Current and Cumulative Stress Experiences: A Model for Arab American Young Adults

Maha Albdour, Thomas Templin, Samuele Zilioli, Jun Sung Hong, Mark A. Lumley

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: The effect of multiple stressors on immigrant young adults’ endocrine functioning and health outcomes has not been comprehensively investigated. Aims: This study tested a theoretical model of cumulative and current stressor effects on the hypothalamic–pituitary–adrenocortical (HPA) axis functioning and health-related quality of life (HRQL) among Arab American young adults. Methods: Using a cross-sectional design, we recruited 160 participants, ages 18 to 24 years, from an urban university in the Midwest. Cumulative stress was assessed by self-report measures of childhood adversity, bullying victimization, and perceived ethnic discrimination. Current perceived stress was measured using the Perceived Stress Scale (PSS) while cortisol levels were measured in participants’ hair. Structural equation modeling tested the effects of cumulative and current stress on cortisol and HRQL. Results: Cumulative stress was negatively associated with HRQL (standardized path coefficient = −.51, p <.05). Interestingly, however, cumulative stress was inversely associated with hair cortisol level (standardized path coefficient = −.51, p <.05). Current stress was positively associated with cortisol level (standardized path coefficient =.43, p <.05) and negatively associated with the mental HRQL (standardized path coefficient < −.37, p <.05). Conclusion: Cumulative stress exhibited a different effect on HPA functioning from current perceived stress. Mental health was significantly impaired by both cumulative and current perceived stress. Implications for mental health nursing practice and research among Arab Americans are discussed.

Original languageEnglish
Pages (from-to)364-377
Number of pages14
JournalJournal of the American Psychiatric Nurses Association
Issue number2
StatePublished - 1 Mar 2024

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  • Arab Americans
  • HPA axis functioning
  • cumulative stress
  • current stress
  • immigrants


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