The Stress Process: Its Origins, Evolution, and Future

COVID-19 Stress and Cognitive Disparities in Black, MENA, and White Older Adults

BACKGROUND AND OBJECTIVES

Population aging has led to an increased interest in cognitive health and, in particular, the role that stress plays in cognitive disparities. This paper extends previous work by characterizing coronavirus disease 2019 (COVID-19) stress type prevalence and its association with cognitive health in metro-Detroit among Black, Middle Eastern/Arab (MENA), and White older adults.

RESEARCH DESIGN AND METHODS

Data come from a regionally representative sample of adults aged 65+ in metro-Detroit (N = 600; MENA n = 199; Black n = 205; White n = 196). We used generalized linear models to compare groups on sociodemographic, objective stress, and social stress indicators. Multiple group structural equation models evaluated whether COVID-19 stress predicted cognitive health and whether that association varied across racial/ethnic groups.

RESULTS

MENA and Black older adults reported higher levels of objective stress than Whites. There were no racial/ethnic group differences in social stress. More objective stress was associated with better cognitive health, and more social stress was associated with worse cognitive health. The positive effect of objective stress was especially apparent for White older adults.

DISCUSSION AND IMPLICATIONS

Though it appears that minority stress was not exacerbated in the context of pandemic stress, links between greater objective stress and better cognitive health apparent among White older adults were not evident among MENA or Black older adults. Broadening health disparities research by including underrepresented populations allows us to elevate scientific knowledge by clarifying what is universal and what is unique about the stress process.

Caring by default: experiences of caregivers of children with developmental disabilities in Ghana mirrored in the context of the stress process model

BACKGROUND

Caring for a child with developmental disabilities (DD) is associated with significant stress and burden. Caregivers' experiences are influenced by factors such as poverty, stigma, and the lack of accessibility to services, equipment, and assistive devices. These factors are prevalent in a low-resource setting like Ghana which ultimately influences the experiences of caregivers. The aim of the study was to explore the experiences of caregivers of children with DD in the context of the Stress Process Model.

METHODS

The study employed a descriptive phenomenological design Caregivers of children with DD attending the Neurodevelopmental Clinic of a Teaching Hospital were purposively sampled. Data collection involved semi-structured interviews, reaching saturation with 14 participants. The interviews were audio-recorded transcribed verbatim and analysed using thematic analysis.

RESULTS

Four main themes emerged: perception of caregiving, stressors faced by caregivers, negative health outcomes and coping strategies. Perception of caregiving had two sub-themes as stressful nature of caregiving and time-consuming. Six sub-themes were linked to stressors faced by caregivers: the child's ADL needs, communication barrier, managing challenging behaviour, child's health needs, unmet educational needs, and economic burden. Negative health outcomes had three sub-themes: decline in physical, mental and social well-being. While some caregivers used maladaptive coping strategies like blaming, others employed adaptive coping strategies like religious coping through prayer, self-encouragement and support from other family members.

CONCLUSION

The study highlights the complex interaction between caregivers' perception of their caregiving situation, the stressors they experience, their coping resources,  and the negative health outcomes associated with caregiving. These findings underscore the need for context-specific caregiver programmes to mitigate the negative impacts of caregiving.

Rates of Recent Adverse Childhood Experiences Among Indigenous Children

The current paper describes rates of recent (past six months) adverse childhood experiences (ACEs) and examines the association of ACEs with cultural connection and depressive symptoms among Indigenous children aged 10 to 14 (N = 177; mean age = 11.8; 48.3% boys; 44.3% girls; 7.4% another gender identity). Children completed baseline surveys as part of a larger evaluation of a culturally grounded, strengths-focused, family-based program to prevent ACEs. Surveys included an inclusive measure of ACEs developed for the current study, an adapted measure of connection to culture, and the Children's Depression Screener. Results for ACEs indicated that 18.6% of Indigenous children reported none, 37.2% reported one to three, and 44.2% reported four or more in the past six months. Importantly, children who reported no ACEs reported greater cultural connection than children who reported one to three ACEs. Depressive symptoms were higher among children who reported one to three and four or more ACEs compared to children who reported no ACEs.

