Neighborhood eviction trajectories and odds of moderate and serious psychological distress during pregnancy among African American women.

African American mothers are unjustly burdened by both residential evictions and psychological distress. We quantified associations between trajectories of neighborhood evictions over time and the odds of moderate and serious psychological distress (MPD and SPD, respectively) during pregnancy among African American women. We linked publicly available data on neighborhood eviction filing and judgment rates to preconception and during-pregnancy addresses from the Life-course Influences on Fetal Environments (LIFE) Study (2009-2011; n = 808). Multinomial logistic regression-estimated odds of MPD and SPD during pregnancy that were associated with eviction filing and judgment rate trajectories incorporating preconception and during-pregnancy addresses (each categorized as low, medium, or high, with two 9-category trajectory measures). Psychological distress was measured with the Kessler Psychological Distress Scale (K6) (K6 scores 5-12 = MPD, and K6 scores ≥13 = SPD). MPD was reported in 60% of the sample and SPD in 8%. In adjusted models, higher neighborhood eviction filing and judgment rates, as compared with low/low rates, during the preconception and pregnancy periods were associated with 2- to 4-fold higher odds of both MPD and SPD during pregnancy among African American women. In future studies, researchers should identify mechanisms of these findings to inform timely community-based interventions and effective policy solutions to ensure the basic human right to housing for all. This article is part of a Special Collection on Mental Health.

Acute decrease in mothers' cortisol following nursing and milk expression.

The glucocorticoid hormone cortisol is an integral component of signaling pathways related to stress reactivity, energy balance, immune function, and other processes. In animal models, lactation is robustly associated with alterations in glucocorticoid signaling, and limited data suggest that similar changes may occur across human lactation. We asked whether milk letdown/secretion in breastfeeding mothers was associated with changes in cortisol, and whether such effects required presence of an infant. We measured changes in maternal salivary cortisol concentrations before and after nursing, the expression of breastmilk with an electric pump, or control activities. Participants conducted pre-session and post-session sampling (at 30 min) for all conditions, and provided a sample of pumped milk from one session. Both nursing and mechanical expression of breastmilk but not control were associated with equivalent declines in maternal cortisol concentration from pre-session values, indicating an effect of milk letdown on circulating cortisol independent of infant contact. Pre-session maternal salivary cortisol concentration was strongly and positively correlated with cortisol concentration in pumped milk samples, indicating that cortisol ingested by offspring provides a signal of maternal cortisol levels. Self-reported maternal stress was associated with higher pre-session cortisol concentrations, as well as with a larger drop in cortisol following nursing or pumping. These findings demonstrate that milk release-in the presence or absence of a suckling infant-regulates cortisol in mothers, and supports the potential for maternal signaling through breastmilk.

Reward Capacity Predicts Leptin Dynamics During Laboratory-Controlled Eating in Women as a Function of Body Mass Index.

OBJECTIVE: The role of leptin in mesolimbic signaling of non-food-related rewards has been well established at the preclinical level, yet studies in humans are lacking. The present investigation explored the association between hedonic capacity and leptin dynamics and whether this association differed by BMI class. METHODS: In this cross-sectional study of 75 women (42 with BMIs in the lean range and 33 with BMIs in the obesity range), serum leptin before and after meal consumption was measured. Reward capacity was assessed using the Snaith-Hamilton Pleasure Scale (SHAPS). Multiple regression tested whether reward capacity was associated with the leptin area under the curve (AUC), with an interaction term to test differences between the lean and obesity groups. RESULTS: The interaction of SHAPS by BMI group was robust (ß = -0.40, P = 0.005); among women with obesity, a greater SHAPS score was associated with a lower leptin AUC (ß = -0.35, P = 0.002, adjusted R2 = 0.66). Among those in the lean group, the association was not statistically significant (ß = -0.16, P = 0.252, adjusted R2 = 0.22). Findings were above and beyond BMI and age. CONCLUSIONS: In this sample, a robust negative association between reward capacity and circulating leptin was stronger in women with obesity compared with lean counterparts. These findings suggest that despite likely leptin resistance, inhibitory leptin functioning related to nonfood rewards may be spared in women with obesity.

