A confirmatory factor analysis of a revised motives for playing drinking games (MPDG-33) scale among university students in the United States.

AIM: Participating in a drinking game (DG) is common practice among university students and can increase students' risk for heavy drinking. Given the theoretical link between motivations to drink and alcohol use, careful consideration should be given to students' motivations to play DGs. In this study, we examined the factor structure, internal consistency, and concurrent validity of a revised version of the motives for playing drinking games (MPDG) scale, the MPDG-33. METHODS: University students (n = 3345, Mage = 19.77 years, SDage = 1.53; 68.8% = women; 59.6% = White) from 12 U.S. universities completed a confidential online self-report survey that included the MPDG-33 and questions regarding their frequency of DG participation and typical drink consumption while playing DGs. RESULTS: Confirmatory factor analysis indicated the 7-factor model fit the data adequately, and all items had statistically significant factor loadings on their predicted factor. All subscales had adequate to excellent internal consistency and were positively correlated with the frequency of DG participation and the typical number of drinks consumed while playing DGs (though the correlations were small). CONCLUSION: Findings suggest that the MPDG-33 can be reliably used in research and clinical settings to assess U.S. university students' motives for playing DGs.

Food and Housing Insecurity in Nevada During the COVID-19 Pandemic.

The COVID-19 pandemic intensified concerns regarding food and housing insecurity in the United States, particularly among vulnerable populations. After the pandemic prompted a shutdown of nonessential businesses in Nevada, unemployment rose dramatically as the gaming, tourism, and hospitality industries struggled. This study analyzed the results of two telephone surveys of Nevada adults' experiences in 2020 (n = 1000) and 2021 (n = 1002). The results demonstrate between 2020 and 2021 an 8.24 percentage point decline in food insecurity (FI) from 30.2% to 21.96% and a 12.58 percentage point increase in housing insecurity (HI) from 12.27% to 24.85%. Age, disability status, and certain categories of race/ethnicity and income were associated with both HI and FI in 2020, but disability was no longer significant in 2021. Instead, spouse/partner-status, living with children ≤ 18-years-old and receipt of SNAP benefits were significantly associated with FI in 2021. In particular, health status became a significant factor of both HI and FI. People of color experienced FI disparities compared to Whites. Asians/Hawaiians/Pacific Islanders were 3.22 times (95% CI 1.51, 6.86) more likely to experience FI in 2021 than Whites. A matched, longitudinal analysis also revealed that Whites experienced a significant 9.1 percentage point estimated decline in the probability of FI between 2020 and 2021. However, the reduction among non-White participants was statistically insignificant at 2.5 percentage points. Results indicate the importance of supporting the food and housing needs of people of color and individuals with disabilities. Further research should especially investigate the comparative FI rate among Asians/Hawaiians/Pacific Islanders in 2021 and offer solutions to the soaring prevalence of housing insecurity.

Prescription Painkiller Misuse in Hispanic and non-Hispanic Adults Ages 50 and Older: Trends and Correlates in a National Sample, 2015-2019.

Background: Older adults, an increasingly diverse segment of the United States population, are a priority population for prescription painkiller misuse. This study documents trends and correlates of prescription painkiller misuse among Hispanic and non-Hispanic adults ages 50 and older. Methods: A secondary analysis of adults 50 years and older across 5 cohorts using the 2015-2019 National Survey on Drug Use and Health (unweighted n = 16,181, 8.5% Hispanic, and 54% female). Logistic regression modeling with complex survey design was used to examine trends in prescription painkiller misuse. Results: Over time, the prevalence of past year painkiller misuse significantly decreased for Hispanic respondents (56.1% relative decrease, p = 0.02); elevated proportions were observed across strata of demographic characteristics. Conclusions: Variability in the prevalence of painkiller misuse may be explained by demographic characteristics. Further, these results emphasize the importance of addressing comorbid recreational marijuana use when designing interventions to address painkiller misuse for older adults.

Delayed care during pregnancy and postpartum linked to poor maternal mental health: evidence in the United States.

