Sleep and mental health among youth experiencing homelessness: A retrospective pilot diary study.

OBJECTIVES: The goal of this study was to describe the nightly sleep conditions of youth experiencing homelessness, and examine the association between sleep and mental health, both cross-sectionally and using diary data. METHODS: n = 147 youth (ages 16-24) experiencing homelessness completed a baseline survey assessing self-reported sleep and depressive and anxious symptoms. A subsample of n = 49 completed a follow-up 7-day diary study measuring nightly sleep conditions and daily depressive and somatic symptoms. RESULTS: According to baseline data, the majority of the sample (71%) reported sleeping less than 7 hours per night on average, and feeling like they did not get adequate sleep, especially among youth identifying as LGBTQ. In a qualitative follow-up question, the plurality attributed poor sleep to mental health woes. Cross-sectionally, youth with lower levels of self-reported sleep quality (more daytime fatigue and insomnia) reported higher levels of depressive and anxious symptoms. The diary data indicated that the most common nightly complaints among shelter utilizers are lack of privacy, noise, and uncomfortable temperatures. Multilevel models suggest that poor sleep conditions predicted higher levels of somatic symptoms the following day, after controlling for baseline levels of depressive and anxious symptoms. CONCLUSIONS: This study highlights the role environmental context plays in sleep health and its subsequent impacts. Individuals experiencing homelessness lack autonomy over their sleeping environments, and thus cannot make adjustments such as reducing disruptions such as noise, temperature, and light. Importantly, these less-than-ideal sleeping conditions contribute to pre-existing health disparities and may have long-term implications.

Daily association between racial discrimination and depressive symptoms among ethnically diverse adolescents: Ethnic identity as a predictor and a buffer.

OBJECTIVES: The present study assessed the association between daily racial discrimination and depressive symptoms over the course of 14 consecutive days, and the predictive and buffering effects of ethnic identity commitment and exploration. METHOD: Participants were 96 high school juniors and seniors (Mage = 17.45, SE = 1.12) from a low-income urban county, all identifying as non-White (28 Black/African American, 31 Latinx, and 37 non-White other). Over a 14-day period, participants reported daily experiences of racial discrimination and depressive symptoms. Baseline ethnic identity was measured approximately 1 month prior to the diary study. RESULTS: Daily discrimination was predicted by higher exploration and lower commitment at baseline. Multilevel models revealed that depressive symptoms were higher on days on which participants experienced more discrimination (within-person association), with no next-day lagged effects. Finally, baseline commitment and exploration weakened, but did not completely eliminate, the correlation between daily discrimination and depressive symptoms. CONCLUSIONS: The study underscores the need to use momentary or daily assessments of discriminatory experiences to understand the full impact of minority-related stress. The current results demonstrate that daily discriminatory experiences are not only commonplace but that ethnic identity alone may not be enough to combat the negative impact of these experiences. Implications of these findings are discussed in the unique context of adolescent development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Posttraumatic stress disorder in incarcerated women: A call for evidence-based treatment.

The majority of women who enter the criminal justice system, most of whom are poor and women of color, have suffered from significant lifetime trauma exposure that can lead to posttraumatic stress disorder (PTSD). It is essential to identify the prevalence of PTSD among this population in order to identify treatment needs. Most studies on PTSD among incarcerated women have focused on PTSD in jailed populations, including women awaiting trial. Using a cross-sectional study design, we estimated the prevalence of PTSD and comorbid physical and mental health conditions in 387 incarcerated women sentenced to a maximum-security prison in the United States. Almost half (44%) of our sample met the diagnostic criteria for PTSD. Women with moderate to severe PTSD symptoms were more likely to report several comorbid physical and mental health conditions than were women without PTSD. Women with the most severe symptoms were most likely to report receiving mental health treatment in prison; women with moderate to severe symptoms were less likely to report receiving similar mental health care. Our findings add support to the link between PTSD and comorbid physical and mental health conditions and suggest that many women with PTSD are not receiving mental health treatment that is likely to benefit them. Because prison has become the mental health safety net for some of the nation's most vulnerable women, it is imperative that prisons provide evidence-based PTSD treatment during incarceration.

Sleep quality and risk for sleep apnea in incarcerated women.

