Most health disparities originate in childhood and extend across the lifespan. However, studies on health disparities have been predominately focused on adults. This study evaluated the biological and psychosocial consequences of exposure to chronic adversity among 491 low-income children 8 to 12 years old (52.1% male; M age = 9.73, SD = 1.0; 68.2% Black/African American; 21.2% Latinx; 267 maltreated and 224 nonmaltreated). Latent profile analyses revealed six distinct profiles of cumulative socioeconomic risk, allostatic load, and mental health functioning. Childhood maltreatment, emotion regulation, affect, and personality characteristics were differentially associated with these latent profiles. Consistent with resilience theory, findings indicate differential effects of chronic adversity on adaptation. These findings also offer evidence that signs of physiological dysregulation emerge at earlier ages in development and suggest there may be a window of opportunity in childhood for interventions to reduce the detrimental effects of chronic adversity on health outcomes in children.
Bidirectional associations between changes in symptoms and alliance are established for in-person psychotherapy. Alliance may play an important role in promoting engagement and effectiveness within unguided mobile health (mHealth) interventions. Using models disaggregating alliance and psychological distress into within- and between-person components (random intercept cross-lagged panel model), we report bidirectional associations between alliance and distress over the course of a 4-week smartphone-based meditation intervention (n=302, 80.0% elevated depression/anxiety). Associations were stable across time with effect sizes similar to those observed for psychotherapy (βs=-.13 to -.14 and -.09 to -.10, for distress to alliance and alliance to distress, respectively). Alliance may be worth measuring to improve the acceptability and effectiveness of mHealth tools. Further empirical and theoretical work characterizing the role and meaning of alliance in unguided mHealth is warranted.
Despite the prominence of shame in stigma theories, its role in explaining population-level mental health disparities between the stigmatized and non-stigmatized has not been investigated. We assessed shame explicitly (via self-report) and implicitly (via a behavioral task) in a prospective, representative cohort of sexual minority and heterosexual young adults in Sweden (baseline n=2,222). Compared to heterosexuals, sexual minorities evidenced higher explicit and implicit shame, which explained sexual orientation disparities in depression, social anxiety, and suicidal thoughts. Among sexual minorities, there was an indirect effect of shame in the association between interpersonal stigma (i.e., past-year family rejection and childhood bullying) and later experiences of adverse mental health; an indirect effect did not exist for the related construct, internalized stigma. Results suggest extending existing stigma theories to consider emotions like shame as characteristic reactions to stigma and guide the search for treatment targets focused on reducing the mental health sequelae of stigma.
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