BACKGROUND: Mental health disorders are important prenatal and postpartum health complications. In the rapidly changing healthcare landscape, concerns have been raised about maternal mental well-being in the United States. This study aimed to investigate the relationship between delayed perinatal care and women's mental health during pregnancy and postpartum. METHODS: We conducted a cross-sectional survey from March through April, 2022, of women currently pregnant (n = 590) or one-year postpartum (n = 525). A generalised linear model examined the association of delayed care during pregnancy and postpartum with mental health outcomes, specifically Major Depressive Disorder (MDD) and Generalised Anxiety Disorder (GAD). RESULTS: Individuals who experienced delayed care tended to exhibit higher rates of mental health symptoms compared to those without delays, especially during postpartum (69.4% vs. 30.7% for MDD; 46.6% vs. 24.8% for GAD). The results from multivariable regression analysis were consistent, showing a greater prevalence of MDD (aPR [adjusted Prevalence Ratio] 2.25, 95%CI 1.82-2.79; p < .001) and GAD (aPR 2.00, 95%CI 1.53-2.61; p < .001), respectively, when delays in postpartum care occurred. Reasons for delayed care, such as financial and time issues, lack of transportation, nervousness about seeing a doctor, and rural residency, were associated with increased mental health symptoms. CONCLUSION: The current analysis highlights the significant adverse health impact of delayed care among pregnant and postpartum women. Continued, targeted efforts to reduce practical barriers to accessing prenatal and postpartum care are required to ensure maternal mental health.

Mental Health and Substance Misuse Indicators Associated with First-Time Homelessness among a Community Sample of Sexual and Gender Minority Adults.

Homelessness is a priority public health issue in the United States (U.S.) given its strong associations with multiple adverse health outcomes. While overall rates of homelessness have decreased over the last decade, some populations-such as sexual and gender minorities-have not seen equitable decreases. The present study explores the relationship between experiences of first-time homelessness with substance misuse (assessed via the DAST-10) and depression and anxiety (assessed via the PHQ-4) in an adult sample of SGM individuals in South Central Texas. The analytic sample (n = 907) was majority gay/lesbian or same-gender loving (55.8%) followed by bisexual or pansexual (34.7%) or another sexual identity (9.5%) and 12.5% were transgender. First-time homelessness was more common in childhood than adulthood. Multivariate logistic regression models were used to evaluate relationships between first-time homelessness and outcomes of interest. The odds of substance misuse (DAST > 3) were marginally higher for those experiencing first-time homelessness in childhood and significantly higher for those reporting first-time homelessness in adulthood. The odds of experiencing past 2-week depression were significantly greater for those reporting homelessness in childhood or adulthood. However, only first-time homelessness in adulthood was significantly associated with past two-week anxiety. These findings underscore the need to consider intersectionality when exploring solutions to existing health disparities, as this work suggests that both sexual and gender identity and homelessness are important factors in shaping mental and behavioral health outcomes.

Domains matter: A prospective investigation of traditional feminine gender roles and alcohol use among Latinas.

Scholars suggest traditional feminine gender roles (TFGRs) influence alcohol use among U.S. Latinas, but relevant literature is limited. This two-wave study examined how multi-dimensional internal (i.e., beliefs) and external (i.e., practices) TFGR processes related to drinking among college-bound Latina emerging adults across time. TFGRs characterized by virtue predicted less alcohol engagement, while some TFGR dimensions (e.g., subordinate) predicted more. TFGR practices more strongly predicted cross-sectional alcohol outcomes than TFGR beliefs, although some TFGR beliefs predicted later drinking. These findings highlight the utility of assessing multiple TFGR dimensions and domains to better understand the link between TFGRs and drinking among Latinas.

Adverse childhood experiences and sleep difficulties among young adult college students.

