Latina mother-daughter dyads: relations between attachment and sexual behavior under the influence of alcohol or drugs

Neighborhood Collective Efficacy: A Longitudinal Social Determinant of Access to Medical Care Among Recently Immigrated Latina Young Adults

The present longitudinal study examined changes in perceived access to health care among a recently immigrated cohort of Latina young adults who were assessed annually during their first 3 years in the United States. A parallel process growth model of perceived access to health care and neighborhood collective efficacy was examined, accounting for socioeconomic indicators and immigration status. Five hundred thirty Latina young adults (ages 18-23) participated at baseline assessment, and approximately 95% were retained over three annual assessment time points. Participants' mean level of perceived access to health care increased during their initial 3 years in the United States. Women who reported more of an increase in perceived access to health care tended to also indicate increased neighborhood collective efficacy relative to their peers during their first 3 years in the United States. Findings offer important information about the individual- and community-level factors that influence recently immigrated Latinas' health care access.

Unpacking the Layers: Dismantling Inequities in Substance Use Services and Outcomes for Racially Minoritized Adolescents

Minoritized youth have lower prevalence rates of substance use disorders (SUD) compared with White peers, but proportionally those that are diagnosed are less likely to engage in specialized care and there are few culturally responsive treatments or programs available. We examine social determinants of SUD, with emphasis on the impact of trauma, including racial trauma, and include an intersectional approach incorporating race, ethnicity, and gender. This review of the literature highlights evidence-based effective clinical practice as examples for the field in developing therapeutic approaches to SUD for this population.

VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history

BACKGROUND

Girls have unique developmental pathways to substance use and justice system involvement, warranting gender-responsive intervention. We tested the efficacy of VOICES (a 12-session, weekly trauma-informed, gender-responsive substance use intervention) in reducing substance use and HIV/STI risk behaviors among justice- and school-referred girls.

METHODS

Participants were 113 girls (M_age = 15.7 years, SD = 1.4; 12 % White, 19 % Black, 15 % multi-racial; 42 % Latinx) with a history of substance use referred from juvenile justice (29 %) and school systems (71 %). Study assessments were completed at baseline, 3-, 6- and 9-months follow-up. Primary outcomes included substance use and HIV/STI risk behaviors; secondary outcomes included psychiatric symptoms (including posttraumatic stress) and delinquent acts. We hypothesized that girls randomized to the VOICES (n = 51) versus GirlHealth (attention control; n = 62) condition would report reduced alcohol, cannabis and other substance use, HIV/STI risk behaviors, psychiatric symptoms, and delinquent acts.

RESULTS

Girls randomized to VOICES reported significantly less cannabis use over 9-month follow-up relative to the control condition (time by intervention, p < .01), but there were no between group differences over time in HIV/STI risk behavior. Girls in both conditions reported fewer psychiatric symptoms and delinquent acts over time.

CONCLUSIONS

Data support the use of a trauma-informed, gender-responsive intervention to reduce cannabis use among girls with a substance use history and legal involvement; reducing cannabis use in this population has implications for preventing future justice involvement and improving public health outcomes for girls and young women, who are at disproportionate health and legal risk relative to their male counterparts.

Intrapersonal psychological empowerment profiles on ethnic identity, social support, and lifetime drug use among Hispanic adolescent girls

The abbreviated Sociopolitical Control Scale for Youth (SPCS-Y) factor structure, used to measure intrapersonal psychological empowerment, was tested among a sample of Hispanic adolescent girls (N = 490). Confirmatory factor analysis and latent class analyses were conducted, and five distinct cluster groups emerged. Multivariate analysis of covariance was used to examine conceptually related variables and support the two-factor structure and validity of the scale. Participants with higher levels of intrapersonal psychological empowerment also had high social support, ethnic identity, and lower levels of alcohol and drug use. Findings support the use of the scale on Hispanic adolescent girls and contribute to alcohol and drug use prevention research.

