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Weight discrimination has adverse effects on health that include increasing the risk factors for developing type 2 diabetes. Preliminary evidence suggests a positive association between weight discrimination and diagnosed diabetes; however, it is unknown whether psychosocial resources may buffer this association. In logistic regressions stratified by gender, we examined links between weight discrimination and diabetes among a nationally representative sample of U.S. adults (the National Social Life, Health, and Aging Project; N = 2,794 adults age 50 and older in 2015-16). We also tested the extent to which trait-resilience and social support from a spouse/partner, family, and friends buffered any observed association. We adjusted for known predictors of diabetes (age, race/ethnicity, Body Mass Index) and conducted sensitivity analyses restricted to men and women with obesity. Net of covariates, in the overall sample, weight discrimination was associated with significantly greater odds of having ever had diabetes among women (OR = 2.00, 95% CI [1.15, 3.47]), but not men. Among women with obesity, weight discrimination was only significantly associated with greater odds of diabetes for those with low resilience (OR = 1.84, 95% CI [1.01, 3.35]). Among men overall, weight discrimination was associated with lower odds of diabetes for those with high family support (OR = 0.03, 95% CI [0.003, 0.25]) as well as those with high friend support (OR = 0.34, 95% CI [0.13, 0.91]); similar effects were observed in men with obesity. These novel findings evince a role for psychosocial resources in buffering associations between weight discrimination and diabetes. [ABSTRACT FROM AUTHOR]

Resilience, which relates to one's ability to respond to stressors, typically declines with age and the development of comorbid conditions in older organisms. Although progress has been made to improve our understanding of resilience in older adults, disciplines have employed different frameworks and definitions to study various aspects of older adults' response to acute or chronic stressors. "Overview of the Resilience World: State of the Science," a bench‐to‐bedside conference on October 12–13, 2022, was sponsored by the American Geriatrics Society and National Institute on Aging. This conference, summarized in this report, explored commonalities and differences among the frameworks of resilience most commonly used in aging research in the three domains of resilience: physical, cognitive, and psychosocial. These three main domains are intertwined, and stressors in one domain can lead to effects in other domains. The themes of the conference sessions included underlying contributors to resilience, the dynamic nature of resilience throughout the life span, and the role of resilience in health equity. Although participants did not agree on a single definition of "resilience(s)," they identified common core elements of a definition that can be applied to all domains and noted unique features that are domain specific. The presentations and discussions led to recommendations for new longitudinal studies of the impact of exposures to stressors on resilience in older adults, the use of new and existing cohort study data, natural experiments (including the COVID‐19 pandemic), and preclinical models for resilience research, as well as translational research to bring findings on resilience to patient care. [ABSTRACT FROM AUTHOR]

Little is known about the mediating role of adolescent chronic pain in the connection between adolescent parental rejection and psychosocial and physical health (i.e., disease risk) outcomes in young adulthood (YA). To address this gap, the present study tested a model of a successively contingent developmental process that integrates neurophysiological research and the life course developmental perspective. The model included parental rejection and chronic pain in adolescence and depressive symptoms, low education attainment, economic hardship and allostatic load in YA. The study utilized 13 years of prospective data from a nationally representative sample of 11,030 US adolescents. The findings largely supported the hypothesized model. Adolescent chronic pain, as influenced by parental rejection, was associated with depressive symptoms and economic hardship in YA. In addition, parental rejection directly influenced depressive symptoms, education level and economic hardship, all of which, in turn, contributed to greater physical health risk (i.e., allostatic load) in YA. These associations persisted even after controlling for adolescent illness, depressive symptoms, age, sex and race/ethnicity. Multi‐group analysis showed that female participants were more vulnerable to stressful parental rejection and socioeconomic difficulties in YA. The theoretical and practical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Objective: The overarching goal of this review is to provide a clinical overview of epidemiology, diagnosis, and treatment, and to discuss the public health impact, social determinants including access to care, and implications for health care delivery and research. It is estimated that approximately 1 in 4 individuals suffering from a serious mental illness (SMI) may have a co‐occurring opioid use disorder (OUD). In these individuals, the overall disease burden is higher and clinical outcomes are worse compared to those without a co‐occurring illness, making an integrated approach to diagnosis and treatment an urgent priority. Methods: We conducted a selective review of the literature to investigate prevalence, etiology for co‐occurring OUD and SMI, and diagnostic and clinical guidelines in the United States, and consideration special populations. Findings: Our findings suggest that, despite the high prevalence of co‐occurring OUD and SMI, contemporary diagnostics and treatment approaches are underutilized in this patient population. The literature also suggests that both pharmacological and psychosocial treatment approaches need to be tailored to optimize clinical management, and that integrated treatment is pivotal for improving overall outcomes, yet comprehensive clinical guidelines for co‐occurring OUD and SMI are lacking at this time. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Nonmedical switching (NMS) is a change in a patient's treatment regimen for reasons other than lack of efficacy, intolerance, adverse effects, or poor adherence. We describe the impact of NMS on patients, health care workers, and health systems, focusing on NMS to in-class biologic alternatives in US patients with chronic, immune-mediated rheumatic and dermatologic conditions. Additionally, we evaluate the ways in which the COVID-19 pandemic may exacerbate the physical, psychological, and economic impacts of NMS. STUDY DESIGN: Narrative review. METHODS: We performed a search of MEDLINE's PubMed database from October 2015 to October 2020, with a repeat search in October 2021. Search terms included relevant keywords pertaining to NMS, biologics, and disease areas. Results were supplemented by a search of key congress abstracts from 2015 to 2021 and a targeted internet search. RESULTS: NMS increases medication abandonment, errors, and adverse effects, and it can lead to longer patient visits, increased follow-up visits, additional laboratory tests and procedures, and greater overall health care resource utilization (HCRU). The increased HCRU associated with NMS increases patients' financial burden due to additional co-pays and out-of-pocket costs. CONCLUSIONS: The decision to switch treatments should result from shared decision-making between health care providers (HCPs) and patients to achieve the best clinical outcomes and optimal HCRU. The issues related to NMS may be compounded by the financial and psychosocial stress on HCPs and patients created by the COVID-19 pandemic. HCPs should advocate for continuous patient treatment and be familiar with continuity of care legislation, appeals processes, and manufacturer assistance programs. [ABSTRACT FROM AUTHOR]

