Longitudinal Trajectories of Family Functioning Among Recent Immigrant Adolescents and Parents: Links With Adolescent and Parent Cultural Stress, Emotional Wellâ Being, and Behavioral Health

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148234/1/cdev12914.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148234/2/cdev12914_am.pd

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

The Longitudinal Associations Between Discrimination, Depressive Symptoms, and Prosocial Behaviors in U.S. Latino/a Recent Immigrant Adolescents

The links between discrimination and adjustment in U.S. Latino/a immigrant adolescents is an important but understudied phenomenon. We aimed to investigate the longitudinal associations (across 1 year) among discrimination, prosocial behaviors, and depressive symptoms in U.S. Latino immigrant adolescents using two competing models: associations between discrimination and prosocial behaviors via depressive symptoms (mental health strain model), and associations between discrimination and depressive symptoms via prosocial behaviors (prosociality strain model). Participants were 302 Latino/a recent immigrant adolescents (53.3 % boys, M age = 14.51 years at Time 1, SD = .88 years) who completed measures of discrimination, depressive symptoms, and prosocial behaviors at 6-month intervals. The results provided support for both proposed models. The discussion examines the importance of prosocial behaviors in understanding adjustment and effects of discrimination among recently immigrated U.S. Latino adolescents

Latino parent acculturation stress: Longitudinal effects on family functioning and youth emotional and behavioral health

Latino parents can experience acculturation stressors, and according to the Family Stress Model (FSM), parent stress can influence youth mental health and substance use by negatively affecting family functioning. To understand how acculturation stressors come together and unfold over time to influence youth mental health and substance use outcomes, the current study investigated the trajectory of a latent parent acculturation stress factor and its influence on youth mental health and substance use via parent-and youth-reported family functioning. Data came from a 6-wave, school-based survey with 302 recent (<5 years) immigrant Latino parents (74% mothers, Mage = 41.09 years) and their adolescents (47% female, Mage = 14.51 years). Parents' reports of discrimination, negative context of reception, and acculturative stress loaded onto a latent factor of acculturation stress at each of the first 4 time points. Earlier levels of and increases in parent acculturation stress predicted worse youth-reported family functioning. Additionally, earlier levels of parent acculturation stress predicted worse parent-reported family functioning and increases in parent acculturation stress predicted better parent-reported family functioning. While youth-reported positive family functioning predicted higher self-esteem, lower symptoms of depression, and lower aggressive and rule-breaking behavior in youth, parent-reported family positive functioning predicted lower youth alcohol and cigarette use. Findings highlight the need for Latino youth preventive interventions to target parent acculturation stress and family functioning. (PsycINFO Database Recor

The Use of Cultural Identity in Predicting Health Lifestyle Behaviors in Latinx Immigrant Adolescents

Objectives: This study explored whether cultural identity predicts health lifestyle behaviors. Method: Participants included 302 recently immigrated (<5 years in the U.S.) Latinx adolescents (53% boys; mean age 14.51 years at baseline) from Miami and Los Angeles. Participants completed cultural identity measures at baseline and 1-year post baseline. A path analysis was used to estimate associations between cultural identities (ethnic, national, and bicultural) and health lifestyle behaviors (physical activity, diet, and sleep hygiene). Results: Ethnic identity positively predicted diet. Results also indicated a significant interaction between ethnic and national identity on sleep hygiene. Specifically, when national identity was high (+1 SD), ethnic identity positively predicted sleep hygiene. Conclusion: This study focuses on health lifestyle behaviors such as physical activity, diet, and sleep hygiene in this population. Results highlight the need to explore the protective nature of cultural identity retention in relation to health lifestyle behaviors in Latinx adolescents

Longitudinal Trajectories of Family Functioning Among Recent Immigrant Adolescents and Parents: Links With Adolescent and Parent Cultural Stress, Emotional Well-Being, and Behavioral Health

This study examined longitudinal effects of adolescent and parent cultural stress on adolescent and parent emotional well-being and health behaviors via trajectories of adolescent and parent family functioning. Recent immigrant Latino adolescents (M  = 14.51) and parents (M  = 41.09; N = 302) completed measures of these constructs. Latent growth modeling indicated that adolescent and parent family functioning remained stable over time. Early levels of family functioning predicted adolescent and parent outcomes. Baseline adolescent cultural stress predicted lower positive adolescent and parent family functioning. Latent class growth analyses produced a two-class solution for family functioning. Adolescents and parents in the low family functioning class reported low family functioning over time. Adolescents and parents in the high family functioning class experienced increases in family functioning

Disentangling relationships between bicultural stress and mental well-being among Latinx immigrant adolescents

The Acculturative Process and Context Framework (Ward & Geeraert, 2016) proposes that acculturative stressors influence psychological well-being over time. In fact, extant literature has linked bicultural stress with psychological functioning; yet, no studies have explored the causal dominance of bicultural stress. The purpose of the present study was to evaluate the directionality of prospective relations among bicultural stress and psychosocial functioning (i.e., depressive symptoms, hopefulness, and self-esteem) in Latinx immigrant adolescents across 5 waves. There were 303 Latinx adolescents who were recruited for this study from Los Angeles and Miami and were assessed across 5 waves at 6-month intervals. Adolescents were 14.50 years old on average ( = .88) and 53.16% were male. Adolescents reported living in the United States for 2.07 years on average ( = 1.87). A Random-Intercept Cross-Lagged Panel Model (RI-CLPM) was used to examine the between- and within-person relations among bicultural stress, depressive symptoms, hopefulness, and self-esteem in a comprehensive model. The comprehensive RI-CLPM including bicultural stress, depressive symptoms, hopefulness, and self-esteem exhibited excellent model fit. Between-person, trait-like relations among constructs ranged from small to large, as expected. Within-person, cross-lagged estimates among constructs were overall inconsistent, with some evidence that, within individuals, self-esteem influences later hopefulness. Findings from this study indicate that the RI-CLPM is an effective strategy to examine bicultural stress and well-being processes among adolescents. There is a need for further research examining bicultural stress among Latinx immigrant youth, particularly within prevention and intervention studies. (PsycINFO Database Record (c) 2020 APA, all rights reserved)

The role of personal identity as a resource for college students during COVID-19

Objective: We examined the role of personal identity vis-à-vis COVID-related outcomes among college students from seven U.S. campuses during spring/summer 2021. Participants: The present sample consisted of 1,688 students (74.5% female, age range 18-29). The sample was ethnically diverse, and 57.3% were first-generation students. Procedures: Students completed an online survey assessing personal identity synthesis and confusion, COVID-related worries, general internalizing symptoms, positive adaptation, and general well-being. Results: Personal identity synthesis was negatively related to COVID-related worries and general internalizing symptoms, and positively related to positive adaptation, both directly and indirectly through life satisfaction and psychological well-being. Personal identity confusion evidenced an opposing set of direct and indirect associations with outcome variables. Conclusions: Personal identity may potentially be protective against pandemic-related distress among college students, in part through its association with well-being. Reducing identity confusion and promoting identity synthesis are essential among college students during this and future pandemics