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Reynolds A, Paige KJ, Colder CR, Mushquash CJ, Wendt DC, Burack JA, O'Connor RM. Negative Affect and Drinking among Indigenous Youth: Disaggregating Within- and Between-Person Effects. Res Child Adolesc Psychopathol 2024; 52:865-876. [PMID: 38407776 PMCID: PMC11108953 DOI: 10.1007/s10802-024-01173-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024]
Abstract
Negative affect (depression/anxiety) and alcohol use among Indigenous youth in Canada remain a concern for many communities. Disparate rates of these struggles are understood to be a potential outcome of colonization and subsequent intergenerational trauma experienced by individuals, families, and communities. Using a longitudinal design, we examined change in alcohol use and negative affect, and reciprocal associations, among a group of Indigenous adolescents. Indigenous youth (N = 117; 50% male; Mage=12.46-16.28; grades 6-10) from a remote First Nation in northern Quebec completed annual self-reported assessments on negative affect (depression/anxiety) and alcohol use. A Latent Curve Model with Structured Residuals (LCM-SR) was used to distinguish between- and within-person associations of negative affect and alcohol use. Growth models did not support change in depression/anxiety, but reports of drinking increased linearly. At the between-person level, girls reported higher initial levels of depression/anxiety and drinking; depression/anxiety were not associated with drinking. At the within-person level, drinking prospectively predicted increases in depression/anxiety but depression/anxiety did not prospectively predict drinking. When Indigenous adolescents reported drinking more alcohol than usual at one wave of assessment, they reported higher levels of negative affect than expected (given their average levels of depression/anxiety) at the following assessment. Our findings suggest that when Indigenous youth present for treatment reporting alcohol use, they should also be screened for negative affect (depression/anxiety). Conversely, if an Indigenous adolescent presents for treatment reporting negative affect, they should also be screened for alcohol use.
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Affiliation(s)
- Ashley Reynolds
- Department of Psychology, Concordia University, Montreal, QC, Canada.
| | - Katie J Paige
- Department of Psychology, University of Buffalo, Buffalo, NY, USA
| | - Craig R Colder
- Department of Psychology, University of Buffalo, Buffalo, NY, USA
| | - Christopher J Mushquash
- Department of Psychology, Lakehead University, Ontario, Canada
- Thunder Bay Regional Health Sciences Centre, Ontario, Canada
- Thunder Bay Regional Health Research Institute, Ontario, Canada
- Northern Ontario School of Medicine University, Thunder Bay, Ontario, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, Ontorio, Canada
| | - Dennis C Wendt
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Jacob A Burack
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Roisin M O'Connor
- Department of Psychology, Concordia University, Montreal, QC, Canada.
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2
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Pennington ML, Ylitalo KR, Thomas KL, Coe E, Humphries M, Gulliver SB. Suicides among American Indian/Alaska Native firefighters: Data from the National Violent Death Reporting System, 2003 - 2017. Psychiatry Res 2023; 330:115593. [PMID: 37951031 DOI: 10.1016/j.psychres.2023.115593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
Suicide is a significant public health problem in the United States and disproportionally affects male American Indian/Alaska Natives (AI/AN). Suicide is particularly problematic among AI/AN firefighters who are more likely to report suicide ideation, planning, attempts, and risk compared to non-Hispanic white (NHW) firefighters. The aim of the current study was to compare non-Hispanic AI/AN firefighter and NHW firefighter suicide decedents by demographics and risk/precipitating factors using National Violent Death Reporting System data for 45 male non-Hispanic AI/AN firefighter and 588 male NHW firefighter decedents who died by suicide. Compared to NHW firefighter decedents, AI/AN firefighter decedents were significantly younger and had significantly higher odds of experiencing alcohol use problems and a recent death/suicide of a family member/friend. AI/AN firefighter decedents had significantly lower odds of documented mental health problems, documented diagnosis of depression/dysthymia, receipt of mental health treatment, or leaving a suicide note compared to NHW firefighter decedents. Results from this study may inform tailored suicide prevention and screening efforts among first responders with the goal of lowering suicide mortality among AI/AN firefighters and fire service as a whole.
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Affiliation(s)
- Michelle L Pennington
- Department of Public Health, Baylor University, Waco, TX, USA; Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA.
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | | | - Elizabeth Coe
- Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA
| | - Mariah Humphries
- George W. Truett Theological Seminary, Baylor University, Waco, TX, USA
| | - Suzy B Gulliver
- Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, Temple, TX, USA
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Spillane NS, Schick MR, Kirk-Provencher KT, Nalven T, Goldstein SC, Crawford MC, Weiss NH. Trauma and Substance Use among Indigenous Peoples of the United States and Canada: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3297-3312. [PMID: 36197078 DOI: 10.1177/15248380221126184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Substance use has been identified by Indigenous populations as contributing to health disparities facing their communities. Rates of trauma exposure and post-traumatic stress disorder are higher in Indigenous, compared to non-Indigenous, populations and have been linked to substance use. Historical trauma is thought to be one mechanism underlying substance use and related disorders. The purpose of the present study is to summarize the current state of the literature focusing on the association between trauma (historical and lived) and substance use among Indigenous populations in the United States and Canada. Databases were systematically searched using the preferred reporting items for systematic reviews and meta-analyses statement. The search strategy initially yielded 4,026 articles. After exclusion of ineligible articles, 63 articles remained for synthesis. Results of the present review provide evidence for a positive link between substance use and both historical trauma (i.e., 86.4% of studies) and lived trauma (i.e., 84.7% of studies). Indigenous participants reported that historical trauma and pain related to loss of cultural identity contributed to substance use in their communities. Indigenous participants also consistently described an association between lived trauma and substance use. Despite heterogeneity among Indigenous communities, findings suggest a significant association between trauma and substance use across many different tribes and settings (e.g., reservation/reserve, rural/urban). Indigenous participants identified healing from trauma and reconnecting with culture as necessary components for reducing substance use and maintaining sobriety. With this, the development and implementation of interventions should partner with Indigenous communities in a manner that promotes and enhances cultural values for healing.
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Affiliation(s)
| | - Melissa R Schick
- University of Rhode Island, Kingston, USA
- Yale School of Medicine, New Haven CT, USA
| | - Katelyn T Kirk-Provencher
- University of Rhode Island, Kingston, USA
- University of Colorado Anschutz Medical Campus, Aurora, USA
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Carlson TA, Liddell JL. The importance of community support for women in a Gulf Coast Indigenous tribe. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2023; 16:162-175. [PMID: 38770245 PMCID: PMC11104765 DOI: 10.1108/ijhrh-06-2022-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose – Community support is an integral aspect of health and well-being for Indigenous peoples. The purpose of this paper is to demonstrate the valuable role of community support for Indigenous women specifically, who experience reproductive health disparities at alarming rates. This study helps fill an important gap in Indigenous scholarship by centering the resilience of women and Indigenous tribes and by using a framework that is consistent with Indigenous holistic views of health. Design/methodology/approach – The data for this paper was collected as part of a larger study exploring the reproductive health experiences of a state-recognized Gulf Coast tribe. A total of 31 semi-structured interviews were conducted with individuals who identify as women and as members of this tribe using qualitative descriptive methodology. This method is recommended for research with Indigenous communities. A community advisory board with representatives from this tribe provided feedback throughout the project. Findings – Themes expressed by participants included Community Closeness and Support; Community Support in Raising Children; Informal Adoption Common; and Community Values of Mutual Aid and Self-Sufficiency. The findings support current literature noting the value of generational and communal ties for Indigenous peoples. Implications of this research include the need to value and support community networks in programs serving tribes, in addition to meaningfully including Indigenous communities in developing interventions. Originality/value – This paper centers Indigenous women's resilience, approaches the health and well-being of Indigenous tribes holistically and helps to fill an important gap in literature describing informal adoption (outside the legal system) in state-recognized Indigenous communities.
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Affiliation(s)
- Tess A Carlson
- School of Social Work, University of Montana, Missoula, Montana, USA
| | - Jessica L Liddell
- School of Social Work, University of Montana, Missoula, Montana, USA
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Wiglesworth A, Klimes-Dougan B, Prinstein MJ. Preliminary Reporting Patterns of Suicide Ideation and Attempt Among Native American Adolescents in Two Samples. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-15. [PMID: 37318235 PMCID: PMC10721721 DOI: 10.1080/15374416.2023.2222408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Native American adolescents are disproportionately burdened by suicidality. Here, we examine patterns of reporting of suicide ideation and suicide attempt among Native American youth compared to those from other ethnoracial backgrounds, as this data is important for grounding commonly subscribed to frameworks of suicide risk (e.g., ideation-to-action). METHOD Data are from the Youth Risk Behavior Surveillance Survey (N = 54,243; grades 9-12; 51.0% female) and Minnesota Student Survey (N = 335,151; grades 8, 9, 11; 50.7% female). Comparing Native American youth to peers from other ethnoracial backgrounds, we examined two suicide reporting patterns: 1) odds of reporting suicide attempt among those who reported ideation and 2) odds of reporting suicide ideation among those who reported an attempt. RESULTS Across both samples, when reporting suicide ideation, youth from other ethnoracial backgrounds were 20-55% less likely than Native American youth to also report attempt. While few consistent differences were observed between Native American youth and those from other racial minority backgrounds in patterns of co-reporting suicide ideation and attempt across samples, White youth were between 37% and 63% less likely than Native American youth to report a suicide attempt without also reporting ideation. CONCLUSIONS The increased odds of engaging in a suicide attempt with or without reporting ideation question the generalizability of widely held frameworks of suicide risk to Native American youth and have important implications for suicide risk monitoring. Future research is needed to illuminate how these behaviors unfold over time and the potential mechanisms of risk for engaging in suicide attempts in this disproportionately burdened group.Abbreviations: YRBSS: Youth Risk Behavior Surveillance Survey; MSS: Minnesota Student Survey.
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Wilhelm RA, Spechler PA, Demuth MJ, Gonzalez M, Kemp C, Walls M, Aupperle RL, Paulus MP, Stewart JL, White EJ. Striatal hypoactivation during monetary loss anticipation in individuals with substance use disorders in a heterogenous urban American Indian sample. Drug Alcohol Depend 2023; 246:109852. [PMID: 37003108 PMCID: PMC10614574 DOI: 10.1016/j.drugalcdep.2023.109852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023]
Abstract
Research suggests that disproportionate exposure to risk factors places American Indian (AI) peoples at higher risk for substance use disorders (SUD). Although SUD is linked to striatal prioritization of drug rewards over other appetitive stimuli, there are gaps in the literature related to the investigation of aversive valuation processing, and inclusion of AI samples. To address these gaps, this study compared striatal anticipatory gain and loss processing between AI-identified with SUD (SUD+; n = 52) and without SUD (SUD-; n = 35) groups from the Tulsa 1000 study who completed a monetary incentive delay (MID) task during functional magnetic resonance imaging. Results indicated that striatal activations in the nucleus accumbens (NAcc), caudate, and putamen were greatest for anticipating gains (ps < 0.001) but showed no group differences. In contrast to gains, the SUD+ exhibited lower NAcc (p = .01, d =0.53) and putamen (p = .04, d =0.40) activation to anticipating large losses than the comparison group. Within SUD+ , lower striatal responses during loss anticipations were associated with slower MID reaction times (NAcc: r = -0.43; putamen: r = -0.35) during loss trials. This is among the first imaging studies to examine underlying neural mechanisms associated with SUD within AIs. Attenuated loss processing provides initial evidence of a potential mechanism wherein blunted prediction of aversive consequences may be a defining feature of SUD that can inform future prevention and intervention targets.