An exploratory study on material deprivation and loneliness among older adults in Hong Kong

BACKGROUND

Poverty, as a risk factor for loneliness, has been understudied, and there is a need to gain a better understanding of the relationship between poverty examined by material deprivation and loneliness among older adults in Hong Kong. It also aimed to explore the possible mediation and moderation effects of social support, social networks, neighborhood collective efficacy, and social engagement in the link between material deprivation and loneliness.

METHODS

1696 Chinese older adults aged 60 years and above (Mage = 74.61; SD = 8.71) participated in a two-wave study. Older adults reported their loneliness level, material deprivation, perceived level of social support, social network, neighborhood collective efficacy, social engagement, and sociodemographic information. Logistic regression was conducted to examine the effect of material deprivation on loneliness, as well as the mediation and moderation models.

RESULTS

The results indicated that material deprived older adults reported a significantly higher level of loneliness 2 years later when controlling for demographic variables, health-related factors, and loneliness at baseline. We also found that engagement in cultural activities partially mediated the effect of material deprivation and loneliness. Furthermore, neighborhood collective efficacy and engagement in cultural activities were significant moderators that buffer the relationship between material deprivation and loneliness.

CONCLUSIONS

Our results suggested the need to alleviate the negative impact of material deprivation on loneliness by developing interventions focused on promoting neighborhood collective efficacy and social engagement, which could be aimed at building meaningful bonds among Chinese older adults in Hong Kong.

Marital Quality and Depressive Symptoms Among Older Hispanic Adults in the United States

OBJECTIVES

Despite the cultural importance of marriage as a social support system and its well-established link to mental health, older Hispanic adult populations, which are the largest racial and ethnic minoritized groups, remain understudied. The current study examined how positive and negative dimensions of marital quality are associated with depressive symptoms.

METHODS

Data from Hispanic adults aged 51 years and older (n = 1,012) were obtained from the 2016 and 2018 Health and Retirement Study waves. The Center for Epidemiological Studies-Depression scale (0-8 symptoms) was modeled as a function of positive and negative marital quality measures (1-4), as well as the relevant covariates.

RESULTS

Results from a negative binomial regression model showed that a 1-unit change in positive and negative marital quality was associated with a 23.61% reduction and a 23.74% increase, respectively, in depressive symptoms. The interaction terms with marital quality and gender, as well as marital quality and religion, were not statistically significant.

DISCUSSION

In the United States, a large percentage of older Hispanic adults are immigrants, and their extended family tends to reside in their countries of origin. As such, older Hispanic adults may have smaller social networks, and marital quality most likely represents a culturally important social support network in later life. Significant associations between depressive symptoms and marital quality among older Hispanic adults should receive more attention in family and public health policy discussions, particularly given the increasing diversity in U.S. society.

COVID-Related Stressors and Psychological Distress Among Chicago Residents: the Moderating Role of Race

BACKGROUND

Racial and ethnic minorities have been disproportionately affected by the COVID-19 pandemic and have experienced greater financial loss, housing instability, and food insecurity due to COVID-related restrictions. As a result, Black and Hispanic communities may be at greater risk of experiencing psychological distress (PD).

METHODS

Using data collected between October 2020 and January 2021from 906 Black (39%), White (50%), and Hispanic (11%) adults, we assessed racial/ethnic differences in the effect of three COVID-related stressors-employment stress, housing instability, and food insecurity-on PD using ordinary least square regression.

