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Open Access Publications from the University of California

Scholarly Works (26 results)

  • Article
  • Peer Reviewed
UCLA Previously Published Works (2022)

Objective

Subjective social status (SSS) refers to an individual's perception of relative social rank. We tested associations between SSS and allostatic load, a multisystem index of physiological dysregulation, in a sample of women 1 year after the birth of a child.

Method

Participants (n = 1,168) in the Community Child Health Network study were recruited in five sites across the United States shortly after the birth of a child. SSS was assessed at 6 months after birth using the MacArthur Scale of Subjective Social Status. Participants also reported household income and years of education completed. Biomarkers were assessed and allostatic load was calculated by assigning one point for each of 10 biomarkers above clinical cutoffs at a subsequent visit approximately 6 months later. Multiple linear regression analyses tested associations of SSS with allostatic load, adjusting for socioeconomic (SES) indicators of household income, years of education, and other covariates (race/ethnicity, relationship status, maternal age, and study site). We also tested interactions between each of the objective SES measures and SSS.

Results

Higher SSS predicted lower subsequent allostatic load independent of household income, education, and other covariates. Associations between SSS and allostatic load were strongest at higher levels of income and education.

Conclusions

Study findings demonstrate associations between perceptions of relative social standing and wear-and-tear on multiple physiological systems above and beyond indicators of objective SES, suggesting that psychosocial aspects of lower status may contribute to the gradient between social status and health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
    Cover page: Subjective Social Status and Allostatic Load in Mothers 1 Year After Birth
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2014)
    Extensive evidence documents that prenatal maternal stress predicts a variety of adverse physical and psychological health outcomes for the mother and baby. However, the importance of the ways that women cope with stress during pregnancy is less clear. We conducted a systematic review of the English-language literature on coping behaviours and coping styles in pregnancy using PsycInfo and PubMed to identify 45 cross-sectional and longitudinal studies involving 16,060 participants published between January 1990 and June 2012. Although results were often inconsistent across studies, the literature provides some evidence that avoidant coping behaviours or styles and poor coping skills in general are associated with postpartum depression, preterm birth and infant development. Variability in study methods including differences in sample characteristics, timing of assessments, outcome variables and measures of coping styles or behaviours may explain the lack of consistent associations. To advance the scientific study of coping in pregnancy, we call attention to the need for a priori hypotheses and greater use of pregnancy-specific, daily process, and skills-based approaches. There is promise in continuing this area of research, particularly in the possible translation of consistent findings to effective interventions, but only if the conceptual basis and methodological quality of research improve.
      Cover page: Coping during pregnancy: a systematic review and recommendations
      • Thesis
      • Peer Reviewed
      UCLA Electronic Theses and Dissertations (2014)

      Chronic stress predicts a number of adverse health outcomes, including depression, cardiovascular disease, and all-cause mortality. In the context of women's reproductive health, chronic stress exposure has been associated with increased risk of adverse birth outcomes and postpartum depression. Systemic inflammation resulting from immune system dysregulation is one of the pathways through which chronic stress is thought to influence physical health outcomes. Increasingly strong evidence suggests that engaging in regular physical activity protects individuals from the health-damaging effects of stress, possibly through alterations of biological stress responses. The present research pursued two main objectives using data from a prospective investigation conducted by academic researchers and community members at five collaborating sites across the U.S. These objectives were: 1) describing the levels and correlates of physical activity at six months postpartum in mothers of three ethnic/racial groups and different levels of SES including a large proportion who are poor and; 2) developing and testing multivariate models of the combined influence of chronic stress, physical activity, and other resilience resources on C-reactive protein (CRP), a marker of systemic inflammation that is associated with elevated risk of chronic disease.

      Results indicated that African American race, Latina ethnicity, and living in a rural area were generally associated with lower levels of physical activity, whereas working outside the home was associated with high activity. In analyses predicting CRP, women with higher Financial Stress one month after the birth of child had higher CRP at both six months and one year postpartum. Notably, these subjective appraisals of Financial Stress were stronger predictors of inflammation than more objective resource indicators such as income and education. Additional analyses using structural equation modeling demonstrated that this relationship was mediated by adiposity. There was no evidence that behavioral or psychological resilience resources moderated the associations between chronic stressors and CRP. These findings advance existing knowledge by identifying correlates and predictors of important health outcomes during the first postpartum year.