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Affiliation(s)
| | | | - Mara J Demuth
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Miigis Gonzalez
- Center for American Indian Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Christopher Kemp
- Center for American Indian Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Melissa Walls
- Center for American Indian Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | | | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA.
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White EJ, Demuth MJ, Nacke M, Kirlic N, Kuplicki R, Spechler PA, McDermott TJ, DeVille DC, Stewart JL, Lowe J, Paulus MP, Aupperle RL. Neural processes of inhibitory control in American Indian peoples are associated with reduced mental health problems. Soc Cogn Affect Neurosci 2023; 18:nsac045. [PMID: 35801628 PMCID: PMC9949499 DOI: 10.1093/scan/nsac045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/17/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
American Indians (AI) experience disproportionately high prevalence of suicide and substance use disorders (SUD). However, accounting for risk burden (e.g. historical trauma and discrimination), the likelihood of mental health disorders or SUD is similar or decreased compared with the broader population. Such findings have spurred psychological research examining the protective factors, but no studies have investigated its potential neural mechanisms. Inhibitory control is one of the potential neurobehavioral construct with demonstrated protective effects, but has not been examined in neuroimaging studies with AI populations specifically. We examined the incidence of suicidal thoughts and behaviors (STB) and SUD among AI (n = 76) and propensity matched (sex, age, income, IQ proxy and trauma exposure) non-Hispanic White (NHW) participants (n = 76). Among the AI sample, functional magnetic resonance imaging (fMRI) data recorded during the stop-signal task (SST) was examined in relation to STB and SUDs. AIs relative to NHW subjects displayed lower incidence of STB. AIs with no reported STBs showed greater activity in executive control regions during the SST compared with AI who endorsed STB. AI without SUD demonstrated lower activity relative to those individual reporting SUD. Results are consistent with a growing body of literature demonstrating the high level of risk burden driving disparate prevalence of mental health concerns in AI. Furthermore, differential activation during inhibitory control processing in AI individuals without STB may represent a neural mechanism of protective effects against mental health problems in AI. Future research is needed to elucidate sociocultural factors contributing protection against mental health outcomes in AIs and further delineate neural mechanisms with respect to specific concerns (e.g. SUD vs STB).
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Affiliation(s)
- Evan J White
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK 74119, USA
| | - Mara J Demuth
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| | - Mariah Nacke
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| | - Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| | | | - Timothy J McDermott
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Department of Psychology, University of Tulsa, Tulsa, OK 74104, USA
| | - Danielle C DeVille
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Department of Psychology, University of Tulsa, Tulsa, OK 74104, USA
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK 74119, USA
| | - John Lowe
- School of Nursing, University of Texas at Austin, Austin, TX 78712, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK 74119, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK 74119, USA
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8
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White EJ, Demuth MJ, Wiglesworth A, Coser AD, Garrett BA, Kominsky TK, Jernigan V, Thompson WK, Paulus M, Aupperle R. Five recommendations for using large-scale publicly available data to advance health among American Indian peoples: the Adolescent Brain and Cognitive Development (ABCD) Study SM as an illustrative case. Neuropsychopharmacology 2023; 48:263-269. [PMID: 36385331 PMCID: PMC9751109 DOI: 10.1038/s41386-022-01498-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
American Indian and Alaska Native (AIAN) populations have suffered a history of exploitation and abuse within the context of mental health research and related fields. This history is rooted in assimilation policies, historical trauma, and cultural loss, and is promulgated through discrimination and disregard for traditional culture and community knowledge. In recognition of this history, it is imperative for researchers to utilize culturally sensitive approaches that consider the context of tribal communities to better address mental health issues for AIAN individuals. The public availability of data from large-scale studies creates both opportunities and challenges when studying mental health within AIAN populations. This manuscript has two goals; first, showcase an example of problematic use of Adolescent Brain Cognitive Development (ABCD) StudySM data to promulgate stereotypes about AIAN individuals and, second, in partnership with collaborators from Cherokee Nation, we provide five recommendations for utilizing data from publicly available datasets to advance health research in AIAN populations. Specifically, we argue for the consideration of (1) the heterogeneity of the communities represented, (2) the importance of focusing on AIAN health and well-being, (3) engagement of relevant communities and AIAN community leaders, (4) consideration of historical and ongoing injustices, and (5) engagement with AIAN regulatory agencies or review boards. These recommendations are founded on principles from broader indigenous research efforts emphasizing community-engaged research and principles of Indigenous Data Sovereignty and Governance.
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Affiliation(s)
- Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA.
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA.
| | - Mara J Demuth
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | | | | | - Valarie Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State Universit y Center for Health Sciences, Tulsa, OK, USA
| | | | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Robin Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
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9
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Marshall V, Vieira D, McLaurin-Jones T, Lashley MB. Examining alcohol interventions across the lifespan among the African diaspora: A systematic review. J Natl Med Assoc 2022; 114:473-494. [PMID: 35811146 DOI: 10.1016/j.jnma.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/21/2022] [Accepted: 06/06/2022] [Indexed: 11/19/2022]
Abstract
AIMS Racial/ethnic and cultural identity influences alcohol use consumption and help-seeking behaviors. The purpose of this systematic review was to assess alcohol prevention programs and interventions targeting African Americans/Blacks among the African Diaspora across the lifespan. METHODS According to PRISMA guidelines, literature searches were conducted via electronic databases, grey literature, and hand searches of relevant journal articles evaluating primary outcome data to reduce alcohol use. To be included in this systematic review, intervention and prevention studies required a population of more than 50% African descent and provided information about statistical significance (p < .05) indicating changes in alcohol as a primary outcome. RESULTS Search strategy identified 5691 citations and the full-text of 148 studies were screened. A total of 23 articles met the inclusion criteria. Studies were geographically located in the United States and African countries. Interventions were implemented in community, patient-care, school, and workplace settings. Adult studies evaluated pharmacological and/or behavioral interventions while utilizing validated instruments and procedures to assess alcohol outcomes. Strategies to change alcohol behavior included psychotherapy, brief motivational interviewing (BMI), and counseling. Adolescent studies utilized family-based, computer-assisted technology, and career development interventions to reduce alcohol use. CONCLUSIONS The systematic review identified a range of intervention articles addressing the reduction of alcohol use for African Americans/Blacks that may be used in various settings and by different age groups. Best practices and strategies designed to address socio-cultural factors by promoting protective and risk-reducing factors of alcohol use and successful alcohol interventions are needed.
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Affiliation(s)
- Vanessa Marshall
- Community & Family Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Dorice Vieira
- New York University Grossman School of Medicine, New York, NY, USA
| | - TyWanda McLaurin-Jones
- Community & Family Medicine, Howard University College of Medicine, Washington, DC, USA.
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10
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Kell PA, Huber FA, Street EN, Shadlow JO, Rhudy JL. Sleep Problems Mediate the Relationship Between Psychosocial Stress and Pain Facilitation in Native Americans: A Structural Equation Modeling Analysis from the Oklahoma Study of Native American Pain Risk. Ann Behav Med 2022; 56:1116-1130. [PMID: 35775809 PMCID: PMC9924047 DOI: 10.1093/abm/kaac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Native Americans (NAs) are more likely to experience chronic pain than non-Hispanic Whites (NHWs); however, the proximate causes predisposing NAs to chronic pain remain elusive. Likely due to centuries of adversity, discrimination, and marginalization, NAs report greater psychological stress than NHWs, which may place them at risk for sleep problems, a well-established risk factor for chronic pain onset. PURPOSE This study examined the effects of psychological stress and sleep problems on subjective and physiological measures of pain processing in NAs and NHWs. METHODS Structural equation modeling was used to determine whether ethnicity (NA or NHW) was associated with psychological stress or sleep problems and whether these variables were related to conditioned pain modulation of pain perception (CPM-pain) and the nociceptive flexion reflex (CPM-NFR), temporal summation of pain (TS-pain) and NFR (TS-NFR), and pain tolerance in a sample of 302 (153 NAs) pain-free participants. RESULTS NAs experienced more psychological stress (Estimate = 0.027, p = .009) and sleep problems (Estimate = 1.375, p = .015) than NHWs. When controlling for age, sex, physical activity, BMI, and general health, NA ethnicity was no longer related to greater sleep problems. Psychological stress was also related to sleep problems (Estimate = 30.173, p = <.001) and psychological stress promoted sleep problems in NAs (indirect effect = 0.802, p = .014). In turn, sleep problems were associated with greater TS-pain (Estimate = 0.714, p = .004), but not other pain measures. CONCLUSIONS Sleep problems may contribute to chronic pain risk by facilitating pain perception without affecting facilitation of spinal neurons or endogenous inhibition of nociceptive processes. Since psychological stress promoted pain facilitation via enhanced sleep problems, efforts to reduce psychological stress and sleep problems among NAs may improve health outcomes.
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Affiliation(s)
- Parker A Kell
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | | | - Erin N Street
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Joanna O Shadlow
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
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11
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Elsouri KN, Kalhori S, Colunge D, Grabarczyk G, Hanna G, Carrasco C, Aleman Espino A, Francisco A, Borosky B, Bekheit B, Ighanifard M, Astudillo AA, Demory Beckler M. Psychoactive Drugs in the Management of Post Traumatic Stress Disorder: A Promising New Horizon. Cureus 2022; 14:e25235. [PMID: 35747039 PMCID: PMC9214830 DOI: 10.7759/cureus.25235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/22/2022] [Indexed: 11/06/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is an anxiety disorder that often presents after exposure to a traumatic, life-threatening event. Experiencing a traumatic event is not rare, with inciting incidents ranging from being burglarized to politically motivated genocide. While traditional psychopharmacology and psychotherapy are the mainstays of the treatment of PTSD currently, psychoactive drugs (otherwise known as psychedelics) are being explored for their novel role in the treatment of PTSD patients. Psychoactive drugs such as MDMA, ketamine, and psilocybin have been shown to specifically target and decrease fear and anxiety pathways in the brain. These unique properties hold the potential to be utilized in addressing symptoms of trauma in those with refractory or treatment-resistant PTSD. Historically, federal and state laws have restricted research into how psychoactive drugs can be used to treat mental illness due to the widespread belief that these drugs present more harm than benefit. However, the current shift in public opinion on psychedelics has propelled research to look into the benefits of these drugs for patients with mental illness. This article aims to discuss the mechanisms of how MDMA, ketamine, and psilocybin work in the PTSD brain, as well as their beneficial role in treatment.
