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Riches S, Yusuf-George M, Steer N, Fialho C, Vasile R, Nicholson SL, Waheed S, Fisher HL, Zhang S. Videoconference-based Creativity Workshops for mental health staff during the COVID-19 pandemic. Arts Health 2024; 16:134-146. [PMID: 36912215 DOI: 10.1080/17533015.2023.2184402] [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: 02/25/2022] [Accepted: 01/03/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. METHODS Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. RESULTS Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. CONCLUSIONS Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing.
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Affiliation(s)
- Simon Riches
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Meirion Yusuf-George
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Natalie Steer
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- The Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
| | - Carolina Fialho
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Ruxandra Vasile
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- The Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
| | - Sarah L Nicholson
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Saira Waheed
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Helen L Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Shuo Zhang
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- King's College London, Department of Child Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Motley RO, Walker DT, Willock J, Byansi W. Health Impact of Racism-Based Experiences Among Black African Immigrant Adults in the United States: An Integrative Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253827. [PMID: 38770911 DOI: 10.1177/15248380241253827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Racism-based experiences among Black African immigrants in the United States are a growing concern due to the prevalence of these events and risk for negative health (mental, behavioral, and physical) outcomes. This integrative review appraised published studies (2012-2023) addressing the relationship between racism-based experiences and adverse health for Black African immigrants. Articles were identified using structured search terms in several databases (APA PsycINFO, CINAHL, PubMed, Web of Science), Google Scholar, and citation mining. A total of fourteen studies met the inclusion criteria. Studies found a significant positive association between racism-based experiences and adverse mental (n = 9), behavioral (n = 3), and physical (n = 2) health outcomes. Racism-based experiences appear to have mental, behavioral, and physical health consequences for Black African immigrant adults. Given the growing population of Black African immigrants in the United States, more work is needed to elucidate the relationship between racism-based experiences and negative health outcomes.
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Affiliation(s)
- Robert O Motley
- Boston College School of Social Work, Chestnut Hill, MA, USA
| | - Danielle T Walker
- Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
| | - Jamelia Willock
- Boston College School of Social Work, Chestnut Hill, MA, USA
| | - William Byansi
- Boston College School of Social Work, Chestnut Hill, MA, USA
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Cahill M, Illback R, Peiper N. Perceived Racial Discrimination, Psychological Distress, and Suicidal Behavior in Adolescence: Secondary Analysis of Cross-Sectional Data from a Statewide Youth Survey. Healthcare (Basel) 2024; 12:1011. [PMID: 38786419 PMCID: PMC11121279 DOI: 10.3390/healthcare12101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Developmental, clinical, and epidemiological research have demonstrated the salience of perceived racial discrimination (PRD) as a contributor to negative mental health outcomes in adolescence. This article summarizes secondary analyses of cross-sectional data from a large-scale youth survey within a predominantly rural state, to estimate the prevalence and strength of the association between PRD and serious psychological distress (SPD), suicidal ideation, and prior suicidal attempts. Data from 93,812 students enrolled in 6th, 8th, 10th, or 12th grade within 129 school districts across Kentucky were examined, to determine prevalence rates for subgroups within the cohort. Logistic regression analyses assessed the differences and established comparative strength of the association among these variables for racial/ethnic subgroups. PRD was self-reported at high rates across several demographic subgroups and was most evident among Black (24.5%) and Asian (22.1%) students. Multiracial students experienced the highest rates of both SPD and suicidality (ideation and prior attempt). Both for the entire cohort and for each racial/ethnic subgroup, PRD was significantly associated with an increased likelihood of negative mental health outcomes, although the strength of these associations varied across the subgroups and developmental levels. The implications for early intervention and prevention are discussed.
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Affiliation(s)
| | | | - Nicholas Peiper
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY 40202, USA;
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Campo Redondo M, Andrade G. Nightmare experiences and perceived ethnic discrimination amongst female university students in the United Arab Emirates: a cross-sectional study. J Sleep Res 2024:e14148. [PMID: 38233953 DOI: 10.1111/jsr.14148] [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: 11/11/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
Perceived ethnic discrimination is known to be associated with anxiety and depression, and in turn, anxiety and depression are known to be associated with nightmare frequency and distress. This elicits a question: is perceived ethnic discrimination associated with nightmare frequency and distress? In this study, 179 female university students from the United Arab Emirates were assessed to answer that question. Results showed that while anxiety and depression were related to nightmare experiences, perceived ethnic discrimination was a stronger predictor of nightmare experiences. We posit two explanations for this finding: one based on psychoanalytical insights, and the other based on the Disposition-Stress model with neurobiological correlates. No significant differences were found across ethnicity when it comes to nightmare experiences or perceived ethnic discrimination. This is an encouraging sign of optimal societal integration in the United Arab Emirates.
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Slaughter-Acey J, Simone M, Hazzard VM, Arlinghaus KR, Neumark-Sztainer D. More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization. Am J Epidemiol 2023; 192:1624-1636. [PMID: 37401016 DOI: 10.1093/aje/kwad152] [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] [Received: 08/10/2022] [Revised: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 07/05/2023] Open
Abstract
Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18-25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010-2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat "social location" and systems of marginalization and power as interdependent social factors influencing EAs' mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs' subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs' experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.
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Allen JD, Kunicki ZJ, Greaney ML. Mental Health of Brazilian Immigrant Women: The Role of Discrimination, Social Support, and Community Strengths. J Immigr Minor Health 2023; 25:1016-1024. [PMID: 37191876 PMCID: PMC10185951 DOI: 10.1007/s10903-023-01485-2] [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: 04/08/2023] [Indexed: 05/17/2023]
Abstract
Little is known about the mental health status of Brazilians living in the U.S. We assessed the prevalence and correlates of depression to guide the development of culturally relevant community-based mental health interventions. An online survey was conducted between July and August 2020 among a sample of Brazilian women living in the U.S. (age 18 and over, born in Brazil, English or Portuguese speaking) recruited through Brazilian social media pages and community organizations. The survey assessed depression using the Center for Epidemiological Study Depression Scale (CES-D-10), the Everyday Discrimination Scale (EDS), the Oslo Social Support Scale (OSSS), and community strengths (CS). We first assessed the correlation between CES-D-10 scores and EDS, OSSS, and CS. We found that half of the participants (52.2%) had CES-D-10 scores of 10 or greater, indicating the presence of depressive symptomatology. In a multivariable model controlling for significant covariates (age, time lived in U.S.), EDS was positively associated with CES-D-10 scores (β = 0.64, 95% CI = 0.45, 0.83), while OSSS was negatively associated with CES-D-10 scores (β = -0.53, 95% C I= -0.80, -0.27). No statistically significant relationship was observed between CES-D-10 and CS scores. In this sample of Brazilian immigrant women, depressive symptomatology was highly prevalent, and experiences of discrimination were associated with increased symptoms of depression. There is a need to understand and address mental health in Brazilian immigrant women.
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Affiliation(s)
- Jennifer D Allen
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Avenue, Medford, MA, 02155, USA.
| | - Zachary J Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard Box G-BH, Providence, RI, USA
| | - Mary L Greaney
- Department of Health Studies, University of Rhode Island, 25 West Independence Way, Kingston, RI, USA
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Espinosa A, Ruglass LM, Conway FN. The relative contribution of ethnic identity and ethnic discrimination on alcohol, tobacco, and other drug use disorders among Hispanic/Latin American individuals. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:208963. [PMID: 37654011 DOI: 10.1016/j.josat.2023.208963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/09/2022] [Accepted: 01/17/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination and ethnic identity, the affiliation and connection to one's ethnic group, are important for understanding alcohol, tobacco, and drug use disorders (AUD, TUD, DUD, respectively) among Hispanic/Latin American individuals. Although discrimination is a well-recognized risk factor, the role of ethnic identity is less understood. Moreover, no study has examined which of these factors is more important for informing AUD, TUD, and DUD. This information is necessary for creating effective prevention and treatment programs tailored for Hispanic/Latin American people. Herein we examined the role and relative importance of racial/ethnic discrimination and Hispanic ethnic identity on past year AUD, TUD, and DUD. METHODS Hispanic/Latin American participants of the National Epidemiologic Survey on Alcohol and Related Conditions-III constituted the sample for this cross-sectional secondary data analysis. Participants (N = 7037) were 39.93 years old on average (SD = 15.32). More than half were female (56.1 %) and had family incomes below the median household income in the United States (58.7 %). Most had national origins in North America (79.3 %), including US dependent territories and Mexico. Confirmatory factor analysis (CFA) verified the psychometric properties of the discrimination and Hispanic ethnic identity measures. Logistic regressions, supplemented with dominance analysis, estimated the role and relative contribution of discrimination and Hispanic ethnic identity on the probability of past year AUD, TUD, and DUD. RESULTS The CFAs yielded adequate convergent validity and reliability for each construct. More racial/ethnic discrimination and a higher Hispanic ethnic identity related to a higher and lower probability of AUD, TUD, and DUD, respectively. The magnitude of the association between Hispanic ethnic identity and the probability of TUD exceeded that of racial/ethnic discrimination, but the converse was the case for AUD and DUD. CONCLUSIONS Prevention and treatment programs for TUD that highlight the value of having a strong sense of self as a member of a Hispanic ethnic group, and that encourage the individual to explore their Hispanic ancestry may prove effective among Hispanic/Latin American individuals, particularly those who have experienced racial/ethnic discrimination. Programs for AUD and DUD tailored for Hispanic Latin/American adults should also incorporate coping strategies to address experiences with racial/ethnic discrimination.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York, CUNY, United States of America; Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, United States of America.
| | - Lesia M Ruglass
- Department of Psychology, The City College of New York, CUNY, United States of America; Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, United States of America
| | - Fiona N Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
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8
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Cook SH, Wood EP, Risner E, Weng CA, Xin Y. A national examination of discrimination, resilience, and depressive symptoms during the COVID-19 pandemic: the All of Us Research Program. Front Psychol 2023; 14:1175452. [PMID: 37823074 PMCID: PMC10562571 DOI: 10.3389/fpsyg.2023.1175452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Objective To examine the impact of resilience on the association between discrimination and trajectories of depressive symptoms during the COVID-19 pandemic across racial and ethnic groups. Methods Data were drawn from 5 waves of the All of Us Research Program's survey on the impact of COVID-19 on the lives of American adults. Linear mixed-effects models were fitted to assess the association between discrimination exposure throughout the pandemic and depressive symptoms over time. An interaction term was introduced between resilience and discrimination exposure to assess if resilience buffered the association between discrimination and depressive symptoms over time. Race-stratified linear mixed-effects models examined racial/ethnic differences in the association between resilience, discrimination, and depressive symptoms over time. Results Fifty-one thousand nine hundred fifty-eight participants completed surveys between May and December of 2020. Results indicated that exposure to more discrimination was associated with increasing trajectories of depressive symptoms over time (b = 0.48, p < 0.001). However, resilience moderated the association between discrimination and well-being over time such that higher resilience mitigated the detrimental effect of experiencing discrimination on depressive symptoms across time (b = -0.02, p < 0.001). Conclusion Identifying protective features such as resilience can promote the development of culturally tailored interventions to address mental health in the context of discrimination.