Posttraumatic Stress Disorder Symptoms and Problematic Overeating Behaviors in Young Men and Women.

BACKGROUND: Posttraumatic stress disorder (PTSD) is a risk factor for obesity, but the range of behaviors that contribute to this association are not known. PURPOSE: The purpose of this study was to examine associations between self-reported PTSD symptoms in 2007, with and without comorbid depression symptoms, and three problematic overeating behaviors in 2010, and to estimate the associations of PTSD-related overeating behaviors with obesity. METHODS: Cross-sectional and longitudinal analyses included 7438 male (n = 2478) and female (n = 4960) participants from the Growing Up Today Study (mean age 22-29 years in 2010). Three eating behavior outcomes were assessed: binge eating (eating a large amount of food in a short period of time with loss of control), top quartile of coping-motivated eating (from the Motivations to Eat scale), and top quartile of disinhibited eating (from the Three-Factor Eating Questionnaire). RESULTS: PTSD symptoms were associated with two- to threefold increases in binge eating and top-quartile coping-motivated eating; having ≥4 PTSD symptoms, relative to no PTSD symptoms, was associated with covariate-adjusted RRs of 2.7 (95% CI 2.1, 3.4) for binge eating, 2.1 (95% CI 1.9, 2.4) for the top quartile of coping-motivated eating, and 1.5 (95% CI 1.3, 1.7) for the top quartile of disinhibited eating. There was a trend toward PTSD symptoms in 2007 predicting new onset binge eating in 2010. Having depression symptoms comorbid with PTSD symptoms further increased risk of binge eating and coping-motivated eating. All eating behaviors were associated with obesity. CONCLUSION: Clinicians treating patients with PTSD should know of potential comorbid problematic eating behaviors that may contribute to obesity.

Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults.

BACKGROUND: Use of laxatives for weight loss and drugs or supplements to build muscle (eg, steroids) differs by gender and sexual orientation; little is known about factors contributing to these disparities. Conformity to gender norms concerning appearance could underlie these differences. METHODS: This study examined associations between childhood gender conformity and laxative and muscle-building product use from ages 13 to 25 years in a sample of 13 683 males and females in the US prospective Growing Up Today Study. Adjusted multivariable logistic regression models of repeated measures estimated odds of past-year laxative and muscle-building product use by quartiles of greater childhood gender conformity in heterosexual and sexual minority (eg, bisexual, gay) participants. RESULTS: By age 23 years, ∼20% of sexual minority females reported past-year laxative use. By age 19 years, 12% of all males reported past-year muscle-building product use. Sexual minority females had twice the odds of heterosexual females of using laxatives (P < .0001). The most gender-conforming females had 50% greater odds than the least-conforming females of using laxatives (P < .01). Moderate (odds ratio, 2.09; 95% confidence interval, 1.58-2.75) and highly (odds ratio, 1.79; 95% confidence interval, 1.38-2.33) gender-conforming males had higher odds than gender-nonconforming males of using muscle-building products. CONCLUSIONS: Sexual minority females are at high risk for laxative abuse. Regardless of sexual orientation, gender conformity increased the odds of laxative abuse among females and muscle-building product use among males. Findings can inform prevention efforts to target youth at risk for laxative or muscle-building product use.

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

BACKGROUND: Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. PURPOSE: The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. METHODS: We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. RESULTS: Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. CONCLUSIONS: Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.

Sexual Minority Stressors, Internalizing Symptoms, and Unhealthy Eating Behaviors in Sexual Minority Youth.

