Religious involvement and DSM-IV 12-month and lifetime major depressive disorder among African Americans

Are There Regional Differences in Mental Health among Black Americans? An Exploration of Explanatory Mechanisms

Using data from the National Survey of American Life (NSAL) (2001-2003), we examine regional differences in past-year anxiety disorder and past-year major depressive episodes among a geographically diverse sample of Black Americans (N = 3,672). We find that Black Americans residing in the South experience a mental health advantage over Black Americans living in other parts of the country, experiencing lower rates of both anxiety disorder and past-year major depression. We also examine the extent to which stress exposure, religious involvement, and neighborhood contexts help explain any regional differences. We find that stress exposure helps to explain much of the differences observed across regions, while religious involvement and neighborhood contexts help explain observed regional differences to a lesser extent. These findings highlight the importance of considering regional contexts in understanding intra-racial differences in mental health.

Religious Involvement and Cognitive Function Among White, Black, and Hispanic Older Adults

We examined whether religious involvement was associated with cognitive function among older adults in the 2006-2020 waves of the Health and Retirement Study. Using growth curve analysis, we found the association between religious involvement and cognition varied by facet of religious involvement and race and Hispanic ethnicity. Attending religious services with friends was associated with higher initial levels of cognitive function (b = 0.22, p < .05). For Hispanic older adults, frequent attendance at religious services was associated with a slower rate of cognitive decline (b = 0.16, p < .01). Stratified models by race and Hispanic ethnicity demonstrated that religious salience was associated with lower initial levels of cognitive function among non-Hispanic White adults (b = -0.19, p < .01). We found no association between religious involvement and cognitive function among non-Hispanic Black respondents. In sum, elements of religious involvement are positively or negatively related to cognitive function in later life and vary by race and ethnicity.

Research on Religion and Aging Among Black Americans and Mexican Americans: The Impact of the National Institute on Aging

For 50 years, the National Institute on Aging (NIA) has supported and promoted research on religious involvement among older adult populations. NIA funding of research on religious involvement has (i) broadened our understanding of how religious involvement is conceptualized and measured; (ii) explored the important role of social networks and interactions within religious communities in relation to congregants' health; (iii) supported research on national samples of the U.S. population that explore demographic variability in religious practices and beliefs, as well as their social correlates; and (iv) examined health-relevant frameworks and topics in relation to religion's association with physical and mental health and well-being. This article focuses on research on African Americans and Mexican Americans as well as comparative work involving non-Latino Whites. Selected topics in religion and aging include Conceptualization and Measurement of Religious Participation; Religious Participation; Religion and Mental Health; Religion and Physical Health, Church-Based Informal Support, Church Support, and Mental and Physical Health; Religious Coping; and the Use of Clergy for serious problems. NIA's long record of support for scholarship and research has significantly enriched our understanding of why and how religion matters for the health and social well-being of diverse populations of older adults.

"So, Do Not Fear": Religion and the prevalence, persistence, and severity of anxiety disorders among Black Americans

BACKGROUND

There is a dearth of scholarship that explicates the effects of religious participation on anxiety disorders among Black Americans. A better understanding of the links between religious participation, a coping resource, and anxiety disorders among Black Americans remains essential, given Black Americans are less likely than their white counterparts to seek professional treatment for mental health problems, leading to greater unmet mental health needs. The aim of this study was to investigate whether religious participation is associated with the prevalence, persistence, and severity of anxiety disorders among Black adults.

METHODS

We used a national sample of Black adults (N = 4999) from the National Survey of American Life, a cross-sectional study conducted from 2001 to 2003. Five anxiety disorders were assessed: posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and agoraphobia. Three dimensions of religious participation were assessed: organizational, non-organizational, and subjective religious participation. Weighted logistic and linear regressions were estimated to examine the associations between religious participation and anxiety disorders.

RESULTS

Findings indicate that organizational religious participation and subjective religiosity were associated with lower odds of anxiety disorders and decreased severity. Findings for non-organizational religious participation in relation to the prevalence, persistence, and severity of anxiety disorders were mixed.

LIMITATIONS

The study limitations include the utilization of self-reported measures, cross-sectional study design, and age of the data set.

