Socioeconomic status and psychological stress: Examining intersection with race, sex and US geographic region in the REasons for Geographic and Racial Differences in Stroke study

Oral issues and childhood stress in eight-to-ten-year-old schoolchildren: a case-control study

OBJECTIVE

The aim of the present study was to investigate whether oral problems, harmful oral habits, and sociodemographic factors are associated with the occurrence of stress in schoolchildren.

MATERIALS AND METHODS

A case-control study nested within a cross-sectional study was conducted with a sample of 375 schoolchildren eight to ten years of age in the city of Diamantina, Brazil. The case group (with childhood stress) and control group (without childhood stress) were matched for age and sex at a 1:4 ratio (75 cases to 300 controls). Data collection involved the self-administration of a questionnaire by parents/caregivers addressing sociodemographic characteristics and the child's history of harmful oral habits. The children answered the Child Stress Scale (CSS) and underwent a clinical oral examination to determine the presence/absence of dental caries, malocclusion, and traumatic dental injuries. Data analysis involved the calculation of frequencies, the chi-square test, and conditional logistic regression (95% CI; p ≤ 0.05).

RESULTS

The final adjusted conditional logistic regression model showed that dental caries (OR = 1.78, 95% CI: 1.01 - 3.14, p = 0.044) and biting objects (OR = 1.81, 95% CI: 1.02 - 3.22, p = 0.041) remained associated with stress in the schoolchildren analysed.

CONCLUSION

The present results showed that children with dental caries and the habit of biting objects were more likely to have childhood stress.

CLINICAL RELEVANCE

The study allows paediatric dentists to expand their knowledge with regards to the influence of oral problems and harmful habits on the occurrence of childhood stress and serves as a guide for decision-making related to oral problems in schoolchildren.

Prenatal Cannabis Use and Offspring Autism-Related Behaviors: Examining Maternal Stress as a Moderator in a Black American Cohort

Prenatal cannabis use and maternal stress have been proposed as risk factors for autism spectrum disorder (ASD). Black mothers and mothers of lower socioeconomic status (SES) may be especially likely to experience high levels of stress. This study examined the impact of prenatal cannabis use and maternal stress (i.e., prenatal distress, racial discrimination, and lower SES) on child ASD-related behaviors in a sample of 172 Black mother-child pairs. We found that prenatal stress was significantly associated with ASD-related behaviors. Prenatal cannabis use did not predict ASD-related behaviors and did not interact with maternal stress to predict ASD-related behaviors. These findings replicate previous work on prenatal stress-ASD associations and add to the limited literature on prenatal cannabis-ASD associations in Black samples.

The prevalence and its associated factors of psychological stress among middle school students in China: pooled evidence from a systematic scoping review

Psychological issues are of significant concern in present-day society, as poor mental well-being results in depression and suicidal behavior. Understanding the current situation of psychological stress among secondary school students will help policy makers to formulate targeted measures to help them cope with stress, and at the same time evaluate the effectiveness of the existing policies to address the shortcomings and enhance the diversification of interventions. The main purpose of this review was to map the existing evidence on the prevalence and levels of psychological stress among adolescents in China, and to identify the associated risk factors. This review strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was performed spanning Web of Science, PubMed, and Scopus databases. Studies involving only humans and full text in English were selected. Selection was limited to samples from mainland China, Hong Kong, Macau, and Taiwan. Variables were extracted, exploring the factors that affected the mental wellness of Chinese middle school students. A final 15 articles and 1 report were included. The findings revealed psychological stress is prevalent among Chinese middle school population, with the degree of prevalence from low to severe stress levels. Three dimensions of psychological stress affecting Chinese secondary school students: school, family and lifestyle. Within the school, the factors included academic stress, peer relationships etc. Family-related factors were comprised of parent-child relationship, parents' mental health status etc. Lastly, lifestyle-related factors included poor diet, sedentary and inactivity etc. Our findings suggest that policy makers should reduce the excessive emphasis on examination results and focus on the all-round development of students, and that schools should organize a variety of extra-curricular activities to reduce students' stress. Parents should create a harmonious family atmosphere to minimize conflicts and maintain close communication with teachers.

Systematic Review Registration

OSF; https://doi.org/10.17605/OSF.IO/HEFCP.

Women's preconception psychological stress and birth outcomes in a fertility clinic: the EARTH study

Background

The epidemiologic literature on women's perceived stress in relation to perinatal outcomes has been inconclusive and does not consider the preconception window of exposure.

Objective

To evaluate whether women's preconception perceived stress is related to live birth, gestational age, and birthweight in a cohort receiving fertility treatment.