BACKGROUND: Sexual minorities are more likely than heterosexuals to engage in unhealthy eating behaviors. PURPOSE: The purpose of this study is to examine sexual minority stressors and internalizing symptoms as predictors of unhealthy eating behaviors among sexual minority youths. METHODS: We used longitudinal data from 1461 sexual minority youths in the Growing Up Today Study, across ages 14-28 years. We hypothesized that sexual minority stressors would predict unhealthy eating behaviors, in part due to internalizing symptoms. Linear regression models fit via generalized estimating equations were stratified by gender and sexual orientation. RESULTS: Significant positive and inverse associations between stressors and eating behaviors were detected among females and males, with more significant associations among females. Associations were attenuated by up to 71 % for females and 12 % for males when internalizing symptoms were added to the models. CONCLUSIONS: Sexual minority stressors predicted unhealthy eating behaviors overall and more so for some sexual orientation and gender groups; associations were partially explained by internalizing symptoms. The conceptual model appears to best describe the experiences of bisexual females. Findings have clinical implications for adolescent health.

Experimental Evidence That Low Social Status is Most Toxic to Well-being When Internalized.

What makes low social status toxic to well-being? To internalize social status is to believe the self is responsible for it. We hypothesized that the more people internalize low subjective social status, the more their basic psychological needs are thwarted. Experiment 1 randomly assigned participants to imagine themselves in low, middle, or high social status and assessed their subjective social status internalization by independent ratings. The more participants internalized low status, the more they reported their basic psychological needs were thwarted. This effect did not appear among their higher status counterparts. Experiment 2 replicated and extended these findings using a behavioral manipulation of subjective social status and a self-report measure of internalization. We discuss implications for basic and action research.

Child abuse as a predictor of gendered sexual orientation disparities in body mass index trajectories among U.S. youth from the Growing Up Today Study.

PURPOSE: This research aimed to explain sexual orientation disparities in body mass index (BMI) by examining child abuse history, weight-related behaviors, and sociodemographics. METHODS: We used data from 7,960 females and 5,992 males from the prospective Growing Up Today Study over nine waves between 1996 (ages 12-14 years) and 2007 (ages 20-25 years). Using repeated measures of BMI (kg/m(2)) as a continuous outcome, gender-stratified latent quadratic growth models adjusted for child abuse history, weight-related behaviors, and sociodemographics. BMI at age 17 years (intercept) and 1-year change in BMI (slope) are reported. RESULTS: Bisexual females had higher BMI at age 17 years (ß = 1.59, 95% CI = 1.00-2.18) and displayed greater one-year increases in BMI (ß = .09, 95% CI = .03-.14), compared with completely heterosexual females. Gay males displayed smaller 1-year increases in BMI (ß = -.19, 95% CI = -.25 to -.12), compared with completely heterosexual males. No sexual orientation differences in BMI at age 17 years were observed for males, but gay males' BMI at age 25 was less than completely heterosexual males' BMI by 2 units. Among females, sexual orientation differences remained but were slightly attenuated after controlling for child abuse history, weight-related behaviors, and sociodemographics. Among males, the addition of child abuse and weight-related behaviors did not change the estimated difference in 1-year BMI increases. CONCLUSIONS: Sexual orientation differences in BMI were partly explained by child abuse and weight-related behaviors in females. More research is needed to explore additional drivers of these disparities among both females and males.

The impact of social contagion on non-suicidal self-injury: a review of the literature.

In this review, we explore social contagion as an understudied risk factor for non-suicidal self-injury (NSSI) among adolescents and young adults, populations with a high prevalence of NSSI. We review empirical studies reporting data on prevalence and risk factors that, through social contagion, may influence the transmission of NSSI. Findings in this literature are consistent with social modeling/learning of NSSI increasing risk of initial engagement in NSSI among individuals with certain individual and/or psychiatric characteristics. Preliminary research suggests iatrogenic effects of social contagion of NSSI through primary prevention are not likely. Thus, social contagion factors may warrant considerable empirical attention. Intervention efforts may be enhanced, and social contagion reduced, by implementation of psychoeducation and awareness about NSSI in schools, colleges, and treatment programs.

Low Social Status Markers: Do They Predict Depressive Symptoms in Adolescence?