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Affiliation(s)
- Stephanie H. Cook
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Erica P. Wood
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
| | - Emma Risner
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Chenziheng Allen Weng
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Yao Xin
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
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Louder CN, Meyer ML, Del Rey GM, Franklin AR. Elevating community-driven socioecological participation and action: A case study with Black youth. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:145-156. [PMID: 37166061 DOI: 10.1002/ajcp.12679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/03/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023]
Abstract
Context is important when considering how racism acts to harm Black youth. Hence, social scientists developed socioecological theories that consider both the individual and the context(s) which shapes them. We used these theories to make sense of the challenges facing Black youth and identify points for intervention. However, these theories were rarely shared with community participants. Theory, at its core, is a way to make sense of the world. Theory shared in an age-appropriate manner can help youth make sense of their experiences in a way that promotes psychological wellness. This paper describes the intentional sharing of socioecological theory with community members engaged in two community-based mental health programs. Our team has collaborated closely with community stakeholders to implement and iteratively improve these programs. This first-person account presents the doctoral students' experiences in engaging community members in using socioecological theory to improve the programs with which they have identified as useful to their community. The article underscores the importance of elevating community voices when engaging in community-based research and how that engagement is more fundamental as programs become well-established.
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Affiliation(s)
- Ceewin N Louder
- Department of Educational and Psychological Studies, University of Miami, Miami, Florida, USA
| | - Marisol L Meyer
- Department of Educational and Psychological Studies, University of Miami, Miami, Florida, USA
| | - Gabrielle M Del Rey
- Department of Educational and Psychological Studies, University of Miami, Miami, Florida, USA
| | - Alexis R Franklin
- Department of Educational and Psychological Studies, University of Miami, Miami, Florida, USA
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Hagiwara N, Shipman-Lacewell J, Smith D, Jones HA, Green TL, Belgrave F, Valrie C. Personal- vs. Group-Level Discrimination and Physical and Mental Health Outcomes Among Black Adolescents. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01758-4. [PMID: 37624537 DOI: 10.1007/s40615-023-01758-4] [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: 04/28/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The negative health consequences of personal experiences of racial discrimination (personal-level discrimination) has been well-documented across developmental stages, including adolescence, in Black individuals. There is also some evidence suggesting perceiving other Black individuals experiencing racial discrimination (group-level discrimination) can protect one's health in Black adults. METHODS This study examined the role of personal- and group-level discrimination in Black adolescent health. The study was a secondary analysis of survey data collected from 186 Black adolescents that included reports of discrimination, physical function, anxiety, and depression. RESULTS Black adolescents who reported greater, as opposed to lower, personal-level discrimination were more likely to experience poorer physical and mental health outcomes. While group-level discrimination was also associated with physical health outcomes, it was not directly associated with mental health outcomes. Importantly, across all three health outcomes, awareness of group-level discrimination mitigated the negative health consequences of personal-level discrimination. Among adolescents who reported low levels of group-level discrimination, personal-level discrimination was associated negatively with physical function and positively with anxiety and depressive symptoms. Among adolescents who reported high levels of group-level discrimination, there was no association between personal-level discrimination and any of the health outcomes. DISCUSSION Consistent with prior research with Black adults, awareness of high group-level discrimination may protect Black adolescents from the negative health consequences of personal-level discrimination. The pattern of the results is also consistent with the literature of the personal-group discrimination discrepancy (PGDD) and psychological wellbeing. Future research should investigate the psychological mechanisms implicated in PGDD (e.g., external attribution of discrimination and intragroup comparison) as potential coping strategies for Black adolescents against the negative health consequences of personal-level discrimination.
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Affiliation(s)
- Nao Hagiwara
- University of Virginia, Charlottesville, VA, USA.
| | | | - Danyel Smith
- University of Virginia, Charlottesville, VA, USA
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Xavier Hall CD, Harris R, Burns P, Girod C, Yount KM, Wong FY. Utilizing Latent Class Analysis to Assess the Association of Intersectional Stigma on Mental Health Outcomes Among Young Adult Black, Indigenous, and Sexual Minority Women of Color. LGBT Health 2023; 10:463-470. [PMID: 36951670 PMCID: PMC10468552 DOI: 10.1089/lgbt.2022.0083] [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] [Indexed: 03/24/2023] Open
Abstract
Purpose: Discrimination has detrimental effects on mental health, particularly among Black, Indigenous, and people of color who are also sexual minority women (BIPOC SMW); however, measurement of multiple intersecting forms of discrimination (e.g., race, gender, and sexual identity discrimination among BIPOC SMW) poses methodological challenges. This analysis uses latent class analysis (LCA) to examine the influences of discrimination on mental health in a convenience sample of BIPOC SMW. Methods: Online survey data from BIPOC SMW aged 18-29 years (n = 324) were used to estimate latent classes for discrimination type (race, gender, and sexual identity). Data for this study were collected from July to October 2018. Adjusted linear regressions examined the influences of discrimination profiles on perceived stress and depressive symptoms. Results: Utilizing LCA, the following four classes emerged: (1) low discrimination; (2) mid-level discrimination; (3) high racial, medium gender, and low sexual identity discrimination; (4) high discrimination. Classes 3 and 4 were positively associated with perceived stress and depressive symptoms relative to Class 1 in adjusted models. Conclusion: This analysis highlights the importance of intersectionality and the adverse impact of multiple forms of discrimination on mental health outcomes for BIPOC SMW. Respondents reporting higher levels of racial or multiple forms of discrimination had poorer mental health outcomes. LCA is a promising analytical tool for investigating intersectional stigma and discrimination. There is an urgent need to develop tailored, culturally appropriate intersectional mental health interventions to address the multiple identities and oppressions faced by BIPOC SMW.
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Affiliation(s)
- Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rachel Harris
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Paul Burns
- John D. Bower School of Population Health, Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Sociology, Emory University, Atlanta, Georgia, USA
| | - Frankie Y. Wong
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
- Department of Epidemiology, Fudan University, Shanghai, China
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Baiden P, Onyeaka HK, Aneni K, Wood B, LaBrenz CA, Muoghalu C, Peoples JE, Szlyk HS, Gobodzo EC, Baiden JF, Adeku Y, Mets VE, Brown FA, Cavazos-Rehg P. Perceived racial discrimination and polysubstance use among racial/ethnic minority adolescents in the United States. Drug Alcohol Depend 2023; 248:109894. [PMID: 37167795 PMCID: PMC11003345 DOI: 10.1016/j.drugalcdep.2023.109894] [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: 11/28/2022] [Revised: 03/28/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Polysubstance use among adolescents is a significant public health concern, yet most studies on adolescent substance use focus on a singular substance. This study is one of the first to investigate the association between perceived racial discrimination (PRD) in school and polysubstance use among racial/ethnic minority adolescents using a nationally representative sample. METHODS Data was from the 2021 Adolescent Behaviors and Experiences Survey. The sample included 4145 racial/ethnic minority adolescents (52.8% female). Hierarchical binary logistic regression was used to examine the association between PRD in school and polysubstance use among racial/ethnic minority adolescents. RESULTS About 12% of racial/ethnic minority adolescents engaged in polysubstance use and 23.4% reported experiencing PRD in school sometimes/most of the time/always. Controlling for other factors, experiencing PRD in school sometimes/most of the time/always was associated with 1.52 times higher odds of polysubstance use when compared to adolescents who never experienced PRD in school (OR=1.52, p=.044, 95% CI=1.01-2.30). Cyberbullying victimization, symptoms of depression, and being emotionally abused by a parent during COVID-19 were also associated with polysubstance use. CONCLUSION Controlling for demographic characteristics and psychosocial stressors, PRD in school was significantly associated with higher odds of polysubstance use among racial/ethnic minority adolescents. The findings of this study could inform clinicians and policymakers of the association between PRD in school and polysubstance use, which could contribute to early identification of polysubstance use among racial/ethnic minority adolescents.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA.
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Boston, MA02115, USA; Massachusetts General Hospital, Department of Psychiatry, Boston, MA02115, USA; McLean Hospital, Department of Psychiatry, Boston, MA02478, USA
| | | | - Bethany Wood
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Chioma Muoghalu
- Plains Regional Medical Center, Clovis, New Mexico, NM88101, USA
| | - JaNiene E Peoples
- The Brown School at Washington University in St. Louis, One Brookings Drive, St. Louis, MO63130, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
| | | | - John F Baiden
- East Airport International School, P.O. Box KAPM 57, KIA, Accra, Ghana
| | - Yvonne Adeku
- Western University, Department of Sociology, Social Science Centre, Room 5306, London, OntarioN6A 5C2, Canada
| | - Vera E Mets
- University of Ghana, Legon, Department of Social Work, P.O. Box LG 419, Legon, Accra, Ghana
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr, Box 19528, Arlington, TX76019, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
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Wheeler B, Jung S, Hall DL, Purohit M, Silva Y. An Analysis of Temporal Trends in Anti-Asian Hate and Counter-Hate on Twitter During the COVID-19 Pandemic. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:535-545. [PMID: 37462920 DOI: 10.1089/cyber.2022.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Recent studies have documented increases in anti-Asian hate throughout the COVID-19 pandemic. Yet relatively little is known about how anti-Asian content on social media, as well as positive messages to combat the hate, have varied over time. In this study, we investigated temporal changes in the frequency of anti-Asian and counter-hate messages on Twitter during the first 16 months of the COVID-19 pandemic. Using the Twitter Data Collection Application Programming Interface, we queried all tweets from January 30, 2020 to April 30, 2021 that contained specific anti-Asian (e.g., #chinavirus, #kungflu) and counter-hate (e.g., #hateisavirus) keywords. From this initial data set, we extracted a random subset of 1,000 Twitter users who had used one or more anti-Asian or counter-hate keywords. For each of these users, we calculated the total number of anti-Asian and counter-hate keywords posted each month. Latent growth curve analysis revealed that the frequency of anti-Asian keywords fluctuated over time in a curvilinear pattern, increasing steadily in the early months and then decreasing in the later months of our data collection. In contrast, the frequency of counter-hate keywords remained low for several months and then increased in a linear manner. Significant between-user variability in both anti-Asian and counter-hate content was observed, highlighting individual differences in the generation of hate and counter-hate messages within our sample. Together, these findings begin to shed light on longitudinal patterns of hate and counter-hate on social media during the COVID-19 pandemic.