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12
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Haeny AM, Oluwoye O, Cruz R, Iheanacho T, Jackson AB, Fisher S, Crouch M, O'Malley S. Drug and alcohol treatment utilization and barriers among Black, American Indian/Alaskan Native, Latine, Asian/Pacific Islander/Native Hawaiian, and White adults: Findings from NESARC-III. J Subst Abuse Treat 2021; 131:108569. [PMID: 34393011 PMCID: PMC9084614 DOI: 10.1016/j.jsat.2021.108569] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/24/2021] [Accepted: 07/14/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Existing epidemiological data suggest differences across racial/ethnic groups in drug and alcohol treatment utilization and barriers to treatment and typically include only Black, Latine, and White adults. The objective of this study was to examine whether disparities remain for DSM-5 lifetime alcohol use disorder (AUD) and drug use disorder (DUD) treatment utilization and barriers across Black, American Indian/Alaska Native (AI/AN), Latine, Asian/Pacific Islander/Native Hawaiian (Asian/PI/NH), and White adults. METHODS The current study conducted secondary analyses on data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). Regression analyses, followed by pairwise comparisons, investigated differences across racial/ethnic groups. RESULTS Analyses indicated differences across racial/ethnic groups in AUD treatment utilization. White and AI/AN adults were more likely to utilize a health care professional than were Black adults. Asian/PI/NH and Latine adults were more likely to endorse language as a barrier to AUD treatment than were White adults. Black adults were more likely to use 12-step programs for DUD treatment utilization than were White and Latine adults, and Black and White adults were more likely to use outpatient programs than were Latine adults. Further, Black adults were more likely than Asian/PI/NH and Latine adults to use specialty DUD treatment. AI/AN, Asian/PI/NH, and White adults were more likely to endorse fear of what others would think as a barrier to DUD treatment relative to Black adults. AI/AN adults were more likely to endorse fear of being hospitalized relative to Black, Latine, and White adults. Asian/PI/NH and Latine adults were more likely to indicate that the hours were inconvenient relative to Black and White adults. White adults were more likely to endorse a family member objected relative to Black adults. AI/AN and White adults were more likely to endorse they stopped on their own relative to Black, Asian/PI/NH, and Latine adults. Further, AI/AN and White adults reported the greatest number of barriers to DUD treatment. CONCLUSIONS Differences remain across racial/ethnic group in drug and alcohol treatment utilization and barriers to treatment. Future research aimed at increasing treatment utilization across racial/ethnic groups should focus on social determinants of health.
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Affiliation(s)
- Angela M Haeny
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States.
| | | | - Rick Cruz
- Utah State University, United States
| | - Theddeus Iheanacho
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States
| | - Asti B Jackson
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States
| | | | - Maria Crouch
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States; University of Alaska Anchorage, United States
| | - Stephanie O'Malley
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States
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Rhudy JL, Kuhn BL, Demuth MJ, Huber FA, Hellman N, Toledo TA, Lannon EW, Palit S, Payne MF, Sturycz CA, Kell PA, Guereca YM, Street EN, Shadlow JO. Are Cardiometabolic Markers of Allostatic Load Associated With Pronociceptive Processes in Native Americans?: A Structural Equation Modeling Analysis From the Oklahoma Study of Native American Pain Risk. THE JOURNAL OF PAIN 2021; 22:1429-1451. [PMID: 34033965 PMCID: PMC8578174 DOI: 10.1016/j.jpain.2021.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/07/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
Native Americans (NAs) experience higher rates of chronic pain than the general U.S. population, but the risk factors for this pain disparity are unknown. NAs also experience high rates of stressors and cardiovascular and metabolic health disparities (eg, diabetes, cardiovascular disease) consistent with allostatic load (stress-related wear-and-tear on homeostatic systems). Given that allostatic load is associated with chronic pain, then allostatic load may contribute to their pain disparity. Data from 302 healthy, pain-free men and women (153 NAs, 149 non-Hispanic Whites [NHW]) were analyzed using structural equation modeling to determine whether cardiometabolic allostatic load (body mass index, blood pressure, heart rate variability) mediated the relationship between NA ethnicity and experimental measures of pronociceptive processes: temporal summation of pain (TS-pain) and the nociceptive flexion reflex (TS-NFR), conditioned pain modulation of pain (CPM-pain) and NFR (CPM-NFR), and pain tolerance. Results indicated that NAs experienced greater cardiometabolic allostatic load that was related to enhanced TS-NFR and impaired CPM-NFR. Cardiometabolic allostatic load was unrelated to measures of pain perception (CPM-pain, TS-pain, pain sensitivity). This suggests cardiometabolic allostatic load may promote spinal sensitization in healthy NAs, that is not concomitant with pain sensitization, perhaps representing a unique pain risk phenotype in NAs. PERSPECTIVE: Healthy, pain-free Native Americans experienced greater cardiometabolic allostatic load that was associated with a pronociceptive pain phenotype indicative of latent spinal sensitization (ie, spinal sensitization not associated with hyperalgesia). This latent spinal sensitization could represent a pain risk phenotype for this population.
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Affiliation(s)
- Jamie L Rhudy
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma.
| | - Bethany L Kuhn
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Mara J Demuth
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | | | - Natalie Hellman
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Tyler A Toledo
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Edward W Lannon
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Shreela Palit
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Michael F Payne
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma; Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, Ohio
| | | | - Parker A Kell
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Yvette M Guereca
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Erin N Street
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Joanna O Shadlow
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
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14
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Kerr WC, Ye Y, Williams E, Mulia N, Cherpitel CJ. Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016. Inj Prev 2021; 27:435-441. [PMID: 33093126 PMCID: PMC8519032 DOI: 10.1136/injuryprev-2020-043951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/19/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Alcohol and drug use are significant problems in the US, and American Indian/Alaska Native (AI/AN) communities and individuals are known to be among the most affected. This study evaluates disparities in unintentional injury mortality causes since 1999. METHODS Analyses in 2020 of unintentional injury mortality rate disparities between AI/ANs and white population over the 1999-2016 period with attention to motor vehicle crashes, alcohol poisoning, drug poisoning and all other cause types. Rates in each of the 10 states with the largest AI/AN populations were also investigated to account for geographical concentration. RESULTS Motor vehicle mortality rates declined for both AI/AN and white groups, but a large racial disparity was maintained. Conversely, poisoning mortality rates rose substantially in both groups, with a jump in rates in 2007 due to a coding change, resulting in a large disparity that was maintained through 2016. Comparison of alcohol and drug poisonings showed that the AI/AN alcohol poisoning rate was about eight times the white rate, whereas drug poisoning rates were similar. For 'all other' unintentional injuries, the highest rates were seen for AI/AN men, with rates generally rising over the study period. State-specific analyses found substantial variation in AI/AN rates, with few or no disparities in New York and Texas. CONCLUSIONS Results indicate substantial and persisting disparities in unintentional injury mortality, with especially large differences in alcohol poisoning. The absence of disparities in New York and Texas suggest the importance of situational factors.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Edwina Williams
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Cheryl J Cherpitel
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
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15
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Lillie KM, Shaw J, Jansen KJ, Garrison MM. Buprenorphine/Naloxone for Opioid Use Disorder Among Alaska Native and American Indian People. J Addict Med 2021; 15:297-302. [PMID: 33074852 PMCID: PMC10395652 DOI: 10.1097/adm.0000000000000757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). METHODS The sample was 240 ANAI adults in Anchorage, Alaska who received buprenorphine/naloxone treatment for an OUD. We gathered data from the electronic health record from January 1, 2015 to December 31, 2019. We used survival analysis to explore possible predictors (demographic variables, psychiatric comorbidity, medical severity, previous opioid prescriptions, previous injury, alcohol use disorder, and co-occurring substance use) of length of treatment retention (in days) while accounting for right censoring. RESULTS We found that 63% of the 240 patients were retained in buprenorphine/naloxone treatment at 90 days, 51% at 6 months, and 40% at 1 year, slightly lower than the general US population. Younger age (hazard ratio 1.69, 95% confidence intervals 1.17-2.45) and co-occurring substance use (hazard ratio 2.95, 95% confidence intervals 1.99-4.38) were associated with increased rate of buprenorphine/naloxone treatment discontinuation. CONCLUSIONS Younger patients and those with co-occurring substance use remain at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people. Treatment programs serving ANAI people may consider paying special attention to patients with these characteristics to prevent treatment discontinuation. Our study highlights the need to address poly-substance use among ANAI people in treatment.
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Affiliation(s)
- Kate M Lillie
- Southcentral Foundation, 4085 Tudor Centre Drive, Anchorage, AK (KML, JS, KJJ); University of Washington, 4333 Brooklyn Ave NE, Seattle, WA (MMG)
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Tolliver-Lynn MN, Marris AM, Sullivan MA, Armans M. The role of the parent-child relationship in fostering resilience in American Indian/Alaskan Native children. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:419-431. [PMID: 33135173 DOI: 10.1002/jcop.22468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
Resilience is a key characteristic to study in families, particularly those who have experienced significant systemic risk factors. While much resilience research focuses on ethnic and cultural minorities, little research focuses specifically on American Indian/Alaskan Native (AI/AN) families. The parent-child relationship has been demonstrated to be a key characteristic in families, and this relationship may also serve as a protective factor for AI/AN families. Positive parent-child relationships are consistently linked to positive child outcomes, and parental psychological symptoms are linked with child psychological symptoms in non-Native families. These associations warrant further examination among AI/AN families. We hypothesized that the parent-child relationship would moderate the link between parent distress (i.e., depressive and anxious symptoms) and child internalizing problems in a sample of 57 AI/AN parents of children 3-5 years of age. As expected, the parent-child relationship moderated the associations between parent anxiety symptoms and child internalizing symptoms, and between parent depressive symptoms and child internalizing symptoms. Furthermore, the strength of the parent-child relationship buffered the effects of parent distress on child internalizing symptoms. Results highlight the potentially protective role of strong parent-child relationships in AI/AN families.
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Affiliation(s)
| | - Alvina M Marris
- The Confederated Tribes of The Colville Reservation, Nespelem, Washington, USA
| | - Maureen A Sullivan
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Mira Armans
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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17
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Tyra AT, Ginty AT, John-Henderson NA. Emotion Regulation Strategies Predict PTSS During the COVID-19 Pandemic in an American Indian Population. Int J Behav Med 2021; 28:808-812. [PMID: 33559008 PMCID: PMC7870357 DOI: 10.1007/s12529-021-09964-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 11/29/2022]
Abstract
Background Poor emotion regulation is associated with post-traumatic stress symptoms (PTSS). However, limited prospective research prevents any directional conclusions. No known studies have assessed emotion regulation with PTSS in American Indians, a high-risk population for poor mental health outcomes. The present prospective study explored whether emotion regulation strategies (cognitive reappraisal, expressive suppression) predicted later PTSS related to the COVID-19 global pandemic in a solely American Indian sample. Methods American Indian participants (N = 210; Mean (SD) age = 54.85(13.08) years, 58.7% female) completed the Emotion Regulation Questionnaire (ERQ) during Phase 1 (a few weeks before pandemic declaration) and the Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic during Phase 2 (7–8 weeks after pandemic declaration). Bivariate correlations and hierarchical linear regression analyses were utilized. Results ERQ reappraisal was negatively associated with IES-R total scores, such that higher reappraisal predicted lower PTSS. In contrast, ERQ suppression was positively associated with IES-R total scores, such that higher suppression predicted higher PTSS. Conclusions Greater suppression and lower reappraisal predicts PTSS in response to the COVID-19 pandemic in an entirely American Indian sample, providing critical information for future interventions in a population at high-risk for mental health disparities.
