Racial/Ethnic Differences in Psychometric Properties of Alcohol-Related Behaviors in the USA.

OBJECTIVE: Alcohol-related behaviors are often examined using surveys assessing participants' self-report of attitudes/actions. However, racial/ethnic differences exist in scale construction and evaluation, and surveys evaluating alcohol behaviors lack invariance across ethnic groups. These dissimilarities may be due to deep-rooted differences in ethnic classification of unhealthy substance use behaviors. METHODS: We examined factor structure of "Number of days per month drank alcohol in past 12 months," "Number of days had one or more drinks in past 30 days," and "Number of days had four/five or more drinks in past 30 days," administered during the 2017 National Survey on Drug Use and Health. Factorial invariance was examined across 12- to 17-year-old White, Black/African American, Asian American, and Hispanic/Latinx boys and girls endorsing alcohol use. A multigroup confirmatory factor analysis statistically determined whether the factor structure was invariant across groups. RESULTS: The alcohol scale lacked invariance across all groups, indicating racial/ethnic group identification is related to alcohol-related cognitions. CONCLUSIONS: Psychometric properties of scales assessing alcohol-related behaviors generalized across racial/ethnic groups require evaluation.

Miles over mind: Transnational death and its association with psychological distress among undocumented Mexican immigrants.

Objective: This study examined the association between transnational death and psychological distress among undocumented Mexican immigrants. The Minority Stress Model and a disenfranchised grief perspective were used as frameworks for this study.Method: Respondent driven sampling (RDS) was used to collect data from clinical interviews with 248 undocumented Mexican immigrants residing near the US-Mexico border.Results: After controlling for relevant covariates, experiencing transnational death was a significant predictor of clinically significant distress in this at-risk population.Conclusions: Our findings underscore the need to contextualize transnational death among undocumented immigrants from a perspective of disenfranchised grief that requires the development of contextually and culturally sensitive interventions aimed at addressing the high prevalence of transnational death and its associated distress in this marginalized population.

Reliability and validity of the Perceived Stress Scale-10 in Hispanic Americans with English or Spanish language preference.

This study examined the psychometric properties of the Perceived Stress Scale-10 among 436 community-dwelling Hispanic Americans with English or Spanish language preference. Multigroup confirmatory factor analysis examined the factorial invariance of the Perceived Stress Scale-10 across language groups. Results supported a two-factor model (negative, positive) with equivalent response patterns and item intercepts but different factor covariances across languages. Internal consistency reliability of the Perceived Stress Scale-10 total and subscale scores was good in both language groups. Convergent validity was supported by expected relationships of Perceived Stress Scale-10 scores to measures of anxiety and depression. These results support the use of the Perceived Stress Scale-10 among Hispanic Americans.

Late effects awareness website for pediatric survivors of acute lymphocytic leukemia.

OBJECTIVES: Every day 43 children are newly diagnosed with cancer. Fortunately, almost 90% of these childhood cancer patients will survive. However, 60-90% of these survivors will experience late effects, health problems that occur months or years after treatment has ended. Late effects could occur as a result of the disease, its treatment, and patient-related factors. The two main objectives of this research are to: 1) Examine the existence of all web-based resources for childhood cancer survivors with acute lymphocytic leukemia which focus on medical and psychological aspects of late effects, and 2) Create an innovative website specifically designed to fill this void. MATERIALS AND METHODS: A systematic literature review, followed by input from >20 different organizations, resulted in the creation of LEAP3 AHEAD (Late Effects Awareness for Patients, Physicians and the Public; Advancing Health and Eliminating All Disparities), a multi-dimensional website centering on late effects. RESULTS: An extensive review revealed 14 pediatric cancer websites, none of which focused exclusively on late effects. LEAP3 AHEAD is the first interactive website for acute lympocytic leukemia childhood cancer survivors and families, as well as physicians, and the public to: a) increase awareness about risks, detection, diagnosis, treatment, and prevention of medical and psychological late effects, b) provide suggestions to successfully reintegrate into schools, careers, and socially, and c) present opportunities including camps, scholarships, and pet therapy programs. CONCLUSION: LEAP3 AHEAD is the first national website to provide a comprehensive, accessible, affordable, and multi-dimensional resource for pediatricians, internists, nurse practitioners, psychologists, survivors and their families, as well as the public about late effects.

"One Scar Too Many:" The Associations Between Traumatic Events and Psychological Distress Among Undocumented Mexican Immigrants.