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Affiliation(s)
- Brittany Wheeler
- School of Social and Behavioral Sciences and Arizona State University, Glendale, Arizona, USA
| | - Seong Jung
- School of Mathematical and Natural Sciences, Arizona State University, Glendale, Arizona, USA
| | - Deborah L Hall
- School of Social and Behavioral Sciences and Arizona State University, Glendale, Arizona, USA
| | - Monika Purohit
- Department of Computer Science, Loyola University Chicago, Chicago, Illinois, USA
| | - Yasin Silva
- Department of Computer Science, Loyola University Chicago, Chicago, Illinois, USA
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14
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Hong S, Walton B, Kim HW, Rhee TG. Predicting the Behavioral Health Needs of Asian Americans in Public Mental Health Treatment: A Classification Tree Approach. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:630-643. [PMID: 36988832 PMCID: PMC10052246 DOI: 10.1007/s10488-023-01266-x] [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: 03/19/2023] [Indexed: 03/30/2023]
Abstract
Given the fact that experiencing pandemic-related hardship and racial discrimination worsen Asian Americans' mental health, this study aimed to identify unique characteristics of behavioral health needs among Asian Americans (N = 544) compared to White Americans (N = 78,704) and Black Americans (N = 11,252) who received publicly funded behavioral health services in Indiana before and during the COVID-19 pandemic. We used 2019-2020 Adults Needs and Strengths Assessment (ANSA) data for adults eligible for Medicaid or funding from the state behavioral health agency. Chi-squared automatic interaction detection (CHAID) was used to detect race-specific differences among demographic variables, the pandemic status, and ANSA items. Results indicated that, regardless of age, gender, or pandemic status, Asian Americans who received behavioral health services, struggled more with cultural-related factors compared to White and Black individuals. Within this context, intersections among behavioral/emotional needs (psychosis), life functioning needs (involvement in recovery, residential stability, decision making, medical/physical health), and strengths (job history, interpersonal, and spiritual) further differentiated the mental health functioning of Asian from White and Black Americans. Classification tree algorithms offer a promising approach to detecting complex behavioral health challenges and strengths of populations based on race, ethnicity, or other characteristics.
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Affiliation(s)
- Saahoon Hong
- Indiana University School of Social Work, Indianapolis, IN, USA.
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA.
| | - Betty Walton
- Indiana University School of Social Work, Indianapolis, IN, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA
| | - Hea-Won Kim
- Indiana University School of Social Work, Indianapolis, IN, USA
| | - Taeho Greg Rhee
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
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15
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Mayo Bs D, Le PhD B. Perceived discrimination and mental health in college students: A serial indirect effects model of mentoring support and academic self-concept. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1184-1195. [PMID: 34242542 DOI: 10.1080/07448481.2021.1924725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/28/2021] [Accepted: 04/25/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Examine the direct and indirect effects of perceived discrimination, mentoring support, and academic self-concept on college student mental health. PARTICIPANTS Three hundred fifteen undergraduates of minorized gender (72%), ethnic (57%), and sexual (37%) identities. METHODS An online survey assessed perceived discrimination, mentoring support, academic self-concept, and mental health. RESULTS Perceived discrimination was associated with mentoring support (B=-0.11, p=.019), academic self-concept (B=-0.13, p<.001), and mental health (B=-0.15, p<.001). Additionally, mentoring support (B = 0.29, p<.001) and academic self-concept (B = 0.53, p<.001) were associated with mental health, and each other (B = 0.25, p<.001). Significant indirect effects were observed such that mentoring support and academic self-concept, individually and collectively, contributed to the association between perceived discrimination and mental health. CONCLUSIONS Addressing discrimination, creating supportive relationships, and facilitating academic growth may reduce mental health concerns in undergraduate populations, thereby having implications for college transition and retention strategies.
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Affiliation(s)
- Daniel Mayo Bs
- Department of Psychology, Haverford College, Haverford, Pennsylvania, USA
| | - Benjamin Le PhD
- Department of Psychology, Haverford College, Haverford, Pennsylvania, USA
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16
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Gonzalves LC, Ferrer E, Robins RW, Guyer AE, Hastings PD. Psychosocial Predictors of Suicidal Thoughts and Behaviors in Mexican-Origin Youths: An 8-Year Prospective Cohort Study. Clin Psychol Sci 2023; 11:425-443. [PMID: 37197008 PMCID: PMC10184188 DOI: 10.1177/21677026221102924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/28/2022] [Indexed: 12/03/2022]
Abstract
Suicide is the second leading cause of death for youths in the United States. More Latino adolescents report suicidal thoughts and/or behaviors (STBs) than youths of most other ethnic communities. Yet few studies have examined multiple psychosocial predictors of STBs in Latino youths using multiyear longitudinal designs. In this study, we evaluated the progression of STBs in 674 Mexican-origin youths (50% female) from fifth grade (10 years old) to 12th grade (17 years old) and identified psychosocial predictors of changes in STBs across this period. Latent growth curve models revealed that being female and later-generation status were associated with increasing prevalence in STBs across adolescence. Family conflict and peer conflict predicted increased STBs, whereas greater familism predicted less STBs. Thus, interpersonal relationships and cultural values contribute to the development of STBs in Mexican-origin youths and may be key levers for decreasing suicidality in this understudied but rapidly growing portion of the U.S. adolescent population.
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Affiliation(s)
- Lauren C. Gonzalves
- Department of Psychology, University of California, Davis
- Center for Mind and Brain, University of California, Davis
| | - Emilio Ferrer
- Department of Psychology, University of California, Davis
| | | | - Amanda E. Guyer
- Center for Mind and Brain, University of California, Davis
- Department of Human Ecology, University of California, Davis
| | - Paul D. Hastings
- Department of Psychology, University of California, Davis
- Center for Mind and Brain, University of California, Davis
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17
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Cordoba E, Garofalo R, Kuhns LM, Pearson CR, Batey DS, Bruce J, Radix A, Belkind U, Hidalgo MA, Hirshfield S, Schnall R. A Cross-sectional Study of Perceived Stress and Racial Discrimination Among a National Sample of Young Men Who Have Sex With Men. J Assoc Nurses AIDS Care 2023; 34:226-237. [PMID: 37129475 DOI: 10.1097/jnc.0000000000000407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
ABSTRACT Research regarding the impact of racism on stress among young men who have sex with men (YMSM) is sparse. Secondary data were assessed from a 2018-2020 national mHealth prevention trial for YMSM aged 13-18 years (N = 542). Linear regression models examined associations between perceived stress and interpersonal and vicarious racism, adjusting for covariates. Stratified models by race/ethnicity were included. A subanalysis (n = 288) examined associations between nine interpersonal racial discriminatory events and perceived stress. Over 50% of participants experienced racial discrimination. In the multivariable models, exposure to interpersonal (β = 1.43, p-value: .038) and vicarious (β = 1.77, p-value: .008) racism was associated with perceived stress because there were four interpersonal racial discriminatory events. Stratified analysis by race/ethnicity found significant associations between interpersonal and vicarious racism and perceived stress among some racial/ethnic groups. Racial discrimination was common among YMSM, making them susceptible to the possible effects of vicarious and interpersonal racism on stress.
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Affiliation(s)
- Evette Cordoba
- Evette Cordoba, PhD, MPH, is a Postdoctoral Research Scientist, Columbia University School of Nursing, New York, New York, USA. Robert Garofalo, MD, MPH, is the Division Head of Adolescent and Young Adult Medicine, the Potocsnak Family Professorship in Adolescent & Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, and Professor of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Lisa M. Kuhns, PhD, is a Research Associate Professor of Pediatrics (Adolescent Medicine), Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Cynthia R. Pearson, PhD, is a Research Professor and Director of Research at the Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, Washington, USA. D. Scott Batey, PhD, MSW, is an Associate Professor of Social Work, Tulane University, New Orleans, Louisiana, USA. Josh Bruce, MPH, is the Director of Research Initiatives, Birmingham AIDS Outreach, Birmingham, Alabama, USA. Asa Radix, MD, PhD, MPH, FIDSA, is the Senior Director of Research and Education, Callen-Lorde Community Health Center, New York, New York, USA. Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Adolescent Health (Health Outreach to Teens), Callen Lorde Community Health Center, New York, New York, USA. Marco A. Hidalgo, PhD, MA, is a Faculty Psychologist at the Center for Transyouth Health and Development and Assistant Professor of Clinical Pediatrics, Children's Hospital Los Angeles, The Saban Research Institute and the Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Sabina Hirshfield, PhD, is a Principal Research Scientist, STAR Program, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA. Rebecca Schnall, PhD, MPH, RN-BC, FAAN, FACMI, is the Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion, Columbia University School of Nursing, Professor of Population and Family Health, Columbia University, New York, New York, USA
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18
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Venkatesan UM, Rabinowitz AR, Bernier RA, Soto JA, Hillary FG. Effects of Perceived Discrimination on Behavioral Health Outcomes in People Aging With Traumatic Brain Injury. J Head Trauma Rehabil 2023; 38:191-200. [PMID: 36731038 DOI: 10.1097/htr.0000000000000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate major and everyday experiences of discrimination (MED and EED, respectively) in relation to behavioral health outcomes in people with traumatic brain injury (PwTBI). SETTING Outpatient research laboratory. PARTICIPANTS Adults, 50 years or older, with a chronic (1+ year) history of moderate or severe TBI ( N = 118). DESIGN Cross-sectional observational study. MAIN MEASURES MED and EED (primary measures of interest) and behavioral health outcomes: global cognition, psychological symptoms, neurobehavioral symptoms, societal participation, and health-related quality of life (HRQoL). In participants with available geodata ( N = 28), neighborhood socioeconomic deprivation (ND) was examined as a potential contributor to MED, EED, and measured outcomes. RESULTS EED and MED were significantly associated with psychological symptoms, neurobehavioral symptoms, and HRQoL after correction for multiple comparisons. Counter to expectations, EED were related to higher societal participation. MED and EED were unrelated to cognition. When MED and EED were entered together in hierarchical regressions, only EED made significant contributions beyond demographic and injury-related covariates to each outcome. Sensitivity analyses revealed that most of these relationships were not solely accounted for by disability-related discrimination. ND showed negligible associations with discrimination but moderate effect sizes for cognition and participation. Race was not significantly related to discrimination and was not a significant predictor in regression models but was strongly associated with ND. CONCLUSION The current data provide preliminary support for perceived discrimination as an important factor in neurobehavioral and psychosocial health, but not cognitive performance, after TBI. These relationships appear to be driven by daily experiences of discriminatory treatment versus single major instances of injustice. Measured outcomes may also reflect socioeconomic challenges and structural discrimination faced by diverse PwTBI, although more work in this area is urgently needed. Multiple sources of marginalization and disenfranchisement and their functional effects should be considered in TBI rehabilitation and outcome monitoring.
