Would Caring Teachers Buffer the Link Between Violence Victimization and Early Sexual Initiation? Comparing Heterosexual and Non-Heterosexual African American Youth.

This study investigated the relationship between youth violence exposures (i.e., peer and neighborhood) and early sexual initiation. It also explored whether caring relationships with teachers might moderate this relationship and whether results differed for heterosexual versus non-heterosexual African American youth. The study sample (N = 580) comprised 475 heterosexual and 105 non-heterosexual youths, 319 female and 261 male, ages 13 to 24 years (M age = 15.8). Students were assessed for peer and neighborhood violence, relationship with teachers, early sexual initiation, sexual orientation, and socioeconomic status. Major results indicated a positive relationship between exposure to peer and neighborhood violence and early sexual initiation for heterosexual youth but not those who identified as non-heterosexual. Further, identifying as female (vs. male) was significantly associated with later sexual initiation for both heterosexual and non-heterosexual youth. In addition, caring teachers moderated the relationship between exposure to peer violence and age of sexual initiation among non-heterosexual youth. Programs and interventions to curtail violence sequelae would need to consider the unique effects of various types of youth violence exposures and the significance of sexual orientation.

Health-related quality of life among US young adults during the COVID-19 pandemic: Psychiatric symptoms and emotional experiences to target within clinical practice.

BACKGROUND: The current study aimed to determine the role of psychological experiences during the COVID-19 pandemic (depression, anxiety, loneliness, and COVID-19-related grief and worry) on young adult physical and mental health functioning as measured by health-related quality of life (HRQoL). METHODS: Using hierarchical multiple regression analyses, this cross-sectional study examined psychological predictors of physical and mental health functioning among young adults (age 18 to 30 years) from April 13 to September 5, 2020. RESULTS: Pre-existing depression diagnoses (beta = -0.124, P < .001), current depression symptoms (beta = -0.298, P < .001), and COVID-19-related worry (beta = -0.142, P < .001) significantly predicted poorer physical health functioning. Current depression and anxiety symptoms (beta = -0.342 and beta = -0.268), loneliness (beta = -0.135), and COVID-19-related grief (beta = -0.180) predicted lower self-reported mental health functioning (P < .001). Black (beta = -0.072) and Hispanic/Latinx participants (beta = -0.082) were more likely to indicate poorer physical health functioning (P < .01) relative to White participants, whereas women reported poorer mental health relative to men (beta = -0.047, P < .05). CONCLUSIONS: This study identifies potential negative impacts of pandemic-related psychological experiences for young adults' health during the COVID-19 pandemic. There is a need to consider mental health symptomatology, COVID-19-related experiences, race, and gender when designing efforts to address long-term implications on health.

Experiences of COVID-19-related anti-Asian discrimination and affective reactions in a multiple race sample of U.S. young adults.

BACKGROUND: Little remains known about both Asian and Asian American (A/AA) and non-Asian young adults' experiences and affective reactions regarding COVID-19 anti-Asian discrimination. To our knowledge, this is the first study that explores the nature and impact of COVID-19 anti-Asian discrimination within a multi-racial sample. METHODS: This study uses qualitative open-ended responses from a sub-sample of Wave I of the COVID-19 Adult Resilience Experiences Study (CARES) data collected between March to September 2020. Thematic analysis was used to explore two open-ended questions: "Are there experiences we missed in the survey so far that you wish to describe?" and "What are your thoughts about the current social climate?" The data analysis for this study focused on 113 discrimination or racism-related comments. RESULTS: A total of 1331 young adults completed an online survey of which 611 provided comments; a multi-racial sample of 95 individuals (65.3% non-Asians, 24.7% A/AA) contributed 113 COVID-19 anti-Asian discrimination or racism-related comments. Two overarching themes were: types of discrimination (societal, interpersonal, intrapersonal) and affective reactions to discrimination (fear, anxiety/distress, hopelessness/depression, and avoidance). Not only did both A/AA and non-Asian participants report witnessing or hearing reports of anti-Asian discrimination, but both groups described having negative affective reactions to anti-Asian discrimination. CONCLUSION: Anti-Asian discrimination in the face of COVID may be more widespread than initial reports indicate. Our finding suggests that anti-Asian discrimination is a societal illness that impacts all populations in the U.S. This calls for cross-racial coalitions and solidarity in the fight against discrimination and racism.