Although adverse childhood experiences (traumatic events such as maltreatment and household dysfunction) are associated with increased risk for sleep difficulties among adults, the association between adverse childhood experiences and poor sleep health among young adult college populations is understudied. This study examined the adverse childhood experience-sleep health (self-reported sleep difficulty and diagnosis of insomnia or "other" sleep disorder) association among college students. Data are from the 2018/2019 American College Health Association-National College Health Assessment II (ACHA-NCHA-II) survey administered at public universities in California (n = 3606) and Texas (n = 407). Logistic regression models investigated the relative effect of adverse childhood experiences (maltreatment only, household dysfunction only, and maltreatment + household dysfunction) on three sleep health indicators. Approximately 40% of the sample reported adverse childhood experiences: 11% maltreatment only, 14% household dysfunction only, and 17% both. Compared with students with no adverse childhood experience history, students who reported only household dysfunction or only maltreatment had higher odds of experiencing sleep difficulty in the past year [adjusted odds ratios: 1.52-2.40; 95% confidence intervals: 1.26-2.97]. Additionally, students who reported maltreatment only had 2.47 times the odds of receiving an insomnia diagnosis [95% confidence interval: 1.52, 4.01]. However, students who reported both had higher odds of all three sleep health indicators: past-year sleep difficulty, insomnia diagnosis, and "other" sleep disorder diagnosis [adjusted odds ratios: 2.53-3.10; 95% confidence intervals: 1.51-4.66]. Sleep is an important facet of health among the college student population, and plays a crucial role in overall well-being, psychosocial processes, attention and academic success. Results point toward a need for sleep health programmes and interventions on college campuses focused on healthy sleep behaviours in order to mitigate further negative health effects.

The Relationship Between Adverse Childhood Experiences and Utilization of Different HIV Testing Strategies Among Young Men Who Have Sex with Men in Texas.

Adverse childhood experiences (ACEs) are a well-documented HIV-risk factor, but less is known about the relationship between ACEs and different HIV testing strategies. This study used data from an LGBTQ + community health assessment, that was part of a multi-staged community-based participatory research project in San Antonio, Texas. Overall, 464 young men who have sex with men (YMSM; < 36-years-old) completed an online, cross-sectional survey that included questions about ACEs and HIV testing behavior. An association between increased ACEs exposure and the odds of clinic-based testing and HIVST HIV significantly decreased relative to never testing for HIV. Additionally, greater ACEs exposure was significantly associated with increased odds of reporting community-based testing (AOR = 1.09, 95% CI = 1.00, 1.20) and significantly reduced odds of HIV self-testing (AOR = 0.72, 95% CI = 0.63, 0.82) compared to clinic-based testing. Cumulative ACEs exposure is important in understanding HIV testing behaviors in YMSM and should be considered when developing HIV testing programs.

Leaving "Drug Abuse" behind: A Theoretical and Methodological Heuristic to Selecting "Problem Drug Use" or "Drug Misuse" as Alternative Terms.

Background: Historically, drug abuse described the negative consequences of drug use as a proxy measure of maladaptive behavior that manifests within the addiction process. Negative consequences can span multiple domains including physical (e.g., blacking out), psychological (e.g., mood shifts), interpersonal (e.g., relationship problems), social (e.g., drinking and driving), and economic (e.g., job loss) problems. Objective: In determining the appropriate terminology to describe the phenomenon under investigation, researchers should consider (1) the theoretical objective (i.e., substance use construct under investigation) and (2) the research methodology being employed. Results: Problem substance use is appropriate for describing the outcome of interest when conducting cross-sectional, or pre-post, designs where investigators are interested in a snapshot of problems associated with substance use behavior. Conversely, substance misuse reflects a pattern of negative consequences over time and is appropriate when conducting longitudinal research with three or more time points. Here, substance misuse captures a pattern of substance use problems over time that may be indicative of a substance use disorder. These terms should be distinguished from studies investigating the frequency (how often) and quantity (how much) of a substance is being used where risky substance use is appropriate for cross-sectional studies and heavy substance use is appropriate for longitudinal studies. Conclusion: This framework is intended to describe the phenomena being investigated (i.e., the variable) and not the person or people experiencing a substance use problem. We should continue the dialogue of semantics in science realizing that our choice of words has important "real world" ramifications for the populations we serve.

Psychometric evaluation of the perceived context of reception scale among Hispanic and Somali adolescents.

OBJECTIVES: This study validates the psychometric properties and correlates of the perceived context of reception (PCOR) scale, a measure of immigrant youth's perceptions of the openness or hostility of their receiving communities, among Hispanic and Somali adolescents. METHODS: Confirmatory factor analyses (CFA) was conducted to assess the properties of PCOR among a sample of first- and second-generation Hispanic and Somali youth (N = 311) recruited in the Twin Cities metro area of Minnesota. RESULTS: CFA results provided evidence that the negative dimension of PCOR was structurally equivalent across ethnicity and generation and has acceptable internal consistency reliability. Negative perception of the receiving community's attitude toward newcomers was positively correlated with perceived discrimination, depressive symptoms, and anxiety. CONCLUSION: Results suggest that negative PCOR is cross-ethnically valid and that perceptions of the receiving community should be considered an important component of immigrant adaptation.