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Affiliation(s)
- Umesh M Venkatesan
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania (Drs Venkatesan and Rabinowitz); Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Drs Venkatesan and Rabinowitz); Department of Neurosciences, UC San Diego School of Medicine, La Jolla, California (Dr Bernier); Department of Psychology, Pennsylvania State University, University Park (Drs Soto and Hillary); and Department of Neurology, Penn State Hershey Medical Center, Hershey, Pennsylvania (Dr Hillary)
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19
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Cuevas AG, Mann FD, Krueger RF. Discrimination Exposure and Polygenic Risk for Obesity in Adulthood: Testing Gene-Environment Correlations and Interactions. Lifestyle Genom 2023; 16:90-97. [PMID: 36750036 PMCID: PMC11078300 DOI: 10.1159/000529527] [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] [Received: 04/19/2022] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Exposure to discrimination has emerged as a risk factor for obesity. It remains unclear, however, whether the genotype of the individual can modulate the sensitivity or response to discrimination exposure (gene × environment interaction) or increase the likelihood of experiencing discrimination (gene-environment correlation). METHODS This was an observational study of 4,102 white/European Americans in the Health and Retirement Study with self-reported, biological assessments, and genotyped data from 2006 to 2014. Discrimination was operationalized using the average of nine Everyday Discrimination Scale items. Polygenic risk scores (PRSs) for body mass index (BMI) and waist circumference (WC) were calculated using the weighted sum of risk alleles based on studies conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium. RESULTS We found that greater PRS-BMI was significantly associated with more reports of discrimination (β = 0.04 ± 0.02; p = 0.037). Further analysis showed that measured BMI partially mediated the association between PRS-BMI and discrimination. There was no evidence that the association between discrimination and BMI, or the association between discrimination and WC, differed by PRS-BMI or PRS-WC, respectively. CONCLUSION Our findings suggest that individuals with genetic liability for obesity may experience greater discrimination in their lifetime, consistent with a gene-environment correlation hypothesis. There was no evidence of a gene-environment interaction. More genome-wide association studies in diverse populations are needed to improve generalizability of study findings. In the meantime, prevention and clinical intervention efforts that seek to reduce exposure to all forms of discrimination may help reduce obesity at the population level.
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Affiliation(s)
- Adolfo G. Cuevas
- Department of Social and Behavioral Sciences Department, School of Global Public Health, New York University
| | - Frank D. Mann
- Department of Family, Population, and Preventative Medicine, Program in Public Health, Stony Brook University
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20
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Yamaguchi S, Bentayeb N, Holtom A, Molnar P, Constantinescu T, Tisdall EKM, Tuong J, Iyer SN, Ruiz-Casares M. Participation of Children and Youth in Mental Health Policymaking: A Scoping Review [Part I]. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:58-83. [PMID: 36357819 DOI: 10.1007/s10488-022-01223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/12/2022]
Abstract
Although youth participation is oft-acknowledged as underpinning mental health policy and service reform, little robust evidence exists about the participation of children and youth in mental health policymaking. A scoping review based on Arksey and O'Malley's framework was conducted to identify and synthesize available information on children and youth's participation in mental health policymaking. Published studies up to November 30, 2020 were searched in Medline (OVID), PsycINFO (OVID), Scopus, and Applied Social Sciences Index and Abstracts (PROQUEST). Further studies were identified through Google Scholar and a grey literature search was conducted using Google and targeted web searches from October to December, 2020. Three reviewers performed screening and data extraction relevant to the review objective, followed by an online consultation. From 2,981 records, 25 publications were included. A lack of diversity among the youth involved was found. Youth were often involved in situational analysis and policy design, but seldom in policy implementation and evaluation. Both the facilitators of and barriers to participation were multifaceted and interconnected. Despite a range of expected outcomes of participation for youth, adults, organizations, and communities, perceived and actual effects were neither substantially explored nor reported. Our recommendations for mental health policymaking highlight the inclusion of children and youth from diverse groups, and the creation of relational spaces that ensure safety, inclusiveness, and diversity. Identified future research directions are: the outcomes of youth participation in mental health policymaking, the role of adults, and more generally, how the mental health of children and youth shapes and is shaped by the policymaking process.
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Affiliation(s)
- Sakiko Yamaguchi
- CHILD-BRIGHT Network, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. .,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. .,Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, QC, H3A 1A1, Canada.
| | - Naïma Bentayeb
- CIUSSS du Centre-Ouest-de-L'île-de-Montréal, SHERPA University Institute, Montreal, QC, Canada.,École Nationale d'Administration Publique, Montreal, QC, Canada.,School of Social Work, McGill University, Montreal, QC, Canada
| | | | - Paula Molnar
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Teodora Constantinescu
- CIUSSS du Centre-Ouest-de-L'île-de-Montréal, SHERPA University Institute, Montreal, QC, Canada
| | - E Kay M Tisdall
- Childhood and Youth Studies, MHSES, University of Edinburgh, Edinburgh, UK
| | - Josie Tuong
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, Canada
| | - Srividya N Iyer
- Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, QC, H3A 1A1, Canada.,Douglas Research Centre, ACCESS Open Minds (Youth Mental Health Network), Montreal, QC, Canada
| | - Mónica Ruiz-Casares
- Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, QC, H3A 1A1, Canada.,CIUSSS du Centre-Ouest-de-L'île-de-Montréal, SHERPA University Institute, Montreal, QC, Canada.,School of Child & Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
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21
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Intersecting identities and adolescent depression: Patterns of depressed mood and anhedonia in the past decade. J Affect Disord 2022; 319:518-525. [PMID: 36162694 DOI: 10.1016/j.jad.2022.09.088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Research suggests adolescent depression is increasing and certain adolescents may be uniquely vulnerable. However, limited conceptualizations of identity and time, as well as the reliance on unitary conceptualizations of depression, inhibits a nuanced perspective on these trends. In response, we examined how adolescent depressive symptoms, depressed mood, and anhedonia, vary across intersecting identities over time. METHODS Secondary data analysis on the National Survey on Drug Use and Health between 2009 and 2017 was conducted. In total 145,499 nationally representative adolescents (ages 12-17) completed a diagnostic assessment for depression. Lifetime and past year reports of depressive symptoms, depressed mood, and anhedonia were treated as separate variables. A novel, mixed-level model in which participants were nested within identity (defined by one's age, gender, race/ethnicity, poverty level) and time was used to test our aims. RESULTS Overall, the relation between depression outcomes and identity did not vary over time (p > .01). Further, identity's impact on depression was approximately ten-fold that of temporal effects. Multiracial, late adolescent, female adolescents were at particular risk. Findings concerning depressed mood and anhedonia were similar across analyses. LIMITATIONS All facets of identity (e.g., sexual identity) were not included in the model and a unidimensional measure of poverty may have underestimated its depressogenic influence. CONCLUSION Adolescent depression outcomes are mostly consistent across criterial symptom subtypes and time, but vary as a function of identity. Prevention protocols that highlight mechanisms of risk tethered to social identity, and include salient experiences of females, late adolescents, and multiracial youth in particular, need to be prioritized in mental health initiatives.
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22
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Davis A, Solomon M, Belcher H. Examination of Race and Autism Intersectionality Among African American/Black Young Adults. AUTISM IN ADULTHOOD 2022; 4:306-314. [PMID: 36777378 PMCID: PMC9908282 DOI: 10.1089/aut.2021.0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background African American/Black (AA/B) young adults with diagnoses of autism spectrum disorders rarely are studied in a way that acknowledges both their racial identity and their autism diagnosis. Little is known about intersectional oppression in the lives of these young adults. Early adulthood is a time when a young people of color may come to terms with a society that may not treat them fairly and equally due to their race. Autistic AA/B young adults may be even more vulnerable to stress and psychological disempowerment due to the added impact of negative experiences of being Black and having an autism diagnosis. Methods Thirty-two autistic and 30 non-autistic AA/B young adults took part in an online survey examining risk factors of everyday discrimination, perceived stress and potential protective factors of psychological empowerment, and Black identity. Differences in score measures for the autistic and non-autistic samples were examined along with the predictors of perceived stress assessed. Frequencies of intersectional discrimination experiences were also examined. Results Autistic AA/B participants reported significantly less everyday discriminatory experiences than non-autistic AA/B participants, whereas perceived stress was not significantly different between the two groups. The majority of non-autistic AA/B participants endorsed race as their prime source of experiences of discrimination, whereas autistic AA/B participants also cited being autistic as a major contributor to reports of discrimination. Although the autistic group had significantly lower reports of self-determination, they reported higher on the Black identity, private regard scale, pertaining to feelings about group membership, which can be considered a protective factor. There is heterogeneity in reasons for discriminatory experiences for autistic AA/B young adults whereby some of the participants (12%-30%) endorsed race + disability as dual reasons for experiencing regular discrimination. Conclusions Mental health clinicians and other direct service providers working with autistic AA/B young adults should understand that intersecting identities of race and disability may be at play when they are working with these individuals, and that treatment should consider these factors.
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Affiliation(s)
- Amber Davis
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marjorie Solomon
- Department of Psychiatry, University of California Davis, Sacramento, California, USA
| | - Harolyn Belcher
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
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23
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Keum BT, Choi AY. COVID-19 Racism, Depressive Symptoms, Drinking to Cope Motives, and Alcohol Use Severity Among Asian American Emerging Adults. EMERGING ADULTHOOD (PRINT) 2022; 10:1591-1601. [PMID: 38603255 PMCID: PMC9353315 DOI: 10.1177/21676968221117421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The COVID-19 pandemic has incited widespread anti-Asian racism, which is linked to numerous behavioral health consequences including depressive symptoms. As racism-induced depressive symptoms are linked to coping-related alcohol use and because alcohol-related problems represent a significant public health concern in this population, we investigated whether COVID-19 racism predicted alcohol use severity through depressive symptoms and drinking to cope motives among Asian American emerging adults (N = 139; Mage = 23.04; 50% women, 50% men). We conducted a serial mediation wherein COVID-19 racism predicted alcohol use severity sequentially through depressive symptoms and drinking to cope motives. COVID-19 racism directly and significantly predicted alcohol use severity. The indirect effect via depressive symptoms and drinking to cope motives was also significant, suggesting that COVID-19 racism is likely a risk factor for alcohol-related problems. Results inform intervention science and highlight the need for policy and behavioral health services to curb COVID-19 racism.