This study examined the relationships between three life domains--physical health, risky/deviant lifestyle, and psychosocial adjustment--and traditional bullying and cyberbullying victimization among youths in 23 countries. Methods: We first estimated logistic regression models that examined the relationships between indicators of physical health, risky/deviant lifestyle, and psychosocial adjustment using 23 distinct national samples. This analysis also allowed us to observe patterns of similarity and dissimilarity across countries regarding the correlates of for traditional bullying and cyberbullying victimization. Next, we estimated multilevel models of bullying victimization that combined data across 21 countries and estimated the effects of a country-level indicator of quality of human development (IHDI) in interaction with individual-level indicators of physical health, risky/deviant lifestyle, and psychosocial adjustment. Results: There were both cross-country similarities and differences regarding the individual-level correlates of traditional bullying and cyberbullying victimization. Additionally, countries that had relatively greater quality of human development tended to exhibit lower prevalence of traditional and cyberbullying victimization. Finally, country-level quality of human development conditioned relationships between individual level factors and both traditional and cyberbullying victimization. Conclusions: Findings suggest that student-level bullying-prevention programs should address risk/protective factors across three student life domains, with some risk/protective factors seemingly universally relevant. Moreover, cross-level interactions suggest that enhancing country-level quality of human development can also play an important role in youth bullying prevention. [ABSTRACT FROM AUTHOR]

Since 1950, public communication about the neurobiological-psychosocial basis of mental illness from the diathesis-stress model has promoted reception to treatment yet violent/dangerous stereotypes have increased during this period. Moreover, public mental health communication efforts have predominantly diffused in English-language media, excluding Spanish/Latinx media and its consumers from these efforts. To inform future mental health communication strategies, this study leverages high versus low diffusion of public mental health communication across English and Spanish/Latinx media to examine public mental health communication effects on stigma and treatment beliefs via neurobiological-psychosocial beliefs. A quota sample of 2058 U.S.-based Latinx residents ages 13–86 with diverse language/cultural media preferences was recruited to self-complete a survey about mental health information acquisition in 2021. Assessments ascertained frequency of Spanish/Latinx and English media use and mental health content scanning and seeking (α = 0.86–0.94); and items from the General Social Survey about mental illness neurobiological-psychosocial causal beliefs (α = 0.72)—genetics, brain chemistry, environment, stress; treatment beliefs—mental illness improves with treatment or on its own; and stigma beliefs—violent/dangerous and bad character stereotypes and unwillingness to socialize with a person with mental illness. Structural equation models estimated total, direct, and indirect effects of Spanish/Latinx and English media exposures on treatment and stigma beliefs via neurobiological-psychosocial beliefs, net individual/family factors. Spanish/Latinx media reduced, while English media increased, neurobiological-psychosocial beliefs (p < 0.01). Neurobiological-psychosocial beliefs, in turn, increased treatment and stigma beliefs (p < 0.01), simultaneously. Indirect pathways were also significant (p < 0.05). Proportion mediated on treatment beliefs was one-third for Spanish/Latinx and two-thirds for English media. Proportion mediated on stigma beliefs for all media exposures averaged ≥1. While consumers of Spanish/Latinx media report lower neurobiological-psychosocial knowledge that impedes treatment beliefs, consumers of English media report greater neurobiological-psychosocial and treatment knowledge and, consequently, more stigma. Innovation in public mental health communication is needed to counter stigma and health inequity. • Mental health communication is inequitable across English- and Spanish/Latinx-media. • Spanish/Latinx-media reduces, while English-media increases, neurobiological-psychosocial causal beliefs. • Neurobiological-psychosocial causal beliefs increase treatment and stigma beliefs, simultaneously. • Public mental health communication requires innovation to combat stigma and inequity. [ABSTRACT FROM AUTHOR]