RESULTS

Black adults reported lower PD levels compared to White adults (β =  - 0.23, P < 0.001), but Hispanic adults did not differ significantly from White adults. COVID-related housing instability (β = 0.46, P < 0.001), food insecurity (β = 0.27, P < 0.001), and employment stress (β = 0.29, P < 0.001) were associated with higher PD. Employment stress was the only stressor to differentially affect PD by race/ethnicity. Among those that reported employment stress, Black adults had lower levels of distress compared to Whites (β =  - 0.54, P < 0.001) and Hispanics (β =  - 0.04, P = 0.85).

CONCLUSION

Despite relatively high exposure to COVID-related stressors, Black respondents had lower levels of PD compared to Whites and Hispanics which may reflect differences in race-specific coping mechanisms. Future research is needed to elucidate the nuances of these relationships and identify policies and interventions that prevent and minimize the impact of employment, food, and housing-related stressors and support coping mechanisms that promote mental health among minority populations, such as policies that support easier access to mental health and financial and housing assistance.

The Effects of Midlife Acute and Chronic Stressors on Black-White Differences in Cognitive Decline

OBJECTIVES

Midlife stressors may be particularly consequential for cognitive performance and disparities in cognitive decline. This study examined Black-White differences in trajectories of cognition among middle-aged adults and the effects of acute and chronic stressors on these trajectories.

METHODS

Data come from 4,011 cognitively healthy individuals aged 51-64 (620 Black and 3,391 White) who participated in the 2006-2018 waves of the Health and Retirement Study. Stressors included a count of recent life events and measures of financial strain and everyday discrimination. Global cognition was assessed using a modified version of the Telephone Interview for Cognitive Status. Linear mixed models with random slopes and intercepts assessed change in cognition over time. Race-by-time, race-by-stressor, time-by-stressor, and race-by-stressor-by-time interactions were assessed as were quadratic terms for time and each stressor.

RESULTS

After adjusting for sociodemographic, health behaviors, and health-related factors, Black respondents had lower initial cognitive performance scores (b = -1.75, p < .001) but experienced earlier but slower decline in cognitive performance over time (Black × Time2 interaction: b = 0.02, p < .01). Financial strain, discrimination, and recent life events each had distinct associations with cognitive performance but did not influence racial differences in levels of or change in cognition over time.

DISCUSSION

Middle-aged Black adults have lower initial cognition levels and experience earlier but less accelerated cognitive decline compared to White middle-aged adults. Midlife acute and chronic stressors influence baseline cognition but do so in different ways. Future research should examine the influence of other stressors on racial differences in cognitive decline at other points in the life course.

Academic Achievement After Violence Exposure: The Indirect Effects of School Attachment and Motivation to Succeed

Disparities in educational outcomes for students living in communities burdened with high rates of violence are striking as they are at an increased risk for misbehavior, low GPA, poor school attendance, and decreased standardized test scores. However, limited research identifies the role that schools play in exacerbating exposure to violence to inform changes that aid in mitigating violence exposure. As such, this study utilizes the Pathways to Desistance Study to explore the mediating roles of school attachment and motivation to succeed on students' academic outcomes after exposure to community violence. Using a serial mediation model, findings indicate that school attachment and motivation to succeed mediate the relationship between exposure to violence and grades. Implications for adapting school programs and policies as well as providing teacher training to increase school attachment and motivation are discussed.

Pre-COVID-19 predictors of low-income women's COVID-19 appraisal, coping, and changes in mental health during the pandemic

Study examined predictors and mental health consequences of appraisal (threat, support satisfaction) and coping (active, avoidant) in a sample of low-income women during coronavirus disease 2019 (COVID-19). Pre-COVID-19 contextual risk and individual resources and COVID-19-specific risk factors were examined as predictors of COVID-19 appraisal and coping, which, in turn, were tested as predictors of changes in depression and anxiety across the pandemic. Pre-COVID-19 resilience predicted more active coping, whereas pre-COVID-19 anxiety and depression predicted more avoidant coping and lower support satisfaction, respectively. Increases in anxiety were predicted by lower pre-COVID-19 self-compassion and higher concurrent threat appraisal and avoidant coping. Increases in depression were related to lower pre-COVID-19 self-compassion, active coping and support satisfaction, and higher COVID-19 hardships and health risk. Findings highlight contextual and individual factors and processes that contribute to mental health problems in a vulnerable population during community-level stressors, with implications for prevention and intervention.

