residing in major cities compared with regional/remote areas was protective against self-harm (OR 5.94, 95% CI 1.31−26.81). Strong cultural identity was not found to be a protective factor against self-harm and/or suicidality in the sample. Conclusions: This study identified key individual- and community-level factors that can protect Australian Indigenous adolescents against self-harm and suicidality, particularly family cohesion. Identifying strengths for this at-risk population can inform prevention strategies, particularly for rural living adolescents with high distress.

Peer Discrimination, Deviant Peer Affiliation, and Latino/a Adolescent Internalizing and Externalizing Symptoms: A Prospective Study

OBJECTIVE

U.S. Latino/a adolescents experience high levels of ethnic discrimination, particularly in new immigrant destinations. Due to the salience of peers during adolescence, this study examined how peer discrimination related directly and indirectly, through deviant peer affiliation, to changes in Latino/a adolescents' internalizing and externalizing symptoms. Culture-specific moderators hypothesized to buffer discrimination impacts on adolescent symptomology included Spanish language enculturation and adolescents' social ties to relatives in the family's country-of-origin.

METHOD

The sample of 547 Latino/a adolescent participants from the Caminos al Bienestar study (55.4% female; age M = 12.8, range = 11-16) was selected at random from middle schools in a large, suburban school district in Atlanta, Georgia. Three time points of survey data spaced roughly 6 months apart were collected during 2018 and 2019.

RESULTS

Results from longitudinal structural equation models revealed that peer discrimination was associated indirectly with increased externalizing symptoms, through increases in affiliation with deviant peers (β = 0.05; SE = 0.02; B = 0.02; 95% CI = 0.01, 0.09). We did not observe direct or indirect effects of peer discrimination on changes in internalizing symptoms, and we found no significant protective effects of either Spanish language enculturation or social ties with the country-of-origin.

CONCLUSIONS

Ethnic discrimination by peers may lead to deviant peer affiliation and, in turn, increased externalizing behaviors. Future research identifying protective factors that buffer discrimination impacts on deviant peer affiliation is needed to inform the development of interventions that can prevent Latino/a adolescents' externalizing symptoms.

Gendered Citizenship, Inequality, and Well-Being: The Experience of Cross-National Families in Qatar during the Gulf Cooperation Council Crisis (2017–2021)

This study explores the impact of gendered citizenship on the well-being of cross-national families following the political blockade imposed on Qatar in 2017. More specifically, it examines how these families, women, and children face challenges related to their lives, well-being, and rights. Twenty-three face-to-face interviews were conducted with Qatari and non-Qatari women and men married to non-Qatari spouses residing in Qatar. The study’s findings revealed that Qatari women with non-Qatari husbands did not enjoy the benefits of full citizenship, further undermining their psychological well-being and their socioeconomic and legal rights. Additionally, children born before or during the blockade have become stateless and undocumented, which jeopardizes their mental and physical well-being and the prospects of their parents’ economic advancement. This study contributes to the conceptualization of and debate on gender citizenship rules and policies, which can exclude these women and children and deny them the recognition and rights they deserve. Since ensuring full citizenship rights is crucial for people’s well-being, increasing gender equality and reforming Qatar’s existing citizenship policies would benefit both groups and provide social justice for all.

Suicidal ideation and its related factors among older adults: a population-based study in Southwestern Iran

Objectives

Suicidal ideation is a major risk factor for suicide and can negatively affect self-care and health behaviors among the older adults. There are limited data on the prevalence and risk factors of suicidal ideation among the older population during the COVID-19 pandemic. The aim of the present study was to examine the prevalence and risk factors of suicidal ideations among Iranian older adults during the COVID-19 pandemic.

Methods

A total of 803 older community adults in Shiraz (Southwestern Iran) were surveyed to determine potential factors influencing suicidal ideation, including demographic factors, physical health status, access to healthcare, current depression status, fear of COVID-19, perceived social support, and social engagement. Data were collected utilizing face-to-face interviews between November and December 2020. Multivariate logistic regression analysis was used to identify independent variables associated with suicidal ideations.

Results

Among the 803 participants, 69 reported suicidal ideations (8.6%). Individuals with suicidal ideations were more likely to have greater fear of COVID-19. However, based on the results of multivariate logistic regression analysis, current depression (OR: 2.07, CI 95%: 1.18–3.65), not being married (OR: 1.82, CI 95%: 1.06–3.13), inability to pay for medical bills (OR: 2.16, CI 95%: 1.23–3.79), low perceived social support (OR: 2.03, CI95%: 1.11–3.71), and having limited social network (OR:1.77, CI 95%: 1.02–3.10) appeared to be more powerful influencing factors.

Conclusion

Suicidal ideation appears to be relatively common among Iranian older adults during the COVID-19 pandemic. A lack of longitudinal data makes it difficult to establish an association between suicidal ideations and the COVID-19 pandemic. Systematic monitoring of suicidal ideation is recommended among high-risk groups, particularly the older population.

