Lauri A. Pasch

Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among Mexican-Origin Adults

This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when perceived stress was taken into account. Perceived stress predicted depression and poorer general health while controlling for the effects of perceived discrimination. The influence of perceived discrimination on general health was greater for men than women, and the effect of perceived stress on depression was greater for women than men. Results provide evidence that discrimination is a source of chronic stress above and beyond perceived stress, and the accumulation of these two sources of stress is detrimental to mental and physical health. Findings suggest that mental health and health practitioners need to assess for the effects of discrimination as a stressor along with perceived stress.

Perceived Racial/Ethnic Discrimination, Posttraumatic Stress Symptoms, and Health Risk Behaviors among Mexican American Adolescents.

Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact.

Social support, problem solving, and the longitudinal course of newlywed marriage

Married couples (N = 172) were observed as newlyweds and observed again 1 year later while engaging in 2 problem-solving and 2 personal support discussions. Microanalytic coding of these conversations was used to examine associations between problem-solving and social support behaviors for 1 year and their relative contributions to 10-year trajectories of self-reported relationship satisfaction and dissolution. Results demonstrated that initially lower levels of positive support behaviors and higher levels of negative support behaviors predicted 1-year increases in negative emotion displayed during problem-solving conversations. Emotions coded from the initial problem-solving conversations did not predict 1-year changes in social support behaviors. Controlling for emotions displayed during problem-solving interactions eliminated or reduced associations between initial social support behaviors and (a) later levels of satisfaction and (b) relationship dissolution. These findings corroborate models that prioritize empathy, validation, and caring as key elements in the development of intimacy (e.g., Reis & Shaver, 1988) and suggest that deficits in these domains foreshadow deterioration in problem solving and conflict management. Implications for integrating support and problem solving in models of relationship change are outlined, as are implications for incorporating social support in education programs for developing relationships.

The use of complementary and alternative fertility treatment in couples seeking fertility care: data from a prospective cohort in the United States

OBJECTIVE To determine the prevalence of complementary and alternative medicine (CAM) use among couples seeking fertility care and to identify the predictors of CAM use in this population. DESIGN Prospective cohort study. SETTING Eight community and academic infertility practices. PATIENT(S) A total of 428 couples presenting for an infertility evaluation. INTERVENTION(S) Interviews and questionnaires. MAIN OUTCOME MEASURE(S) Prevalence of complementary and alternative medicine therapy. RESULT(S) After 18 months of observation, 29% of the couples had utilized a CAM modality for treatment of infertility; 22% had tried acupuncture, 17% herbal therapy, 5% a form of body work, and 1% meditation. An annual household income of > or =

Sexual, marital, and social impact of a man's perceived infertility diagnosis.

200,000 (odds ratio 2.8, relative to couples earning <

A randomized comparison of A-CASI and phone interviews to assess STD/HIV-related risk behaviors in teens

100,000), not achieving a pregnancy (odds ratio 2.3), and a positive attitude toward CAM use at baseline were independently associated with CAM use. CONCLUSION(S) A substantial minority of infertile couples use CAM treatments. CAM was chosen most commonly by wealthier couples, those not achieving a pregnancy, and those with a baseline belief in the effectiveness of CAM treatments.

Costs of infertility treatment: results from an 18-month prospective cohort study

INTRODUCTION Male factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples. AIM To measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility. METHODS Cross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participants perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown). MAIN OUTCOME MEASURES Personal Impact, Social Impact, Marital Impact, and Sexual Impact scales. RESULTS Among the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity. CONCLUSIONS Male partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men.

Effect of valued activity disability, social comparisons, and satisfaction with ability on depressive symptoms in rheumatoid arthritis

PURPOSE To compare response bias associated with a telephone survey of sexually transmitted disease/human immunodeficiency virus (STD/HIV)-related risk behaviors and an in-home self-administered audio computer assisted self interview (A-CASI). METHODS We randomly assigned an urban household sample of 223 African-American adolescents to a telephone interview or an A-CASI in their home. The sample was previously recruited by telephone for an earlier study regarding STDs and sexual behavior. We queried participants about their STD/HIV-related risk behaviors. We also assessed their perceived comfort, honesty, and accuracy in answering questions in the different modes through a telephone computer-assisted self-interview (T-CASI). RESULTS There were no significant differences by mode in percentages of participants reporting STD/HIV-related risk behaviors, except more A-CASI participants reported having engaged in sexual intercourse in past 3 months (43.8% vs. 33.3%). There were no differences in perceived comfort, honesty, and accuracy in answering questions in the different modes. These results also did not change after we adjusted for age, household structure, and current school enrollment. CONCLUSIONS Telephone interviews, a more economical mode, can be employed without much risk of increasing the response bias in the data assessing crude measures of risk.

Parental feeding practices in Mexican American families: initial test of an expanded measure.

OBJECTIVE To examine resource use (costs) by women presenting for infertility evaluation and treatment over 18 months, regardless of treatment pursued. DESIGN Prospective cohort study in which women were followed for 18 months. SETTING Eight infertility practices. PATIENT(S) Three hundred ninety-eight women recruited from infertility practices. INTERVENTION(S) Women completed interviews and questionnaires at baseline and after 4, 10, and 18 months of follow-up. Medical records were abstracted after 18 months to obtain details of services used. MAIN OUTCOME MEASURE(S) Per-person and per-successful-outcome costs. RESULT(S) Treatment groups were defined as highest intensity treatment use. Twenty percent of women did not pursue cycle-based treatment; approximately half pursued IVF. Median per-person costs ranged from

Violence involvement, substance use, and sexual activity among Mexican-American and European-American adolescents.

1,182 for medications only to