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Affiliation(s)
- Brian TaeHyuk Keum
- Department of Social Welfare, University of California, Los Angeles, CA, USA
| | - Andrew Young Choi
- Counseling and Student Development Center, University of Hawaiʻi at Mānoa, HI, USA
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24
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Stepanikova I, Acharya S, Colón-López A, Abdalla S, Klanova J, Darmstadt GL. Maternal gender discrimination and child emotional and behavioural problems: A population-based, longitudinal cohort study in the Czech Republic. EClinicalMedicine 2022; 53:101627. [PMID: 36060515 PMCID: PMC9433606 DOI: 10.1016/j.eclinm.2022.101627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/18/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Gender discrimination may be a novel mechanism through which gender inequality negatively affects the health of women and girls. We investigated whether children's mental health varied with maternal exposure to perceived gender discrimination. METHODS Complete longitudinal data was available on 2,567 mother-child dyads who were enrolled between March 1, 1991 and June 30, 1992 in the European Longitudinal Cohort Study of Pregnancy and Childhood-Czech cohort and were surveyed at multiple time points between pregnancy and child age up to 15 years. The Strengths and Difficulties Questionnaire (SDQ) was administered at child age 7, 11, and 15 years to assess child emotional/behavioural difficulties. Perceived gender discrimination was self-reported in mid-pregnancy and child age 7 and 11 years. Multilevel mixed-effects linear regression of SDQ scores were estimated. Mediation was tested using structural equation models. FINDINGS Perceived gender discrimination, reported by 11.2% of mothers in mid-pregnancy, was related to increased emotional/behavioural difficulties among children in bivariate analysis (slope = 0.24 [95% confidence interval (CI): 0.15, 0.32], p<0.0001) and in the fully adjusted model (slope = 0.18 [95% CI: 0.09, 0.27], p<0.0001). Increased difficulties were evident among children of mothers with more depressive symptoms (slope = 0.04 [95% CI: 0.03, 0.05], p<0.0001), boys (slope = 0.26 [95% CI: 0.19, 0.34], p<0.0001), first children (slope = 0.16 [95% CI: 0.09, 0.23], p<0.0001), and families under financial hardship (slope = 0.09 [95% CI: 0.04, 0.14], p<0.0001). Effects were attenuated for married mothers (slope-0.12 [95% CI: -0.22, -0.01], p<0.05]. Maternal depressive symptoms and financial hardship mediated about 37% and 13%, respectively, of the total effect of perceived gender discrimination on SDQ scores. INTERPRETATION Perceived gender discrimination among child-bearing women in family contexts was associated with more mental health problems among their children and adolescents, extending prior research showing associations with maternal mental health problems. Maternal depressive symptoms and, to a lesser extent, financial hardship both partially mediated the positive relationship between perceived gender discrimination and child emotional/behavioural problems. This should be taken into consideration when measuring the societal burden of gender inequality and gender-based discrimination. Moreover, gender-based discrimination affects more than one gender and more than one generation, extending to boys in the household even moreso than girls, highlighting that gender discrimination is everyone's issue. Further research is required on the intergenerational mechanisms whereby gender discrimination may lead to maternal and child mental health consequences. FUNDING Bill and Melinda Gates Foundation; Ministry of Education, Youth and Sports, Czech Republic and European Structural and Investment Funds.
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Affiliation(s)
- Irena Stepanikova
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Sanjeev Acharya
- Department of Criminology, Sociology, and Geography, Arkansas State University, Jonesboro, Arkansas, USA
| | - Alejandra Colón-López
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Safa Abdalla
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Jana Klanova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Gary L. Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Corresponding author at: 1701 Page Mill Road, Palo Alto, CA 94304, USA.
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Dean KE, Long ACJ, Trinh NH, McClendon J, Buckner JD. Treatment Seeking for Anxiety and Depression Among Black Adults: A Multilevel and Empirically Informed Psycho-Sociocultural Model. Behav Ther 2022; 53:1077-1091. [PMID: 36229108 DOI: 10.1016/j.beth.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 02/24/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Black adults with anxiety and/or depressive disorders underutilize outpatient psychotherapy and pharmacological treatment compared to White adults. Notably, anxiety and depressive disorders tend to be chronic and Black individuals with these disorders experience greater functional impairment than White individuals. Documented racial disparities in mental health treatment initiation indicate a need for research that addresses culture-specific barriers to treatment. This review paper critically evaluates existing theoretical models of treatment seeking among Black adults to inform a novel integrated, culturally contextualized model. This model extends previous ones by incorporating factors relevant to treatment seeking among Black adults (e.g., racial identity, perceived discrimination, medical mistrust) and critically examines how these factors intersect with key factors at three levels of influence of the treatment seeking process: the individual level, the community level, and the societal level. We posit interactions among factors at the three levels of influence and how these may impact treatment seeking decisions among Black adults. This model informs suggestions for enhancing interventions designed to support outpatient service use among Black adults.
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Affiliation(s)
| | | | - Nhi-Ha Trinh
- Massachusetts General Hospital/Harvard Medical School
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26
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Walsh K, Gilmore AK, Barr SC, Frazier P, Ledray L, Acierno R, Ruggiero KJ, Kilpatrick DG, Resnick HS. The Role of Discrimination Experiences in Postrape Adjustment Among Racial and Ethnic Minority Women. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17325-NP17343. [PMID: 34229508 DOI: 10.1177/08862605211028006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although recent studies have linked discrimination frequency among Black and Latinx individuals to PTSD symptom severity, to our knowledge, these associations have yet to be examined among a diverse sample of recent rape survivors. The current secondary analysis of existing data examined the role of discrimination experiences in post-traumatic stress disorder (PTSD) symptoms, depression, and alcohol and drug problems among a racially and ethnically diverse sample of recent rape survivors. Participants were 139 Black (48.2%; n = 67), American Indian (18.7%; n = 26), Hispanic (15.1%; n = 21), and mixed race (17.3%; n = 24) girls and women age 15 or older who presented to the emergency department (ED) for a sexual assault forensic medical exam. They were randomly assigned to one of three intervention conditions, and completed a six-month postrape follow-up, including questions about mental health, substance use problems, and discrimination experiences. Regression analyses revealed that Black women experienced discrimination in significantly more situations and with greater frequency compared to American Indian and Hispanic women. Discrimination frequency was positively associated with PTSD and depression symptoms even after controlling for age, education, race, and intervention condition, but was not associated with alcohol or drug problems. Findings highlight the importance of attending to the heterogeneous experiences of discrimination among racial and ethnic minority women. Future work should adapt evidence-based early interventions to be maximally effective at combating both racial and sexual trauma exposures.
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Affiliation(s)
- Kate Walsh
- University of Wisconsin-Madison, WI, USA
| | | | - Simone C Barr
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | | | - Linda Ledray
- SANE SART Resource Service, Minneapolis, MN, USA
| | - Ron Acierno
- University of Texas Health Science Center, Houston, TX, USA
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Dowhower DP, Harvey SM, Oakley LP. Experiences of discrimination and endorsement of HIV/AIDS conspiracy beliefs: exploring difference among a sample of Latino, Black, and White young adults. ETHNICITY & HEALTH 2022; 27:1537-1554. [PMID: 34056960 DOI: 10.1080/13557858.2021.1932765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
Racial/ethnic discrimination and HIV/AIDS conspiracy beliefs may contribute to disparities in use and satisfaction with healthcare services. Previous studies that examined racial/ethnic experiences of everyday discrimination (EOD), health care discrimination (HCD), and HIV/AIDS conspiracy beliefs (HCB) focused primarily on African Americans with few studies focusing on Latinos. This study used data from in-person structured interviews with 450 Latino, Black, and White young adults from East Los Angeles, California. Multivariable models, adjusting for all demographic covariates, investigated if race/ethnicity and gender were associated with EOD and HCD and endorsing HCB, and if the associations between race/ethnicity and discriminations and HCB varied by gender. Blacks and Latinos reported more experiences of EOD and HCD in almost all forms and endorsed more HIV/AIDS conspiracy beliefs compared to Whites. Additionally, Black and Latino men reported stronger feelings of EOD than their female counterparts. More reports of experiences of HCD and endorsement of HCB beliefs were found for Blacks, Latinos, and participants with children compared to their counterparts. This study contributes to a growing understanding of how different racial/ethnic groups experience discrimination across various settings and everyday activities and their endorsement of HIV/AIDS conspiracy beliefs. The field of Public Health must address the problems of racism and discrimination similar to any other toxic pathogen. In so doing, Public Health becomes proactive in its efforts to mitigate the effects of racial discriminations on population health.
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Affiliation(s)
- Daniel P Dowhower
- Division of Community and Exercise Health, Western Oregon University, Monmouth, Oregon, USA
| | - S Marie Harvey
- College of Public Health and Human Sciences, Oregon State University, Monmouth, Oregon, USA
| | - Lisa P Oakley
- College of Public Health and Human Sciences, Oregon State University, Monmouth, Oregon, USA
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28
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Alvarez K, Cervantes PE, Nelson KL, Seag DEM, Horwitz SM, Hoagwood KE. Review: Structural Racism, Children's Mental Health Service Systems, and Recommendations for Policy and Practice Change. J Am Acad Child Adolesc Psychiatry 2022; 61:1087-1105. [PMID: 34971730 PMCID: PMC9237180 DOI: 10.1016/j.jaac.2021.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Racism is a public health crisis that impacts on children's mental health, yet mental health service systems are insufficiently focused on addressing racism. Moreover, a focus on interpersonal racism and on individual coping with the impacts of racism has been prioritized over addressing structural racism at the level of the service system and associated institutions. In this paper, we examine strategies to address structural racism via policies affecting children's mental health services. METHOD First, we identify and analyze federal and state policies focused on racism and mental health equity. Second, we evaluate areas of focus in these policies and discuss the evidence base informing their implementation. Finally, we provide recommendations for what states, counties, cities, and mental health systems can do to promote antiracist evidence-based practices in children's mental health. RESULTS Our analysis highlights gaps and opportunities in the evidence base for policy implementation strategies, including the following: mental health services for youth of color, interventions addressing interpersonal racism and bias in the mental health service system, interventions addressing structural racism, changes to provider licensure and license renewal, and development of the community health workforce. CONCLUSION Recommendations are provided both within and across systems to catalyze broader systems transformation.
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Affiliation(s)
- Kiara Alvarez
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | | | - Katherine L Nelson
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Merck & Co., Inc., Kenilworth, New Jersey
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Associations between discrimination and adverse mental health symptoms and disorder diagnoses among college students in the United States. J Affect Disord 2022; 310:249-257. [PMID: 35561881 DOI: 10.1016/j.jad.2022.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/19/2022] [Accepted: 05/05/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mental health disorders are prevalent among college students in the US. Perceived discrimination is a known risk factor for adverse mental health and is widespread on college campuses. METHODS We estimated the association between perceived discrimination and mental health among US college students using the American College Health Association-National College Health Assessment (ACHA-NCHA), a large national cross-sectional survey of college students. RESULTS 7.9% of students reported experiences of discrimination, and that discrimination was more common among minority students. Perceived discrimination was associated with 86 excess cases of students reporting being too depressed to function per 1000 students, and 27 excess cases of students reporting seriously considering suicide per 1000 students. Students who experienced discrimination had a 37% increase in the number of mental health symptoms (IRR 1.37 [95% CI 1.35, 1.39], P < .0001) compared to non-discriminated students, and a 94% increase in the number of mental health diagnoses (IRR 1.94 [95% CI 1.89, 1.99], P < .0001). Discrimination was positively associated with all mental health symptoms and diagnoses. This pattern was largely held across sub-analyses by race/ethnicity, gender, and sexual orientation, but with varying magnitudes. LIMITATIONS Inability to distinguish between the forms of discrimination experienced, whether involving gender, sexual orientation, or race/ethnicity. CONCLUSIONS Consequences of perceived discrimination are of clinical relevance for healthcare providers in general and mental health providers in particular. This study confirms the association between perceived discrimination and adverse mental health in college students. Efforts to reduce discrimination and bias in college campuses may improve the mental health of students.
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30
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Police killings and suicide among Black Americans. Soc Sci Med 2022; 305:114964. [PMID: 35660700 DOI: 10.1016/j.socscimed.2022.114964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/02/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022]
Abstract
Black Americans are killed at higher rates by police than whites. Previous studies have shown that discrimination can lead to suicidal ideation, and that mental health of Black Americans deteriorates after police killings. The objective of this study is to examine whether police killings are associated with an increase in suicide rates amongst Black Americans. Controlling for a number of factors, we found that on months with at least one killing of a Black person by police, there were, on average, 0.0472 additional suicides per 100,000 Black Americans in the U.S. Census Division where the killing occurred. We did not find any spillover effects on other divisions. This association persisted when controlling for gun ownership, and did not seem to be a result of variance in deaths by assault. There was no association between killings of Black Americans and white suicides; white killings and Black suicides; or white killings and white suicides. This study highlights another reason for urgent action on reducing police killings.