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Affiliation(s)
- Alexandra T Tyra
- Department of Psychology and Neuroscience, Baylor University, One Bear Place 97334, Waco, TX, 76798, USA
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, One Bear Place 97334, Waco, TX, 76798, USA
| | - Neha A John-Henderson
- Department of Psychology, Montana State University, 319 Traphagen Hall, Bozeman, MT, 59717, USA.
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18
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Burnette CE, Liddell J, Roh S, Lee YS, Lee HY. American Indian women cancer survivors' perceptions and experiences with conventional and non-conventional mental health care for depressive symptoms. ETHNICITY & HEALTH 2021; 26:186-205. [PMID: 29962228 PMCID: PMC6314900 DOI: 10.1080/13557858.2018.1493439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/06/2018] [Indexed: 05/12/2023]
Abstract
Background: Despite cancer and depression being disproportionately high for American Indian and Alaska Native (AI/AN) women, such cancer survivors' help-seeking practices and perceptions related to depression are absent in extant research. A broader context of historical oppression has set the stage for unequal health outcomes and access to quality services. The purpose of this article was to explore AI women cancer survivors' experiences with conventional mental health services and informal and tribally-based assistance, as well as barriers related to mental health service utilization.Methods: A qualitative descriptive study methodology, with qualitative content analysis, was used to examine the experiences of AI women cancer survivors as they related to help-seeking experiences for depressive symptoms. The sample included 43 AI women cancer survivors (n = 14 breast cancer, n = 14 cervical cancer, and n = 15 colon and other types of cancer survivors).Results: Since receiving a cancer diagnosis, 26 (62%) participants indicated they had feelings of depression. Some participants (n = 13) described mixed perceptions of the mental health service system. Generally, participants viewed families and informal support systems as primary forms of assistance, whereas conventional services were reported as a supplementary or 'as needed' forms of support, particularly when the informal support system was lacking. Participants received help in the forms of psychotropic medications and psychotherapy, as well as help from family and AI-specific healing modalities (e.g. sweat lodges and healing ceremonies). Stigma and confidentiality concerns were primary barriers to utilizing conventional services as described by 12 (29%) participants.Discussion: Participants' help primarily came from family and tribally-based entities, with conventional mental health care being more salient when informal supports were lacking. The mixed perceptions espoused by participants may be related to a broader context of historical oppression; family and social support and tribally-based services may be protective factors for cancer survivors with depression.
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Affiliation(s)
- Catherine E. Burnette
- School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Jessica Liddell
- City, Community, and Culture PhD Program, School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, 1400 West 22 Street, Sioux Falls, SD 57105, Phone: 605-357-1593,
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132, Phone: 415-405-0944,
| | - Hee Yun Lee
- School of Social work, The University of Alabama, 1022 Little Hall, Box 870314, Tuscaloosa, AL 35487, Phone: 205-348-6553,
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McKinley CE, Roh S, Lee YS. American Indian Alcohol Use from a Sex-Specific Wellness Approach: Exploring Its Associated Physical, Behavioral, and Mental Risk and Protective Factors. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:32-48. [PMID: 32780658 PMCID: PMC7790549 DOI: 10.1080/26408066.2020.1799648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The top causes of death for American Indians (AIs), including heart and liver disease, are associated with alcohol use. Using the culturally based Framework of Historical Oppression, Resilience, and Transcendence (FHORT), the purpose of this article was to examine AI alcohol use from a sex-specific wellness approach, exploring its associated physical, behavioral, and mental risk and protective factors. METHOD Data were drawn from a cross-sectional survey with 479 AI adults in South Dakota. We employed a series of multiple hierarchical regression analyses to assess the associations of demographic (sex, age, marital status, income, and educational attainment), physical (Body Mass Index and cardiovascular risk), behavioral (smoking and health self-efficacy) and mental (depressive symptoms) factors with alcohol use. RESULTS Results indicated that surveyed males tended to drink three times that of females, and depressive symptoms were associated with higher levels of alcohol use. DISCUSSION This study highlights the need to examine AI alcohol use with sex in mind.
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Affiliation(s)
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, Sioux Falls, SD, USA
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, CA, USA
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20
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Walls M, Sittner KJ, Whitbeck LB, Herman K, Gonzalez M, Elm JHL, Hautala D, Dertinger M, Hoyt DR. Prevalence of Mental Disorders from Adolescence through Early Adulthood in American Indian and First Nations Communities. Int J Ment Health Addict 2020; 19:2116-2130. [PMID: 35002580 PMCID: PMC8734560 DOI: 10.1007/s11469-020-00304-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Melissa Walls
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | | | - Les B. Whitbeck
- University of Nebraska, Lincoln, Department of Sociology, Lincoln, NE
| | - Kaley Herman
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Miigis Gonzalez
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Jessica H. L. Elm
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Dane Hautala
- University of Minnesota, Department of Psychiatry, Minneapolis, MN
| | - Melinda Dertinger
- University of Minnesota Medical School, Duluth campus, Department of Family Medicine & Biobehavioral Health
| | - Dan R. Hoyt
- University of Nebraska, Lincoln, Department of Sociology, Lincoln, NE
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21
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Martinez MM, Armenta BE. Trajectories of Depressive Symptoms Among North American Indigenous Adolescents: Considering Predictors and Outcomes. Child Dev 2020; 91:932-948. [PMID: 31364166 PMCID: PMC6992502 DOI: 10.1111/cdev.13268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 11/27/2018] [Accepted: 02/07/2019] [Indexed: 11/30/2022]
Abstract
We identified developmental trajectories of depressive symptoms among 674 Indigenous adolescents (Mage = 11.10, SD = 0.83 years) progressing from early to late adolescence. Four depressive symptoms trajectories were identified: (a) sustained low, (b) initially low but increasing, (c) initially high but decreasing, and (d) sustained high levels of depressive symptoms. Trajectory group membership varied as a function of gender, pubertal development, caregiver major depression, and perceived discrimination. Moreover, participants in the different trajectory groups were at differential risk for the development of an alcohol use disorder. These results highlight the benefit of examining the development of depressive symptoms and the unique ways that depressive symptoms develop among North American Indigenous youth as they progress through adolescence.
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Rhudy JL, Lannon EW, Kuhn BL, Palit S, Payne MF, Sturycz CA, Hellman N, Güereca YM, Toledo TA, Huber F, Demuth MJ, Hahn BJ, Chaney JM, Shadlow JO. Assessing peripheral fibers, pain sensitivity, central sensitization, and descending inhibition in Native Americans: main findings from the Oklahoma Study of Native American Pain Risk. Pain 2020; 161:388-404. [PMID: 31977838 PMCID: PMC7001897 DOI: 10.1097/j.pain.0000000000001715] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Native Americans (NAs) have a higher prevalence of chronic pain than other U.S. racial/ethnic groups, but there have been few attempts to understand the mechanisms of this pain disparity. This study used a comprehensive battery of laboratory tasks to assess peripheral fiber function (cool/warm detection thresholds), pain sensitivity (eg, thresholds/tolerances), central sensitization (eg, temporal summation), and pain inhibition (conditioned pain modulation) in healthy, pain-free adults (N = 155 NAs, N = 150 non-Hispanic Whites [NHWs]). Multiple pain stimulus modalities were used (eg, cold, heat, pressure, ischemic, and electric), and subjective (eg, pain ratings and pain tolerance) and physiological (eg, nociceptive flexion reflex) outcomes were measured. There were no group differences on any measure, except that NAs had lower cold-pressor pain thresholds and tolerances, indicating greater pain sensitivity than NHWs. These findings suggest that there are no group differences between healthy NAs and NHWs on peripheral fiber function, central sensitization, or central pain inhibition, but NAs may have greater sensitivity to cold pain. Future studies are needed to examine potential within-group factors that might contribute to NA pain risk.
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Affiliation(s)
- Jamie L. Rhudy
- The University of Tulsa, Department of Psychology, Tulsa, OK
| | | | - Bethany L. Kuhn
- The University of Tulsa, Department of Psychology, Tulsa, OK
| | - Shreela Palit
- The University of Tulsa, Department of Psychology, Tulsa, OK
- University of Florida, Pain Research and Intervention Center of Excellence, Gainesville, FL
| | - Michael F. Payne
- The University of Tulsa, Department of Psychology, Tulsa, OK
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Division of Behavioral Medicine & Clinical Psychology, Cincinnati, OH
| | | | - Natalie Hellman
- The University of Tulsa, Department of Psychology, Tulsa, OK
| | | | - Tyler A. Toledo
- The University of Tulsa, Department of Psychology, Tulsa, OK
| | - Felicitas Huber
- The University of Tulsa, Department of Psychology, Tulsa, OK
| | - Mara J. Demuth
- The University of Tulsa, Department of Psychology, Tulsa, OK
| | | | - John M. Chaney
- Oklahoma State University, Department of Psychology, Stillwater, OK
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Sundberg MA. Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities. J Grad Med Educ 2019; 11:624-628. [PMID: 31871558 PMCID: PMC6919166 DOI: 10.4300/jgme-d-19-00078.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Hiratsuka VY, Moore L, Avey JP, Dirks LG, Beach BD, Dillard DA, Novins DK. An Internet-Based Therapeutic Tool for American Indian/Alaska Native Adults With Posttraumatic Stress Disorder: User Testing and Developmental Feasibility Study. JMIR Form Res 2019; 3:e13682. [PMID: 31719027 PMCID: PMC6914281 DOI: 10.2196/13682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/05/2019] [Accepted: 08/31/2019] [Indexed: 11/18/2022] Open
Abstract
Background Posttraumatic stress disorder (PTSD) is a major public health concern among American Indian and Alaska Native populations. Primary care clinics are often the first point of contact for American Indian and Alaska Natives seeking health care and are feasible locations for trauma-focused interventions. Objective Web-based therapeutic interventions have the potential to reduce PTSD symptoms by offering psychoeducation and symptom self-management tools. We investigated the feasibility of a culturally adapted Web-based therapeutic intervention in two American Indian and Alaska Native–serving primary care sites. We developed and tested a self-guided Web-based therapeutic intervention aimed at improving knowledge and awareness of, and provision of guidance, support, and symptom-management for, PTSD symptoms. Methods A community-based participatory research process was used to refine adaptations to the veteran’s administration’s PTSD Coach Online, to develop new content, and to guide and interpret the results of the feasibility pilot. This process resulted in a 16-guide intervention “Health is Our Tradition: Balance and Harmony after Trauma” website. The feasibility pilot included 24 American Indian and Alaska Natives aged 18 years and older who scored positive on a primary care PTSD screener. Enrolled participants completed a demographic questionnaire, an experience with technology questionnaire, and baseline behavioral health measures. Once measures were complete, research staff described weekly text messages, minimum study expectations for website use, and demonstrated how to use the website. Feasibility measures included self-reported website use, ratings of satisfaction and perceived effectiveness, and website metrics. Feasibility of obtaining measures for an effectiveness trial was also assessed to include behavioral health symptoms and service utilization through self-report instruments and electronic health record queries. Self-reported measures were collected at enrollment and at 6 and 12 weeks post enrollment. Electronic health records were collected from 12 months before study enrollment to 3 months following study enrollment. Changes between enrollment and follow-up were examined with paired t tests, analysis of variance or logistic regression, or the Wilcoxon signed rank test for nonnormally distributed data. Results The culturally adapted website and associated text message reminders were perceived as satisfactory and effective by participants with no differences by age or gender. The majority of participants (86%, 19/24) reported use of the website at 6 weeks and nearly all (91%, 20/22) at 12 weeks. At 6 weeks, 55% (12/22) of participants reported using the website at the recommended intensity (at least three times weekly), dropping to 36% (8/22) at 12 weeks. Participant use of modules varied from 8% (2/24) to 100% (24/24), with guide completion rates being greater for guides that were only psychoeducational in nature compared with guides that were interactive. There were no significant changes in patterns of diagnoses, screening, medications, or service utilization during exposure to the website. Conclusions “Health is Our Tradition: Balance and Harmony after Trauma” shows promise for an effectiveness pilot.
