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Scholarly Works (4 results)

  • Thesis
  • Peer Reviewed
UC San Diego Electronic Theses and Dissertations (2022)

Rationale: Prevalence of mental health challenges (MHC) in graduate students has increased, which may impair academic performance (AP). Graduate students from racially minoritized groups are a growing demographic who may be faced with greater MHC than those from majority groups. This study examined (1) differences in MHC, discrimination, and AP by minoritized status and sex; (2) interplay of MHC, discrimination, and AP, and (3) roles of resilience, advisor contact, social support in buffering relationships.

Methods: Archival data from the Healthy Minds Study 2018-2019 annual survey included self-reported depression severity (PHQ-9), anxiety severity (GAD-7), suicidal ideation (yes/no in past year, SI), mental health burden (diagnoses of depression, anxiety, both), frequency of discrimination (past year), and AP (GPA of A or below A). Analyses included 5,820 graduate students (mean(SE) age = 28(8.2) years, 72% female, and 61% in master’s program), categorized into non-Latino White (n=4032) and minoritized (n=1,788) groups, and used generalized linear mixed models.

Results: Minoritized graduate students experienced higher levels of discrimination (F(1574)=13.9, p<.001) and were more often in the lower AP category compared to majority groups (F(5320)=33.3, p<.001); no significant racial/ethnic differences for any MHC were observed (p’s>.05). Women reported higher anxiety (F(3909)=41.9, p=<.001), more anxiety diagnoses (t(1634)=2.84, p=.004), were more likely to experience discrimination once in a while (F(1639)=11.8, p<.001), and had better AP compared to males (F(5320)=15.9, p<.001). Non-Latino White men were most likely to report SI (F(5159)=12.04, p<.001). Moderate levels of discrimination were associated with higher MHCs (p’s <.05). Moderate levels of any MHC were associated with lower AP (all p’s <.005). Race, sex, advisor contact, or social support (all p’s >.05) did not significantly moderate relationships of MHC with AP or discrimination; resilience buffered relationships of some MHC to discrimination.

Conclusions: Replicating previous findings, women were more likely than men to report anxiety symptoms and diagnoses and graduate students with MHC experienced higher levels of discrimination and less-than-perfect AP. While minoritized graduate students do not seem differentially at risk for MHC and show similar inter-relationships between MHC and both AP and discrimination, resilience interventions might lessen impacts of discrimination on mental health in all students.

    Cover page: Understanding the Interplay of Mental Health Challenges, Discrimination, and Academic Performance Among Racially Minoritized Graduate Students and Possible Mitigating Factors
    • Article
    • Peer Reviewed
    UC San Diego Previously Published Works (2022)

    Background

    Impulsivity is a prominent feature of bipolar disorder associated with various negative sequelae; moreover, it may be a precursor to shifts in affect or mood, but little is known about its association with affect on a day-to-day timescale. Ecological momentary assessments (a method that captures moment-to-moment ratings of psychological states by repeatedly sampling the same individual) of impulsivity and affect using mobile surveys allow for more nuanced examination of mechanisms of mood and behavior dysregulation. However, few existing studies have validated an ecological momentary assessment of impulsivity in bipolar disorder and examined its time-lagged associations with positive and negative affect. 70 participants with bipolar disorder and 102 healthy comparisons participated in an intensive longitudinal study: they underwent 14 days of ecological momentary assessment data collection annually for 1-4 years. Multiple measures of impulsivity and affect were collected using self-report, behavioral, and ecological momentary assessment modalities; these measures were compared, and levels of impulsivity were compared between bipolar disorder and healthy comparison groups. Time-lagged analyses using daily means explored the next-day predictive relationship of impulsivity on positive/negative affect, and vice versa.

