The direct link between acculturative stress and eating behavioral problems has been previously examined. However, scientific research focusing on Asian descendants and the mechanism behind this association is scant. Understanding the mechanisms underlying the association is critical. It can contribute to refining culturally sensitive preventive measures of eating pathologies and obesity, which can ultimately provide methods of minimizing health disparities in the United States. The present study sought to investigate the relation between acculturative stress and eating disinhibition among Asian young adults, as well as the mediating effect of depressive symptoms and the moderating effect of gender on these associations. Asian undergraduate students (N = 477; 78% females; Mage = 20.35, SD = 1.72) participated in an online cross-sectional study. Results showed that there was a positive association between acculturative stress and eating disinhibition. Depressive symptoms partially mediated this positive relation. Gender moderated the path between acculturative stress and depressive symptoms in the mediation model, and the mediating effect of depressive symptoms was stronger among Asian male than female students. Findings spark several promising future research directions, which are discussed. When treating eating disinhibition in the context of acculturative stress, the results suggest that preventive and treatment measures may prove effective to target depressive symptoms, especially among Asian male students.

Domestic violence (DV) is a public health concerns that is associated with negative mental health outcomes that may be amplified during pregnancy. Emergency maternity shelters provide support for at-risk pregnant women by increasing self-sufficiency, which is associated with improved health and behavioral outcomes. This study explored the relationships between childhood domestic violence, intimate partner violence, and self-sufficiency outcomes using archival data of 337 pregnant women residing in a local emergency maternity shelter. IPV and length of stay emerged as predictors of self-sufficiency outcomes. Length of stay at the shelter moderated the relationship between intimate partner violence and improvements in self-sufficiency. Length of stay was associated with total self-sufficiency scores at exit for shelter residents regardless of intimate partner violence experience. This study provides evidence that targeted interventions in emergency maternity shelters can increase self-sufficiency for pregnant women in-crisis, and that these benefits continue to accumulate over time.

Background

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Conclusion

The gender-health paradox is a well-documented and persistent epidemiological phenomenon: women outlive men, but live “sicker lives” with higher rates of chronic illness and disability over the life course than their male counterparts. Across disciplines, theories attempting to explicate this disparity have overlooked women’s disproportionate exposure to interpersonal violence, a form of trauma with lasting impact on health. Furthermore, contemporary analytic techniques that account for heterogeneity in experiences (i.e., person-centered approaches) have only recently gained momentum despite their potential for more accurately assessing the impact of violence across the lifespan. This dissertation examines whether the link between violence against women and women's overrepresentation in some of the most disabling morbidities are factors that are inextricably linked. In Chapter 2, a systematic review was conducted to identify and summarize the empirical literature on experiences of interpersonal violence and diagnosed health conditions. Only studies using person-centered approaches (i.e., latent class analyses) were considered. Results showed that person-centered approaches can illuminate the most health-hazardous combinations of violence experiences, and that women were overrepresented in these high-risk groups; however, results also showed a paucity of research explicitly testing gender differences in violence configurations, and physical health conditions were rarely examined. Chapter 3 addressed the major gaps found in Chapter 2 by examining gender-driven patterns of interpersonal violence and the context in which they occur. A multi-group latent class analysis revealed gender differences in the types of violence experienced as adversities accumulated: women experienced intimate partner and sexual violence, while men experienced more child abuse and neglect. Results from logistic regressions also showed gradient-like associations with morbidity as exposures accumulated for women. Among men, adversity profiles appeared to confer about equal risk or less risk for morbidity, suggesting that other factors may be at play in men’s disease pathology. In Chapter 4, at-risk women with complex trauma histories were centered, using pregnancy as a conceptual framework for illuminating pathways from violence exposure to adverse health. Results showed the possible intersection of violence, trauma, mental health, and substance use were consequential to pregnancy complications, potentially compounding risk for disease long-term. Qualitative analyses revealed psychological processes signaling risk and resilience. Implications for understanding the gender-health paradox and future research on gender-based health disparities more broadly are discussed.

Globally, one in seven infants is born with low birth weight while 3 to 7% of infants are both with high birth weight, with the greatest burden noted in low- and middle-income countries (LMICs). An unhealthy birth weight is associated with developmental difficulties and health problems both in early-life and throughout the life span. One aspect of a healthy pregnancy is maternal glucose regulation. Despite global disparities, the majority of research has been conducted in high-income countries, with most participants identifying as Caucasian or White. To address this gap in the literature, this study investigated whether average maternal glucose regulation during pregnancy (assessed via HbA1c) is associated with birth weight and whether fetal sex moderated this association. The analytic samples were comprised of adult healthy pregnant women in Pakistan (N = 111) and Kenya (N = 34). It was hypothesized that higher maternal glucose regulation during pregnancy would be associated with higher infant birth weight and that this association would be stronger for women carrying male versus female fetuses. Regression analyses suggested that higher glucose regulation was associated with higher birth weight infants in Pakistani women (b = 198.82, t[101] = 2.6, p = .01, 95% CI [49.35, 348.28]) and with lower birth weight infants in Kenyan women (b = 328.7, t[26] = -2.4, p = .02, 95% CI [-608.94, -48.48]), but only after adjusting for key covariates. Fetal sex did not significantly moderate these findings. These results suggest the importance of considering relevant cofounding variables, such as gestational age at birth, ethnicity, and pregnancy weight. Moreover, findings point to a need to study sociocultural factors, which could help explain the different direction of results for Pakistani and Kenyan women.