Sexual risk during initial months in US among Latina young adults

Latina young adults are disproportionately at risk for sexually transmitted infections (e.g., HIV). However, little is known about social and cultural factors contributing to sexual health disparities among young adult Latina recent immigrants. The present study examined social and cultural factors contributing to sexual risk behaviors among 530 Latina women (ages 18-23) who immigrated to Miami-Dade County, Florida, approximately 12 months before assessment. At the cultural/macrosystemic level, participants who reported more sexual risk behaviors tended to (a) be less acculturated; (b) use less positive religious coping; (c) endorse to a greater extent the marianismo belief that Latinas should be the pillar of the family; and (d) endorse less of the marianismo belief that Latinas should be virtuous and chaste (i.e., abstain from premarital sex). As for individual-level factors, participants who reported more sexual risk behaviors also indicated (e) older age, (f) being married/partnered, (g) being employed, (h) living in the US longer, and (i) drinking more alcohol. Findings indicate areas for HIV/STI prevention for this underserved population.

Latina young adults' use of health care during initial months in the United States

We examined social ecological predictors of health care utilization among Latina young adults during their initial year after immigration to the United States. Participants were 530 Latinas (ages 18-23) who immigrated to Miami-Dade County, Florida, 11.5 months before assessment. We used multiple logistic regression to test predictors of health care usage. Approximately 36% utilized care. Dimensions of marianismo differentially associated with usage. Usage also was more likely for participants who reported more social network attachment, better health, greater neighborhood cohesion, and possessed a job and health insurance. Findings inform interventions to increase health care usage globally among women after immigration.

A Social Ecological Study of Psychological Distress among Recently Immigrated, Latina Young Adults

The present study examined potential individual-, cultural-, and interpersonal-level determinants of psychological distress among young adult Latina immigrants during their initial months in the United States (US). Five hundred thirty participants (aged 18-23 years old) immigrated an average of one year before assessment. Higher levels of psychological distress (as measured by the Brief Symptom Inventory, Derogatis & Fitzpatrick, 2004) were associated with undocumented immigration status, more immersion in the dominant (US) society, and more acculturative stress. Participants who more strongly endorsed certain marianismo beliefs [i.e., Latina women should be (a) the spiritual leaders of their family and are responsible for the family's spiritual growth and (b) virtuous and chaste] indicated less distress. Participants who endorsed the belief that Latina women should be subordinate and self-silencing to maintain harmony in relationships reported more intense distress. Women who endorsed the belief that Latinas should be the main source of strength for their family also reported more distress. Participants' attachment to their social network served as a moderator of several direct effects. Participants who experienced close attachment to their social network and more ethnic immersion reported substantively less distress than other participants did. Participants reporting lower attachment and lower endorsement of the virtuous and chaste belief experienced more distress than their peers did. Participants indicating lower attachment and higher endorsement of subordinate and self-silencing beliefs also reported more distress than peers did. Finally, participants who spent less time in the US and reported lower attachment indicated higher levels of distress. Findings inform interventions to eliminate mental health disparities affecting Latina young adults.

Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample

Few studies have examined the sociocultural determinants of risky sexual behavior trajectories among adult Latinas. To longitudinally examine the link between sociocultural determinants of risky sexual behaviors, we followed a sample of adult Latina mother-daughter dyads (n = 267) across a 10-year span through four waves of data collection. The present study investigates how risky sexual behavior (operationalized as sex under the influence of alcohol or other drugs, sex without a condom, or multiple sex partners) is affected by: (a) socioeconomic conditions; (b) mental health; (c) medical health; (d) acculturation to U.S. culture; (e) interpersonal support; (f) relationship stress; (g) mother-daughter attachment; (h) intimate partner violence; (i) religious involvement; and (j) criminal justice involvement. Results indicate the following factors are negatively associated with risky sexual behavior: drug and alcohol use, treating a physical problem with prescription drugs, religious involvement, and mother-daughter attachment. The following factors are positively associated with risky sexual behavior: higher number of mental health symptoms, being U.S.-born, and criminal justice involvement. We discuss implications for the future development of culturally relevant interventions based on the study findings.

Differences in Acculturation and Trajectories of Anxiety and Alcohol Consumption Among Latina Mothers and Daughters in South Florida