Disempowering Parenting and Mental Health among Asian American Youth: Immigration and Ethnicity.

Guided by the concept of ABCDG (Abusive, Burdening, Culturally Disjointed, Disengaged, and Gender Prescriptive) parenting, this study investigated how subdomains of disempowering parenting adversely influence young people's mental health, independently and collectively, using a large-scale longitudinal survey data of community samples among Filipino American (FA) and Korean American (KA) youth (M AGE =15.01, N=1,580; 391 FA and 417 KA families). Regression results showed that the subdomains of disempowering parenting, while individually harmful, were differentially associated with mental health. For example, abusive and disengaged parenting and culturally disjointed parenting (a.k.a. intergenerational cultural conflict) were the most notably adverse subdomains and remained significant when all subdomains were accounted together. This study pinpoints specific aspects of disempowering parenting that may lead to mental distress among FA and KA youth and underscores a need for culturally tailored intervention programs that address the harms of disempowering parenting approaches.

Overeating and binge eating among immigrants in the United States: new terrain for the healthy immigrant hypothesis.

BACKGROUND: Prior research indicates that, compared to individuals born in the United States (US), immigrants are less likely to experience mental health and inhibitory control problems. However, our understanding of overeating and binge eating-both related to mental health and inhibitory control-among immigrants in the US remains limited. Drawing from a large national study, we report the prevalence of overeating and binge eating among immigrants vis-à-vis the US-born. METHODS: The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS: The prevalence of any (immigrants = 7.8%, US-born = 17.0%) and recurrent overeating (immigrants = 2.9%, US-born = 5.3%) was lower among immigrants than US-born individuals. Among those reporting recurrent overeating, the prevalence of binge eating with loss of control was comparable among immigrant (37.2%) and US-born participants (39.9%), in general. However, stratified analyses revealed that risk of binge eating with loss of control was lower among immigrant women compared to US-born women (AOR 0.54, 95% CI 0.29-0.98). CONCLUSIONS: Findings from the present study provide clear results that immigrants are substantially less likely to overeat as compared to US-born individuals and that, among women but not men, immigrant status is associated with lower risk of binge eating with loss of control.

Exploring Asian American attitudes regarding mental health treatment in primary care: A qualitative study.

BACKGROUND: In this exploratory study, we examined attitudes regarding mental health treatment among 10 Asian American patients in an urban primary care setting to better understand contextual barriers to care. METHODS: Ten semi-structured telephone interviews were conducted with Asian Americans recruited from primary care practices in an urban medical center. RESULTS: The study's qualitative data suggest that focusing on specific cultural concerns is essential for increasing mental health access for Asian Americans. Although few participants initially expressed interest in a culturally focused mental health program themselves, when phrased as being part of their primary care practice, 8 expressed interest. Furthermore, most felt that the program could help family or friends. Many participants preferred to seek care initially from social systems and alternative and complementary medicine before seeking psychiatric care. CONCLUSIONS: Because Asian Americans face notable barriers to seeking mental health treatment, addressing cultural concerns by providing culturally sensitive care could help make mental health treatment more acceptable, particularly among less acculturated individuals. To our knowledge, this is the first qualitative study exploring barriers to Asian Americans accessing integrated mental health services in primary care.

Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage.

Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.

Asian Women's Action for Resilience and Empowerment Intervention: Stage I Pilot Study.

This study describes the development and pilot test of Asian Women's Action for Resilience and Empowerment (AWARE), a culturally informed group psychotherapy intervention designed to reduce depressive symptoms, suicidality, substance use, and HIV and sexual risk behaviors among 1.5 and second generation Asian American (AA) women. To participate, AA women had to meet the criteria for posttraumatic stress disorder (PTSD) or have a history of exposure to interpersonal violence (IPV) as determined using the Clinician-Administered PTSD Scale (CAPS) and Traumatic Life Events Questionnaire (TLEQ). This article also presents the preliminary feasibility and acceptability of AWARE from its Stage I pilot study of nine Chinese, Korean, and Vietnamese American women. To foster holistic treatment, AWARE was developed based on original research findings from Stage 0 and integrated theoretical models including fractured identity theory, empowerment theory, cognitive behavioral therapy (CBT), mindfulness-based techniques, and the AIDS Risk Reduction Model (ARRM). The development of AWARE was an iterative process informed by participant feedback, which led to frequent intervention modifications for a future randomized controlled trial (RCT) in Stage II. A qualitative analysis of participant feedback informed the following modifications: further exploration of feelings, improvements in technology delivery, learning and practicing coping skills, more specific cultural tailoring related to sexual health, decreased number of sessions and increased time per session. Findings provide support for the acceptability and feasibility of AWARE as "culturally informed" for AA young women with IPV histories, high-risk behaviors, and mental health issues.