Cumulative Pandemic Stressors, Psychosocial Resources, and Psychological Distress: Toward a More Comprehensive Test of a Pandemic Stress Process

Although the mental health consequences of individual COVID-19 stressors (e.g., bereavement, job loss, or financial strain) have been well-documented, little is known about the cumulative toll of multiple pandemic stressors. Using national data from the Crime, Health, and Politics Survey (May–June 2021), we test whether the accumulation of pandemic stressors is associated with greater psychological distress. We also consider whether this association is moderated by psychosocial resources (i.e., mastery, self-esteem, and social support). Our findings suggest that individuals who report three or more pandemic stressors tend to exhibit greater psychological distress than those who report fewer pandemic stressors or no pandemic stressors. While mastery offsets the impact of pandemic stressors at higher levels of stress exposure (i.e., two or more COVID-19 stressors), social support and self-esteem played a stress-buffering role to a point, but became ineffective at the highest levels of pandemic stress. The current study provides new insights into the pandemic stress process by conceptualizing and operationalizing the cumulative impact of COVID-19 stressors. We also confirm the continued significance of traditional coping resources in the context of novel pandemic stressors.

Daily discrimination, church support, personal mastery, and psychological distress in black people in the United States

OBJECTIVE

This study used the stress process model to test the mediating effects of personal mastery and moderating effects of church-based social support on the relationship between daily discrimination and psychological distress across three age groups of African American and Afro-Caribbean adults.

METHODS

Using a national sample of 5008 African Americans and Afro-Caribbean adults from the National Survey of American Life Study, this study employs structural equation modeling to investigate the relationships between daily discrimination, personal mastery, church-based social support, and psychological distress.

RESULTS

Daily discrimination was an independent predictor of psychological distress across all groups. Group- and age-specific comparisons revealed significant differences in the experience of daily discrimination and psychological distress. Mastery was a partial mediator of the relationship between discrimination and psychological distress among Afro-Caribbeans while church support was a significant moderator only among the young and older African Americans.

IMPLICATIONS

Together, our study findings provide useful first steps towards developing interventions to reduce the adverse psychological impacts of daily discrimination on African Americans and Afro-Caribbeans. Intervention efforts such as individual psychotherapy aimed to improve Afro-Caribbean individuals' sense of mastery would be a partial solution to alleviating the adverse effects of discrimination on their psychological health.

Perceived Marriage Squeeze and Subjective Well-Being Among Unmarried Rural Men in China: The Mediating Role of Sense of Coherence

The marriage-squeeze unmarried rural men perceive during their daily life is one of the main stressors severely affecting their subjective well-being under the universal marriage culture. The mechanism of this relationship is still unknown. Based on the Stress Process Model, using data from the "Survey on Rural Family Martial Status," this study examines the relationship between perceived marriage squeeze (PMS) and subjective well-being (SWB) and the mediating effect of sense of coherence (SOC). A sample of 417 Chinese unmarried rural men with an average age of 28.88 years was enrolled in this cross-sectional. Ordinary least square regressions and Bootstrap-mediated effect analysis methods were used to examine the association between PMS, SWB, and SOC. The results show that PMS has significant negative effects on both SWB and SOC of unmarried rural men, and SOC has a significant positive impact on SWB; the more perceived marriage squeeze they have, the lower SWB and SOC they have. The mediated analysis shows that SOC plays a mediating role in the influence of PMS on the SWB of unmarried rural men. This is to say, SOC can mitigate PMS's negative effects on the SWB of unmarried rural men. Our findings highlight the importance of SOC in protecting the SWB of unmarried rural men. Considering the propounding influence of the marriage squeeze, policies that enhance the level of SOC should be implemented to relieve the influence of PMS on vulnerable unmarried rural men's SWB.

