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OBJECTIVE:To test whether effects of multiple (up to 5) disasters on mental health responses were cumulative (additive effects), or whether an earlier disaster produced sensitization (higher) or habituation (lower) responses to a later one. METHOD:The Gulf Resilience on Women's Health study interviewed 1,366 southern Louisiana women regarding their exposure to Hurricanes Katrina, Rita, Gustav, and Ike and the Gulf oil spill (measured several ways), and administered validated measures of symptoms of depression and posttraumatic stress disorder (PTSD). Multiple linear and logistic regression with disaster exposures entered singly, combined, and as an interaction were used to model mental health. RESULTS:Both exposure to the oil spill and hurricane disaster were associated with likely depression and PTSD, consistent with a cumulative model, but we did not find statistical interactions that would suggest sensitization or habituation. When results were examined with continuous symptom measures of depression and PTSD, they were similar, with the exception that exposure to the oil spill and experiencing illness or injury because of the hurricane disaster showed a significant interaction (p < .05) in a manner consistent with a sensitization effect when predicting PTSD symptoms. The results of this study point mainly to a cumulative risk for the mental health effects of multiple disasters, although some indication of sensitization occurred among those with particularly severe experiences. There was no evidence for habituation. CONCLUSIONS:These findings may guide efforts to assist those in regions experiencing multiple disasters that occur in close sequence. (PsycINFO Database Record

OBJECTIVE:We hypothesized second trimester serum cortisol would be higher in spontaneous preterm births compared to provider-initiated (previously termed 'medically indicated') preterm births. STUDY DESIGN:We used a nested case-control design with a sample of 993 women with live births. Cortisol was measured from serum samples collected as part of routine prenatal screening. We tested whether mean-adjusted cortisol fold-change differed by gestational age at delivery or preterm birth subtype using multivariable linear regression. RESULT:An inverse association between cortisol and gestational age category (trend p = 0.09) was observed. Among deliveries prior to 37 weeks, the mean-adjusted cortisol fold-change values were highest for preterm premature rupture of the membranes (1.10), followed by premature labor (1.03) and provider-initiated preterm birth (1.01), although they did not differ statistically. CONCLUSION:Cortisol continues to be of interest as a marker of future preterm birth. Augmentation with additional biomarkers should be explored.

During crisis events, people often seek out event-related information to stay informed of what is happening. However, when information from official channels is lacking or disseminated irregularly, people may be at risk for exposure to rumors that fill the information void. We studied information-seeking during a university lockdown following an active-shooter event. In study 1, students in the lockdown (n = 3,890) completed anonymous surveys 1 week later. Those who indicated receiving conflicting information about the lockdown reported greater acute stress [standardized regression coefficient (b) = 0.07; SE = 0.01; 95% confidence interval (CI), 0.04, 0.10]. Additionally, those who reported direct contact with close others via text message (or phone) and used Twitter for critical updates during the lockdown were exposed to more conflicting information. Higher acute stress was reported by heavy social media users who trusted social media for critical updates (b = 0.06, SE = 0.01; 95% CI, 0.03, 0.10). In study 2, we employed a big data approach to explore the time course of rumor transmission across 5 hours surrounding the lockdown within a subset of the university's Twitter followers. We also examined the patterning of distress in the hours during the lockdown as rumors about what was happening (e.g., presence of multiple shooters) spread among Twitter users. During periods without updates from official channels, rumors and distress increased. Results highlight the importance of releasing substantive updates at regular intervals during a crisis event and monitoring social media for rumors to mitigate rumor exposure and distress.