Adverse Childhood Experiences and Depressive Symptoms among Young Adult Hispanic Immigrants: Moderating and Mediating Effects of Distinct Facets of Acculturation Stress

Hispanic immigrants experience more adverse childhood experiences (ACEs) and depressive symptom chronicity/severity than non-Hispanic peers. Acculturation stress relates to both depressive symptoms and ACEs, but the mechanism is not well-understood. We conducted a secondary data analysis of baseline data, from an ongoing longitudinal study to test theoretically-based mediating and moderating effects of acculturation stress on the relationship between ACEs and depression in a sample of young adult Hispanic immigrants (N = 391). Results indicated ACEs predicted depressive symptoms. Mediation and moderation effects were significant for cumulative and distinct facets of acculturation stress. Implications for mental health nurses are discussed.

Theories of Change and Mediators of Psychotherapy Effectiveness in Adolescents With Externalising Behaviours: A Systematic Review

BACKGROUND

Externalising behaviours are becoming a remarkably prevalent problem during adolescence, often precipitating both externalising and internalising disorders in later adulthood. Psychological treatments aim to increase the social functioning of adolescents in order for them to live a more balanced life and prevent these negative trajectories. However, little is known of the intervening variables and mediators involved in these treatments' change mechanisms. We conducted a systematic review, exploring the available evidence on mediators of psychological treatments for externalising behaviours and symptoms amongst adolescents (10 to 19 years old).

METHODS

A systematic search was performed on Medline and PsycINFO databases, which identified studies from inception to February 23, 2020. Eligible studies included randomised controlled trials that enrolled adolescents with externalising symptoms and behaviours as, at least, one of the primary outcomes. A group of 20 reviewers from the COST-Action TREATme (CA16102) were divided into 10 pairs. Each pair independently screened studies for inclusion, extracted information from the included studies, and assessed the methodological quality of the included studies and the requirements for mediators, following Kazdin's criteria. Risk of bias of RCTs was assessed by the Mixed Methods Appraisal Tool. Extracted data from the included studies were reported using a narrative synthesis.

RESULTS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), after removing duplicates, 3,660 articles were screened. Disagreements were resolved by consensus. In a second stage, 965 full-text articles were assessed for eligibility. A total of 14 studies fulfilled all inclusion criteria. The majority were related to systemic psychological treatment approaches. Two types of mediators were identified as potentially being involved in the mechanisms of change for better social improvements of adolescents: to increase healthier parent-adolescent relationships and parental discipline. However, there were significant and non-significant results amongst the same mediators, which led to discussing the results tentatively.

CONCLUSIONS

Family variables were found to be the largest group of investigated mediators, followed by relational, behavioural, and emotional variables. No cognitive or treatment-specific mediators were identified. Both adequate behavioural control of adolescents' peer behaviour and a better positive balance in their relationships with their parents seemed to buffer the effects of externalising behaviours in adolescents. Several methodological limitations concerning mediation testing design, outcome measures, and mediator selection have been identified.

ETHICS AND DISSEMINATION

Ethical approval was not required. PROSPERO registration number: CRD42021231835.

Cumulative Lifetime Adversity in a National Sample of Hispanic/Latino Immigrants: Exploring Construct Validity Across Six Hispanic/Latino Groups Using Data From the HCHS/SOL Sociocultural Ancillary Study

Hispanic/Latino immigrants often experience significant adversity before, during, and after migrating to the United States. However, no extant studies have tested the construct validity of a cumulative measure of lifetime adversity with Hispanic/Latino immigrants. Our objective was to assess the construct validity of a comprehensive measurement model of lifetime adversity (i.e., adverse childhood experiences, adult chronic stress, adult perceived stress, adult acculturation stress, and lifetime ethnic discrimination) with a national sample of Hispanic/Latinos born outside the mainland United States. Guided by the life course perspective, we examined the (a) dimensionality of cumulative lifetime adversity; (b) extent to which the functioning of this measurement model differed across various Hispanic/Latino subgroups including Mexicans, Cubans, Puerto Ricans, Dominicans, Central Americans, and South Americans; and (c) association between cumulative lifetime adversity and other constructs (e.g., anxiety and depression). We used existing data from the Hispanic Community Health Survey/Study of Latinos-Sociocultural Ancillary Study, a national survey of Hispanic/Latinos living in the United States (N = 3,296). Results from confirmatory factor analyses indicated that a five-factor bifactor measurement model for cumulative lifetime adversity fit the data adequately (e.g., comparative fit index = .91, root mean square error of approximation = .04, standardized root mean square residual = .07). Results from multigroup confirmatory factor analyses suggested that the measurement model functioned similarly across Hispanic/Latino subgroups, providing evidence for measurement invariance. The model also displayed convergent and discriminant validity based on associations with other constructs. We discuss implications for advancing the precision of assessment instruments for lifetime adversity with populations with high within-group diversity.

Effect of family cohesion on symptom distress during hematopoietic stem cell transplantation

PURPOSE

Family may play an important role in hematopoietic stem cell transplantation (HSCT) recovery; however, little is known about the effect of family functioning on an individual's health. The purpose of this study was to examine the effect of family cohesion (family functioning) on the trajectory of HSCT recipients' symptom distress (symptom frequency and symptom bother) before, during, and after HSCT.