An increasing number of U.S. families are adopting children with HIV born outside the country. This exploratory qualitative study seeks to understand providers' perspectives on international adoptee and family preparation and adjustment to life in the U.S. Eleven psychosocial and five medical care providers participated in hour-long, semi-structured, recorded interviews focused on their experiences caring for internationally adopted children with HIV (IACH) and their adoptive parents. Transcribed interviews were analyzed to identify emergent themes. Providers described considerable variation among families who adopted children. Some had grown biological children and several adopted multiple children with special needs. Most were connected to communities of faith which served as an inspiration to adopt and offered support. Serious medical and HIV-related issues were minimal. Psychosocial concerns were more common and included attachment, adjustment, and behavioral issues. Participants noted that adoptive parents were well informed about HIV, but less prepared for cognitive delays and emotional challenges. Some providers experienced or expected to have challenges offering sexual and reproductive health education to adolescents due to their adoptive parents' religious beliefs on sexuality. Additional support managing behavioral and emotional challenges, as well as sexual education, may be needed especially as IACH transition into adolescence and young adulthood. [ABSTRACT FROM AUTHOR]

Little is known about the psychological stress and secondary impacts emerging among the general U.S. population as a result of the ongoing COVID-19 pandemic. The purpose for the current study is to assess the prevalence rates of Generalized Anxiety Disorder (GAD) and to establish psychosocial correlates, pandemic-themed concerns, and other comorbidities for those with GAD at the initial onset of the COVID-19 pandemic. This online study included 2,101 U.S. adults between April 14–22, 2020, during the initial stay-at-home protocols and assessed GAD, psychosocial factors, and pandemic-related factors including concerns, changes in health behaviors, and adherence to protocols. The results demonstrated a high prevalence rate (17.9%) for GAD during the initial COVID-19 outbreak compared with the prior 1.8% 12-month estimate before the pandemic. Individuals with GAD reported significantly higher levels of stress, loneliness, fatigue, and empathic concern, along with reductions in levels of quality of life. Likewise, those with GAD reported significantly higher pandemic-related concerns, poorer changes in general health behaviors, and less confidence in the government's response to the pandemic. For clinical purposes, these findings provide insight into the various types of pandemic-themed worries that individuals meeting clinical criteria for GAD will have the most difficulties controlling. [ABSTRACT FROM AUTHOR]

• Student experiences with COVID-19 are characterized by severity and type of impact. • Gender identity, generation, and year in school distinguished impact profiles. • Impact profiles were not distinguished by student race/ethnicity. • Impact profile was associated with college adjustment and self-esteem. The COVID-19 pandemic has been highly disruptive for college students and has altered their living, learning, and working environments. COVID-19-related financial impact, access to needed resources, and psychological impacts are reported amongst college students, though research has yet to examine how severity and type of impact varies by student. This study investigated how undergraduate college students were impacted during the COVID-19 pandemic regarding finances, access to needed resources, and psychological well-being, and explored outcomes associated with patterns of perceived impact. Participants were 894 college students at a southeastern university who completed an online survey during the Spring 2021 semester. Students reported on how the COVID-19 pandemic affected their finances, resources, and psychological health; students also reported their current self-esteem, and adjustment to college (academic and relational). Latent profile analysis was utilized to develop profiles of COVID-19-related impact. Results indicated that most participants experienced moderate levels of financial and psychological impact but low resource impact (34.6%) or experienced low impact across the range of financial, resource, and psychological domains (32.5%). Seventeen percent were highly impacted across all domains and 15.8% experienced moderate financial and resource impact but low psychological impact. Student gender identity, generational status, and first-year status were significant predictors of profile membership – student race was not associated with profile membership. Highly impacted students had significantly lower self-esteem and college adjustment compared to students in relatively less-impacted profiles. [ABSTRACT FROM AUTHOR]