Everyday Discrimination and Depressive Symptoms among Gujarati Adults: Gender Difference in the Role of Social Support

Discrimination against Asians in the USA and its impact on their mental health are urgent public health concerns. Most research on discrimination against Asians has used aggregated Asian group samples. Focusing on Gujaratis, a specific subgroup of Asian Indians, the second-largest Asian group in the USA, this study examined the relationships between everyday discrimination and psychological distress and how they vary by gender. Data were collected via computer-assisted telephone interviews with a representative sample of 553 Gujaratis aged 18 to 65 years residing in a Midwestern state. Negative binomial regression analyses were conducted to examine how exposure to unfair treatment and three types of social support, respectively, was associated with depressive symptoms. For both women and men, unfair treatment was positively associated with depressive symptoms, controlling for sociodemographic characteristics. For women, but not for men, the incidence rate ratio became non-significant when adding social support measures to the model. All three social support measures for women, and only satisfaction with social support for men, were significantly associated with lower depressive symptoms. The findings highlight the need for further research on the role of different types of social support and gender differences, which can inform gender- and socioculturally-relevant intervention efforts.

Temporal sociomedical approaches to intersex* bodies

The history of the field of intersex bodies/bodies with variations of sex development (VSD) reflects the ongoing tension between sociomedical attempts to control uncertainty and reduce the duration of corporeal uncertainty by means of early diagnosis and treatment, and the embodied subjects who resist or challenge these attempts, which ultimately increase uncertainty. Based on various qualitative studies in the field of intersex, this article describes three temporal sociomedical approaches that have evolved over the last decade and aims to address the uncertainty surrounding intersex/VSD bodies. These approaches are (1) the corrective-concealing approach, which includes early surgeries and hormone therapies intended to "correct" intersex conditions and the deliberate concealment of the ambiguity and uncertainty associated with intersex conditions; (2) the preventive approach, which involves early genetic diagnostic methods aimed at regulating or preventing the recurrence of hereditary conditions under the umbrella of VSD; and (3) the wait-and-see approach, which perceives intersex bodies as natural variations and encourages parents to take time, wait, and give their children the right to bodily autonomy. A comparison of these approaches from biopolitical, phenomenological, and pragmatic perspectives reveals that time is an essential social agent in addressing and controlling uncertainty, a gatekeeper of social norms and social and physical orders, and, on the other hand, a sociopolitical agent that enables creative social change.

Work-Related Stress, Psychosocial Resources, and Insomnia Symptoms Among Older Black Workers

Objectives: To examine the association between work-related stress (job lock and job stress appraisal) and insomnia symptoms among older Black workers, as well as the extent to which psychosocial resources (mastery, social support, and religious involvement) mediate or moderate this association. Methods: This study uses Ordinary Least Squares regression analysis and data from the Health and Retirement Study (HRS) on Black workers aged 51 and older (N = 924). Results: Job lock due to financial reasons and job stress appraisal are associated with increased insomnia symptoms among older Black workers. Religious attendance buffers the harmful effects of financial job lock on sleep quality, while religiosity exacerbates the effects of job stress on insomnia symptoms. Discussion: Taken together, findings underscore the utility of the Stress Process Model for understanding diverse stress and sleep experiences in later life. Furthermore, findings have the potential to inform efficacious policies for reducing work-related stress and mitigating its harmful consequences.