Undocumented immigration often presents with multiple stressors and contextual challenges, which may diminish mental health. This study is the first to provide population-based estimates for the prevalence of traumatic events and its association to clinically significant psychological distress among undocumented Mexican immigrants in the United States. This cross-sectional study used respondent-driven sampling to obtain and analyze data from clinical interviews with 248 undocumented Mexican immigrants residing in high-risk neighborhoods near the California-Mexico border. Overall, 82.7% of participants reported a history of traumatic events, with 47.0% of these meeting the criteria for clinically significant psychological distress. After controlling for relevant covariates, having experienced material deprivation, odds ratio (OR) = 2.26, 95% CI [1.18, 4.31], p = .013, and bodily injury, OR = 2.96, 95% CI [1.50, 5.83], p = .002, and not having a history of deportation, OR = 0.36, 95% CI [0.17, 0.79], p = .011, were associated with clinically significant psychological distress. These results support the need to revisit health and immigration policies and to devise solutions grounded in empirical evidence aimed at preventing the negative effects of trauma and psychological distress in this population.

Mental disorders among undocumented Mexican immigrants in high-risk neighborhoods: Prevalence, comorbidity, and vulnerabilities.

OBJECTIVE: This study aimed to: (a) provide population-based estimates for the prevalence of mental disorders, including substance use, among undocumented Mexican immigrants; (b) assess for relevant comorbidities; and (c) identify sociodemographic, immigration and contextual vulnerabilities associated with meeting criteria for a disorder. METHOD: This cross-sectional study used Respondent Driven Sampling (RDS) to collect and analyze data from clinical interviews with 248 undocumented Mexican immigrants residing near the California-Mexico border. The M.I.N.I. Mini International Neuropsychiatric Interview was used as the primary outcome of interest. For all analyses, inferential statistics accounted for design effects and sample weights to produce weighted estimates. Logistic regression was used in multivariate analyses. RESULTS: Overall, 23% of participants met criteria for a disorder (95% CI = 17.1; 29.0). The most prevalent disorders were Major Depressive Disorder (14%, 95% CI = 10.2; 18.6), Panic Disorder (8%, 95% CI = 5.0; 11.9) and Generalized Anxiety Disorder (7%, 95% CI = 3.4; 9.8). Approximately 4% of participants met criteria for a substance use disorder (95% CI = 1.2; 6.1). After controlling for covariates, being 18 to 25 years and experiencing distress from postmigration living difficulties were significantly associated with meeting criteria for a disorder. CONCLUSION: Undocumented Mexican immigrants are an at-risk population for mental disorders, particularly depression and anxiety disorders. Given that distress from postmigration living difficulties is associated with meeting criteria for a disorder, revisiting policies and developing new alternatives to facilitate access and provision of context-sensitive mental health services for this population is necessary to protect the human rights of these immigrants and that of their U.S. families. (PsycINFO Database Record

Human Papillomavirus Vaccination Awareness and Acceptability Among U.S.-Born and U.S. Foreign-Born Women Living in California.

We examined human papillomavirus vaccine awareness and acceptance between U.S.-born and U.S. foreign-born women by utilizing California Health Interview Survey data from 1,672 women (ages 18-27) and 2,994 mothers (ages 28-65). Foreign-born women and mothers had lower vaccine awareness. Foreign-born young adult Latinas had greater vaccine acceptance than U.S.-born Latinas. Other factors associated with young adult women's vaccine acceptability were being younger, unmarried, and sexually active in the past year; having poorer self-reported health; and having heard of the vaccine. Variables associated with mothers' vaccine acceptability were being White, insured, and unmarried; having had a Pap test in past 3 years; being less educated; and being impoverished.

Testing the Invariance of the National Health and Nutrition Examination Survey's Sexual Behavior Questionnaire Across Gender, Ethnicity/Race, and Generation.

Federal and state policies are based on data from surveys that examine sexual-related cognitions and behaviors through self-reports of attitudes and actions. No study has yet examined their factorial invariance--specifically, whether the relationship between items assessing sexual behavior and their underlying construct differ depending on gender, ethnicity/race, or age. This study examined the factor structure of four items from the sexual behavior questionnaire part of the National Health and Nutrition Examination Survey (NHANES). As NHANES provided different versions of the survey per gender, invariance was tested across gender to determine whether subsequent tests across ethnicity/race and generation could be done across gender. Items were not invariant across gender groups so data files for women and men were not collapsed. Across ethnicity/race for both genders, and across generation for women, items were configurally invariant, and exhibited metric invariance across Latino/Latina and Black participants for both genders. Across generation for men, the configural invariance model could not be identified so the baseline models were examined. The four item one factor model fit well for the Millennial and GenerationX groups but was a poor fit for the baby boomer and silent generation groups, suggesting that gender moderated the invariance across generation. Thus, comparisons between ethnic/racial and generational groups should not be made between the genders or even within gender. Findings highlight the need for programs and interventions that promote a more inclusive definition of "having had sex."

