Associations Between Direct and Indirect Forms of Racism Exposure and Stress-Induced Inflammatory Response and Health in Pregnancy

Theory and research suggest chronic direct and indirect exposures to racism impact health, and stress-responsive inflammation may play a role in these paths. This study examines links between forms of racism-related stress, salivary markers of inflammation during acute psychosocial stress, and perinatal mental and physical health in a racially heterogenous sample. Pregnant people (n = 108, 27% non-white) self-reported personal and vicarious exposure to racism (racial microaggressions, online racism, overt racial/ethnic discrimination) and racial collective self-esteem, as well as affective symptoms and general physical health. Five saliva samples collected before and after the Trier Social Stress Test were assayed for pro-inflammatory cytokines and C-reactive protein. Results revealed associations between racism-related stress and greater inflammatory reactivity/delayed recovery to acute stress, between racial collective self-esteem and lower levels of inflammation, and between profiles of inflammatory responses to stress and mental and physical symptoms. We discuss implications for understanding perinatal health disparities.

How do we measure gender discrimination? Proposing a construct of gender discrimination through a systematic scoping review

BACKGROUND

Gender discrimination (GD) has been frequently linked to mental health. The heterogeneity of how GD is defined has led to variation around the analysis of GD. This might affect the study of the association between GD and health outcomes. The main goal of this systematic scoping review is to operationalize the definition of the GD construct.

METHODS

Three search strategies were set in Pubmed, CINAHL and PsycINFO. The first strategy obtained results mainly about women, while the second focused on men. The third strategy focused on the identification of GD questionnaires. The prevalence of GD, factors and consequences associated with GD perception, and forms of discrimination were the principal variables collected. Risk of bias was assessed (PROSPERO:CRD42019120719).

RESULTS

Of the 925 studies obtained, 84 were finally included. 60 GD questionnaires were identified. GD prevalence varied between 3.4 and 67 %. Female gender and a younger age were the factors most frequently related to GD. Poorer mental health was the most frequent consequence. Two components of the GD construct were identified: undervaluation (different recognition, opportunities in access, evaluation standards and expectations) and different treatment (verbal abuse and behaviour).

CONCLUSIONS

Two-component GD definition can add order and precision to the measurement, increase response rates and reported GD.

Synergistic Effects of Psychological Intimate Partner Violence Exposure and Gender Discrimination on Postnatal Mental Health Trajectories

While the literature examining physical intimate partner violence (IPV) is extensive, the impact of psychological IPV on mental health during high-risk times such as the period following childbirth is not well understood. The current study examined associations between psychological IPV and the course and severity of women's postnatal mental health symptoms (depression, anxiety, and trauma symptoms). Both main effects of psychological IPV exposure and possible exacerbation by broader social victimization (i.e., gender discrimination) were considered. Participants were 76 mothers from a larger longitudinal study, who completed self-report measures of IPV, gender discrimination, and affective symptoms at 3, 6, 12, and 18 months postnatal. Hierarchical linear modeling revealed a main effect of psychological IPV on the course of trauma symptoms only. As hypothesized, gender discrimination moderated the effect of psychological IPV on all symptom trajectories in a synergistic manner. At moderate to high levels of gender discrimination only, psychological IPV predicted higher affective symptom severity and an escalating course of postnatal anxiety symptoms. These findings underscore the importance of expanding current conceptualizations of IPV impacts to incorporate relevant aspects of individuals' social-ecological context. Future directions and implications for prevention and intervention are discussed.

The direct and indirect impact of trauma types and cumulative stressors and traumas on executive functions

The goal was to measure the effects of trauma types, cumulative trauma, posttraumatic stress disorder (PTSD), existential annihilation anxiety (EAA), and posttraumatic growth (PTG) on executive functions. The study sample consists of 1155 from Egypt and Kuwait. Measures included adults working memory deficits (WMD) and inhibition deficits (ID), and cumulative stressors and traumas (CST) and trauma types, PTSD, EAA, and PTG. We used Stepwise regression and PROCESS macro to analyze the data. Results indicated that survival and cumulative traumas have direct effects on a lower WMD and ID, attachment traumas and gender discrimination by parents have direct impacts on higher WMD and ID, while personal identity, status identity, secondary trauma, gender discrimination by society, community violence do not have any direct effects on WMD or ID. All traumas have indirect effects on higher WMD or/and ID via PTSD. Gender discrimination by society, community violence, and CST has an additional indirect higher impact on WMD and ID via EAA. There were indirect trajectories from survival trauma, personal identity, status identity trauma, secondary trauma, gender discrimination by society, and CST on lower WMD or/and ID via PTG. Attachment trauma, gender discrimination by parents, perpetration traumas, and community violence were not associated with PTG and its trajectories of lower WMD or/and ID. We discussed the research and clinical implication for these results.