METHODS

Secondary analysis was conducted using data collected from178 individuals who underwent HSCT. Longitudinal parallel process (LPP) modeling was used to examine how family cohesion and HSCT-associated symptoms (symptom frequency and symptom bother) change over time, and how these longitudinal changes relate to each other.

RESULTS

The trajectory of family cohesion predicted the trajectories of HSCT-associated symptom frequency and bother. HSCT recipients who experienced higher family cohesion at baseline (T1) showed lower symptom frequency (p < .01) as well as symptom bother (p < .01) at T1. This trajectory analysis also showed that HSCT recipients who had improved family cohesion over time reported decrease in symptom frequency (p < .01) as well as bother (p < .01) over time.

CONCLUSION

Findings indicate that higher family cohesion predicts decrease in symptom distress over the HSCT trajectory. Interventions aimed at enhancing family cohesion have the potential to lower HSCT recipients' symptom distress. Further research is needed to understand the critical role of family cohesion and family functioning and their relationship with HSCT symptom distress prevention, early detection, and risk stratification.

Evaluating Experiential Avoidance in terms of COVID-19 Fear and Pandemic Emotional Distress Symptoms Among Latinx Adults

Background

The outbreak of the novel 2019 SARS2-Coronavirus disease (COVID-19) has led to substantial psychological distress across the United States and the world. However, emerging work suggests that prominent COVID-19 consequences such as fear of COVID-19 infection and emotional distress resulting from economic adversity and social distancing may afflict the Latinx population disproportionately. The current study sought to investigate the influence of experiential avoidance (EA), or an individual's tendency to rigidly avoid negative internal experiences (i.e. feelings, thoughts, etc.), on the severity of COVID-19 fear and emotional distress symptoms due to economic adversity and social distancing.

Method

Participants included 188 Latinx persons recruited via an online survey panel program.

Results

Results indicated that EA was a statistically significant contributing factor to fear of COVID-19 and emotional distress associated with economic adversity and social distancing. These effects were evident over and above the variance accounted for by gender, years living in the United States, education, and COVID-19 related work and home life stress.

Conclusions

Overall, the present work is the first to document empirically EA as it relates to fear of COVID-19 infection and related emotional distress resulting from economic adversity and social distancing among Latinx persons.

Hispanic health disparities and housing: Comparing measured and self-reported health metrics among housed and homeless Latin individuals

Previous studies argue that Hispanics are healthier and less likely to experience homelessness than other populations in their same socioeconomic position. However, earlier studies have not explored the relationship between housing status and health for Latin individuals. This study examines 1) the health disparities between homeless and housed Hispanics in El Paso, Texas, and 2) the Hispanic health and homelessness paradoxes using an intersectional framework to understand health risks. A large number of Hispanic residents of El Paso (N = 1152) were surveyed. Demographic, health, and housing data were collected. We contribute to the literature by providing detailed health indicators for homeless Hispanics. To our knowledge, this is the first study to examine health disparities between housed and homeless Hispanics. Bivariate analysis, as well as data coded from interviews, indicated that homeless Hispanics were more likely to have barriers to care, less likely to have health insurance, slightly more likely than housed Hispanics to experience mental illness, alcoholism, and addiction, and more likely to be underdiagnosed for health problems, including hypertension. This study shows how certain traditional methods for collecting health data, including self-rated health and reported diagnoses, can be ineffective at revealing health disparities. This paper calls for innovative, mixed-methods approaches to understand the social and structural determinants of health for marginalized populations.

Psychological Distress and Physical Health Symptoms in the Latinx Population During the COVID-19 Pandemic: Exploring the Role of Anxiety Sensitivity

Objective

The outbreak of the novel 2019 SARS2-Coronavirus disease (COVID-19) has led to substantial physical and mental health consequences. Rates of mortality and hospitalization are highest among those of racial and ethnic minority persons, including Latinx persons. Further, Latinx persons have been experiencing elevated mental health problems in response to the pandemic compared to non-Latinx Whites. The current study examined whether individual differences in anxiety sensitivity (AS) related to more severe emotional distress associated with social distancing, financial strain, fear of COVID-19, and physical health symptoms stemming from the COVID-19 pandemic among Latinx adults.

Methods

Participants included 188 Latinx persons (31.4% female, M_age = 34.1 years, SD = 8.16) recruited via an online survey panel program.

Results

Results indicated that AS significantly contributed to increased severity of the emotional stress response associated with social distancing (ΔR² = 0.15, p < 0.001), financial strain (ΔR² = 0.15, p < 0.001), physical health symptoms (ΔR² = 0.03, p = 0.006), and fear of COVID-19 (ΔR² = 0.15, p < 0.001). These effects were evident over and above the variance accounted for by gender, years living in the United States, education, and work and home life COVID-19-related stress.

Conclusions

These cross-sectional findings suggest AS may be an important individual difference factor for better understanding mental health among Latinx persons in the context of the COVID-19 pandemic.