Methods

This observational study included women seeking fertility care at the Massachusetts General Hospital (2004-2019). During preconception, women provided information on their psychological stress using the short version of the validated Perceived Stress Scale 4 (PSS-4). We used regression models to evaluate the associations of stress with live birth (N = 768 attempting to conceive) and perinatal outcomes (N = 413 live births) while adjusting for confounders. Stratified analyses by mode of conception [natural, intrauterine insemination (IUI), and IVF (in vitro fertilization)] and selected socioeconomic factors (race, education, and income) were also conducted.

Results

Higher psychological stress was negatively associated with the overall probability of live birth (adjusted RR = 0.95, 95% CI: 0.92, 0.98), particularly among women conceiving using IVF. However, we found no association between women's psychological stress and gestational age and birth weight in the overall analyses and also stratified by mode of conception. Similarly, we observed no differences in women's psychological stress with any of the measured outcomes by socioeconomic factors.

Discussion

These results highlight the importance of considering the preconception window and mode of conception when evaluating the relationship between women's preconception stress and live birth.

Racial Disparities in COVID-19 Severity Are Partially Mediated by Chronic Stress-Evidence from a Large Integrated Healthcare System

BACKGROUND

Racial and ethnic minorities have experienced a disproportionate burden of severe COVID-19. Whether chronic stress, also disproportionately experienced by racial and ethnic minorities, explains this excess risk is unknown.

METHODS

We identified 9577 adults (≥ 18 years) diagnosed with COVID-19 from January 1, 2020, through September 30, 2021, enrolled in Kaiser Permanente Georgia (KPGA) with complete biomarker data. Self-reported race (Black or White) was defined from electronic medical records. Chronic stress, defined as allostatic load (AL), a composite score (scale 0-7) based on seven cardio-metabolic biomarkers, was categorized as below (low AL) or above (high AL) the median. Severe COVID-19 was defined as hospitalization or mortality within 30 days of COVID-19 diagnosis. The association between race, AL, and severe COVID-19 was assessed using multivariable Poisson regression. The mediating effect of AL was assessed using the Valeri and VanderWeele method. All results were expressed as risk ratios (RRs) with 95% confidence intervals.

RESULTS

Overall, Black (vs. White) KPGA members had an 18% excess risk of AL (RR: 1.18, 95%CI: 1.14-1.23) and a 24% excess risk of severe COVID-19 (RR: 1.24, 95%CI: 1.12, 1.37). AL explained 23% of the Black-White disparities in severe COVID-19.

CONCLUSIONS

In our study, chronic stress, characterized by AL, partially mediated Black-White disparities in severe COVID-19 outcomes.

Preconception Stress and Pregnancy Serum Glucose Levels Among Women Attending a Fertility Center

Context

The association between women's stress and pregnancy glucose levels remain unclear, specifically when considering the preconception period as a sensitive window of exposure.

Objective

We investigated whether preconception perceived stress was associated with glucose levels during pregnancy among women attending a fertility center (2004-2019).

Methods

Before conception, women completed a psychological stress survey using the short version of the validated Perceived Stress Scale 4 (PSS-4), and blood glucose was measured using a 50-gram glucose load test during late pregnancy as a part of screening for gestational diabetes. Linear and log-binomial regression models were used to assess associations of total PSS-4 scores with mean glucose levels and abnormal glucose levels ( ≥ 140 mg/dL), adjusting for age, body mass index, race, smoking, education, physical activity, primary infertility diagnosis, number of babies, and mode of conception.

Results

Psychological stress was positively associated with mean abnormal glucose levels. The adjusted marginal means (95% CI) of mean glucose levels for women in the first, second, and third tertiles of psychological stress were 115 (110, 119), 119 (115, 123), and 124 (119, 128), and mg/dL, respectively (P for trend = .007). Also, women in the second and third tertiles of psychological stress had 4% and 13% higher probabilities of having abnormal glucose compared with women in the first tertile of psychological stress (P trend = .01).

Conclusion

These results highlight the importance of considering preconception when evaluating the relationship between women's stress and pregnancy glucose levels.

Differential effects of western versus mediterranean diets and psychosocial stress on ovarian function in female monkeys (Macaca fascicularis)