Pandemic-Specific Factors Related to Generalized Anxiety Disorder during the Initial COVID-19 Protocols in the United States.

Little is known about the psychological stress and secondary impacts emerging among the general U.S. population as a result of the ongoing COVID-19 pandemic. The purpose for the current study is to assess the prevalence rates of Generalized Anxiety Disorder (GAD) and to establish psychosocial correlates, pandemic-themed concerns, and other comorbidities for those with GAD at the initial onset of the COVID-19 pandemic. This online study included 2,101 U.S. adults between April 14-22, 2020, during the initial stay-at-home protocols and assessed GAD, psychosocial factors, and pandemic-related factors including concerns, changes in health behaviors, and adherence to protocols. The results demonstrated a high prevalence rate (17.9%) for GAD during the initial COVID-19 outbreak compared with the prior 1.8% 12-month estimate before the pandemic. Individuals with GAD reported significantly higher levels of stress, loneliness, fatigue, and empathic concern, along with reductions in levels of quality of life. Likewise, those with GAD reported significantly higher pandemic-related concerns, poorer changes in general health behaviors, and less confidence in the government's response to the pandemic. For clinical purposes, these findings provide insight into the various types of pandemic-themed worries that individuals meeting clinical criteria for GAD will have the most difficulties controlling.

Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender.

BACKGROUND: The original Adverse Childhood Experiences (ACE) study demonstrated strong, graded relationships between child maltreatment and household dysfunction and adult health status. The present study re-examined these relationships in a sample of young adult, college students to better characterize the developmental timing of health problems related to ACE exposure and differences by biological sex. METHOD: A cross-sectional general health questionnaire that included items on ACE was administered to young adults (ages 18-29) at universities in California (n = 3880), Minnesota (n = 7708), and Texas (n = 451) between 2017 and 2018. Seven ACE were assessed: psychological, physical, or sexual abuse; violence between parents; or living with household members who were substance misusers, mentally ill, or ever imprisoned. Binary health indicators were regressed on number of ACE as 0 (referent), 1, 2, 3, and 4 or more using logistic regression controlling for age, biological sex, race/ethnicity, and site. RESULTS: Approximately 51.7% of the sample reported at least one ACE with a significantly higher rate among Texas participants (p < 0.001). We observed graded relationships between levels of ACE exposure and physical, mental, and behavioral health indicators including cigarette use, e-cigarette use, drinking and driving, obesity, lifetime depression, suicide ideation and attempt, non-suicidal self-injury, and lack of restful sleep. ACE-exposed females reported worse mental health status than ACE-exposed males while males reported more substance use than females. Most outcomes did not vary significantly by sex. CONCLUSION: The strong, graded relationships observed between ACE exposure and health status among young adults reinforce the need for trauma-informed intervention programs on college campuses.

The relationships between emerging adult transition themes, adverse childhood experiences, and substance use patterns among a community cohort of Hispanics.

BACKGROUND: Emerging adulthood (ages 18-26) is a time of identity exploration, experimentation, focusing on self or others, and instability, themes captured in the Inventory of Dimensions of Emerging Adulthood (IDEA). Preliminary evidence suggests that emerging adults (EAs) with a history of adverse childhood experiences (ACE) score differently on transition dimensions than their peers, however, the role of ACE in the IDEA-substance use relationship is unknown. METHOD: Data are from a longitudinal study of acculturation and health among Hispanics in California (N = 1,065). Multivariable regression models assessed the association between IDEA and ACE (no ACE, 1-3 ACE, and ≥ 4 ACE) for substance use behaviors over 2 time points. Interaction terms assessed whether ACE moderated the association between subjective perceptions of IDEA at age 20 and substance use at age 24. RESULTS: ACE-exposed EAs scored higher on identity exploration, instability, self-focus, and experimentation dimensions than their peers (ps < .01-.001). Scores on experimentation, identity exploration, and self-focus at age 20 were associated with divergent patterns of substance use across ACE exposure categories. In comparison to other groups, individuals in ≥ 4 ACE group who strongly identified with these transition themes at age 20 had the highest probability of binge drinking, past 30-day alcohol, marijuana, and illicit drug use at age 24 (adjusted odds ratios = 1.09-1.49, confidence interval [1.02-2.58]). CONCLUSION: Our findings suggest that ACE can affect subjective perceptions of transition themes and increased risk for substance use over time. Implications for substance use prevention efforts tailored to Hispanic EAs are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Role of Social Support in the Association between Childhood Adversity and Adolescent Self-injury and Suicide: Findings from a Statewide Sample of High School Students.