Family Factors Related to Three Major Mental Health Issues Among Asian-Americans Nationwide

Asian-Americans (AAs) constitute the fastest growing minority group in the USA. AAs share a common emphasis on collective cultural strengths, especially family values. Using the National Latino and Asian American Study (NLAAS) data, this study investigated the roles of family cohesiveness, along with other cultural strength factors and negative family interactions in three psychiatric disorders. Supporting the study's hypotheses, multivariate analyses showed that family cohesiveness was associated with a lower incidence of general anxiety disorder (GAD), while regular religious attendance was linked with a lower likelihood of having substance use disorder (SUD). Conversely, negative family interactions increased the likelihood of experiencing major depression disorder (MDD) and SUD. Whereas perceived discrimination was related to higher odds of all diagnoses, family cohesiveness moderated the relationship between discrimination and GAD. These findings suggest that family relationships play a critical role in AAs' mental health and should be further explored through a prospective design.

Topical Review: Developmental Framework of Moderators of Family Conflict for Type 1 Diabetes Outcomes

OBJECTIVE

To present a developmental framework of family conflict in youth with type 1 diabetes (T1D) that aims to guide future research.

METHODS

Developmental and pediatric literature are reviewed to highlight family factors that may modify the degree to which diabetes-related family conflict is related to adolescent health outcomes.

RESULTS

Developmental literature suggests that family conflict is not inherently bad; rather, conflict that arises under optimal conditions (moderate frequency, warm and accepting relationships) can be adaptive for adolescents. However, family conflict is consistently associated with poor disease outcomes in youth with T1D, with few researchers examining specific moderators of these associations. In this topical review, we highlight moderators of family conflict and developmental outcomes identified in adolescents without chronic illness (e.g., cultural factors, parent-child relationship quality, conflict characteristics) and how these moderators may operate for a pediatric chronic illness such as T1D.

CONCLUSIONS

Incorporating conceptualizations of family conflict from mainstream developmental research has important implications for future research and intervention adaptations on family conflict in pediatric populations.

Violence, Place, and Strengthened Space: A Review of Immigration Stress, Violence Exposure, and Intervention for Immigrant Latinx Youth and Families

Latinx immigrant families are greatly impacted by US policies and practices that limit immigrant families' and children's rights. This article reviews the effects of such policies and the growing literature examining migration experiences. Latinx immigrant youth and parents may encounter multiple stressors across the stages of migration, including physical and structural violence, fear, poverty, and discrimination, which contribute to higher rates of mental health problems in this population. Despite significant trauma exposure, immigrants demonstrate incredible resilience within themselves, their families, and their communities and through movements and policies aimed at protecting their rights. Numerous culturally relevant universal, targeted, and intensive interventions were developed to magnify these protective factors to promote healing, advance immigration reform, and provide trauma-informed training and psychoeducation. Psychologistsplay a crucial role in implementing, evaluating, and advocating for accessible and collaborative approaches to care so that Latinx immigrant families have the resources to combat the harmful sequelae of immigration stress.

Cumulative Risk and Intimate Partner Aggression

Objective

Intimate Partner Aggression (IPA) is recognized as a serious challenge to public health, and numerous models specify individual, interpersonal, and contextual antecedents of relationally aggressive behavior. The present study aims to synthesize prior work by determining whether the accumulation of selected factors at these three levels of analysis, when considered simultaneously, predicts IPA.

Method

We collected self-report, observational, and social network data from 462 newlywed spouses (231 couples) from low-income neighborhoods at three separate time points across the first 18 months of marriage.

Results

Latent growth curve analyses showed that individual and relational risk were consistently related to IPA initial status (i.e., intercepts), for husbands and wives. Effects of contextual risk on IPA were less consistent. All risk indices were unrelated to 18-month changes in IPA. Furthermore, individual and dyadic deficits increased risk for IPA independent of partners' contextual risk.

Conclusions

Even after adjusting for potential distal influences, individual and dyadic variables emerge as clear risk factors of IPA. Although there were no significant associations between contextual variables and IPA intercepts and slopes in LGCM, we did find evidence for correlations between all three facets of risk. In light of this co-occurrence of risk across various domains, we recommend locating interventions that target individual and relational risk (e.g., therapies addressing neurotic tendencies and couple therapy with a communication skills training component) specifically within higher-risk environments.

Effects of International Male Migration on Wives Left Behind in Rural Tamil Nadu

Emigration by skilled and semi-skilled workers from India to the Middle East is a strategy for better economic returns. Families rarely accompany migrants. Drawing insights from primary data gathered from intensive fieldwork in Sivaganga district, Tamil Nadu, this article attempts to understand the psychological consequences on the wives left behind. A mixed sampling method was used to derive the sample size. Analysis of variance (ANOVA) and Pearson’s chi-square tests were mainly used for quantitative analysis supplemented by qualitative methods. The results indicated that wives considered loneliness the most significant psychological problem arising from their husbands’ absence. Stress was also caused by financial problems and the necessity of taking on additional roles in the family.