Ovarian dysfunction increases risk for chronic diseases of aging including cardiovascular disease, depression, cognitive impairment, as well as bone and muscle loss which promote frailty. Psychosocial stress can disrupt ovarian function, and recent observations suggest that consumption of a Western Diet may also. Determination of causal relationships among diet, psychosocial stress, and ovarian physiology is difficult in humans. Long-tailed (a.k.a. cynomolgus) macaques (Macaca fascicularis) are an excellent translational model for the study of diet and psychosocial effects on ovarian physiology and aging-related processes. They have 28-day menstrual cycles with hormonal fluctuations like those of women, and similar physiologic responses to alterations and/or cessation of cyclicity. We examined ovarian function in 38 middle-aged socially housed females fed either a Western or Mediterranean diet for 31 months (≈ a 9-year period for humans). During the last year, we examined cycle length and peak progesterone per cycle using blood sampling (3/week) and vaginal swabbing for menses (6/week). Repeated measures analysis revealed a circannual pattern consistent with increased menstrual cycle disturbance during the late Summer and early Fall (F(11,348)= 4.05 p < 0.001). In addition, both Western diet (F(1,34)= 3.99; p = 0.05) and the stress of low social status (F(1,34)= 3.99; p = 0.04) reduced mean progesterone levels. Thus, on average, subordinates in the Western group had the lowest average progesterone levels (10.02 ng/pl). Compared to Western diets, Mediterranean diets exhibited protective effects via menstrual cycle regularity. For dominant monkeys, consuming Mediterranean diets resulted in significantly greater likelihood of having regular menstrual cycles. Mediterranean diets also protected individuals from shorter than normal menstrual cycles. The relationships between diet and menstrual regularity were partially mediated by both adrenal reactivity and social isolation. This study demonstrates the additive negative effects of poor diet and psychosocial stress on ovarian physiology in mid-life and lays the groundwork for future investigations to uncover their impact on metabolic signatures of accelerated aging. The results also suggest that - compared to Western-style diets - a Mediterranean diet may exert a protective influence against ovarian dysfunction and its pathologic sequelae.

Associations between household income and disordered eating differ across sex and racial identity in a population-based sample of adults

BACKGROUND

Most research on socioeconomic status (SES) and eating disorders (EDs) has focused on young White women. Consequently, little is known regarding how SES may relate to EDs/disordered eating in older adults, men, or people with different racial identities. We examined whether associations between SES and EDs/disordered eating differed across age, sex, and racial identity in a large, population-based sample spanning early-to-later adulthood.

METHODS

Analyses included 2797 women and 2781 men ages 18-65 (Mage  = 37.41, SD = 7.38) from the population-based Michigan State University Twin Registry. We first examined associations between SES and dimensional ED symptoms, binge eating (BE), and self-reported ED diagnoses across age and sex in the full sample. We then examined the impact of racial identity on associations by conducting within- and between-group analyses among Black and White participants.

RESULTS

In the full sample, lower SES was associated with significantly greater odds of BE and lifetime EDs in men, but not women, across adulthood. The association between lower SES and greater BE risk was stronger for Black men than for White men, though significant in both groups. Conversely, Black women showed a positive association between SES and dimensional ED symptoms that significantly differed from effects for Black men and White women.

CONCLUSIONS

Associations between socioeconomic disadvantage and EDs/disordered eating may be particularly robust for men in adulthood, especially men with a marginalized racial identity. Oppositely, Black women may encounter social pressures and minority stress in higher SES environments that could contribute to somewhat heightened ED risk.

PUBLIC SIGNIFICANCE

Little is known regarding how associations between socioeconomic status (SES) and eating disorders (EDs) may differ across age/sex or racial identity. We found lower SES was associated with greater odds of a lifetime ED or binge eating in men only, with a particularly strong association between lower SES and binge eating for Black men. Results highlight the importance of examining how SES-ED associations may differ across other aspects of identity.

Resilience resources may buffer some middle-aged and older Black Americans from memory decline despite experiencing discrimination

RATIONALE

Experiences of discrimination have been associated with poorer episodic memory in Black Americans. However, resilience resources at multiple levels (individual, social, and endowed) may act as a buffer to protect future memory decline, especially in the face of discrimination.

OBJECTIVE

Using longitudinal data from the 2006-2016 Health and Retirement Study (N = 1862), we tested whether Black Americans aged 50 and older would show different trajectories of episodic memory depending on their reported experiences of discrimination (everyday and major lifetime) and resilience resources.

METHODS

Analyses were conducted in three steps: (1) joint latent cluster mixed modeling (JLCMM) to estimate the number of classes, (2) barycentric discriminant analyses (BADA) to model the combined influence of discrimination and resilience resources between each memory class, and (3) multinomial regression analyses to explore interactions between discrimination and resilience resources.

RESULTS

JLCMM resulted in three memory classes that differentiated baseline from longitudinal memory performance: "High Decliners," "Low Decliners," and "Low Stable." Two independent patterns described the relationships between the three classes in the context of discrimination and resilience resources. First, compared with High Decliners, the two lower baseline memory classes (Low Decliners and Low Stable) reported more everyday discrimination and lower individual and endowed resilience resources. Second, although the Low Stable class did not report different levels of discrimination, they had more social resilience resources (greater social support and more social contact) than both declining classes.

CONCLUSIONS

Black Americans in later life have heterogeneous patterns of memory trajectories as demonstrated by the three memory classes identified. Those with lower baseline memory experienced more everyday discrimination and had fewer resilience resources compared to those with high baseline performance (High Decliners). Greater social resilience resources were associated with maintained episodic memory over time in Black Americans.