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31
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Jones AL, Rafferty J, Cochran SD, Abelson J, Hanna MR, Mays VM. Prevalence, Severity and Burden of Post-Traumatic Stress Disorder in Black Men and Women Across the Adult Life span. J Aging Health 2022; 34:401-412. [PMID: 35510479 PMCID: PMC9175561 DOI: 10.1177/08982643221086071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To examine post-traumatic stress disorder (PTSD) among Black adults in younger, middle, and older ages. Methods: Using nationally representative data from the National Survey of American Life, we estimated lifetime and 12-month prevalence of PTSD in Black men and women ages 18-34, 35-49, and 50+. We determined PTSD persistence and severity by age group, then associations of PTSD with socio-economic status, chronic stress, and racial discrimination in middle age. Results: The lifetime prevalence of PTSD was higher in Black women/men ages 18-34 (prevalence=14.0%/6.3%) and 35-49 (12.8%/4.6%) versus 50 and older (8.7%/5.1%). Those ages 35-49 were more likely than younger/older Black adults to have severe interference in work, relationships, and activities domains. In middle age, PTSD was associated with unemployment, lower education, poverty, and stress in Black men, and unemployment, divorce, poverty, stress, and discrimination in Black women. Discussion: Black women experience a disproportionate burden of PTSD in middle age.
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Affiliation(s)
- Audrey L Jones
- Informatics, Decision-Enhancement and Analytic Sciences Center, 20122Veteran Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jane Rafferty
- Program for Research on Black Americans, 51331Institute of Social Research, Ann Arbor, MI, USA
- School of Social Work, 143265University of Michigan, Ann Arbor, MI, USA
| | - Susan D Cochran
- Departments of Epidemiology and Statistics, Fielding School of Public Health, 25808University of California, Los Angeles, CA, USA
- UCLA BRITE Center for Science, Research & Policy, Los Angeles, CA, USA
| | - Jamie Abelson
- Program for Research on Black Americans, 51331Institute of Social Research, Ann Arbor, MI, USA
- School of Social Work, 143265University of Michigan, Ann Arbor, MI, USA
| | - Matthew R Hanna
- Department of Psychology, 5926The New School for Social Research, New York, NY, USA
| | - Vickie M Mays
- UCLA BRITE Center for Science, Research & Policy, Los Angeles, CA, USA
- Departments of Psychology and Health Policy and Management, Fielding School of Public Health, 8783University of California, Los Angeles, CA, USA
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32
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Alvarez K, Polanco-Roman L, Breslow AS, Molock S. Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems. Am J Psychiatry 2022; 179:422-433. [PMID: 35599542 PMCID: PMC9765395 DOI: 10.1176/appi.ajp.21101001] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Suicide rates among ethnoracially minoritized youth (i.e., youth of color) peak before the age of 30, and striking disparities in access to mental health services have been identified in this age group. However, suicide prevention strategies have yet to fully address structural racism as a mechanism in producing disparities in risk, protective factors, and access to quality effective intervention for youth of color. Such an approach is critical to provide more culturally responsive mental health care. Through an adapted socio-ecological model, the authors propose the Structural Racism and Suicide Prevention Systems Framework and illustrate pathways through which structural racism impacts suicide prevention and intervention for youth of color in the United States. The authors contextualize the impact of structural racism in three key settings where youth suicide prevention occurs: mental health services, schools, and the interface between crisis care and law enforcement. The authors posit that critical attention must be paid to the intersection of mutually reinforcing, interdependent systems rather than to systems in isolation. The authors then propose recommendations to address structural racism in suicide prevention, including macro-level interventions to improve societal conditions, research strategies to inform structural solutions, training approaches to address institutional racism, and clinical approaches to address the impact of racism and racial trauma on youths and families.
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Affiliation(s)
- Kiara Alvarez
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Correspondence: Kiara Alvarez, Massachusetts General Hospital Disparities Research Unit, Department of Medicine, 50 Staniford Street, Suite 830, Boston, MA 02114; ; Phone: 617-724-1237; Fax: 617-726-4120
| | | | - Aaron Samuel Breslow
- PRIME Center for Health Equity, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY,Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, USA
| | - Sherry Molock
- Department of Psychological & Brain Sciences, The George Washington University, Washington, DC
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Zimmerman GM, Trovato D, Miller-Smith A. Discrimination in Context: Examining Neighborhood-Level Variation in the Incidence and Adverse Effects of Perceived Racial and Ethnic Discrimination Among Chicago Youth. RACE AND SOCIAL PROBLEMS 2022; 15:1-24. [PMID: 35601816 PMCID: PMC9106986 DOI: 10.1007/s12552-022-09367-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
A growing body of research links interpersonal racial and ethnic discrimination to adverse youth outcomes. Yet, studies examining the relevance of neighborhood context for discrimination are sparse. This study examines neighborhood-level variation in the incidence and impact of perceived racial and ethnic discrimination on depressive symptoms, suicidal behavior, violent behavior, and substance use. Hierarchical regression models on a sample of 1333 African American and Hispanic youth (52.44% female; x̄ = 13.03 years, SD = 3.25 at wave 1) residing in 238 Chicago neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated little to no neighborhood-level variation in the incidence and impact of discrimination. Findings suggest that the experience of discrimination among youth of color is ubiquitous.
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Affiliation(s)
- Gregory M. Zimmerman
- School of Criminology and Criminal Justice, Northeastern University, 360 Huntington Avenue, Boston, MA 02115 USA
| | - Daniel Trovato
- School of Criminology and Criminal Justice, Northeastern University, 360 Huntington Avenue, Boston, MA 02115 USA
| | - Ayanna Miller-Smith
- School of Criminology and Criminal Justice, Northeastern University, 360 Huntington Avenue, Boston, MA 02115 USA
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Hermaszewska S, Sweeney A, Camminga B, Botelle R, Elliott K, Sin J. Lived experiences of transgender forced migrants and their mental health outcomes: systematic review and meta-ethnography. BJPsych Open 2022; 8:e91. [PMID: 35535515 PMCID: PMC9169499 DOI: 10.1192/bjo.2022.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Owing to multiple, complex and intersecting health inequities, systemic oppression and violence and discrimination in their home countries, some transgender people are forced to migrate to countries that offer them better legal protection and wider social acceptance. AIMS This review sought to explore and understand the multiple factors that shape the mental health outcomes of transgender forced migrants (TFMs). METHOD We systematically searched nine electronic databases for multidisciplinary literature (PROSPERO ID: CRD42020183062). We used a meta-ethnographic approach to synthesise data. We completed a quality appraisal and developed a socio-ecological model to draw together our findings. RESULTS We retrieved 3399 records and screened titles, abstracts and full text to include 24 qualitative studies in this review. The synthesis identified individual survival strategies and factors in interpersonal, organisational and societal environments that contributed to profound deprivation and mental distress in TFMs. Pervasive and persistent violence and discrimination, economic exclusion, barriers to healthcare and a dependency on legal documentation were identified as key factors leading to poor mental health outcomes. Sources of resilience included community acceptance and support, being granted asylum, societal affirmation of gender, fulfilment of basic rights and healthcare access. Individual strategies for survival, such as hope and having purpose in life, were important in bringing relief from distress. CONCLUSIONS Improved communication and knowledge about the unique needs and concerns of TFMs through interventions at the individual, interpersonal, organisational and societal levels are necessary to improve mental health outcomes.
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Affiliation(s)
| | - Angela Sweeney
- Department of Health Service and Population Research, King's College London, UK
| | - B Camminga
- African Centre for Migration & Society, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Jacqueline Sin
- School of Health Sciences, City University of London, UK
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Carden KD, McDuffie DL, Murry K, Bui C, Allen RS. Minority stress process among older Black Americans: the role of age, perceived discrimination, and anxiety. Aging Ment Health 2022; 26:852-859. [PMID: 33836631 DOI: 10.1080/13607863.2021.1904380] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Prolonged experiences of discrimination can be a major source of physical and health-related stress, particularly in older Black Americans. However, there is limited information on the relation between discrimination and anxiety, particularly within the context of other constructs that influence the manifestation of anxiety symptoms. For example, several studies have suggested that ethnic identification may provide psychological and social resources to deal with the effects of discrimination. This study aims to further understand these processes.Method: This study utilized structural equation modeling (SEM) to examine predictors of anxiety symptom severity in a sample of African American and Afro-Caribbean adults aged 55 and older from the National Survey of American Life (N = 1,032).Results: The final structural regression model revealed acceptable fit indices, and was successful in measuring latent anxiety symptom severity, showing that more experienced discrimination was related to higher anxiety and anxiety was directly related to mental health rating. While higher experience of discrimination was associated with higher anxiety, it was not directly related to mental health rating. However, contrary to expectation, ethnic identification did not serve as a protective factor between experienced discrimination and anxiety. As individuals aged, they experienced less discrimination and reported poorer self-rated mental health.Conclusions: While age served as a protective factor for perceived discrimination and anxiety symptom severity, ethnic identification did not. Implications for those working to reduce anxiety symptoms among Black Americans are discussed.
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Affiliation(s)
- Keisha D Carden
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.,Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Danielle L McDuffie
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Kaleb Murry
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Chuong Bui
- Alabama Life Research Institute, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
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Cadigan JM, Duckworth JC, Lee CM. Physical and mental health issues facing community college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:891-897. [PMID: 32569500 DOI: 10.1080/07448481.2020.1776716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 03/09/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveTo examine health concerns among community college (CC) students by (1) identifying and coding the self-reported health issues facing CC students and (2) examining demographic and psychosocial variables associated with health categories. Participants: 946 CC students (Mage = 26.37) recruited from January 2017 to February 2017 who completed a screening survey for a larger study. Students were asked to "List three health issues facing Community College students today." Methods: Health issues were coded into broad categories and subcategories. Results: Among the 2,601 health issues reported, one-third were medical health (36%), one-third were mental health (33%), with substance use (14%), other health (14%), and access to health care (3%) also reported. The most commonly identified health issues were "general medical issues," "stress," "depression," and "sleep." Conclusions: Programmatic efforts to support CC students and promote prevention/intervention strategies for mental health, sleep, substance use, access to health care, and general medical concerns, remain essential.
