Validation of the Multidimensional Acculturative Stress Inventory on adolescents of Mexican origin.

The Multidimensional Acculturative Stress Inventory (MASI), a 36-item measure that assesses acculturative stress among people of Mexican origin living in the United States, was tested on 331 adolescent (14-20 years of age) high school students (204 female, 127 male) of Mexican origin. Exploratory factor analyses yielded 4 factors: bicultural practices conflict (9 items), Spanish competency pressures (8 items), English competency pressures (8 items), and bicultural self-consciousness (2 items). These factors accounted for 59.5% of the variance and correlated in the expected directions with criterion measures of acculturation and the Psychological General Well-Being Schedule. Bicultural practices conflict and bicultural self-consciousness emerged as the first and fourth factors for adolescents, which differed from the last 2 factors observed in a previous study of adults by Rodriguez, Myers, Mira, Flores, and Garcia-Hernandez (2002)--pressure to acculturate and pressure against acculturation. Comparisons of the MASI factor structures between adolescents and adults also revealed that English competency pressures and Spanish competency pressures played a prominent role for both adolescents in this study and adults in the study by Rodriguez et al. (2002). The congruence and difference in factor structure of the MASI between adolescents and adults indicates that both groups experience acculturative stress because of English- and Spanish-language competency pressures, but adolescents differentially experience difficulties in negotiating between American and Latino practices and identities. The results highlight the importance of assessing acculturative stress from both Latino and American culture and recognizing the varying levels of these sources of acculturative stress by generation.

Psychosocial Predictors of Metabolic Syndrome among Latino Groups in the Multi-Ethnic Study of Atherosclerosis (MESA).

OBJECTIVE: We sought to determine the contribution of psychological variables to risk for metabolic syndrome (MetS) among Latinos enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), and to investigate whether social support moderates these associations, and whether inflammatory markers mediate the association between psychological variables and MetS. RESEARCH DESIGN AND METHODS: Cross-sectional analyses at study baseline were conducted with a national Latino cohort (n = 1,388) that included Mexican Americans, Dominican Americans, Puerto Rican Americans and Central/South Americans. Hierarchical logistic regression analyses were conducted to test the effects of psychosocial variables (chronic stress, depressive symptoms, and social support) on MetS. In addition, separate subgroup-specific models, controlling for nationality, age, gender, socioeconomic position, language spoken at home, exercise, smoking and drinking status, and testing for the effects of chronic stress, depressive symptoms and inflammation (IL-6, CRP, fibrinogen) in predicting risk for MetS were conducted. RESULTS: In the overall sample, high chronic stress independently predicted risk for MetS, however this association was found to be significant only in Mexican Americans and Puerto Rican Americans. Social support did not moderate the associations between chronic stress and MetS for any group. Chronic stress was not associated with inflammatory markers in either the overall sample or in each group. CONCLUSIONS: Our results suggest a differential contribution of chronic stress to the prevalence of MetS by national groups.

[Association between psychological stress and metabolic control in patients with type 1 diabetes mellitus]. / Control metabólico en pacientes diabéticos tipo 1 chilenos: rol del estrés psicológico.

BACKGROUND: An association between psychological stress and metabolic control can occur in patients with diabetes. AIM: To determine the longitudinal association between different psychological stress domains (emotional burden, physician-related distress, regimen-related distress, diabetes-related interpersonal distress) and metabolic control of adolescents with Type 1 diabetes. MATERIAL AND METHODS: An intentional sample of 20 Type 1 diabetic adolescents aged 15 ± 4 years was followed-up for one year. Three HbA1c determinations were performed and a stress self-report was obtained with the Polonsky' Diabetes Distress Scale. RESULTS: Several analyses were conducted using growth curve modeling. The first model included the HbA1c measures, the time term (coded as 0, 1, 2) and several covariates (age, years living with type 1 diabetes mellitus, sex, and physical activity). An overall negative linear trend was found for HbA1c. Subsequent models added the stress domains finding that high levels of emotional burden and regimen related-distress were associated with higher HbA1c levels across all exams. A marginal association was found between diabetes-related interpersonal distress and HbA1c. CONCLUSIONS: Stress levels in type 1 diabetic adolescents deserve attention. Different psychological stress factors predicting metabolic control trajectories in type 1 diabetic adolescents were found.