Some markers of social disadvantage are associated robustly with depressive symptoms among adolescents: female gender and lower socioeconomic status (SES), respectively. Others are associated equivocally, notably Black v. White race/ethnicity. Few studies examine whether markers of social disadvantage by gender, SES, and race/ethnicity jointly predict self-reported depressive symptoms during adolescence; this was our goal. Secondary analyses were conducted on data from a socioeconomically diverse community-based cohort study of non-Hispanic Black and White adolescents (N = 1,263, 50.4% female). Multivariable general linear models tested if female gender, Black race/ethnicity, and lower SES (assessed by parent education and household income), and their interactions predicted greater depressive symptoms reported on the Center for Epidemiological Studies-Depression scale. Models adjusted for age and pubertal status. Univariate analyses revealed more depressive symptoms in females, Blacks, and participants with lower SES. Multivariable models showed females across both racial/ethnic groups reported greater depressive symptoms; Blacks demonstrated more depressive symptoms than did Whites but when SES was included this association disappeared. Exploratory analyses suggested Blacks gained less mental health benefit from increased SES. However there were no statistically significant interactions among gender, race/ethnicity, or SES. Taken together, we conclude that complex patterning among low social status domains within gender, race/ethnicity, and SES predicts depressive symptoms among adolescents.

The mediating effect of childhood abuse in sexual orientation disparities in tobacco and alcohol use during adolescence: results from the Nurses' Health Study II.

OBJECTIVE: To examine the mediating effect of childhood abuse on sexual orientation disparities in tobacco and alcohol use during adolescence. METHODS: We carried out analyses with data from over 62,000 women in the ongoing Nurses' Health Study II cohort who provided information on sexual orientation, childhood abuse occurring by age 11, and tobacco and alcohol use in adolescence. We used multivariate regression analyses, controlling for confounders, to estimate the mediating effect of childhood abuse on the association between sexual orientation and tobacco and alcohol use in adolescence. RESULTS: Lesbian and bisexual orientation and childhood abuse were positively associated with greater risk of tobacco and alcohol use during adolescence. For lesbians, the estimated proportion of excess tobacco and alcohol use in adolescence relative to use among heterosexual women that was mediated by abuse in childhood ranged from 7 to 18%; for bisexual women, the estimated proportion of excess use mediated by abuse ranged from 6 to 13%. CONCLUSIONS: Elevated childhood abuse in lesbian and bisexual women partially mediated excess tobacco and alcohol use in adolescence relative to heterosexual women. Interventions to prevent child abuse may reduce sexual orientation disparities in some of the leading causes of cancer in women.

Self-objectification and depressive symptoms: does their association vary among Asian American and White American men and women?

Objectification Theory (Fredrickson & Roberts, 1997) posits that viewing one's body as an object - i.e., self-objectification - increases depressive symptomatology. Though a handful of studies to date have found self-objectification and depressive symptoms correlated among White American women, few studies have examined whether this finding generalizes to other social groups. We examine whether self-objectification and depressive symptoms are associated among Asian Americans and White Americans in a college sample of women and men (N=169). Self-objectification and depressive symptoms were positively associated among White American women but not among White American men or Asian American men or women. These data suggest the parameters of Objectification Theory are circumscribed by both race/ethnicity and gender and self-objectification may put White women, in particular, at risk for depressive symptoms.

Disparities in child abuse victimization in lesbian, bisexual, and heterosexual women in the Nurses' Health Study II.

BACKGROUND: A growing body of research documents multiple health disparities by sexual orientation among women, yet little is known about the possible causes of these disparities. One underlying factor may be heightened risk for abuse victimization in childhood in lesbian and bisexual women. METHODS: Using survey data from 63,028 women participating in the Nurses' Health Study II, we investigated sexual orientation group differences in emotional, physical, and sexual abuse in childhood and adolescence. Multivariable log-binomial and linear regression models were used to examine orientation group differences in prevalence and severity of abuse, with heterosexual as the referent and controlling for sociodemographics. RESULTS: Results showed strong evidence of elevated frequency, severity, and persistence of abuse experienced by lesbian and bisexual women. Comparing physical abuse victimization occurring in both childhood and adolescence, lesbian (30%, prevalence ratio [PR] 1.61, 95% confidence interval [CI] 1.40, 1.84) and bisexual (24%, PR 1.26, 95% CI 1.00, 1.60) women were more likely to report victimization than were heterosexual women (19%). Similarly, comparing sexual abuse victimization occurring in both age periods, lesbian (19%, PR 2.16, 95% CI 1.80, 2.60) and bisexual (20%, PR 2.29, 95% CI 1.76, 2.98) women were more likely to report victimization than were heterosexual women (9%). CONCLUSIONS: This study documents prevalent and persistent abuse disproportionately experienced by lesbian and bisexual women.