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Affiliation(s)
| | - Laurie Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jaedon P Avey
- Research Department, Southcentral Foundation, Anchorage, AK, United States
| | - Lisa G Dirks
- Research Department, Southcentral Foundation, Anchorage, AK, United States
| | - Barbara D Beach
- Cherokee Nation Behavioral Health, Tahlequah, OK, United States
| | - Denise A Dillard
- Research Department, Southcentral Foundation, Anchorage, AK, United States
| | - Douglas K Novins
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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“One Out of Ten Ain’t Going to Make It”: An Analysis of Recovery Capital in the Rural Upper Midwest. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619859309] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Substance use and associated fatalities are disproportionately experienced by rural communities. This study used consensual qualitative research methodology to analyze focus group data from individuals in short- and long-term recovery in rural Michigan and Minnesota. Coding was conducted within a recovery capital framework to improve understanding of the resources and barriers participants experienced in their recovery. Key findings included barriers related to transportation, as well as access to and availability of sober meetings and sober living activities. Participants perceived connections to culturally appropriate treatment as particularly important. A reconstruction of social networks from those promoting addiction to those supporting recovery was also prominently emphasized. Recovery capital appears to be a useful framework for assessing how rural communities are experiencing substance use crises, in addition to identifying areas of low capital and high need in supporting long-term recovery.
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Wexler L, Rataj S, Ivanich J, Plavin J, Mullany A, Moto R, Kirk T, Goldwater E, Johnson R, Dombrowski K. Community mobilization for rural suicide prevention: Process, learning and behavioral outcomes from Promoting Community Conversations About Research to End Suicide (PC CARES) in Northwest Alaska. Soc Sci Med 2019; 232:398-407. [PMID: 31151026 PMCID: PMC6925945 DOI: 10.1016/j.socscimed.2019.05.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 04/19/2019] [Accepted: 05/17/2019] [Indexed: 12/22/2022]
Abstract
RATIONALE This study evaluates the process and preliminary outcomes of Promoting Community Conversations About Research to End Suicide (PC CARES), an intervention that brings key stakeholders together so they can discuss suicide prevention research and find ways to put it into practice. Originally piloted in remote and rural Alaskan communities, the approach shows promise. METHOD Using a multi-method design, the study describes a series of locally-facilitated "learning circles" over 15 months and their preliminary results. Sign-in sheets documented participation. Transcriptions of audio-recorded sessions captured facilitator fidelity, accuracy, and the dominant themes of community discussions. Linked participant surveys (n=83) compared attendees' perceived knowledge, skills, attitudes, and their 'community of practice' at baseline and follow-up. A cross-sectional design compared 112 participants' with 335 non-participants' scores on knowledge and prevention behaviors, and considered the social impact with social network analyses. RESULTS Demonstrating feasibility in small rural communities, local PC CARES facilitators hosted 59 two to three hour learning circles with 535 participants (376 unique). Local facilitators achieved acceptable fidelity to the model (80%), and interpreted the research accurately 81% of the time. Discussions reflected participants' understanding of the research content and its use in their lives. Participants showed positive changes in perceived knowledge, skills, and attitudes and strengthened their 'community of practice' from baseline to follow-up. Social network analyses indicate PC CARES had social impact, sustaining and enhancing prevention activities of non-participants who were 'close to' participants. These close associates were more likely take preventive actions than other non-participants after the intervention. CONCLUSION PC CARES offers a practical, scalable method for community-based translation of research evidence into selfdetermined, culturally-responsive suicide prevention practice.
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Affiliation(s)
- Lisa Wexler
- School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States.
| | - Suzanne Rataj
- School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States.
| | - Jerreed Ivanich
- Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, United States.
| | - Jya Plavin
- School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States.
| | - Anna Mullany
- Health Promotion and Policy, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States.
| | - Roberta Moto
- Maniilaq Association, POB 256, Kotzebue, AK, 99752, United States
| | - Tanya Kirk
- Maniilaq Association, POB 256, Kotzebue, AK, 99752, United States
| | - Eva Goldwater
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States.
| | - Rhonda Johnson
- Department of Health Sciences, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 99508, United States.
| | - Kirk Dombrowski
- Department of Sociology, University of Nebraska-Lincoln, 708 Oldfather Hall, Lincoln, NE, 68588, United States.
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Ka’apu K, Burnette CE. A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known? BRITISH JOURNAL OF SOCIAL WORK 2019; 49:880-898. [PMID: 31308574 PMCID: PMC6615176 DOI: 10.1093/bjsw/bcz009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Related to a broader context of historical oppression, Indigenous peoples of the USA are overburdened with the mental health challenges that social workers tend to treat, including post-traumatic stress disorder (PTSD), depression, suicide and substance use disorders (SUD). The purpose of this systematic review is to use the Framework of Historical Oppression, Resilience and Transcendence (FHORT) to identify empirical research on risk and protective factors related to mental health and SUD amongst these populations. This systematic review includes peer-reviewed quantitative and qualitative research articles from 1980 to 2017 focusing on the mental health of US Indigenous adults. A total of thirty-eight peer-reviewed empirical articles met inclusion criteria. Results reveal adults within Indigenous populations are at a high risk for mental health outcomes, including PTSD, depression, suicide, SUD and comorbidity across these outcomes. Underlying risk factors across outcomes included historical oppression and loss, family problems and SUD. Protective factors tended to include family and social support and engagement with tribal cultural activities. Significant variability was identified based on gender and geographic regions. Given that protective factors tended to include cultural, familial and community tenets, holistic approaches are the most promising programmes for social workers to work towards.
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Heath LM, Torrie J, Gill KJ. Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:180-189. [PMID: 29929388 PMCID: PMC6405817 DOI: 10.1177/0706743718784938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. METHODS Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. RESULTS Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. CONCLUSIONS This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.
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Affiliation(s)
- Laura M Heath
- 1 Department of Psychiatry, McGill University, Montreal, Quebec
| | - Jill Torrie
- 2 Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Quebec
| | - Kathryn J Gill
- 1 Department of Psychiatry, McGill University, Montreal, Quebec.,3 Addictions Unit, McGill University Health Centre, Montreal, Quebec
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Sturycz CA, Hellman N, Payne MF, Kuhn BL, Hahn B, Lannon EW, Palit S, Güereca YM, Toledo TA, Shadlow JO, Rhudy JL. Race/Ethnicity Does Not Moderate the Relationship Between Adverse Life Experiences and Temporal Summation of the Nociceptive Flexion Reflex and Pain: Results From the Oklahoma Study of Native American Pain Risk. THE JOURNAL OF PAIN 2019; 20:941-955. [PMID: 30776495 DOI: 10.1016/j.jpain.2019.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 12/22/2022]
Abstract
Adverse life experiences (ALEs) are associated with hyperalgesia and chronic pain, but the underlying mechanisms are poorly understood. One potential mechanism is hyperexcitability of spinal neurons (ie, central sensitization). Given that Native Americans (NAs) are more likely to have ALEs and to have a higher prevalence of chronic pain, the relationship between ALEs and spinal hyperexcitability might contribute to their pain risk. The present study assessed temporal summation of the nociceptive flexion reflex (TS-NFR; a correlate of spinal hyperexcitability) and pain (TS-Pain) in 246 healthy, pain-free non-Hispanic whites and NAs. The Life Events Checklist was used to assess the number of ALEs. Multilevel growth models were used to predict TS-NFR and TS-Pain, after controlling for age, perceived stress, psychological problems, negative and positive affect, and painful stimulus intensity. ALEs and negative affect were significantly associated with greater pain, but not enhanced TS-Pain. By contrast, ALEs were associated with enhanced TS-NFR. Race did not moderate these relationships. This finding implies that ALEs promote hyperalgesia as a result of increased spinal neuron excitability. Although relationships between ALEs and the nociceptive flexion reflex/pain were not stronger in NAs, given prior evidence that NAs experience more ALEs, this factor might contribute to the higher prevalence of chronic pain in NAs. PERSPECTIVE: This study found a dose-dependent relationship between ALEs and spinal neuron excitability. Although the relationship was not stronger in NAs than non-Hispanic whites, given prior evidence that NAs experience more ALEs, this could contribute to the higher prevalence of chronic pain in NAs.
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Affiliation(s)
| | - Natalie Hellman
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Michael F Payne
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Bethany L Kuhn
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Burkhart Hahn
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Edward W Lannon
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Shreela Palit
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Yvette M Güereca
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Tyler A Toledo
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Joanna O Shadlow
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Jamie L Rhudy
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma.