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Affiliation(s)
- Jennifer M Cadigan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Jennifer C Duckworth
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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37
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Smith NC, Nicholson HL. Perceived discrimination and mental health among African American and Caribbean Black adolescents: ethnic differences in processes and effects. ETHNICITY & HEALTH 2022; 27:687-704. [PMID: 32977736 DOI: 10.1080/13557858.2020.1814998] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Although the relationship between perceived discrimination and mental health among Black youth is well-documented, the mechanisms underlying this association remain unclear. Drawing from the stress process model, this study examines two psychosocial mediators - self-esteem and self-efficacy - in the association between perceived discrimination and mental health among African American and Caribbean Black adolescents. This research addresses three primary research questions: First, how is perceived discrimination associated with mental health? Second, to what extent do self-esteem and self-efficacy mediate the relationship between perceived discrimination and mental health? Finally, do these relationships and processes differ between African American and Caribbean Black adolescents?Design: Data for these analyses come from the National Survey of American Life - Adolescent Supplement. We use generalized structural equation modeling to examine relationships among perceived discrimination, psychosocial resources, and mental health.Results: For both African American and Caribbean Black adolescents, more frequent perceptions of discriminatory events were associated with greater depressive symptoms and a higher likelihood of having an anxiety disorder diagnosis. However, the association between perceived discrimination and depressive symptoms was significantly stronger for Caribbean Black adolescents. Generally, self-esteem and self-efficacy were found to be significant mediators in the association between perceived discrimination and mental health, although mechanisms varied between African American and Caribbean Black youth.Conclusion: African American and Caribbean Black adolescents are highly susceptible to experiences of discrimination that negatively affect their mental health. Heterogeneity among Black youth populations must be considered when developing interventions to reduce exposure to and the effects of discrimination among these adolescents.
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Affiliation(s)
- Nicholas C Smith
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Harvey L Nicholson
- Department of Sociology and Criminology and Law, University of Florida, Gainesville, FL, USA
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Dunbar AS. Black Lives and Black Research Matter: How our Collective Emotions Continue to Drive a Movement. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:307-313. [PMID: 35224807 PMCID: PMC9305767 DOI: 10.1111/jora.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
The author discusses (1) how the collective emotional experience of the Black community has propelled two parallel movements, Black Lives Matter and Black Research Matters, (2) the state of developmental science as it pertains to Black youth, and (3) suggestions for future research to integrate across fields and to evolve beyond Black pain to incorporate Black joy. The author suggests that the palpable anger collectively felt and expressed as a community has propelled a host of social-political actions to dismantle anti-Black systems of oppression, including within academia. She highlights that the scholarship on Black youth development has driven innovations in theory and methodology that have influenced the field of developmental science broadly and recommends future research areas for consideration.
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Quist AJL, Han X, Baird DD, Wise LA, Wegienka G, Woods-Giscombe CL, Vines AI. Life Course Racism and Depressive Symptoms among Young Black Women. J Urban Health 2022; 99:55-66. [PMID: 35031943 PMCID: PMC8760080 DOI: 10.1007/s11524-021-00574-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/25/2022]
Abstract
The objective of this study is to evaluate the life course effects of racism on depressive symptoms in young Black women and to identify particularly sensitive periods. Guided by life-course theory and using logistic regression, we analyzed baseline data on racism frequency and stress from racism at two time periods (before age 20 and during the 20s) and follow-up data (at approximate 20-month intervals) on depressive symptoms (using a modified 11-item Center for Epidemiologic Studies Depression Scale, CES-D) among 1612 Black women participants aged 23-34 years living in Detroit, MI. Of the 1612 women, 65% reported experiencing some racism at baseline, and 36.5% had high depressive symptoms at follow-up. Those who experienced high frequency of racism before age 20 had an increased risk for high depressive symptoms (RR = 1.26, 95% CI: 1.07, 1.46) compared to participants in the low racism frequency group. We observed similar associations for high vs. low stress from racism (RR = 1.30, 95% CI : 1.06, 1.54) and high vs. low combination of racism frequency and stress (RR = 1.38, 95% CI: 1.13, 1.64). These findings did not hold or were weaker when assessing racism during the 20s. Among women who experienced high racism across the two time periods, the risk of high depressive symptoms was higher than those who experienced low racism during both periods (RR = 1.49, 95% CI: 1.14, 1.86). The slightly stronger associations between racism and depressive symptoms in childhood and adolescence than in young adulthood suggest that early life might be a sensitive period for experiencing racism.
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Affiliation(s)
- Arbor J L Quist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xiaoxia Han
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Donna D Baird
- Epidemiology Branch, Women's Health Group, National Institute for Environmental Health Sciences, Research Triangle, NC, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Anissa Irvin Vines
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Masuda A, Barile JP, Spencer SD, Juberg M, Martin TJ, Vibell J. Mindful awareness moderates the association between psychological inflexibility and distress variables: A cross-sectional investigation. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:607-614. [PMID: 32432985 DOI: 10.1080/07448481.2020.1759607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/05/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Informed by the contextual behavioral science (CBS) model of behavioral health, the present cross-sectional study examined whether mindful awareness moderated the associations between psychological inflexibility and four distress variables. PARTICIPANTS Cross-sectional data were collected from 402 ethnically diverse undergraduate college students from September 2015 to October 2015. METHODS Participants competed an online self-report survey. RESULTS Mindful awareness moderated the associations between psychological inflexibility and distress variables, with stronger associations for somatization and anxiety, and weaker associations for general distress and depression. Specifically, the strength of the positive associations between psychological inflexibility and these distress variables were substantially greater among those low in mindful awareness. CONCLUSION These findings suggest that a greater degree of mindful awareness may buffer the effects of psychological inflexibility on distress variables, particularly somatization and anxiety. Theoretical and applied implications as well as limitations of the study are discussed.
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Affiliation(s)
- Akihiko Masuda
- Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - John P Barile
- Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Samuel D Spencer
- Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Michael Juberg
- Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Timothy J Martin
- Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Jonas Vibell
- Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
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Verelst A, Spaas C, Pfeiffer E, Devlieger I, Kankaapää R, Peltonen K, Vänskä M, Soye E, Watters C, Osman F, Durbeej N, Sarkadi A, Andersen A, Primdahl NL, Derluyn I. Social Determinants of the Mental Health of Young Migrants. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2022. [DOI: 10.1027/2512-8442/a000097] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Young migrants face particular risks to develop mental health problems. Discrimination and social support impact mental health, yet little is known about the differential impact thereof on mental health in newcomers, non-newcomer migrants, and non-migrants. Aim: This study sheds light on mental health (posttraumatic stress, behavioral problems, hyperactivity, emotional distress, peer relationship problems, prosocial behavior) and the overall well-being of newcomers, non-newcomer migrants, and non-migrants. Furthermore, the impact of social support and discrimination on mental health is investigated. Method: Descriptive analysis and Structural Equation Modelling (SEM) were applied to analyze responses of 2,320 adolescents through self-report questionnaires in Finland, Sweden, and the UK. Results: Newcomers, non-newcomer migrants, and non-migrants have different psychological profiles. While newcomers suffer more from posttraumatic stress disorder (PTSD) and peer problems, non-newcomers and non-migrants report more hyperactivity. Discrimination strongly threatens all mental health dimensions, while support from family serves as a protective factor. Support from friends has a positive impact on PTSD among newcomers. Limitations: As this study has a cross-sectional design, conclusions about causality cannot be drawn. In addition, history of traumatic life events or migration trajectory was lacking, while it may impact mental health. Conclusion: Different mental health profiles of newcomers, non-newcomer migrants, and non-migrants point to the need for a tailored and diversified approach. Discrimination remains a risk factor for mental health, while family support is a protective factor for adolescents. Interventions that foster social support from friends would be especially beneficial for newcomers.
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Affiliation(s)
- An Verelst
- Centre for the Social Study of Migration and Refugees, Department of Social Work and Social Pedagogy, Ghent University, Belgium
| | - Caroline Spaas
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium
| | - Elisa Pfeiffer
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Germany
| | - Ines Devlieger
- Centre for the Social Study of Migration and Refugees, Department of Social Work and Social Pedagogy, Ghent University, Belgium
| | - Reeta Kankaapää
- Faculty of Social Sciences/Psychology, Tampere University, Finland
| | - Kirsi Peltonen
- Research Centre for Child Psychiatry, University of Turku, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Finland
| | - Emma Soye
- School of Education and Social Work, University of Sussex, UK
| | - Charles Watters
- School of Education and Social Work, University of Sussex, UK
| | - Fatumo Osman
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Natalie Durbeej
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Arnfinn Andersen
- Norwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Norway
| | | | - Ilse Derluyn
- Centre for the Social Study of Migration and Refugees, Department of Social Work and Social Pedagogy, Ghent University, Belgium
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Zimmerman GM, Miller-Smith A. The impact of anticipated, vicarious, and experienced racial and ethnic discrimination on depression and suicidal behavior among Chicago youth. SOCIAL SCIENCE RESEARCH 2022; 101:102623. [PMID: 34823672 DOI: 10.1016/j.ssresearch.2021.102623] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 07/09/2021] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
There is a growing body of research linking racial and ethnic discrimination to adverse youth outcomes. Beyond experienced racial and ethnic discrimination, this study considers the relevance of anticipated and vicarious racial and ethnic discrimination for depression and suicidal behavior. Hierarchical regression models on a diverse sample of 1147 youth (50.31 % female) within 79 neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated that experienced, anticipated, and vicarious racial and ethnic discrimination were associated with an increased risk of depression and suicidal behavior. Additionally, African American and Hispanic youth were disproportionately exposed to-but not differentially impacted by-racial and ethnic discrimination. Findings suggest that developmental research should account for experienced, anticipated, and vicarious racial and ethnic discrimination.
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Affiliation(s)
- Gregory M Zimmerman
- Big Data and Quantitative Methods Initiatives | College of Social Sciences and Humanities | School of Criminology and Criminal Justice Northeastern University, 431 Churchill Hall, 360 Huntington Avenue Boston, MA, 02115, USA.
| | - Ayanna Miller-Smith
- School of Criminology and Criminal Justice, 204 Churchill Hall, 360 Huntington Avenue, Boston, MA, 02115, USA.
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Woody ML, Bell EC, Cruz NA, Wears A, Anderson RE, Price RB. Racial Stress and Trauma and the Development of Adolescent Depression: A Review of the Role of Vigilance Evoked by Racism-Related Threat. CHRONIC STRESS 2022; 6:24705470221118574. [PMID: 35966451 PMCID: PMC9373112 DOI: 10.1177/24705470221118574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/22/2022] [Indexed: 12/03/2022]
Abstract
There are known disparities in the burden of illness and access/quality of care
for African, Latino/a, Asian, and Native American (ALANA) patients diagnosed
with depressive disorders, which may occur because of health inequities. Racial
stress and trauma (RST), or the significant fear and distress that can be
imparted from exposure to racism, is one such inequity linked to the development
of depression. The current review summarizes past research examining the
association between racism, RST, and depression, as well as avenues in which RST
becomes biologically embedded in ALANA individuals. We describe multimodal
research that supports vigilance as a potential mediator of the association
between RST and depression and consider the nuanced role that vigilance plays
during experiences with racism. Finally, we describe methodological advances in
the assessment of vigilance evoked by RST and the clinical implications that may
be generated by future improvements. In each of these areas, we present examples
of how ongoing and future research can be leveraged to provide support for
psychosocial programs that facilitate autonomous community healing and
resilience, increase calls for public policy changes, and support clinical
interventions that lessen the burden of racism on ALANA communities.