Disparities in Smoking Behavior by Race/Ethnicity in 10 Diverse Communities in Chicago: Findings from Sinai Community Health Survey 2.0

Disparities in smoking prevalence persist among and within racial/ethnic groups in the U.S. This study aimed to identify racial/ethnic smoking behavior disparities in Chicago between 2015 and 2016. We used data from the Sinai Community Health Survey 2.0, a population-based survey conducted among adults living in ten diverse communities in Chicago. A total of 1543 adults completed the survey. We estimated the prevalence of smoking behavior among participants who had smoked at least 100 cigarettes in their lives (N = 598). We stratified by race/ethnicity and sex, reporting statistically significant differences at p < 0.05 threshold. Current smoking was highest among NHBs (40%), followed by Puerto Ricans (28%), NHWs (24%), and Mexicans (13%). Among participants who had smoked 100 cigarettes in their life, over 60% of Puerto Rican (65%) and NHB (63%) participants were daily smokers. Although 72% of NHB smokers tried to quit smoking in the previous year, only 15% of them quit smoking for more than 12 months. Among Puerto Rican current smokers, 44% smoked a pack of cigarettes per day or more while only 6% of NHBs smoked more than a pack a day. Only 20% of Mexican participants were advised by a health professional to quit smoking in the past year. Among Puerto Rican females, 55% started smoking before the age of 15. We found important differences in smoking behavior by race/ethnicity groups and sex. These disparities highlight the importance of implementing targeted evidence-based strategies to reduce tobacco use, particularly among those groups with the highest prevalence.

Refining acculturation measures for health research: Latina/o heterogeneity in the National Latino and Asian American Study

OBJECTIVES

This study factor analyzes six scales relating to acculturation and related experiences among a nationally representative sample of United States-residing Latina/os (n = 2,541) from the National Latino and Asian American Study (NLAAS), using measurement invariance (MI) testing to explore differences in latent constructs by Latina/o subgroup.

METHODS

Factor Analysis (FA) within an Exploratory Structural Equation Modeling framework was used to analyze the factor structure of six scales measuring acculturation and related experiences (i.e., acculturation [language use and preference], enculturation [ethnic identity], discrimination, neighborhood context, and family environment). We tested for MI by two important Latina/o subgroups: ethnic heritage and generational status.

RESULTS

The underlying latent factors resulting from FA strongly aligned with the NLAAS subscales. No scale achieved full MI, yet the degree to which MI held varied greatly by scale and by subgroup.

CONCLUSIONS

Findings show that Latina/os are heterogeneous, but that this often depends on the construct and subgrouping of interest. Future research should use these scales in a latent framework, accounting for the lack of MI, to ensure that the underlying acculturative constructs of interest are validly measured when investigating their association with mental health outcomes in this population.

Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants

This paper applies the Minority Stress framework to data collected from an ongoing community-based participatory research project with health and social service agencies in Southeast Michigan. We examine the stressors and coping strategies employed by undocumented Latinx immigrants and their families to manage immigration-related stress. We conducted in-depth interviews with 23 immigrant clients at Federally Qualified Health Care Centers (FQHC) in Southeast Michigan and 28 in-depth interviews with staff at two FQHC's and a non-profit agency serving immigrants. Findings suggest that immigrants face heightened anxiety and adverse mental health outcomes because of unique minority identity-related stressors created by a growing anti-immigrant social environment. Chronic stress experienced stems from restrictive immigration policies, anti-immigrant rhetoric in the media and by political leaders, fear of deportation, discriminatory events, concealment, and internalized anti-immigrant sentiment. Though identity can be an important effect modifier in the stress process, social isolation in the immigrant community has heightened the impact of stress and impeded coping strategies. These stressors have resulted in distrust in community resources, uncertainty about future health benefits, delayed medical care, and adverse mental health outcomes. Findings provide a framework for understanding the unique stressors experienced by immigrants and strategies for interventions by social service agencies.

Selection and Characterization of Cultural Priming Stimuli for the Activation of Spanish and English Cultural Mindsets among Hispanic/Latino Bilinguals in the United States

Cultural priming studies frequently employ non-validated, stereotypical images. Here, we select images to separately evoke two cultural mindsets: Hispanic and US-American. Spanish-English bilinguals identifying as Hispanic/Latino (N=149) rated 50 images online for their cultural and emotional evocation. Based on relative cultural identification, cultural "delegate" (strongly US-American, strongly Hispanic, balanced bicultural) subsamples' ratings were averaged to isolate particularly salient images. Image ratings were compared across respondents' national origins. Ratings of seven selected pairs of content-matched Hispanic and US-American primes were compared across the full sample. High discrimination across cultural mindsets and positive emotion ratings were maintained regardless of various demographic factors. Thus, we provide empirical justification for incorporating these stimuli, individually or as sets, within cultural priming studies among Hispanic/Latino samples.

Cumulative Lifetime Adversity and Depression among a National Sample of U.S. Latinx Immigrants: Within-group Differences in Risk and Protective Factors Using Data from the HCHS/SOL Sociocultural Ancillary Study

Background

Latinx immigrants are exposed to multiple stressors before, during, and after migration. However, most past research has assumed the effects of these stressors are uniform across Latinx groups despite considerable within-group variation. The purpose of this study was to (a) assess the moderating effects of several risk and protective factors on the association between cumulative lifetime adversity and depression among U.S. Latinx immigrants and (b) examine the extent to which risk and protective processes differed between Latinx subgroups.