Discrimination in Context: Examining Neighborhood-Level Variation in the Incidence and Adverse Effects of Perceived Racial and Ethnic Discrimination Among Chicago Youth

A growing body of research links interpersonal racial and ethnic discrimination to adverse youth outcomes. Yet, studies examining the relevance of neighborhood context for discrimination are sparse. This study examines neighborhood-level variation in the incidence and impact of perceived racial and ethnic discrimination on depressive symptoms, suicidal behavior, violent behavior, and substance use. Hierarchical regression models on a sample of 1333 African American and Hispanic youth (52.44% female; x̄ = 13.03 years, SD = 3.25 at wave 1) residing in 238 Chicago neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated little to no neighborhood-level variation in the incidence and impact of discrimination. Findings suggest that the experience of discrimination among youth of color is ubiquitous.

Childhood Experiences and Psychological Distress: Can Benevolent Childhood Experiences Counteract the Negative Effects of Adverse Childhood Experiences?

Background

Childhood experiences can exert a huge impact on adult psychological conditions. Previous studies have confirmed the effects of adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) on psychological distress (e.g., stress, depression, and suicidal ideation) separately, but few studies explored a combined effect of ACEs and BCEs on psychological distress. The aim of this study was to explore a combined effect of ACEs and BCEs on psychological distress among Chinese undergraduates.

Methods

Participants were undergraduates aged 17–24 years (N = 1,816) and completed a self-reported questionnaire. A series of regression analyses were conducted to examine the association between childhood experiences and psychological distress.

Results

A total of 65.7% of undergraduates had BCEs, 27.1% of undergraduates had ACEs, and 12.9% of undergraduates had ACEs and BCEs simultaneously. Logistic regression analysis indicated that undergraduates who experienced high ACEs were more likely to have a high risk of psychological distress [odds ratio (ORs) = 1.46, 1.84, and 3.15 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively], while undergraduates who experienced High BCEs were less likely to have psychological distress (ORs = 0.33, 0.22, and 0.32 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively) compared with Low-Both group. The combined effect of ACEs and BCEs (High-Both group) could also play as a protective factor in uncertainty stress (OR = 0.56) and depressive symptoms (OR = 0.47).

Conclusion

Our findings suggested that ACEs and BCEs could not only predict the psychological distress independently, but also BCEs could counteract the negative effect of ACEs in psychological problems. There is an even greater need to identify and support the victims of ACEs and to increase BCEs in early childhood.

Weather, Workload and Money: Determining and Evaluating Sources of Stress for Farmers in Ireland

The demands of modern farming can place substantial stress upon the farmer, adversely impacting their wellbeing. This study identifies both the prevalence of stress and assesses the demographic, farm, and social characteristics that impact the incidence of stress. We report the results of a survey of a nationally representative sample of farm enterprises in Ireland undertaken in association with the Teagasc National Farm Survey (NFS) in 2018, which saw 736 questionnaires completed by farm operators. Frequency analysis is used to report the primary sources and prevalence of stress. A probit model is developed identifying and quantifying the factors that impact the incidence of stress. There were 57% of farmers who reported experiencing stress resulting from their farm work. Key sources of stress included "poor weather", (47%), "workload" (32%) and "financial" concerns (28%). The results of the probit model establish that the effect of age on the incidence of stress is significant, positive, and non-linear, indicating as farmers get older they are more likely to experience stress but at a declining rate. Operating a sheep farm system, as opposed to any other type of farm system, reduces the probability of stress. Working off-farm also reduces the probability of stress by 0.097, other things being equal. The findings highlight variance in the levels of stress reported by farmers by age and farm system, and consequently, the need to develop targeted supports that take consideration of differences within the population of farmers and farm enterprises.

Associations between spousal caregiving and health among older adults in Mexico: A targeted estimation approach

OBJECTIVE

To evaluate associations between spousal caregiving and mental and physical health among older adults in Mexico.

METHODS

Data come from the Mexican Health & Aging Study, a national population-based study of adults ≥50 years and their spouses (2001-2015). We compared outcomes for spousal caregivers to outcomes for those whose spouses had difficulty with at least one basic or instrumental activity of daily living (I/ADL) but were not providing care; the control group conventionally includes all married respondents regardless of spouse's need for care. We used targeted maximum likelihood estimation to evaluate the associations with past-week depressive symptoms, lower-body functional limitations, and chronic health conditions.

