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Background: Emerging evidence notes increased depression, anxiety, and stress among the general population during the COVID-19 pandemic. However, little is known about populations at increased risk for emotional distress as the pandemic continues. Persons with adverse childhood experiences (ACE) are one group that may be at higher risk for emotional distress. Aim: The aim of this study is to examine whether young adults, particularly Black young adults, with histories of ACEs report more emotional distress during the pandemic than those with no ACE exposure. Method: Using a cross-sectional, quota sampling approach, 100 Black and 100 White young adults were recruited using online sources (e.g., University website, Facebook). Due to the pandemic, participants were screened via Zoom and, if eligible, completed a demographic questionnaire, emotional distress measures (i.e., anxiety, depression, stress), and the ACE Questionnaire online via a Qualtrics survey. Structural equation modeling (SEM) analysis examined the ACE and emotional distress relationship, and multigroup SEM assessed racial differences. Results: High levels of both emotional distress and ACEs were observed. Black young adults reported significantly more ACEs than Whites. ACEs were significantly associated with each measure of emotional distress regardless of race or other covariates. Conclusions: Findings reveal that during the pandemic, persons exposed to ACEs reported greater emotional distress than those with no ACE exposure. Nurses must screen patients for both emotional distress and ACE to target those at higher risk for early intervention and initiate treatment as needed to mitigate long-term mental health consequences. [ABSTRACT FROM AUTHOR]

Background: The effect of multiple stressors on immigrant young adults' endocrine functioning and health outcomes has not been comprehensively investigated. Aims: This study tested a theoretical model of cumulative and current stressor effects on the hypothalamic–pituitary–adrenocortical (HPA) axis functioning and health-related quality of life (HRQL) among Arab American young adults. Methods: Using a cross-sectional design, we recruited 160 participants, ages 18 to 24 years, from an urban university in the Midwest. Cumulative stress was assessed by self-report measures of childhood adversity, bullying victimization, and perceived ethnic discrimination. Current perceived stress was measured using the Perceived Stress Scale (PSS) while cortisol levels were measured in participants' hair. Structural equation modeling tested the effects of cumulative and current stress on cortisol and HRQL. Results: Cumulative stress was negatively associated with HRQL (standardized path coefficient = −.51, p <.05). Interestingly, however, cumulative stress was inversely associated with hair cortisol level (standardized path coefficient = −.51, p <.05). Current stress was positively associated with cortisol level (standardized path coefficient =.43, p <.05) and negatively associated with the mental HRQL (standardized path coefficient < −.37, p <.05). Conclusion: Cumulative stress exhibited a different effect on HPA functioning from current perceived stress. Mental health was significantly impaired by both cumulative and current perceived stress. Implications for mental health nursing practice and research among Arab Americans are discussed. [ABSTRACT FROM AUTHOR]