Extensive literature documents that adverse childhood experiences increase risk for non-suicidal self-injury (NSSI) and suicide behaviors among adolescents. However, few studies have examined patterns of co-occurring family based adversities, whether distinct patterns of adversity are differentially associated with NSSI and suicide behaviors, and if social support can offset the impact of adversity for these behaviors. This study used a statewide school-based sample that was 50.1% female, 71% non-Hispanic White, and evenly divided by grade (9th grade N = 39,682; 11th grade N = 33,966). Latent class analysis identified three mutually exclusive, homogeneous subgroups of co-occurring familial adversities; low or no family based adversity, parental dysfunction but low maltreatment, and parental dysfunction plus maltreatment. The relationships between membership in the identified subgroups and past year NSSI, suicidal ideation, and suicide attempt were assessed separately for 9th graders (average age = 14) and 11th graders (average age = 17). Although membership in the parent dysfunction plus maltreatment class was associated with the highest odds of NSSI, suicidal ideation, and suicide attempt, membership in either class of familial adversity elevated risk for these behaviors compared to membership in the low or no adversity class. Whether the protective effects of perceived peer and teacher social support moderated these associations and varied across age groups was also explored. The findings suggest that peer and teacher social support can promote positive outcomes even for youth living in stressful family conditions and that the protective effects of social support increase as the number of sources of support expands.

Substance Use Outcomes for Hispanic Emerging Adults Exposed to Incarceration of a Household Member during Childhood.

This study investigates whether Hispanic emerging adults exposed to household incarceration before age 18 report higher rates of past 30-day cigarette, alcohol, binge drinking, marijuana use, and negative substance use consequences, relative to participants not exposed to incarceration of a household member. Respondents were matched on key characteristics to create balanced groups of exposed and nonexposed respondents. Negative binomial regression models assessed primary research questions. There were significant long-term associations between household incarceration and the frequency of past 30-day binge drinking, marijuana use, and number of negative substance use consequences. Policies and health programs addressing household incarceration may be a promising prevention approach to reduce negative substance use outcomes among Hispanic emerging adults.

Prescription opioid misuse and comorbid substance use: Past 30-day prevalence, correlates and co-occurring behavioral indicators in the 2016 National Survey on Drug Use and Health.

BACKGROUND AND OBJECTIVES: Prescription opioid misuse has not been well examined in the context of comorbid substance use in representative samples of substance users. Past 30-day comorbid prescription opioid misuse and recreational substance use (eg, alcohol, marijuana, cocaine, etc.) was studied in a representative sample of substance users in the United States using the 2016 National Survey on Drug Use and Health (NSDUH). METHODS: Prevalence of prescription opioid misuse with and without comorbid substance use was estimated with the 2016 NSDUH. Generalized linear modeling was used to describe demographic correlates of opioid and comorbid substance use and explore the relation of opioid and comorbid substance use with social and behavioral health indicators. RESULTS: The majority of past month prescription opioid misusers reported use of other substances including cigarettes, alcohol, marijuana, or hard drugs (cocaine, methamphetamine, etc.). Males and younger respondents had a significantly higher risk of reporting past month prescription opioid misuse with illicit drug or polydrug use (p's < .01). Prescription opioid and polydrug users had the greatest odds of stealing property, selling drugs, having suicidal ideations, major depressive episode, and perceived treatment need in the past year compared to all other categories of prescription opioid misuse categories. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Prescription opioid misuse is likely a part of a larger set of psychological, behavioral, and mental health problems. More attention should be given to the profiles of recreational (non-medical) substance use involving prescription opioids to curtail the current opioid crisis and prevent other similar epidemics in the future. (Am J Addict 2019;XX:1-8).