RESULTS

At baseline, 846 women and 629 men had a spouse with ≥1 I/ADL. Of these, 60.9% of women and 52.6% of men were spousal caregivers. Spousal caregiving was associated with more past-week depressive symptoms for men (Marginal Risk Difference (RD): 0.27, 95% confidence internal [CI]: 0.03, 0.51) and women (RD: 0.15, 95% CI: 0.07, 0.23). We could not draw conclusions about associations with lower-body functional limitations and chronic health conditions. On average, all respondents whose spouses had caregiving needs had poorer health than the overall sample.

CONCLUSION

We found evidence of an association between spousal caregiving and mental health among older Mexican adults with spouses who had need for care. However, our findings suggest that older adults who are both currently providing or at risk of providing spousal care may need targeted programs and policies to support health and long-term care needs.

"There Is So Much More for Us to Lose If We Were to Kill Ourselves": Understanding Paradoxically Low Rates of Self-Harm in a Socioeconomically Disadvantaged Community in London

London has unexpectedly low overall rates of self-harm in public health data and contains highly deprived areas with these paradoxically low rates. Qualitative data were collected via interviews and focus groups with 26 individuals living and working in one such area. Using the Stress Process Model, we explore why this ethnically diverse community, which is exposed to multiple, chronic stressors, might nonetheless appear to have low rates of self-harm. Participants described significant impacts of stressors on the mental health of people locally. These were partly buffered by social resources related to community solidarity and a culture of self-reliance. However, identifying oneself as mentally ill through being known to have self-harmed was seen as highly risky, diminishing a person's social status and exposing them to additional stressors from the community and services. Consequently, people tended to hide distress, respond with behaviors less linked to mental illness, and avoid mental health services.

Mediating effects of self-esteem in the relationship between childhood maltreatment and non-suicidal self-injury among adolescents: The roles of sex and only-child status

RATIONALE

Although childhood maltreatment is known to be associated with non-suicidal self-injury (NSSI), few studies have investigated the mediating effect of self-esteem on this relationship. Additionally, it is unknown whether the impacts vary by sex or only-child status.

OBJECTIVE

We investigated the mediating effects of self-esteem on the relationship between childhood maltreatment and NSSI in adolescents and identified the significance of sex and only child status.

METHOD

An adolescent health survey was conducted in 15 schools in China between 2013 and 2014. In total, 9704 students aged 11-19 years completed standard questionnaires to report the details of childhood maltreatment, NSSI, and self-esteem.

RESULTS

Childhood maltreatment was negatively correlated with self-esteem and positively correlated with the frequency of NSSI. Lower self-esteem was also correlated with higher NSSI frequency. Self-esteem mediated the relationship between childhood maltreatment and NSSI, and the estimated ratio of the total effect of childhood maltreatment that could be explained by mediation through self-esteem was 16.3%. The ratio was higher in boys (28.6%) than in girls (9.9%), and it was higher in only children (31.5%) than in children with siblings (11.0%).

CONCLUSIONS

Childhood maltreatment is positively correlated with the frequency of NSSI and may be mediated by self-esteem. Interventions aimed at reducing NSSI associated with childhood maltreatment may be enhanced by efforts to strengthen self-esteem, especially in boys and only children.