Advancing Understanding of Acculturation for Adolescents of Asian Immigrants: Person-Oriented Analysis of Acculturation Strategy Among Korean American Youth.

Acculturation strategy, a significant predictor of immigrant adaptation, has been under-studied with Asian Americans, in particular, Asian American youth. Using person-oriented latent profile analysis, this study identified acculturation strategies among Korean American early adolescents living in the Midwest. Two-hundred ninety-one families were interviewed in 2007 that included 220 youth (mean age 13, 47.7 % female), along with 272 mothers and 164 fathers (N = 656). They were re-interviewed in 2008 (N = 588). The study found three distinct acculturation strategies: separation (11.8 %, n = 26), integrated bicultural (66.9 %, n = 150), and modest bicultural (21.3 %, n = 44). Integrated bicultural youth reported the strongest sense of ethnic identity and the most favorable characteristics, providing empirical support for the benefit of biculturalism. The findings further suggest that separation may not be as detrimental as previously thought, and modest bicultural-biculturalism that is not fully developed-may in fact be less desirable among Korean American youth.

Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide.

BACKGROUND: Despite the substantially high prevalence of depression, suicidal ideation and suicide attempts among Asian American women who are children of immigrants, little is known about the prevalence of mental health utilization and the perceived barriers to accessing care. METHODS: The data were from the Asian American Women's Sexual Health Initiative Project (AWSHIP), a 5-year mixed methods study at Boston University. The quantitative analysis examined the differential proportion of mental health utilization among 701 survey participants based on their mental health risk profile determined by current moderate to severe depression symptoms and lifetime history of suicidality. Mental health risk groups were created based on participants' current depression symptoms and history of suicide behaviors: Group 1-low-risk; Group 2-medium-risk; Group 3-high-risk. Mental health care utilization outcomes were measured by any mental health care, minimally adequate mental health care, and intensive mental health care. The qualitative analysis explored the perceived barriers to mental health care among 17 participants from the medium and high-risk groups. RESULTS: Among 701 participants, 43% of women (n = 299) reported that they either suffered from current moderate to severe depression symptoms or a lifetime history of suicidal ideation or suicide attempt. Although the high-risk group demonstrated statistically significant higher mental health utilization compared to the low and medium-risk groups, more than 60% of the high-risk group did not access any mental health care, and more than 80% did not receive minimally adequate care. The qualitative analysis identified three underutilization factors: Asian family contributions to mental health stigma, Asian community contributions to mental health stigma, and a mismatch between cultural needs and available services. CONCLUSIONS: Despite the high prevalence of depression and suicidal behaviors among young Asian American women in the sample, the proportion of mental health care utilization was extremely low. The qualitative analysis underscores the influence of Asian family and community stigma on mental health utilization and the lack of culturally appropriate mental health interventions. Prevention and intervention efforts should focus on raising mental health awareness in the Asian American community and offering culturally sensitive services.

Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic.

OBJECTIVE: The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD: We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS: Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION: Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Drug use and suicidality among Asian American women who are children of immigrants.

This study investigates the association between drug use and lifetime suicidal behaviors among Asian American women (n = 720) residing throughout Massachusetts, using data collected from 2010 to 2011. Logistic regression models identified that a history of hard drug use alone or in combination with soft drug use has a significant association with both suicidal ideation and suicide attempts among Asian American women, adjusting for demographic covariates, history of psychiatric diagnosis, and family communication. These findings highlight the importance of addressing hard drug use when designing suicide prevention programs for Asian American women.

COVID-19-Related Racial Discrimination during Lockdown and Its Impact on Asian American Women.