    Results

    The ecological momentary measure of impulsivity was moderately correlated with the self-report but not behavioral impulsivity measure. Bipolar disorder participants evinced higher self-report, behavioral, and daily impulsivity than healthy comparison participants. Time-lagged analyses revealed a bi-directional association between high impulsivity and high next-day negative (but not positive) affect. Post hoc analyses showed that impulsivity specifically predicted next-day anger and anxiety.

    Conclusions

    Our multimodal assessment of impulsivity allowed for an examination of the day-to-day course of impulsivity and affect, crucial steps toward understanding the mechanisms of mood symptom and episode onset in bipolar disorder.
      Cover page: The interplay of daily affect and impulsivity measured by mobile surveys in bipolar disorder
      • Article
      • Peer Reviewed
      UC San Diego Previously Published Works (2021)

      Objective

      The present study aimed to develop norms applicable to Spanish-speakers living in the United States (U.S.)- Mexico border region for the Halstead Category Test (HCT), a test of executive function.

      Methods

      Healthy native Spanish-speakers (N = 252; Age: range 19-60 years, M = 37.28, SD = 10.24; Education: range 0-20 years; M = 10.65, SD = 4.33; 58.33% women) living in the U.S.-Mexico border region of California and Arizona completed the HCT as part of a comprehensive neuropsychological test battery. The univariable and interactive effects of demographic variables on HCT raw scores were examined. Total scores were normed using fractional polynomial equations, controlling for age, education, and gender. T-scores were also computed for HCT scores of the current Spanish-speaking normative sample using published, demographically-adjusted norms for English-speaking non-Hispanic Whites and Blacks. Impairment rates (T-Scores < 40) were calculated using published and current norms.

      Results

      Age was significantly associated with increased number of errors, and education and male gender were associated with decreased number of HCT errors (total raw scores). Applying norms developed for English-speaking non-Hispanic Whites and Blacks resulted in overestimation of impairment rates in the current sample (impairment: 48% with White norms and 27% with Black norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using non-Hispanic Black norms were comparable to those based on newly developed norms.

      Conclusion

      The present study presents norms for the HCT in a sample of U.S. Spanish-speakers, providing an important tool for identifying executive dysfunction in this population.
        Cover page: Demographically adjusted normative data for the Halstead category test in a Spanish-speaking adult population: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS)
        • Article
        • Peer Reviewed
        UC San Diego Previously Published Works (2019)
        Sixty percent of Hispanics/Latinos are bilingual which research suggests may confer certain cognitive advantages. Female sex confers cognitive advantages in verbal learning and memory compared to male sex, regardless of race or ethnicity. Understanding the independent and interactive associations of bilingualism and sex with cognition may aid in predicting cognitive aging in Hispanics/Latinos. We examined baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos, a multicenter, prospective community-based study. Our analyses included 6,110 males and females ≥45 years old who self-reported birth and parents' origin outside of the continental US, Spanish as their first language, and were evaluated in Spanish. Bilingualism was assessed along a Likert scale (1 = only Spanish to 4 = English>Spanish) for language proficiency (reading/spoken) and patterns of use (thinking/socializing). Cognitive testing included verbal learning, memory, fluency, and Digit Symbol Substitution (DSS). Linear regression models adjusted for relevant confounders, the complex survey design, and sampling weights. Participants' self-reported language proficiency was Spanish better than English, while patterns of use suggested more Spanish than English. Higher language proficiency was associated with higher performance on all cognitive indices while higher patterns of use associated with higher fluency and DSS scores (p-values < 0.01). Female sex was associated with higher performance on all cognitive indices (p-values < 0.05). There were no significant interactions with bilingualism (regardless of metric) by sex on cognition. For Hispanics/Latinos residing in the continental US and reporting birth and parents' origin elsewhere, bilingualism and female sex have independent cognitive benefits that are important to consider when evaluating cognitive performance.
          Cover page: The Independent and Interactive Associations of Bilingualism and Sex on Cognitive Performance in Hispanics/Latinos of the Hispanic Community Health Study/Study of Latinos.
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