Psychological distress and health behaviours among Cambodian Americans at risk for developing diabetes

Julie Wagner, Angela Bermúdez-Millán, S. Megan Berthold, Thomas Buckley, Orfeu M. Buxton, Richard Feinn, Sengly Kong, Theanvy Kuoch, Lindsay Master, Mary Scully, Kagnica Seng

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


This paper reports secondary data analysis of associations between psychological distress and health behaviours among Cambodian Americans. Data are from baseline assessments from a diabetes prevention trial. All participants met stucriteria 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. For actigraphy, higher distress was associated with lower moderate/vigorous physical activity and higher mean variability of 24 h 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. 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.

Original languageEnglish (US)
Pages (from-to)372-383
Number of pages12
JournalStress and Health
Issue number2
StatePublished - Apr 2023

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Applied Psychology
  • Psychiatry and Mental health


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