During the lockdown period of the COVID-19 pandemic, Asian American (AA) women have experienced a surge in anti-Asian hate crimes and racial discrimination, and a majority of studies have quantitatively shown the negative impact of these incidents on Asian Americans' well-being. Our research expands on the existing literature by qualitatively investigating types of COVID-19-related racial discrimination during lockdown and its impacts on changes in emotions, behaviors, well-being, and racial identity development among AA women. This study covered two timepoints (December 2019 to May 2020) and the data were collected using an open-ended survey with 40 AA women. Thematic analysis identified core themes related to types of racial discrimination, emotional and behavioral changes, and racial identity status that emerged due to COVID-19-related racial discrimination experiences. The findings shed light on the long-lasting impacts of racial discrimination on AA women's overall well-being and dynamic development of racial identity. Altogether, our findings underscore the need for systematic forms of advocacy to combat anti-Asian racism and call for solidarity for AA women's well-being.

Psychological Distress and Heavy Alcohol Consumption Among U.S. Young Women During the COVID-19 Pandemic.

INTRODUCTION: The predictors of heavy drinking among U.S. young women during the COVID-19 pandemic are not well-examined. This study aims to determine the prospective relationship between COVID-19 psychological distress and heavy alcohol use among U.S. young adult women. DESIGN: This study used the COVID-19 Adult Resilience Experiences Study (CARES) data collected from April 13, 2020, to August 31, 2020 (T1) and September 21, 2020, to March 15, 2021 (T2). Among the young adults (ages 18-30) who participated in both surveys, a total of 684 identified as women (including transgender women) and were included in the analysis. Three or more drinks as a typical intake were defined as heavy drinking. Psychological distress in T1 was measured using scores for financial stress, COVID-19-related worry, and COVID-19-related grief. A series of logistic regression analyses were performed to identify risk factors associated with young women's heavy drinking during the pandemic. RESULTS: Twenty-two and one-half percent of young women reported heavy drinking in a typical intake. After controlling for covariates, women who reported high levels of COVID-19-related grief were more likely to report heavy drinking (odds ratio, 1.06; 95% confidence interval [CI], 1.01-1.13; p < .05). Those with high levels of COVID-19-related worry were less likely to report drinking heavily (odds ratio, 0.90; 95% confidence interval, 0.85-0.97; p < .01). CONCLUSIONS: Those who suffer from a deeper sense of COVID-19-related grief are particularly at risk of heavy drinking and should be targeted for outreach and clinical intervention. Further research is necessary to determine the long-term impacts of the pandemic on heavy drinking among young women and should include a more comprehensive assessment of psychological distress.

Posttraumatic growth as a moderator between pandemic-related distress and mental health symptoms in U.S. young adults.

OBJECTIVE: Compared to other age groups, young adults are at risk of suffering COVID-19 pandemic-related psychological problems. Prior research suggests that such adverse events (like the pandemic) can initiate adaptive psychological changes, referred to as posttraumatic growth (PTG); however, limited studies have examined the moderating role of PTG among young adults in the United States with regard to COVID-19-related distress. Thus, this study examines whether pandemic-related distress has a differential effect on young adults' mental health symptoms based on varying levels of PTG. METHOD: Using the data from 661 participants who completed all three waves of the CARES study (T1: April-August 2020; T2: September 2020-March 2021; T3: April-May 2021), a moderator analysis was performed using the PROCESS Macro to determine the moderating effect of PTG. RESULTS: In our data, higher levels of PTG buffered the effects of pandemic-related distress from 2020 on depressive symptoms in 2021; PTG did not show a moderating effect with anxiety as an outcome. CONCLUSIONS: Understanding the moderating role of PTG would help to further understand the mental health trajectories of young adults in the United States who are particularly distressed by the pandemic. Our findings suggest the importance of further exploring contributors to PTG for young adults, particularly among those who have experienced high levels of pandemic-related distress to date. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Home away from home: international students' experiences during the COVID-19 pandemic and the role of US higher education.