When Is Hope Enough? Hopefulness, Discrimination and Racial/Ethnic Disparities in Allostatic Load

Hopefulness is associated with better health and may be integral for stress adaptation and resilience. Limited research has prospectively examined whether hopefulness protects against physiological dysregulation or does so similarly for U.S. whites, blacks and Hispanics. We examined the association between baseline hopefulness and future allostatic load using data from the Health and Retirement Study (n = 8,486) and assessed differences in this association by race/ethnicity and experiences of discrimination. Four items measured hopefulness and allostatic load was a count of seven biomarkers for which a respondent's measured value was considered high-risk for disease. A dichotomous variable assessed whether respondents experienced at least one major act of discrimination in their lifetime. We used Poisson regression to examine the association between hopefulness and allostatic load and included a multiplicative interaction term to test racial/ethnic differences in this association. Subsequent analyses were stratified by race/ethnicity and tested the interaction between hopefulness and discrimination within each racial/ethnic group. Hopefulness was associated with lower allostatic load scores, but its effects varied significantly by race/ethnicity. Race-stratified analyses suggested that hopefulness was protective among whites and not associated with allostatic load among Hispanics irrespective of experiencing discrimination. Hopefulness was associated with lower allostatic load among blacks reporting discrimination but associated with higher allostatic load among those who did not. Findings suggest that hopefulness plays differing roles for older whites, blacks and Hispanics and, for blacks, its protective effects on physiological dysregulation are intricately tied to their experiences of discrimination.

Applying the Stress Process Model to Stress-Burnout and Stress-Depression Relationships in Biomedical Doctoral Students: A Cross-Sectional Pilot Study

Although doctoral students in the biomedical sciences have been recognized as a population at particular risk for mental health problems such as burnout and depression, little research has been conducted to identify candidate targets for intervention. To this end, we used the stress process model to evaluate potential mediators of stress-burnout and stress-depression relationships in biomedical doctoral students. A cross-sectional sample (n = 69) completed validated self-report measures of stress; symptoms of burnout and depression; and perceptions of mastery, social support, and advisor support. In linear regression models, we found that academic stressors were most predictive of burnout, whereas family/monetary stressors were most predictive of depression. In mediation models, we found that the relationship between stress and burnout was partially mediated by mastery and advisor support, while the stress-depression relationship was partially mediated by mastery. These findings represent a first step in identifying interventional targets to improve mental health in this at-risk population. Whereas certain stressors are inherent to the doctoral training environment, psychosocial interventions to enhance one's sense of mastery and/or to improve advisor relationships may mitigate the influence of such stressors on burnout and depression.

Education and Psychosocial Functioning Among Older Adults: 4-Year Change in Sense of Control and Hopelessness

Objectives

This study investigates education differences in levels and change in sense of control and hopelessness among older adults.

Method

We used data from the Health and Retirement Study, an ongoing biennial survey of a nationally representative sample of older Americans, to examine education differences in sense of control (e.g., mastery and perceived constraints) and hopelessness. Our sample included 8,495 adults aged 52 and older who were interviewed in 2006/2008 and 2010/2012. We assessed separate models for change in sense of control and hopelessness, accounting for recent changes in social circumstances and health status.

Results

Low mastery, perceived constraints, and hopelessness were highest among individuals with less than a high school education. Over a 4-year period, this group experienced the greatest declines in psychosocial functioning, as indicated by greater increases in low mastery, perceived constraints, and hopelessness. Education differences existed net of recent negative experiences, specifically the loss of intimate social relationships and social support and increases in disease and disability.

Discussion

These findings highlight the importance of education for sense of control and hopelessness in older adulthood and demonstrate the cumulative advantage of higher levels of education for psychosocial functioning.

Sociological inquiry into mental health: the legacy of Leonard I. Pearlin

As a tribute to the body of work created by our late colleague Leonard I. Pearlin, this essay assesses how the evolution of the Stress Process Model, the centerpiece of his work, repeatedly reinvented sociological research on stress and mental health and explains why this model, therefore, possesses the potential to renew itself well into the future. This essay revisits some of Pearlin's seminal contributions: the original specification of the stress process and three extensions of it--the concept of stress proliferation, the formulation of the role of social structure and functioning in the stress process, and the articulation of linkages between the stress process and the life course perspective. The resultant body of work has had formative influences on the ways sociologists now think about the impact of society on the inner emotional lives of its members.