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.

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.

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.

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.

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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.

Acculturative processes are a common experience among ethnic minority groups and are proposed as important contributors to health disparities (Berry, 2007). Acculturation is a process of cultural adaptation that occurs with exposure to cultural context that differs from one’s own, involving measurable changes in values, beliefs, and behaviors. Acculturative stress is the stress associated with the acculturation process and is experienced when coping challenges exceed coping resources (Berry, 2007; Smart & Smart, 1995). The present meta-analysis integrates and reconciles findings and moderators across the growing literature about the correlation between acculturative stress and mental health in the U.S. Greater acculturative stress was statistically significantly related to greater adverse mental health outcomes. A greater percentage of first-generation participants within a sample and a lower state diversity index were associated with an increased magnitude of the correlation between acculturative stress and adverse mental health outcomes. These findings expose vulnerabilities among affected groups, and future studies should focus on why that is the case and what can be done to help through culturally sensitive interventions. 

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