Idealized cultural beliefs about gender: implications for mental health.

BACKGROUND: In this paper, we examined the relationship between culture-specific ideals (chastity, masculinity, caste beliefs) and self-esteem, shame and depression using an idealized cultural model proposed by Mahalingam (2006, In: Mahalingam R (ed) Cultural psychology of immigrants. Lawrence Erlbaum, Mahwah, NJ, pp 1-14). METHODS: Participants were from communities with a history of extreme male-biased sex ratios in Tamilnadu, India (N = 785). RESULTS: We hypothesized a dual-process model of self-appraisals suggesting that achieving idealized cultural identities would increase both self-esteem and shame, with the latter leading to depression, even after controlling for key covariates. We tested this using structural equation modeling. The proposed idealized cultural identities model had an excellent fit (CFI = 0.99); the effect of idealized identities on self-esteem, shame and depression differed by gender. CONCLUSIONS: Idealized beliefs about gender relate to psychological well-being in gender specific ways in extreme son preference communities. We discuss implications of these findings for future research and community-based interventions.

Does harboring hostility hurt? Associations between hostility and pulmonary function in the Coronary Artery Risk Development in (Young) Adults (CARDIA) study.

OBJECTIVE: To examine the cross-sectional association between hostility and pulmonary function (PF) and its consistency across race/ethnicity-gender groups. DESIGN: Data were from the Coronary Artery Risk Development in (Young) Adults (CARDIA) cohort study (N=4,629). Participants were recruited from 4 metropolitan areas in the United States, ages 18-30 years at baseline in 1985-1986, approximately balanced across race/ethnicity (Black, White) and gender. MAIN OUTCOME MEASURES: Main outcome measures were percent predicted values for forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). RESULTS: In full-sample multiple linear regression analyses, each 1 standard deviation (SD) increase in hostility was associated with a 0.66% decrease in FEV-sub-1 (p=.0002) and a 0.60% decrease in FVC (p=.0006). This inverse association of hostility with PF remained after controlling for age, height, current socioeconomic status (SES), participant smoking status, and asthma and is more consistent than that of smoking and PF. In stratified analyses, each 1 SD increase in hostility predicted statistically significant reductions in PF for Black women, White women, and Black men. For White men, hostility showed no statistically significant relation with PF, although the pattern relating hostility to PF was similar to the pattern in the other three groups. Further, both of the post hoc three-way interaction terms for hostility, race/ethnicity, and gender predicting FEV-sub-1 and FVC were nonsignificant. CONCLUSION: PF was inversely associated with hostility across race/ethnicity and gender, independent of age, height, current SES, smoking, and asthma. On the basis of these cross-sectional findings, the authors hypothesize that higher hostility will predict a more rapid decline in PF.

Essentialism and the cultural psychology of gender in extreme son preference communities in India.

Using a cultural ecological framework, the authors examined key psychological antecedents of a pressing public health problem in Tamilnadu, India: the persistence of extreme forms of female neglect including female infanticide and feticide. Community-based respondents (N = 798) were recruited from Tamilnadu, a south Indian state, from villages with highly male biased sex ratios. Study 1 examined beliefs about behavioral gender transgressions in the villages that are identified as having extremely male-biased sex ratios. Study 2 examined the same participants several weeks later, investigating beliefs about biological gender essentialism and attitudes toward violence. Although behavioral and biological aspects of gender were essentialized differently, a regression analysis controlling for SES and marital status found that the more men essentialized female identity, the more they endorsed violence against women and the less anxiety they felt. The authors conclude by discussing the cultural psychological implications of this asymmetry in the essentialist beliefs about gender.