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Emerson MA, Moore RS, Caetano R. Correlates of Alcohol-Related Treatment Among American Indians and Alaska Natives with Lifetime Alcohol Use Disorder. Alcohol Clin Exp Res 2019; 43:115-122. [PMID: 30347442 PMCID: PMC6318056 DOI: 10.1111/acer.13907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/11/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND To describe sociodemographic and selected psychiatric disorder patterns and estimate correlates of seeking alcohol treatment among American Indians and Alaska Natives (AIAN) and non-Hispanic Whites (NHW) with lifetime alcohol use disorder (AUD). METHODS Data come from the 2012 to 2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions-III. We retrospectively identified participants who completed information on lifetime AUD, race/ethnicity, and seeking alcohol treatment or help for AUD. We used a generalized linear model with a log link and Poisson distribution to estimate prevalence ratios (PRs) among adults with DSM-5 lifetime AUD. We included the following correlates: race/ethnicity, sex, age, personal annual income, marital status, education, urban/rural status, U.S. region, any illegal drug use disorder, nicotine use disorder, and select mood-, anxiety-, personality-, and trauma-related disorders. RESULTS Among AIAN, the prevalence of lifetime AUD was 46.6%. Among AIAN with lifetime AUD, 33.8% sought alcohol-related treatment. Among individuals with lifetime AUD, AIAN were associated with greater alcohol-related treatment-seeking compared to NHW (adjusted PR = 1.41 [95% CI 1.26 to 1.58]). Among AIAN with AUD, being male and age 35 to 64 were statistically significant correlates of seeking treatment or help for AUD. CONCLUSIONS A relatively higher proportion of AIAN than NHW with AUDs sought alcohol treatment. Among individuals with lifetime AUD, significant demographic and psychiatric disorder correlates of treatment are present, showing that certain groups are less likely to seek treatment or help for alcohol-related issues. Among AIAN with AUD, these correlates may reflect distinct patterns of seeking alcohol-related treatment, which can inform more effective treatment promotion efforts with this population.
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Affiliation(s)
- Marc A. Emerson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Roland S. Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
| | - Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
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Walls ML, Whitesell NR, Barlow A, Sarche M. Research with American Indian and Alaska Native populations: Measurement matters. J Ethn Subst Abuse 2019; 18:129-149. [PMID: 28441113 PMCID: PMC7670846 DOI: 10.1080/15332640.2017.1310640] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Research is an important tool in addressing myriad American Indian and Alaska Native (AIAN) health disparities; however, tensions exist between common empirical measurement approaches that facilitate cross-cultural comparisons and measurement specificity that may be more valid locally and/or culturally appropriate. The tremendous diversity of AIAN communities, small population sizes of distinct AIAN cultural groups, and varying cultural contexts and worldviews should influence measurement decisions in health research. We provide a framework for guiding measurement in collaboration with AIAN communities using examples from substance abuse research for illustration. Our goal is to build upon ongoing efforts to advance measurement validity for AIAN research by engaging community-researcher partnerships and critical thinking in the selection, adaptation, creation, and implementation of measures.
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Affiliation(s)
- Melissa L Walls
- a University of Minnesota Medical School , Duluth , Minnesota
| | - Nancy Rumbaugh Whitesell
- b Colorado School of Public Health , University of Colorado Anschutz Medical Campus , Aurora , Colorado
| | - Allison Barlow
- c Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland
| | - Michelle Sarche
- b Colorado School of Public Health , University of Colorado Anschutz Medical Campus , Aurora , Colorado
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Avey JP, Dirks LG, Dillard DA, Manson SM, Merrick M, Smith JJ, Prickette GC, Tetpon S, Galbreath D, Triplett B, Robinson RF. Depression management interests among Alaska Native and American Indian adults in primary care. J Affect Disord 2018; 239:214-219. [PMID: 30025310 DOI: 10.1016/j.jad.2018.05.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 05/05/2018] [Accepted: 05/28/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Depression remains the second leading cause of disability worldwide. Symptoms of depression are expressed and experienced differently across cultural groups, impacting treatment decisions. Patient preferences predict service utilization, treatment selection and persistence, as well as health outcomes for medical and behavioral health conditions, including depression. We identified depression management preferences of Alaska Native and American Indian (AN/AI) people who receive care within a comprehensive, integrated, tribally owned and operated healthcare facility in Anchorage, Alaska. METHODS Adult AN/AI patients who screened positive for depression (10 or greater on the Patient Health Questionnaire - 9 (PHQ-9)) completed a culturally-tailored decision-support tool to assess their depression management interests. RESULTS The 125 eligible patients, who screened positive for depression, preferred counseling and medications to peer support groups, herbal remedies, and spiritual support. Those 18-39 years of age were more likely to prefer medications and less likely to prefer spirituality and peer support than those 40 years of age and older. Patients with moderate and severe depression were more likely to prefer exercise, healthy eating, and stress reduction than individuals with mild depression. LIMITATIONS Women comprised 78% of the sample. Responses may not adequately represent the views of men. CONCLUSIONS Counseling and medications should consistently be made available earlier in the course of depression management. Patient interest in exercise, stress reduction, and healthy eating to manage depression, especially among those with moderate and severe depression, offers opportunity for additional collaboration in an integrated care setting.
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Affiliation(s)
- Jaedon P Avey
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA.
| | - Lisa G Dirks
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Denise A Dillard
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Spero M Manson
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Melissa Merrick
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Julia J Smith
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Guilford C Prickette
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Sonda Tetpon
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Donna Galbreath
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Brianna Triplett
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
| | - Renee F Robinson
- Southcentral Foundation, 4085 Tudor Center Drive, Suite 238, Anchorage, AK 99508, USA
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Ehlers CL, Wills D, Gilder DA. A history of binge drinking during adolescence is associated with poorer sleep quality in young adult Mexican Americans and American Indians. Psychopharmacology (Berl) 2018; 235:1775-1782. [PMID: 29589068 PMCID: PMC6013062 DOI: 10.1007/s00213-018-4889-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/16/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE Binge drinking during adolescence is common, and adolescents and young adults with alcohol problems may also have sleep difficulties. However, few studies have documented the effects of a history of adolescent binge drinking on sleep in young adulthood in high-risk minority populations. OBJECTIVES To quantify sleep disturbance, as indexed by the Pittsburgh Sleep Quality Index (PSQI), in a sample of young adult Mexican American and American Indian men and women (18-30 years, n = 800) with and without a history of alcohol binge drinking during adolescence, controlling for age, gender, and race. RESULTS Gender was found to affect PSQI responses with females reporting waking up at night, having more bad dreams, and later habitual bedtimes than males, and males reporting more problems with breathing and snoring. Increasing age was associated with snoring or coughing, less hours spent in bed, and later evening bedtimes. Race also influenced the PSQI with American Indians reporting longer sleep latencies and sleep durations, more hours spent in bed, and more trouble with coughing and snoring than Mexican Americans, and Mexican Americans reporting later bedtimes. A history of adolescent regular binge drinking was associated with longer sleep latencies, more problems with breathing, bad dreams, and an overall higher PSQI total score, when controlling for age, race, and gender. CONCLUSIONS This report suggests, like what has been found in young adults in general population samples, that binge drinking during adolescence is associated with deleterious consequences on sleep quality in young adulthood in these high-risk and understudied ethnic groups.
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Affiliation(s)
- Cindy L Ehlers
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA.
| | - Derek Wills
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA
| | - David A Gilder
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA
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Olvera Alvarez HA, Appleton AA, Fuller CH, Belcourt A, Kubzansky LD. An Integrated Socio-Environmental Model of Health and Well-Being: a Conceptual Framework Exploring the Joint Contribution of Environmental and Social Exposures to Health and Disease Over the Life Span. Curr Environ Health Rep 2018; 5:233-243. [PMID: 29574677 DOI: 10.1007/s40572-018-0191-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF THE REVIEW Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues. RECENT FINDINGS Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior. The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
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Affiliation(s)
- Hector A Olvera Alvarez
- School of Nursing, University of Texas El Paso, 500 W. University Ave, El Paso, TX, 79968, USA.
| | - Allison A Appleton
- School of Public Health, Department of Epidemiology and Biostatistics, University at Albany, 1 University Place, Rensselaer, NY, 12144, USA
| | - Christina H Fuller
- School of Public Health, Division of Environmental Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302, USA
| | - Annie Belcourt
- School of Community and Public Health Sciences/Pharmacy Practice, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Avey JP, Hiratsuka VY, Dirks LG, Moore LA, Beach B, Novins DK, Caindec K, Dillard DA. Disseminating Information on Trauma Screening, Brief Intervention, and Referral to Treatment in a Tribal Health Setting: A Case Study. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2018; 25:43-61. [PMID: 29671857 PMCID: PMC6342266 DOI: 10.5820/aian.2501.2018.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Exposure to trauma is consistently associated with co-occurrence of behavioral health disorders. Primary care settings are opportune places to screen for traumatic experiences and symptoms, as they are often the initial point of care for behavioral health concerns by the Alaska Native and American Indian (AN/AI) population. In this case study, we examine results dissemination activities at the SCF Research Department-hosted 2016 Alaska Native Health Research Forum (Forum) of a pilot study of a trauma-focused screening, brief intervention, and referral to treatment (T-SBIRT) process for AN/AI adults in primary care. Feedback included audience responses to the presentation delivered at the Forum and recommendations to guide future community dissemination of T-SBIRT results. Attendees (N = 31) found the presentation clear, interesting, and included the right amount of detail. Four broad dissemination themes were identified in discussion groups: 1) share results with everyone; 2) share results in ways that reach all AN audiences; 3) provide a summarized status update at each stage of the study; and 4) use results to improve care for trauma and related symptoms.
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Factors Associated with American Indian Mental Health Service Use in Comparison with White Older Adults. J Racial Ethn Health Disparities 2017; 5:847-859. [PMID: 29052176 DOI: 10.1007/s40615-017-0430-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Our objective was to identify the factors that impact mental health service use among American Indian (AI) older adults living in South Dakota compared to their White counterparts. DESIGN AND METHODS Using a cross-sectional design with 735 participants (n = 502 Whites, n = 233 AIs), we used ordinal regressions to analyze the extent to which predisposing, need, and enabling/hindering factors predicted the level of mental health service utilization. RESULTS White older adults used more mental health services as compared with AI older adults. For both groups, more adverse childhood experiences along with prior negative experience with mental health service use were significantly related to an increased level of mental health service use. Compared to their White counterparts, AI older adults who reported a higher level of depressive symptoms, better self-perceived physical health, and a more positive attitude toward mental health services tended to use more mental health services. CONCLUSIONS To reduce mental health disparities among AI older adults, community, local government, and academic partners should pay attention to how to encourage the use of mental health services to meet the unique needs of AI older adults.
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Brave Heart MYH, Chase J, Elkins J, Martin J, Nanez J, Mootz J. Women finding the way: American Indian women leading intervention research in Native communities. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2017; 23:24-47. [PMID: 27383085 DOI: 10.5820/aian.2303.2016.24] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although there is literature concentrating on cross-cultural approaches to academic and community partnerships with Native communities, few address the process and experiences of American Indian women leading federally funded and culturally grounded behavioral health intervention research in Native communities. This paper summarizes relevant literature on community-engaged research with Native communities, examines traditional roles and modern challenges for American Indian women, describes the culturally grounded collaborative process for the authors' behavioral health intervention development with Native communities, and considers emergent themes from our own research experiences navigating competing demands from mainstream and Native communities. It concludes with recommendations for supporting and enhancing resilience.
