Type 1 diabetes in very young children: a model of parent and child influences on management and outcomes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135479/1/pedi12351.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135479/2/pedi12351_am.pd

Examining Links between Multidimensional Stress and Health Outcomes in a Pediatric Sample from Low-Income Families

Within pediatric health psychology, low socioeconomic status is a risk factor for adverse physical, socio-emotional, and behavioral outcomes (Clarke & Erreygers, 2020). The impact of environmental stressors may be further exacerbated in the context of poverty, which may influence scores and factor-loadings on common pediatric assessments (Hurt & Betancourt, 2017). Therefore, the current study pursued two aims. First, the factor structure and psychometric properties of the 24-item Children’s Somatization Inventory (CSI-24) were examined in a predominantly low-income sample of children and caregivers from a family medicine practice. Second, the impact of multidimensional stressors on somatization, health-related quality of life, mental health, and one-year medical service utilization was examined. Given that modifiable health behaviors may serve as a low-cost way to alleviate negative outcomes associated with chronic environmental stress, moderating variables of physical activity and sleep were considered within the stressor-health association in a predominantly low-income sample (Kleszczewska et al., 2019). A confirmatory factor analysis (CFA) of the CSI-24 was initially proposed; however, the CFA was unfeasible due to the available sample size. Alternate exploratory analyses on the psychometric and structural properties of the CSI-24 were therefore conducted, considering factors identified in prior research. The relationship between multidimensional stress and health outcomes was examined via a series of stepwise multiple regressions, controlling for age and gender. Moderating variables of physical activity and sleep were examined using a separate model for each dependent variable. Results found preliminary support for differences in the psychometric properties of the CSI-24 when used in a low-income sample, supported a relationship between multidimensional stress and health outcomes, and provided a rare examination of sleep and physical activity as moderators in the stress-health relationship in this population. Gaps in the existing literature were addressed related to the stress-health relationship, potential moderators, and properties of the CSI-24 when administered to a low-income sample. Findings have implications for interpretation of the CSI-24, and for targeted interventions related to multidimensional stress and health

Mental Health Outcomes of Discrimination among College Students on a Predominately White Campus: A Prospective Study

Racial discrimination is a social stressor harmful to mental health. In this paper, we explore the links between mental health and interpersonal discrimination-related social events, exposure to vicarious racism via social media, and rumination on racial injustices using a daily diary design. We utilize data from a racially diverse sample of 149 college students with 1,489 unique time observations at a large, predominantly white university. Results show that interpersonal discrimination-related social events predicted greater self-reported anger, anxiety, depressive symptoms, and loneliness both daily and on average over time. Vicarious racism from day to day was associated with increased anxiety symptoms. In contrast, rumination was not associated with negative mental health outcomes. These findings document an increased day-to-day mental health burden for minority students arising from frustrating and alienating social encounters experienced individually or learned about vicariously

Race and ethnic variation in college students’ allostatic regulation of racism-related stress

Racism-related stress is thought to contribute to widespread race/ ethnic health inequities via negative emotion and allostatic stress process up-regulation. Although prior studies document racerelated stress and health correlations, due to methodological and technical limitations, they have been unable to directly test the stress-reactivity hypothesis in situ. Guided by theories of constructed emotion and allostasis, we developed a protocol using wearable sensors and daily surveys that allowed us to operationalize and time-couple self-reported racism-related experiences, negative emotions, and an independent biosignal of emotional arousal. We used data from 100 diverse young adults at a predominantly White college campus to assess racism-related stress reactivity using electrodermal activity (EDA), a biosignal of sympathetic nervous system activity. We find that racism-related experiences predict both increased negative emotion risk and heightened EDA, consistent with the proposed allostatic model of health and disease. Specific patterns varied across race/ethnic groups. For example, discrimination and rumination were associated with negative emotion for African American students, but only interpersonal discrimination predicted increased arousal via EDA. The pattern of results was more general for Latinx students, for whom interpersonal discrimination, vicarious racism exposure, and rumination significantly modulated arousal. As with Latinx students, African students were particularly responsive to vicarious racism while 1.5 generation Black students were generally not responsive to racism-related experiences. Overall, these findings provide support for allostasis-based theories of mental and physical health via a naturalistic assessment of the emotional and sympathetic nervous system responding to real-life social experiences