        Cover page: Physical Activity, Chronic Stress, and Inflammation in Mothers during the First Postpartum Year
        • Article
        • Peer Reviewed
        UCLA Previously Published Works (2020)
        Background: Prenatal health disparities exist for African Americans and low socioeconomic status (SES) individuals when compared to non-Hispanic Whites and people of higher SES, particularly in cardio-metabolic diseases. Furthermore, having had a pregnancy-specific cardio-metabolic disease, e.g. preeclampsia, increases risk for future cardio-metabolic disease. Although these factors (race, SES and pregnancy cardio-metabolic disease) are interrelated, studies have rarely considered their combined effect on postpartum cardio-metabolic risk. The purpose of this study was to assess whether SES, race/ethnicity, and prenatal cardio-metabolic disease interact in the prediction of postpartum cardio-metabolic risk. Methods: A sample of 1,753 low-income women of African American, Latina, non-Hispanic White race/ethnicity was recruited after a birth in 5 US sites. Household income was used to categorize poverty status as Poor (< Federal Poverty Level; FPL), near poor (100-200% FPL), or low/middle income (> 200% FPL). Three prenatal cardio-metabolic disease diagnoses (preeclampsia, gestational hypertension, gestational diabetes) were identified from medical records. Four biomarkers (mean arterial pressure, glycosylated haemoglobin, total cholesterol:HDL ratio, and waist-hip ratio) were collected at 6 and 12 months postpartum, and combined into an average postpartum cardio-metabolic risk index. Maternal age, pre-pregnancy body mass index, parity, health behaviors and employment status were covariates. Results: Analyses revealed interactions of race/ethnicity, poverty status, and prenatal cardio-metabolic diseases in the prediction of postpartum cardio-metabolic risk. African American women had higher postpartum cardio-metabolic risk, which was exacerbated following a prenatal cardio-metabolic disease. Low/middle income African American women had higher cardio-metabolic risk compared to poor African American, and all Latina and White women. Conclusions: African American women, and especially those who experienced pregnancy complications, emerged as vulnerable, and greater household income did not appear to confer protection against worse postpartum cardio-metabolic risk for this group. These results highlight the complex interplay between socioeconomic status and race/ethnicity with respect to understanding health disparities.
          Cover page: Interactions between race/ethnicity, poverty status, and pregnancy cardio-metabolic diseases in prediction of postpartum cardio-metabolic health
          • Article
          • Peer Reviewed
          UCLA Previously Published Works (2015)
          Laboratory research has found that individuals will consume more calories and make unhealthy food choices when in the presence of an overweight individual, sometimes even regardless of what that individual is eating. This study expanded these laboratory paradigms to the field to examine how weight salience influences eating in the real world. More specifically, we tested the threshold of the effect of weight salience of food choice to see if a more subtle weight cue (e.g., images) would be sufficient to affect food choice. Attendees (N = 262) at Obesity Week 2013, a weight-salient environment, viewed slideshows containing an image of an overweight individual, an image of a thin individual, or no image (text only), and then selected from complimentary snacks. Results of ordinal logistic regression analysis showed that participants who viewed the image of the overweight individual had higher odds of selecting the higher calorie snack compared to those who viewed the image of the thin individual (OR = 1.77, 95% CI = [1.04, 3.04]), or no image (OR = 2.42, 95% CI = [1.29, 4.54]). Perceiver BMI category did not moderate the influence of image on food choice, as these results occurred regardless of participant BMI. These findings suggest that in the context of societal weight salience, weight-related cues alone may promote unhealthy eating in the general public.
            Cover page: An experimental field study of weight salience and food choice
            • Article
            • Peer Reviewed
            UCLA Previously Published Works (2020)
            Maternal psychosocial stress during pregnancy can adversely influence child development, but few studies have investigated psychosocial stress during the postpartum period and its association with risk of toddler developmental delays. Moreover, given the expanding diversity of the U.S. population, and well-documented health and stress disparities for racial and ethnic minorities, research examining the effect of postpartum stress on risk of developmental delays in diverse populations is of critical importance. In this study, data from the Community Child Health Network provided the opportunity to test maternal postpartum stress as a predictor of toddler risk of developmental delay in a sample of African American, Latina and non-Hispanic White women and their toddlers (N = 1537) recruited in urban, suburban, and rural communities. Postpartum maternal stress over 1 year was operationalized as perceived stress, life events, and negative impact of life events. Regression results revealed higher risk of developmental delays in toddlers whose mothers experienced more negative life events, greater negative impact of events, and higher perceived stress over the year. Prenatal stress, pregnancy/birth complications, and postpartum depression did not explain these associations. Maternal postpartum stress may contribute to increased risk for developmental delays and is an important target for psychosocial intervention.
              Cover page: Maternal postpartum stress and toddler developmental delays: Results from a multisite study of racially diverse families
              • Article
              • Peer Reviewed
              UCLA Previously Published Works (2014)
              This randomised controlled pilot trial tested a six-week mindfulness-based intervention in a sample of pregnant women experiencing high levels of perceived stress and pregnancy anxiety. Forty-seven women enrolled between 10 and 25 weeks gestation were randomly assigned to either a series of weekly Mindful Awareness Practices classes (n = 24) with home practice or to a reading control condition (n = 23). Hierarchical linear models of between-group differences in change over time demonstrated that participants in the mindfulness intervention experienced larger decreases from pre-to post-intervention in pregnancy-specific anxiety and pregnancy-related anxiety (PRA) than participants in the reading control condition. However, these effects were not sustained through follow-up at six weeks post-intervention. Participants in both groups experienced increased mindfulness, as well as decreased perceived stress and state anxiety over the course of the intervention and follow-up periods. This study is one of the first randomised controlled pilot trials of a mindfulness meditation intervention during pregnancy and provides some evidence that mindfulness training during pregnancy may effectively reduce PRA and worry. We discuss some of the dilemmas in pursuing this translational strategy and offer suggestions for researchers interested in conducting mind-body interventions during pregnancy.
                Cover page: Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy
                • Article
                • Peer Reviewed
                UCLA Previously Published Works (2016)