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George J, MacLeod M, Graham K, Plain S, Bernards S, Wells S. Use of Traditional Healing Practices in Two Ontario First Nations. J Community Health 2017; 43:227-237. [DOI: 10.1007/s10900-017-0409-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sittner KJ. Factors associated with Indigenous youths' abstinence from drinking. J Adolesc 2017; 59:8-18. [PMID: 28551200 DOI: 10.1016/j.adolescence.2017.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 05/09/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022]
Abstract
The proportion of youth who abstain from alcohol use decreases during adolescence but little attention has focused on factors associated with abstinence. No research has examined this question for Indigenous youth, many of whom live in communities experiencing high rates of alcohol-related health problems. Using data from a longitudinal study of Indigenous youth (n = 649, ages 10-17 years) in the U.S. and Canada, the current study investigates factors associated promoting or decreasing abstaining from alcohol use. Results from generalized linear growth models demonstrate that abstinence declines significantly during adolescence. In concurrent models, caretaker monitoring and school adjustment increased the odds of abstaining, and frequency of smoking cigarettes and number of best friends who drink decreased the odds. In lagged analysis, only school adjustment, smoking, and peer drinking remained significant. Time-stable characteristics moderated several time-varying associations. This study has important implications for programs aimed at encouraging alcohol abstinence.
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Affiliation(s)
- Kelley J Sittner
- Department of Sociology, Oklahoma State University, 431 Murray Hall, Stillwater, OK, 74078, United States.
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Sawchuk CN, Roy-Byrne P, Noonan C, Craner JR, Goldberg J, Manson S, Buchwald D. Panic attacks and panic disorder in the American Indian community. J Anxiety Disord 2017; 48:6-12. [PMID: 27720578 PMCID: PMC5380607 DOI: 10.1016/j.janxdis.2016.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/09/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
Panic disorder is a common mental health condition, but little is known about panic disorder in non-Caucasian populations. The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian (AI) tribes (N=3084). A culturally-adapted version of the Composite International Diagnostic Interview assessed panic attacks, panic disorder, and various psychiatric comorbidities. After adjusting for age, gender, and tribe, linear and logistic regression analyses were conducted to compare AIs with panic disorder to those with panic attacks only on clinical characteristics and panic symptoms. Approximately 8.5% (N=234) of American Indians reported a lifetime history of panic attacks. Among individuals with panic attacks, comorbid posttraumatic stress disorder was higher in females (p=0.03) and comorbid alcohol-related disorders were higher in males (p≤0.001). The prevalence and clinical features of panic attacks and panic disorder in American Indians were similar to epidemiologic studies with majority populations. However, in contrast to earlier research, panic symptoms were similar in both males and females, and different patterns of comorbidity emerged. Future research should examine the availability and accessibility of evidence-based panic treatments for this traditionally underserved population.
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Affiliation(s)
- Craig N Sawchuk
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
| | - Peter Roy-Byrne
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98104, United States
| | - Carolyn Noonan
- Department of and Epidemiology, University of Washington, Seattle, WA 98104, United States
| | - Julia R Craner
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States
| | - Jack Goldberg
- Department of and Epidemiology, University of Washington, Seattle, WA 98104, United States
| | - Spero Manson
- American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Denver, CO 80045, United States
| | - Dedra Buchwald
- Department of Medicine, Washington State University, Seattle, WA 98101, United States
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Hiratsuka VY, Moore L, Dillard DA, Avey JP, Dirks LG, Beach B, Novins D. Development of a Screening and Brief Intervention Process for Symptoms of Psychological Trauma Among Primary Care Patients of Two American Indian and Alaska Native Health Systems. J Behav Health Serv Res 2017; 44:224-241. [PMID: 27328846 PMCID: PMC5177536 DOI: 10.1007/s11414-016-9519-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
American Indian and Alaska Native (AI/AN) people experience high rates of acute, chronic, and intergenerational trauma. Traumatic experiences often increase the risk of both medical and behavioral health problems making primary care settings opportune places to screen for trauma exposure or symptomology. The objective of this study was to determine considerations and recommendations provided by patients, health care providers, health care administrators, and tribal leaders in the development of an adult trauma screening, brief intervention, and referral for treatment process to pilot at two large AI/AN primary care systems. A qualitative and iterative data collection and analysis process was undertaken using a community-based participatory research approach guided by a cross-site steering committee. Twenty-four leaders and providers participated in individual interviews, and 13 patients participated in four focus groups. Data were thematically analyzed to select a trauma screening instrument, develop a screening process, and develop brief intervention materials. The nature of traumas experienced in the AI/AN community, the need to develop trusting patient-provider relationships, and the human resources available at each site drove the screening, brief intervention, and referral process decisions for a future trauma screening pilot in these health systems.
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Affiliation(s)
- Vanessa Y Hiratsuka
- Southcentral Foundation Research Department, 4085 Tudor Centre Drive, Anchorage, AK, 99508, USA.
| | - Laurie Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 E. 17th Avenue, Aurora, CO, 80045, USA
| | - Denise A Dillard
- Southcentral Foundation Research Department, 4085 Tudor Centre Drive, Anchorage, AK, 99508, USA
| | - Jaedon P Avey
- Southcentral Foundation Research Department, 4085 Tudor Centre Drive, Anchorage, AK, 99508, USA
| | - Lisa G Dirks
- Southcentral Foundation Research Department, 4085 Tudor Centre Drive, Anchorage, AK, 99508, USA
| | - Barbara Beach
- Cherokee Nation Behavioral Health, 1277 Skill Center Circle, Tahlequah, OK, 74464, USA
| | - Douglas Novins
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 E. 17th Avenue, Aurora, CO, 80045, USA
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Genome-Wide Association Study of Post-Traumatic Stress Disorder in Two High-Risk Populations. Twin Res Hum Genet 2017; 20:197-207. [PMID: 28262088 DOI: 10.1017/thg.2017.12] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Mexican Americans (MAs) and American Indians (AIs) constitute conspicuously understudied groups with respect to risk for post-traumatic stress disorder (PTSD), especially in light of findings showing racial/ethnic differences in trauma exposure and risk for PTSD. The purpose of this study was to examine genetic influences on PTSD in two minority cohorts. A genome-wide association study (GWAS) with sum PTSD symptoms for trauma-exposed subjects was run in each cohort. Six highly correlated variants in olfactory receptor family 11 subfamily L member 1 (OR11L1) were suggestively associated with PTSD in the MA cohort. These associations remained suggestively significant after permutation testing. A signal in a nearby olfactory receptor on chromosome 1, olfactory receptor family 2 subfamily L member 13 (OR2L13), tagged by rs151319968, was nominally associated with PTSD in the AI sample. Although no variants were significantly associated after correction for multiple testing in a meta-analysis of the two cohorts, pathway analysis of the top hits showed an enrichment cluster of terms related to sensory transduction, olfactory receptor activity, G-protein coupled receptors, and membrane. As previous studies have proposed a role for olfaction in PTSD, our results indicate this influence may be partially driven by genetic variation in the olfactory system.
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Mulia N, Karriker-Jaffe KJ, Witbrodt J, Bond J, Williams E, Zemore SE. Racial/ethnic differences in 30-year trajectories of heavy drinking in a nationally representative U.S. sample. Drug Alcohol Depend 2017; 170:133-141. [PMID: 27889594 PMCID: PMC5270645 DOI: 10.1016/j.drugalcdep.2016.10.031] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Racial/ethnic minorities bear a disproportionate burden of alcohol-related problems in the U.S. It is unknown whether this reflects harmful patterns of lifecourse heavy drinking. Prior research shows little support for the latter but has been limited to young samples. We examine racial/ethnic differences in heavy drinking trajectories from ages 21 to 51. METHODS Data on heavy drinking (6+ drinks/occasion) are from the 1979 National Longitudinal Survey of Youth (N=9468), collected between 1982 and 2012. Sex-stratified, generalized estimating equations (GEE) were used to model heavy drinking frequency trajectories as a function of age with a cubic curve, and interactions of race with age terms were tested to assess racial/ethnic differences. Models adjusted for time-varying socioeconomic status and marital and parenting status; predictors of trajectories were examined in race- and sex-specific models. RESULTS White men and women had similarly steep declines in heavy drinking frequency throughout the 20s, contrasting with slower declines (and lower peaks) in Black and Hispanic men and women. During the 30s there was a Hispanic-White crossover in men's heavy drinking curves, and a Black-White female crossover among lifetime heavy drinkers; by age 51, racial/ethnic group trajectories converged in both sexes. Greater education was protective for all groups. CONCLUSION Observed racial/ethnic crossovers in heavy drinking frequency following young adulthood might contribute to disparities in alcohol-related problems in middle adulthood, and suggest a need for targeted interventions during this period. Additionally, interventions that increase educational attainment may constitute an important strategy for reducing heavy drinking in all groups.
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Affiliation(s)
- Nina Mulia
- Alcohol Research Group, Emeryville, CA, United States.
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MacLeod MA, George J, Tremblay PF, Elton-Marshall T, DeWit D, Graham K, Wells S. Dimensionality of the PTSD Checklist in a Canadian Aboriginal Sample. J Nurs Meas 2017; 25:4-21. [DOI: 10.1891/1061-3749.25.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: The PTSD Checklist–Civilian Version (PCL-C) is a widely used screening instrument measuring posttraumatic stress disorder (PTSD). However, to our knowledge, the factor structure of the PCL-C has not been examined in an Aboriginal population. Considerable research indicates that PTSD symptoms are characterized by 4 factors, with both the “King model” and the “Simms model” supported by the literature. Methods: Using confirmatory factor analysis on the PCL-C, we examined whether these models and the overall scale were supported in an Aboriginal community sample (N = 273). Results: The data supported both models. However, the 4 factors were highly correlated, providing some support for a 1-factor model as well. Conclusions: Our data support use of the PCL-C in Aboriginal health research.
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Vaeth PAC, Wang-Schweig M, Caetano R. Drinking, Alcohol Use Disorder, and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups. Alcohol Clin Exp Res 2016; 41:6-19. [PMID: 28019654 DOI: 10.1111/acer.13285] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 10/31/2016] [Indexed: 01/07/2023]
Abstract
Data from approximately 140 articles and reports published since 2000 on drinking, alcohol use disorder (AUD), correlates of drinking and AUD, and treatment needs, access, and utilization were critically examined and summarized. Epidemiological evidence demonstrates alcohol-related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. In contrast, Asian Americans are less affected. Differences across Whites, Blacks, and Hispanics are more nuanced. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Research findings also suggest that acculturation to the United States and nativity affect drinking. Recent studies on ethnic drinking cultures uncover the possible influence that native countries' cultural norms around consumption still have on immigrants' alcohol use. The reasons for racial/ethnic disparities in drinking and AUD are complex and are associated with historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage. This disadvantage is present at both individual and environmental levels. Finally, these data indicate that admission to alcohol treatment is also complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals' sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers, and the legal system, and the overall organization of the treatment system. More research is needed to understand facilitators and barriers to treatment to improve access to services and support. Additional directions for future research are discussed.
