Childhood adversity and emotion regulation strategies as predictors of psychological stress and mental health in American Indian adults during the COVID-19 pandemic.

Life events, such as the Coronavirus disease 2019 (COVID-19) pandemic, elicit increases in psychological stress and symptoms of anxiety and depression. In turn, these outcomes have negative implications for mental health. Emotion regulation strategies and prior adversity may moderate the degree to which life events affect outcomes that are linked to mental health. The purpose of the current study was to evaluate whether childhood adversity and emotion regulation strategy use interactively informed changes in outcomes linked to mental health following the onset of the pandemic in American Indian (AI) adults. AI adults (N = 210) reported levels of childhood adversity, emotion regulation strategy use, symptoms of anxiety and depression, and psychological stress 1 month prior to the onset of the COVID-19 pandemic. One month following the declaration of the pandemic, they reported on their stress, symptoms of anxiety and depression once again. The interaction between expressive suppression and childhood adversity predicted changes in psychological stress and symptoms of depression (B = .26, t(198) = 4.43 p < .001, R² change = .06) and (B = .23 t(199) = 4.14, p < .001, R² change = .05) respectively. The findings indicate that expressive suppression may be a maladaptive emotion regulation strategy for AI adults who experienced high levels of childhood adversity. This work represents a first step in understanding the role of emotion regulation strategy use in predicting mental health-relevant outcomes in the context of a life event, in a community that is disproportionately affected by chronic mental health conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

COVID-19 and food insecurity in the Blackfeet Tribal Community.

To examine the impact of the COVID-19 pandemic on food insecurity in the Blackfeet American Indian Tribal Community. American Indian adults residing on the Blackfeet reservation in Northwest Montana (n = 167) participated in a longitudinal survey across 4 months during the COVID-19 pandemic (August 24, 2020- November 30, 2020). Participants reported on demographics and food insecurity. We examined trajectories of food insecurity alongside COVID-19 incidence. While food insecurity was high in the Blackfeet community preceding the pandemic, 79% of our sample reported significantly greater food insecurity at the end of the study. Blackfeet women were more likely to report higher levels of food insecurity and having more people in the household predicted higher food insecurity. Longitudinal data indicate that the COVID-19 pandemic exacerbated already high levels of food insecurity in the Blackfeet community. Existing programs and policies are inadequate to address this public health concern in AI tribal communities.

Covid-19 and changes in sleep health in the Blackfeet Community.

We examined changes in psychological outcomes related to the COVID-19 pandemic (ie psychological stress, perceived control, and perceived ability to cope) and changes in sleep health in the American Indian Blackfeet community over 4 months (August 24, 2020-November 30, 2020). American Indian adults residing on the Blackfeet reservation (n = 167) completed measures of perceived control over contracting COVID-19, perceived ability to cope with pandemic stressors, psychological stress linked to the pandemic, and a measure of sleep health each month. Linear-effects mixed models were used to examine changes in our outcomes. Community members who reported more control over contracting the virus had better sleep health relative to those who reported less control (B = 0.72, SE = 0.29, p = 0.015). Further, during months when individuals felt they had more control over contracting the virus compared to their average perceived control levels, they had better sleep health relative to their own average (B = 1.06, SE = 0.13, p < 0.001). Average sleep health was the lowest in October, 2020, the month during which COVID-19 incidence was at its highest on the reservation. Declines in sleep health linked to low levels of control over contracting COVID-19 may exacerbate high incidence of chronic mental and physical health conditions in tribal communities. Interventions which highlight strategies known to reduce risk of contracting the virus, may increase perceived control and sleep health, and thus may improve downstream health outcomes for this at-risk population.

Associations Between Childhood Abuse and COVID-19 Hyperarousal in Adulthood: The Role of Social Environment.

BACKGROUND: Childhood abuse increases risk for high levels of distress in response to future stressors. Interpersonal social support is protective for health, particularly during stress, and may be particularly beneficial for individuals who experienced childhood abuse. OBJECTIVE: Investigate whether childhood abuse predicts levels of posttraumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic, and test whether the perceived availability of social companionship preceding the pandemic moderates this relationship. METHODS: During Phase 1, adults (N = 120; Age M[SD] = 19.4 [0.94]) completed a retrospective measure of childhood adversity along with a measure of perceived availability of opportunities for social engagement immediately preceding the pandemic. Two weeks after the COVID-19 pandemic declaration, participants completed the Impact of Event Scale-Revised (IES-R) with respect to the pandemic. Hierarchical linear regression analyses examined the interaction between childhood abuse and the perceived availability of social companionship preceding the pandemic as a predictor of PTSD symptoms. RESULTS: Adjusting for covariates, the interaction between childhood abuse and perceived availability of others to engage with before the onset of the pandemic was a significant predictor of IES-hyperarousal (ß = -0.19, t = -2.06, p = 0.04, ΔR 2 = 0.032, CI: [-0.31 to -0.01]). CONCLUSION: Levels of perceived opportunities for social companionship before the pandemic associates with levels of hyperarousal related to the pandemic, particularly for individuals who experienced high levels of childhood abuse. More research is needed to understand how to mitigate the higher levels of distress related to the pandemic for these individuals in order to reduce risk for future psychiatric disorders.

Emotion Regulation Strategies Predict PTSS During the COVID-19 Pandemic in an American Indian Population.