Objective

Method

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Discussion

This meta-analysis set out to integrate and reconcile the disparate research on inflammatory biomarkers and perinatal depressive symptoms, in order to better understand the role of inflammation and depressive symptoms surrounding pregnancy. Overall, a small positive effect with a trending p-value emerged. Small statistically significant effects emerged between several biomarkers indicative of inflammation and depressive symptoms, depending on which markers were included and when during pregnancy or post partum those biomarkers were collected.

Discrimination is a common social problem that that been associated with a variety of negative health consequences. Stress from discrimination experiences and resulting physiological changes have been implicated in the pathway to disease. The role of the hypothalamic-pituitary-adrenal (HPA) axis in this process remains understudied. This dissertation addresses the deficiencies in the literature in two parts. First, a systematic review of the literature was conducted. Ten experimental and 17 observational studies met inclusion criteria. Studies suggest that discrimination is associated with alterations in HPA axis activity, and that the direction of this association depends on the timing and chronicity of the discrimination experience. There is also evidence of important modulating variables (race, socioeconomic status) and contextual confounders (emotional, situational) that warrant further study. The second study tested associations between Latino ethnicity, experiences of discrimination, and cortisol responses to an acute laboratory stressor. One hundred and fifty eight individuals (92 female, 66 male) between the ages of 18 and 29 years participated in the study. Salivary cortisol was measured before and repeatedly after the laboratory stressor, and prior discrimination experiences was measured with the Experiences of Discrimination Scale. A moderated mediation emerged, such that Latino ethnicity predicted heightened cortisol reactivity through discrimination experiences (mediator), and this effect was further moderated by sex, with a significant indirect effect only among males. Of note, the direct path from Latino ethnicity to cortisol reactivity did not emerge as significant. Findings suggest that Latino ethnicity and discrimination interact to predict cortisol dysregulation, which implies that an appropriate model for understanding the sociocultural problem of minority health discrepancies cannot simply rely on the effects of ethnicity or discrimination alone.This research adds to the evidence that discrimination is not merely a social injustice; it is also a public health problem.

Problematic eating behaviors (PEB), which include both disinhibited and restrained eating, are becoming more common worldwide across various cultural groups. These behaviors can severely affect college students’ development and may lead to eating disorders, posing serious health risks. However, most current models of PEB tend to overlook cultural factors, which limits their effectiveness for diverse populations. This dissertation examines the role of culture in shaping PEB and their associated risk factors, such as perceived pressures on thinness and body dissatisfaction. Study 1 evaluates the applicability of an expanded theoretical model (i.e., the Tripartite Influence Model) in China (n = 342), Pakistan (n = 304), and the United States (n = 505). In all three countries, culturally distinct social pressures were related to PEB through body esteem, with paternal, maternal, and peer pressures being significant in the U.S., peer pressure being significant in China, and maternal pressure being significant in Pakistan (e.g., indirect effects in the U.S. for peer pressure = .07, 95% CI = .04, .10, for maternal pressure = .06, 95% CI = .03, .10, and for paternal pressure = .05, 95% CI = .02, .08; in China for peer pressure: .11, 95% CI = .04, .18; in Pakistan for maternal pressure: .12, 95% CI = .03, .20). The expanded Tripartite Influence Model can capture cultural nuances in body dissatisfaction and problematic eating behaviors: while paternal, maternal, and peer pressures all contributed among U.S. young adults, peer pressure was predominant in China and maternal pressure was most influential in Pakistan. Study 2 focuses on the culturally specific experience of acculturative stress among female students in diverse U.S. college settings, examining its unique contribution to PEB beyond theoretical covariates and relevant confounders. Acculturative stress was uniquely associated with higher PEB (β = .23, p < .001). Independent self-construal moderated this relationship (β = -.13, p = .01). When independence was higher, the strength of the association between acculturative stress and PEB was weaker. Thus, incorporating acculturative stress into traditional sociocultural tripartite factors can reveal unique associations that contribute to a more culturally relevant model of risk factors for eating pathology, while also highlighting the importance of individual differences (i.e., independent self-construal) in shaping these dynamics. Study 3 examines the experiences of international migrants, specifically female Chinese international students who experience differences in cultural norms. This study investigates the roles of cultural transition and acculturative stress in body image and PEB. At the group level, body satisfaction decreased (Mdiff. = 0.09, p = .03), self-reported BMI increased (Mdiff. = -0.65, p < .001), and emotional eating increased (Mdiff. = -0.21, p = .001), while other variables (e.g., perceived pressures on thinness) remained stable. Acculturative stress was associated with lower body satisfaction (β = -.14, p = .03) and higher uncontrolled eating (β = .17, p = .02) six months post-arrival, even after accounting for pre-migration levels. Changes in perceived pressure on thinness were indirectly linked to changes in overall problematic eating through changes in body satisfaction (indirect effect = .10, 95% CI = .02, .20). Therefore, cultural transitions and acculturative stress are linked to concerns related to eating behaviors, making these factors particularly critical to consider in the context of increasing globalization and international migrant health. This dissertation highlights the importance of culturally attuned frameworks in PEB research to advance health equity. By uncovering how unique sociocultural pressures shape PEB across populations, it advocates for inclusive, culturally responsive interventions that address the needs of diverse communities globally.