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Affiliation(s)
- Patrice A C Vaeth
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Meme Wang-Schweig
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California.,The University of Texas School of Public Health, Dallas, Texas
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Wolsko C, Lardon C, Mohatt GV, Orr E. Stress, coping, and well-being among the Yup`ik of the Yukon-Kuskokwim Delta: the role of enculturation and acculturation. Int J Circumpolar Health 2016; 66:51-61. [PMID: 17451134 DOI: 10.3402/ijch.v66i1.18226] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To report on the relationships between cultural identity and stress, coping, and psychological well-being in Yup'ik communities. STUDY DESIGN A quantitative self-administered questionnaire. METHODS A health and wellness survey was completed by a total of 488 Yup'ik participants (284 women and 204 men) from 6 rural villages in the Yukon-Kuskokwim Delta region. Respondents were fairly equally distributed across an age range of 14 to 94 (mean +/- SD = 38.50 +/- 17.18). RESULTS Participants who reported living more of a Kass'aq way of life (greater acculturation) reported experiencing greater psychosocial stress, less happiness, and greater use of drugs and alcohol to cope with stress. Participants who reported identifying more with a traditional Yup'ik way of life reported greater happiness, more frequent use of religion and spirituality to cope with stress, and less frequent use of drugs and alcohol to cope with stress. CONCLUSIONS In conjunction with previous research, the data strongly indicates that in general, Yup'ik people in the Y-K Delta tend to associate stress and negative health outcomes with the process of acculturation, and health and healing with the process of enculturation. Research that focuses on documenting the intrinsic strengths of indigenous worldviews may contribute to positive transformations in community health.
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Wendt DC, Gone JP. Integrating Professional and Indigenous Therapies: An Urban American Indian Narrative Clinical Case Study. COUNSELING PSYCHOLOGIST 2016; 44:695-729. [PMID: 27594708 DOI: 10.1177/0011000016638741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present a narrative case study of an urban American Indian male college student who integrated Indigenous and professional therapies during an acute period of stress, loss, and depression. The first published case of an American Indian in an urban context, this article expands on previous clinical cases by focusing on the perspective of the client relative to his own conceptions of help-seeking behaviors. Based on qualitative analysis of five audio-recorded interviews, this case utilizes an innovative methodology to portray four approaches to healing (medication, counseling, bonding, and spirituality), which contribute to holistic well-being. Implications for counseling psychologists include being aware of how some American Indian clients may (a) view professional treatment dynamics through a Native cultural lens (e.g., seeing ideal communication as a "rhythm"); (b) utilize an expanded range of therapeutic agents;
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Brave Heart MYH, Lewis-Fernández R, Beals J, Hasin DS, Sugaya L, Wang S, Grant BF, Blanco C. Psychiatric disorders and mental health treatment in American Indians and Alaska Natives: results of the National Epidemiologic Survey on Alcohol and Related Conditions. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1033-46. [PMID: 27138948 PMCID: PMC4947559 DOI: 10.1007/s00127-016-1225-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 04/16/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE To examine the prevalence of common psychiatric disorders and associated treatment-seeking, stratified by gender, among American Indians/Alaska Natives and non-Hispanic whites in the United States. Lifetime and 12-month rates are estimated, both unadjusted and adjusted for sociodemographic correlates. METHOD Analyses were conducted with the American Indians/Alaska Native (n = 701) and Non-Hispanic white (n = 24,507) samples in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions [(NESARC) n = 43,093]. RESULTS Overall, 70 % of the American Indian/Alaska Native men and 63 % of the women met criteria for at least one Diagnostic and Statistical Manual-IV lifetime disorder, compared to 62 and 53 % of Non-Hispanic white men and women, respectively. Adjusting for sociodemographic correlates attenuated the differences found. Nearly half of American Indians/Alaska Natives had a psychiatric disorder in the previous year; again, sociodemographic adjustments explained some of the differences found. Overall, the comparisons to non-Hispanic whites showed differences were more common among American Indian/Alaska Native women than men. Among those with a disorder, American Indian/Alaska Native women had greater odds of treatment-seeking for 12-month anxiety disorders. CONCLUSION As the first study to provide national estimates, by gender, of the prevalence and treatment of a broad range of psychiatric disorders among American Indians/Alaska Natives, a pattern of higher prevalence of psychiatric disorder was found relative to Non-Hispanic whites. Such differences were more common among women than men. Prevalence may be overestimated due to cultural limitations in measurement. Unmeasured risk factors, some specific to American Indians/Alaska Natives, may also partially explain these results.
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Affiliation(s)
- Maria Yellow Horse Brave Heart
- Division of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, University of New Mexico, MSC09 5030, 1 UNM, Albuquerque, NM, USA.
- New York State Psychiatric Institute, New York, NY, 87131-0001, USA.
| | - Roberto Lewis-Fernández
- New York State Psychiatric Institute, New York, NY, 87131-0001, USA
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Janette Beals
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deborah S Hasin
- New York State Psychiatric Institute, New York, NY, 87131-0001, USA
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Luisa Sugaya
- New York State Psychiatric Institute, New York, NY, 87131-0001, USA
- School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Shuai Wang
- New York State Psychiatric Institute, New York, NY, 87131-0001, USA
| | - Bridget F Grant
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Carlos Blanco
- New York State Psychiatric Institute, New York, NY, 87131-0001, USA
- National Institute on Drug Abuse, Bethesda, MD, USA
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Roh S, Burnette CE, Lee KH, Lee YS, Goins RT. Correlates of Receipt of Colorectal Cancer Screening among American Indians in the Northern Plains. SOCIAL WORK RESEARCH 2016; 40:95-104. [PMID: 27257363 PMCID: PMC4886273 DOI: 10.1093/swr/svw006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 08/25/2015] [Accepted: 09/14/2015] [Indexed: 05/22/2023]
Abstract
Research has consistently documented lower colorectal cancer (CRC) screening rates for racial and ethnic minority populations, with the lowest screening rates among American Indians (AIs). Given the low CRC screening rates among AIs residing in the Northern Plains region, the objective of this research was to identify CRC screening correlates for Northern Plains AIs. With a sample of 181 AIs age 50 years or older, the authors used Andersen's behavioral model to examine the following factors related to receipt of CRC screening: (a) predisposing factors-age, education, marital status, and gender; (b) need factors-personal and family history of cancer; and (c) enabling factors-having a particular place to receive medical care, annual health checkup, awareness of the availability of CRC screening, knowledge of CRC, and self-efficacy of CRC. Nested logistic regression identified the following correlates of receipt of CRC screening: (a) predisposing factors-older age; (b) need factors-having a personal history of cancer; and (c) enabling factors-having an annual health checkup, greater awareness of CRC screening, and greater self-efficacy of CRC. Given the findings, prevention and intervention strategies, including public awareness and education about CRC screening, are promising avenues to reduce cancer screening disparities among AIs.
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Affiliation(s)
- Soonhee Roh
- is assistant professor, School of Social Work, University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069; is assistant professor, School of Social Work, Tulane University, New Orleans. is associate professor, School of Social Work, Wichita State University, Wichita, KS. is associate professor, School of Social Work, San Francisco State University. is professor, Western Carolina University, Cullowhee, NC. The data used in the study were collected with support from the University of South Dakota School of Health Sciences Research and Scholarship Seed Grants. The lead author would like to acknowledge Dr. Robin Miskimins for her mentoring on a Seed Grants for School of Health Sciences for Dr. Roh
| | - Catherine E Burnette
- is assistant professor, School of Social Work, University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069; is assistant professor, School of Social Work, Tulane University, New Orleans. is associate professor, School of Social Work, Wichita State University, Wichita, KS. is associate professor, School of Social Work, San Francisco State University. is professor, Western Carolina University, Cullowhee, NC. The data used in the study were collected with support from the University of South Dakota School of Health Sciences Research and Scholarship Seed Grants. The lead author would like to acknowledge Dr. Robin Miskimins for her mentoring on a Seed Grants for School of Health Sciences for Dr. Roh
| | - Kyoung Hag Lee
- is assistant professor, School of Social Work, University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069; is assistant professor, School of Social Work, Tulane University, New Orleans. is associate professor, School of Social Work, Wichita State University, Wichita, KS. is associate professor, School of Social Work, San Francisco State University. is professor, Western Carolina University, Cullowhee, NC. The data used in the study were collected with support from the University of South Dakota School of Health Sciences Research and Scholarship Seed Grants. The lead author would like to acknowledge Dr. Robin Miskimins for her mentoring on a Seed Grants for School of Health Sciences for Dr. Roh
| | - Yeon-Shim Lee
- is assistant professor, School of Social Work, University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069; is assistant professor, School of Social Work, Tulane University, New Orleans. is associate professor, School of Social Work, Wichita State University, Wichita, KS. is associate professor, School of Social Work, San Francisco State University. is professor, Western Carolina University, Cullowhee, NC. The data used in the study were collected with support from the University of South Dakota School of Health Sciences Research and Scholarship Seed Grants. The lead author would like to acknowledge Dr. Robin Miskimins for her mentoring on a Seed Grants for School of Health Sciences for Dr. Roh
| | - R Turner Goins
- is assistant professor, School of Social Work, University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069; is assistant professor, School of Social Work, Tulane University, New Orleans. is associate professor, School of Social Work, Wichita State University, Wichita, KS. is associate professor, School of Social Work, San Francisco State University. is professor, Western Carolina University, Cullowhee, NC. The data used in the study were collected with support from the University of South Dakota School of Health Sciences Research and Scholarship Seed Grants. The lead author would like to acknowledge Dr. Robin Miskimins for her mentoring on a Seed Grants for School of Health Sciences for Dr. Roh
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Cackler CJJ, Shapiro VB, Lahiff M. Female Sterilization and Poor Mental Health: Rates and Relatedness among American Indian and Alaska Native Women. Womens Health Issues 2016; 26:168-75. [PMID: 26777282 DOI: 10.1016/j.whi.2015.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 10/03/2015] [Accepted: 10/06/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe the reproductive and mental health of American Indian and Alaska Native (AI/AN) women, an understudied population. METHODS Data from the 2004 Behavioral Risk Factor Surveillance System survey were analyzed to determine the 1) prevalence of female sterilization among a nationally representative sample of reproductive age AI/AN women and 2) the association of female sterilization and poor mental health among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women. RESULTS Nearly 25% of AI/AN women reported female sterilization, a prevalence higher than the comparison racial/ethnic groups (p < .005). Adjusting for sociodemographic characteristics, AI/AN women reporting female sterilization had nearly 2.5 times the odds of poor mental health compared with AI/AN women not reporting female sterilization (p = .001). The same magnitude of relationship between female sterilization and poor mental health was not found for non-Hispanic White, non-Hispanic Black, and Hispanic women. CONCLUSIONS The prevalence of female sterilization is greater among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women, and AI/AN women reporting female sterilization have higher odds of reporting poor mental health. Common cultural experiences, such as a shared ancestral history of forced sterilizations, may be relevant, and could be considered when providing reproductive and mental health services to AI/AN women.
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Affiliation(s)
- Christina J J Cackler
- University of California, Berkeley, School of Social Welfare, Berkeley, California; University of California, Berkeley, School of Public Health, Berkeley, California.
| | - Valerie B Shapiro
- University of California, Berkeley, School of Social Welfare, Berkeley, California
| | - Maureen Lahiff
- University of California, Berkeley, School of Public Health, Berkeley, California
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