BACKGROUND: Little is known about characteristics of women's sleep during incarceration. OBJECTIVES: The study objectives were to describe incarcerated women's sleep quality, document incarcerated women's risk for sleep apnea, and identify other factors that contribute to poor sleep quality during incarceration. METHODS: This cross-sectional descriptive exploratory investigation was conducted in a maximum security women's prison in the United States. Incarcerated women's sleep quality and their risk for sleep apnea was assessed by using the Pittsburgh Sleep Quality Index and the Multivariable Apnea Prediction Score, respectively. RESULTS: Four hundred thirty-eight incarcerated women participated in this investigation. Results indicate that 72% of the sample met the Pittsburgh Sleep Quality Index criteria for "poor sleepers." Poor sleepers were significantly more likely to report sleep disturbances and scored significantly higher on the risk for sleep apnea scale compared to women who did not meet the poor sleep threshold. Approximately 10% of the sample had a probability for sleep apnea higher than .50. Factors that contributed to poor sleep included (a) "racing thoughts/worry/thinking about things," (b) environmental noise and other factors, (c) physical health conditions/pain, (d) nightmares and flashbacks, and (e) not taking sleep medication. DISCUSSION: Most participants reported poor sleep quality during incarceration. Poor sleep might exacerbate existing health conditions and contribute to the development of new health problems for incarcerated women. Furthermore, poor sleep quality may reduce a woman's ability to fully participate in beneficial prison programming. This investigation provides a first look at how women sleep in prison and offers recommendations for future research.

Emotional adjustment and distressed interpersonal relations among low-income African American mothers: moderating effects of demanding kin relations.

Association of mothers' emotional adjustment and negative kin relations with distressed interpersonal relations was examined. Among 115 low-income African American mothers, relationship of depressive symptoms, self-esteem, and demanding kin relations with psychological control and stressful interpersonal relations was assessed. Depressive symptoms and demanding kin relations were positively associated with mothers' use of psychological control in parenting. Interaction of self-esteem with demanding kin relations revealed that self-esteem was negatively associated with psychological control for mothers with high-demanding kin relations but not for mothers with low-demanding kin relations. Mothers' depressive symptoms and demanding kin relations were positively associated with their stressful interpersonal relations. Findings were discussed in terms of the need for research on the beneficial and detrimental aspects of families' social network.

The influence of anogenital injury on women's willingness to engage with the criminal justice process after rape.

Medical-legal-social science research has documented that nongenital and/or anogenital injuries play a significant role throughout the criminal justice system from victims reporting to judges determining the length of a sentence. What remains an open question is whether the documentation of anogenital injury influences women's willingness to engage in the criminal justice system. A sample of women age 21 years and older residing in an urban area were asked about willingness to report to police, file charges, and work with the courts to prosecute after rape. Questions were framed with a qualifying statement about the forensic examination being able to detect injury related to forced sexual intercourse. Results show that women had a high willingness to act if the examination could detect anogenital injury and women with and without a history of forced sexual intercourse had significant differences in their responses to these questions. Implications for health care, criminal justice system, and future research are discussed.

Making sense of skin color in clinical care.

The background of this article is that assessment and quantification of skin color is important to health care; color is one indicator of overall health and is linked to oxygenation, tissue perfusion, nutritional status, and injury. The purpose is to describe how skin color varies across racial/ethnic groups so that the information can be applied to clinical practice. The method used is cross-sectional, descriptive design (n = 257). We recorded self-defined race/ethnicity and used a spectrophotometer to measure skin color at two anatomic sites. Skin color variables included L* (light/dark), a* (red/green), and b* (yellow/blue). As regards results, we found significant differences in L*, a*, and b* values by site and race/ethnicity in White, Asian, and Biracial participants. L*: F(3, 233) = 139.04, p < .01 and F(3, 233) = 118.47, p < .01. Black participants had significantly lower mean L* values and wider ranges of L*, a*, and b* as compared with other groups. In regard to application, these findings suggest that clinicians and researchers should plan and provide care based on skin color, rather than race/ethnicity.

How to measure diversity when you must.

Racial/ethnic diversity has become an increasingly important variable in the social sciences. Research from multiple disciplines consistently demonstrates the tremendous impact of ethnic diversity on individuals and organizations. Investigators use a variety of measures, and their choices can affect the conclusions that can be drawn and limit the ability to compare and generalize results across studies effectively. The current article reviews 3 popular approaches to the measurement of diversity: the simplistic majority-minority approach and 2 multiple categories variants, the generalized variance and the lesser used entropy statistic. We discuss the properties of each approach and reject the majority-minority approach. We provide 5 examples using the generalized variance and entropy statistics and illustrate their versatility and flexibility. We urge investigators to adopt these multicategory measures and to use our discussion to determine which measure of diversity is most appropriate given the nature of one's data set and research question.

Demanding kin relations and depressive symptoms among low-income African American women: mediating effects of self-esteem and optimism.

Association of demanding kin relations, depressive symptoms, self-esteem, and optimism was assessed among 130 low-income African American women. Demanding relations with kin were positively associated with depressive symptoms and negatively linked to self-esteem and optimism. Self-esteem and optimism were negatively associated with depressive symptoms and mediated the association of demanding relations with kin and women's depressive symptoms. Findings were discussed in terms of the detrimental effects of demanding social relations with kin and the possible role that other relationships may play in compensating for poor relations with extended family.