Method

Data came from a cross-sectional secondary dataset, called the HCHS/SOL Sociocultural Ancillary Study. The sample (N = 2893) was identified using stratified random probability sampling in four of the largest Latinx metropolitan areas: the Bronx, NY, San Diego, CA, Chicago, IL, and Miami, FL. We included four Latinx subgroups in our study: Puerto Ricans, Cubans, Mexicans, and Dominicans.

Results

Results from multi-group regression analyses suggested that social support moderated the association between cumulative lifetime adversity and depression. However, further subgroup analyses showed the moderation effect was only present for Cuban and Dominican immigrants. We also found that perceived discrimination moderated the association between lifetime adversity and depression for Cuban immigrants and ethnic identity moderated the relationship between lifetime adversity and depression for Dominican immigrants.

Conclusions

Our results provide preliminary evidence for the presence of within-group differences in responses to adverse events among Latinx immigrant groups. Results can be used to inform the development of mental health interventions tailored to the specific needs of various Latinx immigrant populations.

Targeting family functioning, acculturative stress, and sugar-sweetened beverage consumption for obesity prevention: findings from the Hispanic community children's health study/study of Latino youth

Background

Maintaining a bond with one’s family as well coping with stress while acculturating to the US may protect Hispanic/Latino youth from increased sugar-sweetened beverages (SSB) consumption, which heightens the risk for overweight and obesity. This study aims to examine associations between acculturative stress, family functioning, and SSB consumption by acculturation status among U.S. Hispanic/Latino youth.

Methods

With cross-sectional data on 1465 youth 8-16y (49.6% females) participating in the Hispanic Community Children’s Health Study/Study of Latino Youth, we classified youths into four acculturation groups – assimilated, integrated, marginalized/separated, and unclassified. SSB consumption was assessed through two 24-h diet recalls and defined as intake frequency of soda, fruit juice, sweetened soft and fruit drinks. Multi-group path regression models were used to test associations of Hispanic/Latino youth’ acculturative stress and family functioning with SSB consumption, as well as the moderating role of acculturation status.

Results

When controlling for age, sex, and study site, acculturative stress (β = − 0.13, p = 0.01) was inversely associated with SSB, and poor family functioning (β = 0.11, p = 0.07) was only marginally associated with SSB consumption among youth classified as assimilated but not among youth classified as integrated, marginalized/separated, or unclassified.

Conclusions

A socio-ecological perspective that incorporates the role of key acculturation-related factors across multiple levels may aid efforts to identify mechanisms that influence the relationship between acculturation status and diet among Hispanic/Latino youth and their families.

An Exploration of Service Providers' Experiences With Latinos Convicted of a Sex Offense

Despite the growing Latino presence in the U.S. criminal justice system and among those who have committed sex offenses specifically, little is known about the barriers and challenges faced by this population when accessing treatment services. This study sought to gather more information about responsivity factors that may be specific to Latinos who have committed sexual offenses. Service providers who worked with Latinos convicted of sexual offenses completed an online survey and answered questions regarding perceived challenges and barriers they encountered when working with Latino clients and were asked to provide recommendations concerning services and treatment provision. Service providers frequently reported issues related to a lack of culturally sensitive services, bilingual professionals, and clients' limited knowledge about the U.S. legal system. Among service providers with experience working with undocumented Latino immigrants, some indicated specific challenges such as stressors related to their immigration status and a lack of resources. Professionals' recommendations were consistent with the challenges reported and findings are discussed as they pertain to responsivity issues in the provision of treatment services to Latino individuals who have committed sexual offenses.

Caregiver and family factors promoting child resilience in at-risk families living in Lima, Peru

BACKGROUND

Child victimization is one of the most serious, preventable threats to child health and wellbeing around the world. Contemporary research has demonstrated that polyvictimization, or children's experience of multiple types of victimization, is particularly detrimental.

OBJECTIVE

The current study aims to evaluate relationships between child victimization and child resilience with a particular focus on caregiver and family promotive factors.

PARTICIPANTS AND SETTING

Participants included N = 385 caregiver-child dyads from a high-risk neighborhood in San Juan de Lurigancho district in Lima, Peru.

METHODS

Data were collected in the context of a representative survey of houses in the neighborhood; an index child (ages 4-17) was randomly selected for each household and caregivers provided reports on core study constructs.

RESULTS

Child victimization (β = .35, p < .001) and harsh punishment (β = .17, p < .001) were associated with higher levels of child adjustment problems. Caregiver depression was associated with both higher adjustment problems (β = .22, p < .001) and higher prosocial skills (β = .14, p = .003). Caregiver resilience was associated with lower adjustment problems (β = -.15, p = .01) and higher prosocial skills (β = .14, p = .04). Positive parenting was associated with lower adjustment problems (β = -.15, p < .001) and higher prosocial skills (β = .20, p < .001). Family cohesion (β = .23, p = .001) was positively associated only with children's prosocial skills.