Control metabólico en pacientes diabéticos tipo 1 chilenos: rol del estrés psicológico / Association between psychological stress and metabolic control in patients with type 1 diabetes mellitus

Background: An association between psychological stress and metabolic control can occur in patients with diabetes. Aim: To determine the longitudinal association between different psychological stress domains (emotional burden, physician-related distress, regimen-related distress, diabetes-related interpersonal distress) and metabolic control of adolescents with Type 1 diabetes. Material and Methods: An intentional sample of 20 Type 1 diabetic adolescents aged 15 ± 4 years was followed-up for one year. Three HbA1c determinations were performed and a stress self-report was obtained with the Polonsky' Diabetes Distress Scale. Results: Several analyses were conducted using growth curve modeling. The first model included the HbA1c measures, the time term (coded as 0, 1, 2) and several covariates (age, years living with type 1 diabetes mellitus, sex, and physical activity). An overall negative linear trend was found for HbA1c. Subsequent models added the stress domains finding that high levels of emotional burden and regimen related-distress were associated with higher HbA1c levels across all exams. A marginal association was found between diabetes-related interpersonal distress and HbA1c. Conclusions: Stress levels in type 1 diabetic adolescents deserve attention. Different psychological stress factors predicting metabolic control trajectories in type 1 diabetic adolescents were found.

Propiedades psicométricas de la escala de estrés para diabéticos en una muestra de Pacientes diabéticos tipo II chilenos / Psychometric properties of the diabetes distress scale (DDS) in a sample of Chilean diabetic patients

La identificación de niveles de estrés en pacientes diabéticos tiene implicancias clínicas y prácticas. En Chile no hay escalas válidas y confiables que midan estrés en pacientes diabéticos. Con el objetivo de estimar las propiedades psicométricas de la Escala de estrés para diabéticos de Polonsky et al. (2005) en una muestra de pacientes diabéticos chilenos, se realizó análisis de confiabilidad, análisis factorial exploratorio y correlaciones con la escala de síntomas depresivos (CES-D) y con el marcador fisiológico hemoglobina glicosilada (HbA1c), en una muestra de 76 pacientes diabéticos tipo 2 de la ciudad de Temuco, Chile. Tras los análisis, se estimó una consistencia interna de 0.74, una estructura de 4 subfactores y evidencia de validez convergente con la escala CES-D y HbA1c. La escala de estrés para diabéticos posee propiedades psicométricas adecuadas, permite la identificación de 4 subfactores y es de fácil aplicación en el campo clínico e investigativo.

The measurement of stress levels in type 2 diabetic patients has clinical and practical meaning. In Chile, there is a lack of reliable and valid scales that allow for the right assessment of stress level among diabetic patients. The study purpose was to determine the psychometric properties of the Diabetes Distress Scale (DDS) in a sample of Type 2 Chilean diabetic patients. Several analyses including reliability analysis, exploratory factor analysis, and correlations with the depressive symptoms scale (CES-D), and the HbA1c biomarker were conducted with a Type 2 diabetic sample (n= 76) from Temuco City, Chile. The results provided a reliability of 0.74, a four-factor structure, and evidence for convergent validity with both the CES-D scale and the HbA1c marker. The DDS has acceptable psychometrics properties. It allows for the assessment of 4 factors, and has as advantage to be easy to apply in both clinical and research settings.

Exploring the complexities of familism and acculturation: central constructs for people of Mexican origin.

We examined the relationships between three dimensions of familism: importance of family, family support, and family conflict with acculturation, assessed orthogonally (Mexican and American cultural contributions assessed independently), and the relative contribution these factors make to psychological adjustment among 248 (124 women, 124 men) adults of Mexican origin. After controlling for sociodemographic characteristics, positive associations were found between importance of family and the biculturalism of Mexican and American cultural identity; family support and Mexican cultural identity; but no associations between family conflict and level of acculturation. Psychological well-being was positively associated with Mexican cultural identity and family support, whereas psychological distress was associated with greater family conflict and lower family support. The greater relative contribution of Mexican cultural identity to familism and well-being, and the importance of assessing acculturation orthogonally are discussed.

Family or friends: who plays a greater supportive role for Latino college students?

This study compared the relative contribution of perceived family and friend support to psychological well-being and distress and examined whether family or friend support moderated the effects of stress on psychological adjustment in 338 Latino (228 Mexican American, 110 Central American) college students from a predominantly Latino university. Two multiple regressions, controlling for gender, socioeconomic level, acculturation level, and stresses (generic college, acculturative, and minority status), showed that friend support made a slightly greater contribution to well-being than family support, and friend support and not family support protected against psychological distress. Neither family nor friend support moderated the effects of stress on psychological adjustment. Further examination of these variables that assess common-specific stresses within a culture-specific theoretical framework is recommended.

Development of the Multidimensional Acculturative Stress Inventory for adults of Mexican origin.

The Multidimensional Acculturative Stress Inventory (MASI), a 36-item stress measure that was developed to assess acculturative stress among persons of Mexican origin living in the United States, was tested on a community sample of 174 adults (117 women, 57 men). Principal-components analyses yielded 4 stable and internally consistent factors: Spanish Competency Pressures (7 items), English Competency Pressures (7 items), Pressure to Acculturate (7 items), and Pressure Against Acculturation (4 items). These 4 factors accounted for 64.4% of the variance and correlated in the expected directions with criterion measures of acculturation and/or psychological adjustment. Further reliability and validity testing of the MASI is discussed as well as the utility of this measure in assessing acculturative stress among adults of Mexican origin.