This study documents generational differences in the impact of acculturation related factors on anxiety and alcohol use behaviors between adult Latino mothers and adult daughters. Findings indicate that for mothers (n = 144) and daughters (n = 149), self-reported anxiety levels decreased from baseline to follow up (p = 0.001). For mothers at follow up (n = 147), results indicate that affiliation to Latino culture is negatively associated with anxiety (p = 0.018). Conversely, employment and partner relationship stress are positively associated with anxiety (p = 0.05 and p = 0.016 respectively). In addition, self-reported anxiety is positively associated with alcohol intake (p = 0.002) and employment (p = 0.007). For daughters(n = 149), partner relationship stressors, anxiety and alcohol intake decreased significantly from baseline to follow up at a p = 0.01, p = 0.01, p = 0.05 respectively. In addition, for daughters at baseline (n = 160), affiliation to U.S. culture is positively associated with self-reported anxiety (p = 0.01). Employment is negatively associated with alcohol consumption (p = 0.027). At follow up (n = 152), daughters' partner relationship stress is positively associated with self- reported anxiety (p = 0.049). Findings in this study can be used to develop culturally appropriate interventions, support groups and individual therapy sessions by taking into consideration generational differences among Latino women.

Latino Mother/Daughter Dyadic Attachment as a Mediator for Substance Use Disorder and Emotional Abuse

To date, no studies have investigated emotional abuse of adult Latina women by their mothers despite evidence that emotional maternal abuse may significantly contribute to the emotional abuse experienced by Latina women in their lifetime. Cross-sectional data including 316 women was analyzed using mediation and logistic regression. Overall, 7.1 % of mothers and 24.1 % of daughters abused drugs; and, 19.5 % of daughters were emotionally abused by their mothers. Mother's attachment to her daughter mediated the association between mother's drug abuse and emotionally abusing her adult daughter (indirect effect: 0.863). Latina women can serve as perpetrators of emotional abuse of their adult children. Since drug-abusing daughters are more likely to be victims of emotional abuse by their mothers and drug-abusing mothers are more likely to abuse their daughters, drug-rehabilitation practitioners should incorporate a family abuse component into rehabilitation programs.

Attachment affects social information processing: Specific electrophysiological effects of maternal stimuli

Attachment is critical to each individual. It affects the cognitive-affective processing of social information. The present study examines how attachment affects the processing of social information, specifically maternal information. We assessed the behavioral and electrophysiological responses to maternal information (compared to non-specific others) in a Go/No-go Association Task (GNAT) with 22 participants. The results illustrated that attachment affected maternal information processing during three sequential stages of information processing. First, attachment affected visual perception, reflected by enhanced P100 and N170 elicited by maternal information as compared to others information. Second, compared to others, mother obtained more attentional resources, reflected by faster behavioral response to maternal information and larger P200 and P300. Finally, mother was evaluated positively, reflected by shorter P300 latency in a mother + good condition as compared to a mother + bad condition. These findings indicated that the processing of attachment-relevant information is neurologically differentiated from other types of social information from an early stage of perceptual processing to late high-level processing.

Perceived neighborhood safety, recovery capital, and successful outcomes among mothers 10 years after substance abuse treatment

This study examines perceived neighborhood characteristics associated with successful outcome among mothers 10 years after being treated for substance use disorders. Data were obtained from 713 mothers first studied at admission to drug treatment in California in 2000-2002 and followed up in 2009-2011. At follow-up, 53.6% of mothers had a successful outcome (i.e., no use of illicit drugs and not involved with the criminal justice system). Perceived neighborhood safety almost doubled the odds of success. Perceived neighborhood safety interacted with social involvement, decreasing the odds of success among mothers who reported more versus less neighborhood social involvement. Perceived neighborhood climate is associated with long-term outcomes among mothers with substance use disorders independent of individual-level characteristics, underscoring the need for further efforts to understand its interaction with recovery capital in ways that promote and impede health.

Gender differences in recidivism rates for juvenile justice youth: the impact of sexual abuse

Young female offenders represent a growing number of young offenders. Studies have shown that youth in the juvenile justice system, particularly young females, report higher rates of lifetime sexual abuse than their nonoffending peers. The aim of this study was to examine gender differences in risk factors for recidivism, including a history of sexual abuse, among a juvenile court clinic sample. Findings suggest that, even after accounting for previously identified risk factors for recidivism such as prior legal involvement and conduct problems, a history of sexual abuse is the most salient predictor of recidivism for young female offenders, but not for males. The development of gender-responsive interventions to reduce juvenile recidivism and continued legal involvement into adulthood may be warranted.