                Background

                Pregnancy anxiety is associated with risk of preterm birth and an array of other birth, infant, and childhood outcomes. However, previous research has not helped identify those pregnant women at greatest risk of experiencing this specific, contextually-based affective condition.

                Methods

                We examined associations between demographic, medical, and psychosocial factors and pregnancy anxiety at 24-26 weeks of gestation in a prospective, multicentre cohort study of 5271 pregnant women in Montreal, Canada.

                Results

                Multivariate analyses indicated that higher pregnancy anxiety was independently related to having an unintended pregnancy, first birth, higher medical risk, and higher perceived risk of complications. Among psychosocial variables, higher pregnancy anxiety was associated with lower perceived control of pregnancy, lower commitment to the pregnancy, more stressful life events, higher perceived stress, presence of job stress, lower self-esteem and more social support. Pregnancy anxiety was also higher in women who had experienced early income adversity and those who did not speak French as their primary language. Psychosocial variables explained a significant amount of the variance in pregnancy anxiety independently of demographic and medical variables.

                Conclusions

                Women with pregnancy-related risk factors, stress of various kinds, and other psychosocial factors experienced higher pregnancy anxiety in this large Canadian sample. Some of the unique predictors of pregnancy anxiety match those of earlier US studies, while others point in new directions. Screening for high pregnancy anxiety may be warranted, particularly among women giving birth for the first time and those with high-risk pregnancies.
                  Cover page: Demographic, Medical, and Psychosocial Predictors of Pregnancy Anxiety
                  • Article
                  • Peer Reviewed
                  UCLA Previously Published Works (2020)

                  Objective

                  Using a conceptual model of postpartum depression risk in Latinas including both contextual and cultural stressors, we tested contributions to depressive symptom levels and trajectories over the course of 1 year following birth in a community sample of Latinas.

                  Method

                  A multisite sample of low-income U.S.-born and foreign-born Latinas (n = 537; M age = 25.70) was interviewed on many topics including measures of stress and maternal health at 1, 6, and 12 months postpartum. Nested multilevel growth curve models were implemented to test associations of contextual stressors (poverty, domestic violence) with trajectories of depressive symptoms, adjusting for confounds. This model was compared to 1 that added cultural stress variables (everyday discrimination, foreign-born status, language preference, age at immigration) measured 1-month postpartum.

                  Results

                  The best fitting model provided evidence for the independent effects of cultural and contextual stressors. Discrimination (β = .13 SE = .02, p = < .001) and domestic violence (β = .39 SE = .09, p = < .001) predicted trajectories with higher levels of depressive symptoms 1 month postpartum, but not linear change in symptoms over the year.

                  Conclusions

                  The present study provides evidence that discrimination, a cultural factor, and domestic violence, a contextual factor, each predict higher levels of early postpartum depressive symptoms. Interventions addressing discrimination and maternal safety are recommended. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
                    Cover page: Postpartum Depressive Symptoms in Low-Income Latinas: Cultural and Contextual Contributors
                    • Article
                    • Peer Reviewed
                    UCLA Previously Published Works (2015)
                    Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology.
                      Cover page: Biological and Psychosocial Predictors of Postpartum Depression: Systematic Review and Call for Integration
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