Introduction: This study focuses on the impact of the COVID-19 pandemic on international students' overall experiences. Method: We interviewed 22 international students from 11 countries and 17 universities in the US who participated in a large longitudinal study that aims to understand the physical and emotional wellbeing of young adults during the COVID-19 pandemic. Guided by Bronfenbrenner's ecological model, the findings suggested that students were impacted by the COVID-19 pandemic at interpersonal, institutional, political, and personal levels. Results: The results showed that the pandemic exacerbated existing stressors such as the lack of social support from family, various visa regulations, competitive and limited job opportunities, discrimination and xenophobia, particularly toward students from Asia, and financial burdens. Additionally, the findings highlighted students' perceived loss of the "American dream" and the uneven return on investment due to the pandemic. Discussion: This study reveals the importance of US higher education institutions in supporting international students during the pandemic, particularly in terms of their sense of belonging. Recommendations for institutions drawn from the findings are proposed to better support international students during times of COVID-19 and beyond.

Youth Suicide During the First Year of the COVID-19 Pandemic.

OBJECTIVE: To identify potential differential changes in youth suicide deaths associated with the coronavirus disease (COVID-19) pandemic to better inform suicide prevention strategies. METHODS: This cross-sectional study analyzed national suicide data for US youth aged 5 to 24 years from 2015 to 2020. Annual and monthly numbers of suicides were extracted overall and by sex, age, race and ethnicity, and method. Expected suicides were modeled from the trend in monthly deaths before COVID-19 (January 1, 2015-February 29, 2020), by using interrupted time-series analyses with quasi-Poisson regression. Rate ratios (RR) and corresponding 95% confidence intervals (CI) were used to compare expected and observed suicides during the first 10 months of COVID-19 (March 1, 2020-December 31, 2020). RESULTS: Among 5568 identified youth suicides during the 2020 pandemic, 4408 (79.2%) were male, 1009 (18.1%) Hispanic, 170 (3.3%) non-Hispanic American Indian/Alaska Native, 262 (4.7%) Asian/Pacific Islander, 801 (14.4%) Black, and 3321 (59.6%) white. There was a significant increase in overall observed versus expected youth suicides during the COVID-19 pandemic (RR = 1.04, 95% CI = 1.01-1.07), equivalent to an estimated 212 excess deaths. Demographic subgroups including males (RR = 1.05, 95% CI = 1.02-1.08), youth aged 5 to 12 years (RR = 1.20, 95% CI = 1.03-1.41) and 18 to 24 years (RR =1.05, 95% CI = 1.02-1.08), non-Hispanic AI/AN youth (RR = 1.20, 95% CI = 1.03-1.39), Black youth (RR = 1.20, 95% CI = 1.12-1.29), and youth who died by firearms (RR = 1.14, 95% CI = 1.10-1.19) experienced significantly more suicides than expected. CONCLUSIONS: Suicide deaths among US youth increased during COVID-19, with substantial variation by sex, age, race and ethnicity, and suicide method. Suicide prevention strategies must be tailored to better address disparities in youth suicide risk.

Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women.

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

Binge drinking trajectories from adolescence to young adulthood: the effects of peer social network.

This study investigates an association between social network characteristics and binge drinking from adolescence to young adulthood, utilizing National Longitudinal Study of Adolescent Health (n = 7,966) and employing social network and longitudinal analysis. Lower integration and socialization with alcohol-using peers had immediate risks of binge drinking during adolescence; however, over time, the effects of socialization with alcohol-using peers had the most dramatic reduction. The most prestigious adolescents had the highest longitudinal risks of binge drinking, although they had no immediate risk. Alcohol consumption-related interventions overlooking longitudinal dynamics of social networks may not effectively prevent adolescents from binge drinking in young adulthood.

International student stressors and mental health during the COVID-19 pandemic: a qualitative study.

OBJECTIVE: To identify stressors affecting international students' mental health during the COVID-19 pandemic. PARTICIPANTS: Twenty-two international students from 10 countries and 17 US institutions participated. METHODS: Participants were recruited from a larger study examining the wellbeing of young adults during the pandemic. RESULTS: Four main stressors were identified: (1) Uncertainty and anxiety induced by decisions and policies in response to COVID-19; (2) Fears regarding xenophobia; (3) Limited understanding by educators and school staff of international students' unique challenges; (4) Greater awareness of racial and cultural identity. CONCLUSION: The pandemic has contributed to additional stressors for international students. Educators and mental health professionals may help support international students' mental health by gaining basic knowledge about common stressors and directly acknowledging the challenges, educating international students on race and racism and supporting anti-racism efforts, and encouraging the creation of shared affinity spaces and increasing psychoeducation to promote resilience.