Non-medical prescription sedative use among adult Latina mothers and daughters

This study examines correlates of non-medical prescription sedative, tranquilizer, and hypnotics use (hereafter NPSU) among a non-clinical, community-based sample of adult Latina mother-daughter dyads. Participants were 316 Latina mothers and daughters enrolled in a study of intergenerational transmission of drug abuse and HIV/AIDS risk behaviors in South Florida. Interviewers administered a questionnaire containing study variables such as age, education, time in the U.S., Spanish language proficiency, health insurance status, wellness behaviors, perceived health condition, alcohol use, NPSU, and other drug use. Correlates of NPSU across mothers and daughters were determined using a dyadic model analysis. Daughters' health status, age, wellness, and illicit drug use were associated with mothers' NPSU. Mothers who reported being uninsured, having higher levels of education, and indicating poorer health statuses reported more NPSU. Daughters' wellness behaviors, age, illicit drug use, and insurance status were associated with their NPSU. Insured mothers and mothers who engaged in illicit drug use had daughters who reported more NPSU. The study's findings provide a modest understanding of family dynamics surrounding NPSU, and it suggests that as women age and their perceived health status worsens, their NPSU may increase.

High risk sexual behaviors for HIV among the in-school youth in Swaziland: a structural equation modeling approach

Background

Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV) are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned behavior (TPB) for predicting factors associated with protective sexual behaviors, including sexual abstinence and condom use, among in-school youths aged between 15 and 19 years in Swaziland.

Methods

This cross-sectional survey was conducted using a anonymous questionnaire. A two-stage stratified and cluster random sampling method was used. Approximately one hundred pupils from each of four schools agreed to participate in the study, providing a total sample size of 403 pupils of which 369 were ultimately included for data analysis. The response rate was 98%. Structural equation modeling was used to analyse hypothesized paths.

Results

The TPB model used in this study was effective in predicting protective sexual behavior among Swazi in-school youths, as shown by model fit indices. All hypothesized constructs significantly predicted intentions for abstinence and condom use, except perceived abstinence controls. Subjective norms were the strongest predictors of intention for premarital sexual abstinence; however, perceived controls for condom use were the strongest predictors of intention for condom use.

Conclusions

Our findings support application of the model in predicting determinants of condom use and abstinence intentions among Swazi in-school youths.

Explaining long-term outcomes among drug dependent mothers treated in women-only versus mixed-gender programs

Specialized substance abuse treatment for parenting women is thought to improve outcomes, but long-term impacts and how they occur are poorly understood. Utilizing a sample of 789 California mothers followed for 10 years after admission to women-only (WO) or mixed-gender (MG) drug treatment, we examine the relationship between WO treatment and outcomes and whether it is mediated by post-treatment exposures to criminal justice and health services systems. At follow-up, 48% of mothers had a successful outcome (i.e., no use of illicit drugs, not involved with the criminal justice system, alive). Controlling for patient characteristics, WO (vs. MG) treatment increased the odds of successful outcome by 44%. In the structural equation model WO treatment was associated with fewer post-treatment arrests, which was associated with better outcomes. Women-only substance abuse treatment has long-term benefits for drug-dependent mothers, a relationship that may be partially explained by post-treatment exposure to the criminal justice system. Findings underscore additional leverage points for relapse prevention and recovery-supportive efforts for drug-dependent mothers.

Hispanic parenting women in women-only versus mixed-gender drug treatment: a 10-year prospective study

The present study examined Hispanic substance-using parenting women treated in women-only (WO; n=126) versus mixed-gender (MG; n=853) programs and associated outcomes assessed 10 years after admission. Relative to other races/ethnicities of women admitted to the set of 40 California treatment programs in 2000-2002, Hispanic women were underrepresented in WO programs. Compared to those in MG programs, Hispanic women in WO programs demonstrated more severe treatment needs, indicated by their greater severity in drug and alcohol use, health and mental health problems, and criminal justice involvement at admission. They also had fewer economic resources (15% WO vs. 23% MG were employed, p<.05; 48% vs. 37% on public assistance, p<.05). Data based on administrative records covering 3 years pre-admission and 8 years post-admission showed that Hispanic women treated in WO programs had higher mental health service utilization over 8 years post-treatment admission, though no differences were found in trajectories of arrests and incarceration. In sum, long-term outcomes (in terms of criminal justice involvement) among Hispanic women in WO treatment were comparable to those in the MG treatment, despite greater service needs at admission. WO programs were able to engage more Hispanic women in use of mental health services. Future research should focus on factors limiting Hispanic women's participation in WO programs, which could suggest ways for improvement so as to benefit all Hispanic women in need of these special services.