Introduction to the special section on discrimination.

Health Psychology is publishing this special section, consisting of five papers. The first paper looks at the role discrimination plays in the sexual risk behavior of young pregnant women. The second evaluates the impact lifetime racism has on blood pressure during pregnancy, and the effects this may have on fetal growth. The third paper provides data on the degree to which systemic racism serves as a moderator of the relationship between provider racial bias and hypertension treatment adherence. The fourth evaluates discrimination as a mediator of health status and health behavior. The final one provides a systematic review of the impact of perceived discrimination on hypertension. One goal of this special section is to encourage investigators who read Health Psychology and who are interested in health disparities of any kind to include issues related to discrimination as part of their research.

Testing the invariance of adolescent survey-based smoking-related behaviors across ethnic groups and gender.

The present study examined the factor structure of 3 smoking-related items administered as part of the California Health Interview Survey. Factorial invariance was examined across Asian Americans (N = 377), Caucasians (N = 1739), African Americans (N = 115), and Latin Americans (N = 814), and across young men (N = 1612) and women (N = 1767). Factorial invariance analyses revealed all minority ethnic groups to be significantly different (p < .05) from Caucasians, and men to differ significantly from women. These findings suggest that the types of smoking behaviors assessed in the California Health Interview Survey do not predict behaviors uniformly across groups.

Assessing Acculturation Over Time: A Four-year Prospective Study of Asian American Young Adults.

Acculturation is commonly defined as a dynamic and multidimensional process in which individuals and groups change over time when coming into contact with another culture. Despite the emphasis on acculturation as a process of change over time, few researchers have directly assessed this hypothesis. The current study first identifies and then examines "stable" and "dynamic" dimensions of acculturation within a 4-year prospective study of 433 first- and second-generation Chinese- and Korean-American college students. Separate growth model analyses revealed significant linear change for first-generation students toward greater U.S. acculturation. In comparison, tests of linear and quadratic change for second-generation students were not significant. When stratifying by gender, acculturation increased for women but there was no significant change in acculturation for men. While all students reported increases in alcohol consumption over the study period, changes in acculturation predicted changes in alcohol consumption only for women. Chinese men showed greater increases in alcohol consumption than Korean men but there was no effect for ethnicity among women. There was significant individual variability in the models, which underscores the importance of examining change prospectively through within and between person analyses. The findings highlight the importance of examining acculturation changes over time for different migrant groups with implications for further development of acculturation measures, research methodologies, and health interventions. More prospective research designs of acculturation are needed to examine changes in health behavior and overall adaptation across migrant groups at varying stages of development.

Predicting sexual decline and dissatisfaction among older adults: the role of partnered and individual physical and mental health factors.

OBJECTIVES: To target improvement in older adult sexuality by understanding how a myriad of partnered and individual physical and mental health factors, often associated with aging, affect sexual unwellness. METHOD: Data from the Wisconsin Longitudinal Study were used to conduct a case-control study on the risk factors for sexual unwellness (i.e., lack of sexual satisfaction, inability to maintain the sexual relationship) in older adults aged 63-67. RESULTS: Higher risk for lack of sexual satisfaction was associated with poor spousal health, a history of diabetes, and fatigue symptoms. In addition, being of male gender, being satisfied with marital support, and having better spousal health reduced the risk of being unsatisfied sexually. Also, higher risk for being unable to maintain the sexual relationship was independently associated with a higher education level, poorer self-rated health, better spousal health, a history of diabetes, prostate cancer, fatigue, sexual pain, and a history of depression. DISCUSSION: Results show the impact of several physical and mental health risk factors on the development of sexual unwellness in older adults. A gendered pattern also emerged, suggesting that women tend to be less sexually satisfied, as compared to their male peers, who tend to report sexual unwellness that is associated with individual health.

An examination of applicant characteristics of successfully matched interns: is the glass half full or half empty and leaking miserably?

Although the "balance" between the number of potential interns and the number of internship slots needs be addressed, it is imperative that more attention be devoted to examining applicant and program characteristics that result in a successful match. To that end, the current study included pre- and post-match data provided by 330 applicants of the 2009 Association of Psychology Postdoctoral and Internship Centers Match system. In this sample, we found very little evidence that applicant characteristics are related to match outcome. Suggestions to applicants and directors of training are provided and understudied variables and needed analyses are identified. Policy considerations are discussed in terms of not only resolving the supply and demand imbalance but also improving the application process and clearinghouse system.