CONCLUSIONS

Findings suggest that caregiver resilience and positive parenting are consistent promotive factors for child resilience across indicators, including both adjustment problems and prosocial skills. These promotive factors may therefore be promising potential targets address in the context of interventions aimed at promoting child resilience.

Understanding the Influence of Sexual Risk Taking, Ethnic Identity, and Family and Peer Support on School Importance Among Hispanic Adolescents

Despite the broader academic gains experienced by Hispanic students, who represent the largest minority group in the United States, they remain the least educated of all major ethnic groups, and our understanding of their academic needs and strengths remains woefully inadequate. Therefore, this study examined the risk (e.g., sexual risk taking) and protective factors (e.g., family support, supportive peer networks, and ethnic identity) associated with school importance among Hispanic teens (N = 587) residing in a high-risk, resource poor urban community and the ways in which these relationships vary between adolescent males (46.5%) and adolescent females (53.5%). Schools that are able to harness the numerous assets embedded within the Hispanic community are well positioned to create learning environments that are encouraging, are culturally responsive, and can potentially reduce risk involvement that may interfere with valuing the role of school importance. Implications for school-based personnel are discussed.

Advance Care Planning Engagement and End-of-life Preference Among Older Chinese Americans: Do Family Relationships and Immigrant Status Matter?

Objectives

To examine how immigrant status and family relationships are associated with advance care planning (ACP) engagement and end-of-life (EOL) preference in burial planning among older Chinese Americans, the largest subgroup of Asian Americans.

Design

Cross-sectional survey.

Setting

Communities in Honolulu, Hawai'i.

Participants

Participants were 430 older Chinese Americans aged 55 years and older.

Measures

Measures included ACP contemplation, ACP discussion, and EOL preference in burial planning, immigrant status, family cohesion, family conflict, demographic information, and health status.

Results

Results show that in comparison to foreign-born Chinese Americans, US-born Chinese Americans were more likely to have ACP contemplation [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.39-5.63], ACP discussion (OR 3.02, 95% CI 1.50-6.08), and preferences for burial plans at the end of life (OR 4.56, 95% CI 2.04-10.18). Family conflict increased the possibility of having ACP contemplation (OR 1.21, 95% CI 1.07-1.38), ACP discussion (OR 1.22, 95% CI 1.07-1.39), and EOL preference in burial planning (OR 1.22, 95% CI 1.04-1.42), whereas family cohesion was not associated with these study outcomes.

Conclusions and Implications

This study suggests that ACP should be adapted to be more culturally appropriate, especially in a time of coronavirus and xenophobia, such as framing ACP as a tool to help families reduce stress while fulfilling filial obligations, in order to ensure equitable access to ACP.

Perceptions and experiences of living with type 1 diabetes among Latino adolescents and parents with limited English proficiency

We explored perceptions and experiences of living with type 1 diabetes mellitus (T1DM) among U.S. Latino adolescents (age 12-19 years) with T1DM and parents with limited English proficiency. We used a qualitative descriptive approach with semi-structured interviews of adolescents together with their parents. Interview data were reviewed, coded, and combined into themes about participant experiences with T1DM. Twenty-four adolescents (mean age: 15.4 years) and 23 parents participated. Analysis resulted in three themes: (a) Understanding and adapting to T1DM (i.e., initial fear and misunderstandings of T1DM; adolescents' reflections on living with a chronic health condition); (b) Coming to terms with social and environmental influences on T1DM self-management (i.e., T1DM as disruptive to school and social activities; dealing with stigma and judgments related to diabetes); and, (c) Integrating T1DM self-management expectations with components of Latino cultures (i.e., orientation toward family well-being; parent concerns about cultural preferences that influence food choices, positive influence of spirituality and religiousness; parental views of their current health care in comparison to that available in their place of birth). Adolescents and their parents reported experiences that are universal to adolescents with T1DM in addition to challenges that are unique to Latinos. Efforts aimed at improving T1DM self-management during adolescence with this population need to be tailored to meet the unique social and cultural contexts and delivered in a culturally and linguistically congruent manner.

Race-Ethnicity, Social Roles, and Mental Health: A Research Update

Social role involvement engenders sense of purpose and meaning to life, which sustains positive mental health. Racism within American society, however, results in experiences that disadvantage ethnoracial minorities, thus making it likely that social roles do not have universal remunerations. Using the Collaborative Psychiatric Epidemiology Surveys (N = 12,526), this study explores the association between role participation and psychological distress across nine ethnoracial groups. Results indicate that engaging in many roles is associated with better mental health for all ethnoracial groups. However, the combination of social roles has distinct effects for certain groups. We discuss the implications of the study findings for medical sociology, in general, and the social roles literature, in particular.

