Migrant farmwork is often characterized by harsh working conditions that carry significant physical and mental health consequences. Using a learned helplessness framework, the current study examined the extent to which discrimination, immigration legal status difficulties, and adverse childhood experiences moderated the effects of harsh working conditions on depression and anxiety. The study also examined the extent to which harsh working conditions mediated the effects of discrimination, immigration legal status difficulties, and adverse childhood experiences on depression and anxiety. Participants were 241 migrant farmworkers recruited in the Midwest. Participants completed interviews consisting of the Migrant Farmworker Stress Index (MFWSI), Adverse Childhood Events Scale (ACEs), Everyday Discrimination Scale, the Centers for Epidemiology Scale for Depression (CES-D), and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Tests of indirect effects suggested, working conditions mediated the effects of ACEs, immigration legal status fears, and discrimination on CES-D and GAD-7 scores (p values < .05). Higher ACEs and discrimination also appeared to be associated with larger effects of harsh working conditions on depression and anxiety (p values < .05), while legal status fears did not significantly moderate the effect of harsh working conditions on either outcome (p values > .05). Likely through different mechanisms, adverse childhood experiences, discrimination and immigration legal status are associated with higher risk of harsh working conditions and subsequently these conditions account for much of the relations between these 3 stressors with depression and anxiety. Additionally, discrimination and adverse childhood experiences appear to then enhance the effects of working conditions.

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It is difficult to accurately assess and differentially diagnose the anxiety disorders. The current system of assessment relies heavily on the subjective measures of client self-report, clinical observation, and clinical judgment. Fortunately, recent technological advances may enable practitioners to utilize objective, biobehavioral measures of assessment in a clinical setting. The current body of literature on two of these biobehavioral tools (eye-tracking and electrocardiogram devices) is promising, but more validation and standardization research is needed to maximize the utility of these devices. Eye-tracking devices are uniquely capable of providing data that can be used to differentially diagnose anxiety disorders from both other commonly comorbid and misdiagnosed disorders. Both eye-tracking and electrocardiogram devices are able to provide change-sensitive assessment information. This objective, real-time feedback can assist clinicians and researchers in assessing treatment efficacy and symptom fluctuation. Recently developed wearable and highly portable electrocardiogram devices, like the wearable fitness and behavior tracking devices used by many consumers, may be particularly suited for providing this feedback to clinicians. Utilizing these biobehavioral devices would supply an objective, dimensional component to the current categorical diagnostic assessment system. We posit that if adequate funding and attention are directed at this area of research, it could revolutionize diagnostic and on-going assessment practices and, in doing so, bring the field of diagnosis out of the 20th century.

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Objective: Women who have experienced trauma report high rates of heavy episodic drinking (HED) and sleep problems. Prior work suggests that poor sleep exacerbates heavy alcohol use; however, potential mechanisms for this association are unclear. Consistent with the self-medication model, one possibility may be that women with a history of trauma are drinking at increased rates in order to cope with the affective consequences of poor sleep. To examine this possibility, the current study tested the role of drinking to cope motives as a mediator of prospective associations between sleep problems and HED among women who have experienced trauma. Method: Community women reporting a history of trauma (N = 414, M age = 21.8, 59.9% White, 36.2% Black) completed self-report measures at baseline and 4 month and 8 month follow-ups. Measures of trauma exposure (Life Events Checklist [LEC]) and sleep problems (Cohen-Hoberman Inventory of Physical Symptoms-Revised [CHIPS-R]) were taken from baseline, drinking motives (Revised Drinking Motives Questionnaire) at 4 months, and HED at 8 months. Results: Findings supported an indirect association between sleep problems and later HED through increased drinking to cope motives (b = .05, 95% CI [.018, .108], β = .05). Conclusion: As hypothesized, drinking to cope accounted for associations between sleep problems and later HED. Findings underscore the potential value in addressing drinking to cope motives as a means of reducing HED, particularly among women with a history of trauma who are sleeping poorly. Public Health Significance StatementThis study indicates that high rates of heavy alcohol use among women with a history of trauma who are sleeping poorly may be driven by motivations to drink in order to cope with distress. Findings point to sleep problems and drinking to cope as potential targets to reduce heavy episodic drinking (HED) among women who have experienced trauma.

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The Migrant Farmworker Stress Inventory (MFWSI) was developed to measure the distinct stressors faced by migrant farmworkers. The most appropriate measurement and factor structure, however, has been primarily examined with exploratory methods with no studies of confirmatory factor analyses (CFA) to date. The present study built on prior exploratory factor analytic approaches using the MFWSI by applying CFA and other tests of validity to better delineate the component parts of migrant farmworker stress that contribute to anxiety and depression. Participants were 241 Latino migrant farmworkers recruited from rural farmworker campsites in Nebraska. Initially, neither of the previously identified factor structures fit the data well. Following model respecification, only three factors remained from the original exploratory approaches. These models produced both common and unique factors, which were combined to produce a four-factor model. Results suggest that rural migrant farmworker stress may operate with at least four distinct domains: (a) economic difficulties, (b) immigration and legal status, (c) parenting and child difficulties, and (d) social isolation and related challenges. Finally, only economic difficulties predicted depression and anxiety scores, such that those reporting more stress around economic difficulties reported higher depression and anxiety symptoms. Results point to the need for additional measurement and construct refinement to inform empirical, clinical, policy, and social advocacy work. Public Health Significance StatementWe have identified four distinct domains of stress that migrant farmworkers experience, which are economic difficulties, immigration and legal status concerns, parenting and child difficulties, and social isolation and related challenges. In order to effectively reduce these stressors, comprehensive reform needs to occur at the state and federal level, including immigration reform, better oversight of H-2 A visa program, and better access to childcare services in agricultural communities.