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Affiliation(s)
- Mary L. Woody
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Nicolas A. Cruz
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anna Wears
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Riana E. Anderson
- Health Behavior and Health Education Department, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca B. Price
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Dunbar AS, HaRim Ahn L, Coates EE, Smith-Bynum MA. Observed dyadic racial socialization disrupts the association between frequent discriminatory experiences and emotional reactivity among Black adolescents. Child Dev 2022; 93:39-57. [PMID: 34585381 PMCID: PMC8865630 DOI: 10.1111/cdev.13680] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Understanding the underlying mechanisms by which racism degrades mental health and the factors that disrupt these mechanisms is paramount. Black adolescents (Mage = 15.5) and their mothers (Mage = 44) were observed discussing a hypothetical discriminatory situation and surveyed about their discriminatory experiences (N = 110). Results indicated that adolescents' submissive emotional reactivity (e.g., sadness, embarrassment) in direct response to discrimination, rather than dominant reactivity (e.g., anger, frustration), was the primary mechanism explaining the link between discrimination and internalizing and externalizing symptoms. Maternal advocacy combined with high levels of dyadic warmth and emotion expression reduced girls' submissive reactivity, whereas a more directive "no-nonsense" advocacy approach reduced boys' submissive reactivity. Findings demonstrate how racial socialization can disrupt the pain of discrimination.
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Affiliation(s)
- Angel S. Dunbar
- African American Studies Department, University of Maryland, College Park, Maryland, USA
| | - Lydia HaRim Ahn
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, Maryland, USA
| | - Erica E. Coates
- Department of Family Science, University of Maryland, College Park, Maryland, USA
| | - Mia A. Smith-Bynum
- Department of Family Science, University of Maryland, College Park, Maryland, USA
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Ramos G, Aguilera A, Montoya A, Lau A, Wen CY, Cruz Torres V, Chavira D. App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (Preprint). JMIR Res Protoc 2021; 11:e35196. [PMID: 35436228 PMCID: PMC9052031 DOI: 10.2196/35196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/08/2022] [Accepted: 03/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background People of color (POC) who experience race-related stress are at risk of developing mental health problems, including high levels of stress, anxiety, and depression. Mindfulness meditation may be especially well suited to help POC cope, given its emphasis on gaining awareness and acceptance of emotions associated with discriminatory treatment. However, mindfulness meditation rarely reaches POC, and digital approaches could reduce this treatment gap by addressing traditional barriers to care. Objective This study will test the effectiveness of a self-directed app-based mindfulness meditation program among POC who experience elevated levels of race-related stress. Implementation outcomes such as treatment acceptability, adherence, and satisfaction will be examined. Methods Participants (n=80) will be recruited online by posting recruitment materials on social media and sending emails to relevant groups. In-person recruitment will consist of posting flyers in communities with significant POC representation. Eligible participants will be block randomized to either the intervention group (n=40) that will complete a self-directed 4-week mindfulness meditation program or a wait-list control condition (n=40) that will receive access to the app after study completion. All participants will complete measures at baseline, midtreatment, and posttreatment. Primary outcomes include changes in stress, anxiety, and depression, and secondary outcomes constitute changes in mindfulness, self-compassion, rumination, emotion suppression, and experiential avoidance. Exploratory analyses will examine whether changes in the secondary outcomes mediate changes in primary outcomes. Finally, treatment acceptability, adherence, and satisfaction will be examined descriptively. Results Recruitment began in October 2021. Data will be analyzed using multilevel modeling, a statistical methodology that accounts for the dependence among repeated observations. Considering attrition issues in self-directed digital interventions and their potential effects on statistical significance and treatment effect sizes, we will examine data using both intention-to-treat and per-protocol analyses. Conclusions To our knowledge, this will be the first study to provide data on the effectiveness of a self-directed app-based mindfulness meditation program for POC recruited based on elevated race-related stress, a high-risk population. Similarly, meaningful clinical targets for POC affected by stressors related to race will be examined. Findings will provide important information regarding whether this type of intervention is an acceptable treatment among these marginalized groups. Trial Registration ClinicalTrials.gov NCT05027113; https://clinicaltrials.gov/ct2/show/NCT05027113 International Registered Report Identifier (IRRID) DERR1-10.2196/35196
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Affiliation(s)
- Giovanni Ramos
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adrian Aguilera
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Amanda Montoya
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anna Lau
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Chu Yin Wen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Denise Chavira
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
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Weinstein M, Jensen MR, Tynes BM. Victimized in many ways: Online and offline bullying/harassment and perceived racial discrimination in diverse racial-ethnic minority adolescents. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2021; 27:397-407. [PMID: 34043397 PMCID: PMC8754584 DOI: 10.1037/cdp0000436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Objectives: Racial-ethnic minority youth face multiple types of victimization associated with negative developmental outcomes. The present study examined the interplay of youth experiences of online and offline bullying/harassment and racial-ethnic discrimination across three waves. Methods: Racial-ethnic minority adolescents aged 10-19 (N = 735) at Midwest schools were surveyed yearly on Internet usage and experiences, mental well-being, and related risk and protective factors. We analyzed offline and online bullying/harassment, offline and online racial-ethnic discrimination, and time online in an autoregressive cross-lagged panel model. Results: Youth who reported more of one type of victimization also reported more of other victimization types and more time online concurrently. Our results show some (but not consistent) influences over time. Youth who experienced more offline bullying/harassment at wave 1 were more likely to report more wave 2 victimization in another context (online bullying/harassment) and in other content (offline racial-ethnic discrimination), although these associations did not appear in the second wave. Youth who reported more online bullying/harassment at wave 2 also experienced increased risk for offline bullying/harassment at wave 3. Youth who reported more time online were not more likely to experience later victimization, though youth who experienced more wave 1 offline bullying/harassment were more likely to report more next-wave time online. Conclusions: Racial-ethnic minority youth simultaneously and persistently face multiple types of victimization. Offline bullying/harassment interventions may have the added benefit of reducing other forms of victimization down the road, while reducing time online alone is unlikely to protect youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Masuda A, Allen GEK, Liu C, Tully EC. The Roles of Self-Concealment and Perceived Racial and Ethnic Discrimination in General Psychological Distress among Racial and Ethnic Minority College Students in the United States. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2021. [DOI: 10.1007/s10447-021-09441-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ramos G, Ponting C, Bocanegra E, Chodzen G, Delgadillo D, Rapp A, Escovar E, Chavira D. Discrimination and Internalizing Symptoms in Rural Latinx Adolescents: The Protective Role of Family Resilience. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 51:997-1010. [PMID: 34038290 DOI: 10.1080/15374416.2021.1923018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: There is a well-documented relationship between discrimination and increases in internalizing symptoms among rural Latinx youth. Among numerous assets in these adolescents' lives, family resilience emerges as a culturally relevant and robust protective factor. However, it is still unclear whether family resilience is equally protective across different internalizing symptom clusters and whether this buffering effect is independent of other interconnected resilience sources.Method: Latinx adolescents from an underserved rural community (n = 444; Mage = 15.74, SDage = 1.22; 51% male) reported on their internalizing symptoms, experiences of discrimination, and sources of resilience. We examined whether perceived family resilience moderated the association between perceived discrimination and self-reported depressive, somatic, and anxiety symptoms over and above adolescents' sex, self-reported level of acculturation, as well as perceived individual and contextual resilience.Results: Analyses showed that perceived discrimination experiences were robustly associated with higher levels of self-reported internalizing symptoms, while perceived family resilience was related to lower self-reported symptomatology. Closer examination revealed that perceived family resilience buffered the negative effects of perceived discrimination on self-reported depression and somatic symptoms, but not anxiety symptoms.Conclusions: This study addresses a gap in the literature by identifying differential protective effects of family resilience that might be explained by cultural values and practices in rural Latinx families. Findings suggest that interventions that incorporate family members and promote supportive family environments may benefit rural Latinx youth with a broad range of internalizing symptoms.
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Affiliation(s)
- Giovanni Ramos
- Department of Psychology, University of California Los Angeles
| | - Carolyn Ponting
- Department of Psychology, University of California Los Angeles
| | | | - Gia Chodzen
- Department of Psychology, University of California Los Angeles
| | | | - Amy Rapp
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Emily Escovar
- Department of Psychology, University of California Los Angeles
| | - Denise Chavira
- Department of Psychology, University of California Los Angeles
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Stafford AM, Tsumura H, Pan W. Race/Ethnicity, Parental Support, and Youth Depressive Symptoms: A Moderated Longitudinal Mediation Analysis. J Youth Adolesc 2021; 50:1319-1332. [PMID: 34002338 DOI: 10.1007/s10964-021-01447-7] [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: 02/08/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
Racial/ethnic disparities in depression exist among youth in the United States. The purpose of this study was to determine if parental support trajectories in adolescence explain the relationship between race/ethnicity and depressive symptom trajectories in adulthood. A two-step longitudinal parallel process analysis with multigroup structural equation modeling was conducted with a nationally representative sample of youth (N = 5300; 48.5% female; M = 13.33 (Range:12-15) years at baseline). While parental support trajectories did not mediate the relationship between race/ethnicity and depressive symptoms, parental support trajectories were related to depressive symptom trajectories in adulthood. Immigrant generation status also moderated the relationship between race/ethnicity and depressive symptom trajectories. The results demonstrate the impact of parental support on later mental health outcomes regardless of race/ethnicity.
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Affiliation(s)
| | - Hideyo Tsumura
- School of Nursing, Duke University, Durham, NC, 27710, USA
| | - Wei Pan
- School of Nursing, Duke University, Durham, NC, 27710, USA.,School of Medicine, Duke University, Durham, NC, 27710, USA
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50
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Gameon JA, Skewes MC. Historical trauma and substance use among American Indian people with current substance use problems. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:295-309. [PMID: 33829816 PMCID: PMC8084991 DOI: 10.1037/adb0000729] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In the United States, American Indian and Alaska Native (AI/AN) people suffer health inequities associated with alcohol and other drug use and also experience historical trauma symptoms resulting from colonization. Research suggests that historical trauma may be associated with substance use among AI/ANs. METHOD As part of a Community-Based Participatory Research project with tribal partners from a rural AI reservation, our team collected cross-sectional survey data from 198 tribal members who self-identified as having substance use problems. We examined associations between historical trauma thoughts, historical trauma symptoms, and substance use outcomes. We also examined historical trauma symptoms, current trauma symptoms, awareness of systemic discrimination, and ethnic identity as moderators of the associations between historical trauma thoughts and substance use variables. RESULTS Historical trauma thoughts, controlling for symptoms, were associated with greater abstinent days, fewer heavy alcohol use days, fewer drinks per drinking day, and fewer drug use days; historical trauma symptoms, controlling for thoughts, were associated only with fewer abstinent days. Moderation analyses showed that historical trauma thoughts were associated with better substance use outcomes when historical trauma symptoms were low, current trauma symptoms were low, awareness of systemic discrimination was high, and ethnic identity was high. CONCLUSION When distressing trauma symptoms are low, historical trauma thoughts may act as a protective factor or as a marker for other factors associated with better substance use outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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