Depressive Symptoms and Resilience among Hispanic Emerging Adults: Examining the Moderating Effects of Mindfulness, Distress Tolerance, Emotion Regulation, Family Cohesion, and Social Support

Emerging adulthood has been described as a difficult stage in life and may be particularly stressful for Hispanic emerging adults who are disproportionately exposed to adversity and chronic sociocultural stressors. To better prevent and treat depressive disorders among Hispanic emerging adults, more research is needed to identify and understand modifiable determinants that can help this population enhance their capacity to offset and recover from adversity and sociocultural stressors. As such, this study aimed to (1) examine the association between resilience and depressive symptoms among Hispanic emerging adults, and (2) examine the extent to which intrapersonal resources (e.g., mindfulness, distress tolerance, emotion regulation strategies) and interpersonal resources (e.g., family cohesion, social support) moderate the association between resilience and depressive symptoms. To examine these aims, 200 Hispanic emerging adults (ages 18-25) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey, and data were analyzed using hierarchical multiple regression and moderation analyses. Findings from the hierarchical multiple regression indicate that higher resilience was associated with lower depressive symptoms. Findings from the moderation analyses indicate that family cohesion, social support, and emotion regulation strategies (e.g., cognitive reappraisal and expressive suppression) functioned as moderators; however, mindfulness and distress tolerance were not significant moderators. Findings from this study add to the limited literature on resilience among Hispanics that have used validated measures of resilience. Furthermore, we advance our understanding of who may benefit most from higher resilience based on levels of intrapersonal and interpersonal resources.

Impact of pre-trauma, trauma-specific, and post-trauma variables on psychosocial adjustment of Syrian refugee school-age children

This study investigated the psychosocial adjustment in Syrian refugee children and adolescents who resettled in Lebanon and Jordan by examining the potential effects of pre-trauma, trauma-specific, and post-trauma variables. The sample consisted of 1000 children. The results indicated that a child's adjustment was correlated with the host country, traumatic events, and time spent in host country. Coping strategies, family relationships, and school environment are strong predictors. Interventions may target psychosocial problems and risk modifiers that focus on emotion regulation, cognitive restructuring, problem-solving and coping skills, positive relationships within the family, and positive school environment.

Heterogeneity of Latina/os' acculturative experiences in the National Latino and Asian American Study: a latent profile analysis

PURPOSE

This study characterized unobserved subgroups of acculturative experiences among a nationally representative sample of U.S.-residing Latina/os (n = 2541) from the National Latino and Asian American Study.

METHODS

Latent profile analysis was used to characterize the sample by acculturative experiences using nine-factor score indicators regarding discrimination, neighborhood context, family environment, acculturation (language use and preference), and enculturation (ethnic identity). Predictors of profile membership are also examined, including sociodemographics, Latina/o heritage (i.e., ethnic group), generational status, and two acculturative stress domains (legal and interpersonal).

RESULTS

Four Latina/o subgroups were identified based on acculturative experiences. Profiles were differentiated by family context, neighborhood context, and discrimination: (1) positive experiences (n = 1,743, 69%), (2) cohesive conflict (n = 424, 17%), (3) marginalized conflict (n = 237, 9%), and (4) marginalized (n = 137, 5%). Generational status, heritage, and marital status were the salient predictors of profile membership. Among the foreign-born sample (n = 1617), legal acculturative stress also predicted profile membership.

CONCLUSIONS

Latina/os have heterogeneous experiences living in the United States. Discrimination, family context, and neighborhood environment are more related to varying experiences as opposed to traditional measures of acculturation and enculturation. Future research should characterize Latina/o heterogeneity using these experiences rather than strictly by observed demographics, such as heritage or generational status.

Comorbidity of Lifetime Alcohol Use Disorder and Major Depressive Disorder in San Juan, Puerto Rico

OBJECTIVE

The purpose of this study was to update estimates of comorbidity between lifetime alcohol use disorder (AUD) severity and lifetime major depressive disorder (MDD) in San Juan, Puerto Rico.

METHOD

Data are from a household random sample of 1,510 individuals (816 female) 18-64 years of age in San Juan, Puerto Rico. AUD and MDD identification follow criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and Fourth Edition, respectively, both implemented with the Composite International Diagnostic Interview (CIDI). It is possible to implement DSM-5 AUD identification with the CIDI, but only DSM-IV criteria can be applied to identify MDD.

RESULTS

The prevalence of lifetime MDD was 11% among men, 17% among women, and 14% for both genders; the prevalence of lifetime AUD was 38% among men, 16% among women, and 26% for both genders. Among those with AUD, the rate of MDD was 17% among men and 35% among women. Among those without AUD the rate of MDD was 7% among men and 15% among women. Results of multiple logistic regression analysis controlling for gender, illegal drug use, age, level of family cohesion, religion, employment status, marital status, education, and family annual income showed that AUD severity was positively associated with the likelihood of MDD, as follows: mild AUD, adjusted odds ratio [AOR] = 1.78 (95% CI [1.09, 2.91], p < .05); moderate AUD, AOR = 2.58 (95% CI [1.33, 5.01], p < .01); and severe AUD, AOR = 3.34 (95% CI [1.70, 6.56], p < .01).

CONCLUSIONS

MDD frequently occurs as a comorbid condition with AUD in San Juan, Puerto Rico. The frequency of occurrence increases as AUD severity increases. AUD treatment providers should therefore be equally prepared to treat these two comorbid conditions.