BACKGROUND: Poor emotion regulation is associated with post-traumatic stress symptoms (PTSS). However, limited prospective research prevents any directional conclusions. No known studies have assessed emotion regulation with PTSS in American Indians, a high-risk population for poor mental health outcomes. The present prospective study explored whether emotion regulation strategies (cognitive reappraisal, expressive suppression) predicted later PTSS related to the COVID-19 global pandemic in a solely American Indian sample. METHODS: American Indian participants (N = 210; Mean (SD) age = 54.85(13.08) years, 58.7% female) completed the Emotion Regulation Questionnaire (ERQ) during Phase 1 (a few weeks before pandemic declaration) and the Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic during Phase 2 (7-8 weeks after pandemic declaration). Bivariate correlations and hierarchical linear regression analyses were utilized. RESULTS: ERQ reappraisal was negatively associated with IES-R total scores, such that higher reappraisal predicted lower PTSS. In contrast, ERQ suppression was positively associated with IES-R total scores, such that higher suppression predicted higher PTSS. CONCLUSIONS: Greater suppression and lower reappraisal predicts PTSS in response to the COVID-19 pandemic in an entirely American Indian sample, providing critical information for future interventions in a population at high-risk for mental health disparities.

The relationship between health mindsets and health protective behaviors: An exploratory investigation in a convenience sample of American Indian adults during the COVID-19 pandemic.

The Novel-coronavirus disease-2019 (COVID-2019) outbreak was declared a national emergency on March 13, 2020. To reduce the spread of the virus, Americans were asked to physically distance and to increase disinfecting behaviors such as hand washing. Previous research indicates that one's mindset about health, or the degree to which they view health as fixed or modifiable, influences health behaviors. Current data indicates that American Indians (AIs) are at greater risk for COVID-19. As such, it is important to understand whether mindsets about health may affect behaviors which could prevent spread of the virus in AIs. In this exploratory investigation, a convenience sample of two hundred AI adults completed a questionnaire one month prior to the declaration of the COVID-19 pandemic as a national emergency. They provided demographic information and completed a measure of health mindsets. The second wave of data was collected approximately one month later, where we collected a measure of physical distancing behavior and a measure of disinfecting behaviors. In AI adults, health mindset predicted frequency of physical distancing behaviors and disinfecting behaviors, with individuals who viewed health as less fixed engaging in more physical distancing and disinfecting behaviors, while individuals who viewed health as more fixed reported less physical distancing and less disinfecting behaviors. In AIs, growth health mindsets predicted physical distancing and disinfecting behaviors, both of which are important in reducing the spread of COVID-19. Interventions which are designed to promote growth mindsets of health may promote health-protective behaviors in the context of the COVID-19 pandemic.

Childhood trauma as a predictor of changes in sleep quality in American Indian adults during the COVID-19 pandemic.

BACKGROUND: Early life adversity associates with poor sleep in adulthood and is believed to sensitize individuals to later stressors. Infectious disease outbreaks increase psychological stress, and life events impact sleep quality. American Indians have been disproportionately affected by the COVID-19 pandemic. OBJECTIVE: Investigate whether childhood trauma predicts changes in sleep quality following onset of the pandemic and test whether pandemic stress contributes to changes in sleep. METHODS: In a sample of 210 American Indian adults (Age M (SD) = 55.09 (13.10), 59.5% female) demographics, childhood trauma and sleep quality were measured at Time 1. One month following the onset of the pandemic, psychological stress specific to the pandemic and sleep quality were measured. RESULTS: Using linear regression controlling for age, sex, income, and sleep quality at Time 1, childhood adversity predicted both psychological stress specific to the pandemic and changes in sleep quality from Time 1 to Time 2 (ß = 0.33, t(205) = 4.88, P < .001, ΔR2 = 0.10) and (ß = 0.24, t(204) = 3.48, P < .001, ΔR2 = 0.05), respectively. Mediation analyses indicated a significant indirect effect between childhood adversity and changes in sleep quality through COVID-19 stress (indirect effect [standard error, SE] = (0.03[0.01], 95% confidence interval = [0.003, 0.03]). CONCLUSIONS: In American Indians childhood trauma predicts greater declines in sleep quality associated with the onset of the COVID-19 pandemic, in part because greater psychological stress related to COVID-19. Future work should identify factors which alleviate stress related to life events for individuals who experienced childhood trauma in order to improve health behaviors and health.

Historical trauma and social support as predictors of psychological stress responses in American Indian adults during the COVID-19 pandemic.

BACKGROUND: American Indians (AIs) live with historical trauma, or the cumulative emotional and psychological wounding that is passed from one generation to the next in response to the loss of lives and culture. Psychological consequences of historical trauma may contribute to health disparities. PURPOSE: Here, we investigate whether historical trauma predicts changes in psychological stress associated with the onset of the COVID-19 pandemic in AI adults. Based on the stress-sensitization theory, we hypothesize that greater historical trauma will predict greater increases in levels of psychological stress from before the onset of the pandemic to after. METHOD: Our analytic sample consisted of 205 AI adults. We measured historical trauma and levels of psychological stress before and after the onset of the pandemic. RESULTS: Using hierarchical regression models controlling for age, biological sex, income, symptoms of depression and anxiety, psychological stress at Time 1, COVID-19 specific stress, and childhood trauma, we found that greater historical trauma preceding the pandemic predicted greater increases in psychological stress (ß = 0.38, t = 5.17 p < .01, ΔR2 = 0.12), and levels of social support interacted with historical trauma to predict changes in psychological stress (ß = -0.19, t = -3.34, p = .001, ΔR2 = 0.04). The relationship between historical trauma and changes in stress was significant for individuals with low levels of social support. CONCLUSIONS: Historical trauma may contribute to AI mental health disparities, through heightened psychological stress responses to life stressors and social support appears to moderate this relationship.