The Role of Familial Incarceration and Ethnic Identity in Suicidal Ideation and Suicide Attempt: Findings from a Longitudinal Study of Latinx Young Adults in California.

Suicide is a leading cause of death among young adults; however, contextual risks and cultural factors are rarely studied in the context of ethnic minority suicidal ideation (SI) and suicidal attempt (SA). This study assessed the association between familial incarceration and suicide behaviors and examined ethnic identity as a potential moderator. Data from a longitudinal study of health among Hispanics (n = 1,094) in California were used to test associations between familial incarceration, ethnic identity, and SA and SI, adjusting for demographic factors and covariates. Approximately 18% and 8% of respondents reported SI and SA, respectively. Compared to no incarceration, or the incarceration of a relative, parental incarceration was associated with higher odds (AOR: 2.09, 95% CI: 1.23-3.34) of SI whereas higher affective ethnic identity reduced the odds (AOR: 0.52, 95% CI: 0.31-0.89) of SA. Ethnic identity moderated the association between parental incarceration and SI (AOR: 0.33, 95% CI: 0.13-0.79). Incarceration of a family member can set the stage for exclusion from critical institutions and can have long-term consequences for adult mental health. Promoting a positive ethnic identity may be a promising prevention strategy that could bolster resilience among at-risk, urban minority youth.

Perceived discrimination, cultural identity development, and intimate partner violence among a sample of Hispanic young adults.

OBJECTIVE: Despite the prevalence of interpersonal violence (IPV), scientific understanding of the risk and protective factors for unidirectional and bidirectional IPV, and especially the role of sociocultural variables in these behaviors, is limited. This study investigates the association between ethnic-identity search, ethnic-identity affirmation, perceived discrimination, and unidirectional (victimization only, perpetration only) and bidirectional (reciprocal violence) IPV behaviors among foreign-born and U.S.-born Hispanic young adults. METHOD: Data are from Project RED (Reteniendo y Entendiendo Diversidad para Salud), a study investigating the effect of psychosocial and sociocultural factors on health behavior among a community sample of Hispanic young adults in Southern California (n = 1,267). RESULTS: Approximately 40% of the sample reported unidirectional or bidirectional IPV, with significant gender differences across the three categories. Compared with men, women had approximately 70% lower odds of victimization (OR = 0.31, 95% CI = 0.15-0.71), over twice the odds of perpetration (OR = 2.53, 95% CI = 1.98-3.62), and 35% higher odds (OR = 1.35, 95% CI = 1.04-1.81) of bidirectional IPV. Higher ethnic-identity affirmation was protective for victimization (OR = 0.86, 95% CI = 0.81-0.99) and bidirectional IPV (OR = 0.72, 95% CI = 0.62-0.89), whereas higher perceived discrimination scores increased the odds for bidirectional IPV (OR = 1.37 95% CI = 1.26-1.56) and was particularly detrimental for foreign-born participants. CONCLUSION: Intervention strategies should consider gender-specific risk profiles, cultural contexts, and the influence of sociocultural stressors. Addressing the harmful effects of perceived discrimination and leveraging the protective effects of ethnic-identity affirmation may be promising IPV-prevention strategies for Hispanic young adults. Future research directions and implications are discussed. (PsycINFO Database Record

Changes in the strength of peer influence and cultural factors on substance use initiation between late adolescence and emerging adulthood in a Hispanic sample.

We examine whether peer substance use and cultural factors differentially influence the initiation of tobacco, alcohol, and marijuana use in adolescence and emerging adulthood (EA) among a community-based sample of Hispanics. Participants provided data in 11th grade (M = 16.8 years old, SD = 0.54) and emerging adulthood (M = 20.3 years old, SD = 0.6). Peer tobacco use had a stronger association with initiation of tobacco use in emerging adulthood (OR = 1.46, 95% CI = 1.13, 1.89) than in adolescence (OR = 1.20, 95% CI = 1.03, 1.40), but this pattern was not observed with initiation of alcohol or marijuana use. Cultural orientation is associated with initiation of tobacco use during EA but not with initiation of alcohol or marijuana use.