Close relationships are integral to the health and adaptation of our species. The evidence is incontestable, and it is the building block upon which future theory, research, and practice rests. This foreword notes the distinct domains and independent histories of relationship science and health psychology and calls for further thorough integration within the broader context of team science. The articles in this special issue focus on interpersonal mechanisms, cultural specificity, personality and emotion regulation, couples dynamics in chronic disease, and the increasingly complex biological mechanisms involved in linking relationships to health outcomes. They point to the importance of life stage, especially childhood and late adulthood, for understanding unique relationship and health issues. The challenge remains to translate existing and future knowledge into interventions to improve social relationships for the benefit of physical and mental health. (PsycINFO Database Record

Close relationships are integral to the health and adaptation of our species. The evidence is incontestable, and it is the building block upon which future theory, research, and practice rests. This foreword notes the distinct domains and independent histories of relationship science and health psychology and calls for further thorough integration within the broader context of team science. The articles in this special issue focus on interpersonal mechanisms, cultural specificity, personality and emotion regulation, couples dynamics in chronic disease, and the increasingly complex biological mechanisms involved in linking relationships to health outcomes. They point to the importance of life stage, especially childhood and late adulthood, for understanding unique relationship and health issues. The challenge remains to translate existing and future knowledge into interventions to improve social relationships for the benefit of physical and mental health. (PsycINFO Database Record

ObjectiveElevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year.MethodsWe analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum.ResultsForty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index.ConclusionsIn this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.

Background Allostatic load (AL) is an index of multi-system physiological "wear-and-tear," operationalizing emergent chronic disease risk and predicting morbidity and mortality. AL has been proposed as an organizing framework for studying pregnancy outcomes and additional AL biomarkers for the study of maternal health would be valuable. Objectives To test whether adverse perinatal outcomes are associated with postpartum AL and if including vitamin D deficiency (serum 25(OH)D

Objectives Contributing factors to COVID-19 vaccination intention in low-income and middle-income countries have received little attention. This study examined COVID-19-related anxiety and obsessive thoughts and situational factors associated with Pakistani postpartum women’s intention to get COVID-19 vaccination.Design Cross-sectional study administering a survey by a telephone interview format between 15 July and 10 September 2020.Setting Four centres of Aga Khan Hospital for Women and Children—Garden, Kharadar, Karimabad and Hyderabad—in Sindh Province, Pakistan.Participants Women who were enrolled in our longitudinal Pakistani cohort study were approached (n=1395), and 990 women (71%) participated in the survey, of which 941 women who were in their postpartum period were included in the final analysis.Primary outcome measure and factors COVID-19 vaccine intention, sociodemographic and COVID-19-related factors, Coronavirus anxiety, obsession with COVID-19 and work and social adjustment were assessed. Multiple multinomial logistic regression analysis was used to identify factors associated with women’s intentions.Results Most women would accept a COVID-19 vaccine for themselves (66.7%). Only 24.4% of women were undecided about vaccination against COVID-19, and a small number of women rejected the COVID-19 vaccine (8.8%). Women with primary education were less likely to take a COVID-19 vaccine willingly than those with higher education. COVID-19 vaccine uncertainty and refusal were predicted by having no experience of COVID-19 infection, childbirth during the pandemic, having no symptoms of Coronavirus anxiety and obsession with COVID-19. Predictors for women’s intention to vaccinate themselves and their children against COVID-19 were similar.Conclusion Understanding the factors shaping women’s intention to vaccinate themselves or their children would enable evidence-based strategies by healthcare providers to enhance the uptake of the COVID-19 vaccine and achieve herd immunity against Coronavirus.

Many women experience depressive symptoms after birth, and rates among African Americans are as high as 40 percent. Spirituality and religiosity are valued in African American communities, but their relevance to new mothers has not been empirically tested. We examined effects of religiosity and spirituality on trajectories of depressive symptoms during the year following childbirth. Data were collected by the Eunice Kennedy Shriver NICHD Community and Child Health Network (CCHN) focused on maternal-child health disparities. The sample consisted of 702 low SES African American predominantly Christian women. Participants were interviewed in their homes throughout the year following a birth. Spirituality and religiosity each independently predicted changes in depressive symptoms with low levels predicting increases over time. Effects of religiosity were mediated by a woman's spirituality. Religiosity and spirituality functioned as significant, interrelated protective factors in this study which provides novel insight about lower income African American women following birth.