Ethnic disparities in youth access to tobacco: California statewide results, 1999-2003.

The authors examined the role of youth ethnicity in youth access to tobacco with large, random samples of stores and large samples of ethnically diverse youths for the first time. From 1999 through 2003, White, Black, Latino, and Asian youths made 3,361 cigarette purchase attempts (approximately 700 per year) statewide. Analyses revealed that Black youths had significantly higher access than other youths and that access rates for Black and Asian (but not Latino or White) youths exceeded the Synar-mandated < or = 20%. Clerks who failed to demand youth proof of age identification (ID) sold 95% of the tobacco that youths received and sold significantly more often to minorities and to girls, whereas clerks who demanded youth ID sold equally infrequently to all youths. These findings highlight significant ethnic disparities in youth access to tobacco and imply that those might be eliminated by policies and interventions that increase clerk demands for youth ID.

Clinical psychology students' perceptions of diversity training: a study of exposure and satisfaction.

This study examined clinical psychology graduate students' definitions of diversity and their perceptions of their exposure to and satisfaction regarding their level of diversity training. Four hundred and ninety-one students from Counsel of University Directors of Clinical Psychology (CUDCP) member programs completed an online survey. Overall, students perceived that their programs considered diversity narrowly, concentrating primarily on ethnicity, race, and culture to the neglect of sexual orientation, religion, language, and physical disability. Likewise, students expressed greater satisfaction with training regarding ethnicity/race and gender than broader areas of diversity, but rated the importance of addressing all areas of diversity as high. Although this study underscores the limited experience that students perceive they have had with various underrepresented groups, programs appear to have incorporated a variety of diversity training modalities that could be expanded upon to meet the interests of psychology students.

A prospective study of cigarette smoking initiation during college: Chinese and Korean American students.

OBJECTIVE: The present study was a prospective investigation of baseline influences on initial smoking and transition to established smoking among college students who had not smoked prior to college. DESIGN: Included were 267 participants in a longitudinal study of tobacco use. Students of Chinese (52%) or Korean (48%) descent were enrolled during their freshman year in college. Data for the present study were collected during four annual in-person interviews. MAIN OUTCOME MEASURES: (1) Initial use of a cigarette reflected having first smoked a cigarette (more than a puff) during college. (2) Established smoking was defined as having smoked at least 100 cigarettes. RESULTS: Over the course of the study, 25% of baseline never-smokers tried their first cigarette, and 9% became established smokers. Overall, men were significantly more likely to experiment and progress to established smoking. Baseline alcohol and drug use, behavioral undercontrol, and parental smoking predicted smoking experimentation but not established smoking. Students of Korean ethnicity were more likely to become established smokers. However, acculturation was not a significant predictor of experimentation or established smoking after accounting for the effects of other predictors. CONCLUSION: These findings suggest a need for efforts to prevent smoking uptake among Asian American college students.

Disparities in the provision of medical care: an outcome in search of an explanation.

This purpose of this paper is to review the literature on racial/ethnic disparities in the utilization and quality of care and the proposed explanations for these differences. First, the literature on racial/ethnic disparities in medical treatment is reviewed briefly with the goal of providing a sense of the range of procedures and conditions on which these disparities occur. Then, the possible role of physician/provider, patient, and health care system factors in contributing to these disparities is reviewed. Finally, suggestions for new or expanded directions for research in each of these three areas are given. The goal of the paper is to identify factors that might be particularly amenable to the type of research done by health psychologists.

Conceptualizing and measuring ethnic discrimination in health research.

This paper presents the General Ethnic Discrimination Scale, an 18-item measure of perceived ethnic discrimination that can be used in health research with any ethnic group. The 1569 participants (half college students, half community adults) completed the General Ethnic Discrimination scale and measures of cigarette smoking and of psychiatric symptoms. Results revealed that the General Ethnic Discrimination subscales model the latent construct of perceived ethnic discrimination equally well for Blacks, Latinos, Asians, and Whites. Discrimination was strongly related to psychiatric symptoms and to current cigarette smoking for ethnic minorities and Whites alike, but such relationships were stronger for ethnic minorities. Minorities who experienced frequent discrimination were 2.3 times more likely than their low-discrimination counterparts to be smokers. This 5th grade reading-level scale takes 10 min to complete and has sufficient, initial psychometric integrity for use in clinical and community health studies.