Psychological Distress and Health Behaviors among Cambodian Americans at Risk for Developing Diabetes.

AIMS: This paper reports secondary data analysis of associations between psychological distress and health behaviors among Cambodian Americans.

METHODS: Data are from baseline assessments from a diabetes prevention trial. All participants met criteria for depression and were free of diabetes. Participants (n=191) completed surveys, a food frequency assessment, and wore sleep and physical activity actigraphy devices for 7 days. A factor analysis of symptoms of post-traumatic stress, baksbat (a Cambodian culture-bound syndrome), depression, and anxiety yielded a single factor named 'psychological distress'. Multivariate models controlling for psychotropic medications were run for the following outcomes: sleep actigraphy, self-reported sleep, physical activity actigraphy, self-reported physical activity, nutrition, and substance use.

RESULTS: For actigraphy, higher distress was associated with lower moderate/vigorous physical activity and higher mean variability of 24-hour total sleep time. Higher distress was also associated with worse self-reported sleep quality as indicated by standard, and culturally-specific, sleep indicators. Higher distress was also associated with lower use of food labels, lower carbohydrate consumption, and higher alcohol consumption as a coping mechanism.

CONCLUSIONS: Interventions to mitigate diabetes risk in high-distress populations may benefit from strategies to decrease psychological distress. The sequelae of complex trauma may transcend discrete psychiatric diagnoses. This article is protected by copyright. All rights reserved.