CONCLUSIONS

Different dimensions of religious participation have differing effects on anxiety disorders. Religious participation may be an important resource for Black Americans in coping and preventing anxiety disorders.

Relational sanctification, communal coping, and depression among African American couples

Despite the common use of religious buffers, African Americans are disproportionately affected by depressive symptoms. Communal coping may serve as one factor in helping religious African American couples alleviate the symptoms of depression. This study examines the association between relational sanctification and depressive symptoms as mediated by the communal coping of 467 African American married and cohabiting couples. Data from the sampled couples were analyzed using a common fate model, and analyses revealed higher scores on the measure of sanctification were associated with more communal coping; more communal coping was associated with fewer depressive symptoms among women and men, and communal coping acted as a mediator between relational sanctification and depressive symptoms in both partners. Findings from this study underscore the importance of considering how the religiosity and cooperative action of African American couples relate to depressive symptoms.

James S. Jackson and the program for research on Black Americans: Contributions to psychology and the social sciences

James S. Jackson (1944-2020) is remembered as a groundbreaking social psychologist whose career contributions in scholarship, research, and service were fundamental to the field of psychology. This article briefly outlines his career-long work and contributions. A strong believer in interdisciplinary work, his research spanned other related social science disciplines (e.g., sociology, political science), as well as health and social welfare professions (public health, social work, medicine). As the founding director of the Program for Research on Black Americans at the Institute for Social Research, James Jackson initiated and led a long-standing program with a dual focus on research and training and mentoring doctoral students, postdoctoral scholars, and early career scientists. Jackson's efforts in the development of several nationally representative surveys of the Black population in the United States (e.g., National Survey of Black Americans, National Survey of American Life) revolutionized research focusing on the lives of Black Americans. James Jackson's international influence and reputation included numerous prestigious positions within national science organizations and honors and awards for his scientific contributions. Among James S. Jackson's most enduring legacies is the vast network of current scientists, researchers, and academics who were trained under his direction and leadership. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Shades of Black: Gendered Denominational Variation in Depression Symptoms Among Black Christians

Religion and spirituality (R/S) play a central role in shaping the contextual experiences of many Black people in the United States. Blacks are among the most religiously engaged groups in the country. Levels and types of religious engagement, however, can vary by subcategories such as gender or denominational affiliation. Although R/S involvement has been linked to improved mental health outcomes for Black people in general, it is unclear whether these benefits extend to all Black people who claim R/S affiliation irrespective of denomination and gender. Data from the National Survey of American Life (NSAL) sought to determine whether there are differences in the odds of reporting elevated depressive symptomology among African American and Black Caribbean Christian adults across denominational affiliation and gender. Initial logistic regression analysis found similar odds of elevated depressive symptoms across gender and denominational affiliation, but further analysis revealed the presence of a denomination by gender interaction. Specifically, there was a significantly larger gender gap in the odds of reporting elevated depression symptoms for Methodists than for Baptists and Catholics. In addition, Presbyterian women had lower odds of reporting elevated symptoms than Methodist women. This study's findings highlight the importance of examining denominational disparities among Black Christians, and suggest that denomination and gender may work in tandem to shape the R/S experiences and mental health outcomes of Black people in the United States.

Religious Involvement and DSM-IV Anxiety Disorders Among African-Americans

ABSTRACT

This study examined the relationship between eight measures of religious involvement and five anxiety disorders among a nationally representative sample of African-Americans ( N = 3403). The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition , World Mental Health Composite International Diagnostic Interview was used to assess 12-month and lifetime prevalence for each disorder. Logistic regression indicated weekly service attendance was inversely associated with 12-month and lifetime panic disorder, lifetime agoraphobia, and 12-month and lifetime posttraumatic stress disorder (PTSD). Prayer was inversely associated with 12-month agoraphobia, 12-month social phobia, and lifetime PTSD. Listening to religious radio and looking to God for strength were also inversely related to, respectively, 12-month and lifetime panic disorder. Conversely, reading religious materials was positively associated with 12-month panic disorder, 12-month agoraphobia, lifetime PTSD, and lifetime generalized anxiety disorder. The results are discussed in light of conceptual models that specify multiple and sometimes divergent pathways through which religion impacts health, and suggestions for clinicians addressing anxiety disorders are delineated.

Depression in the African American Christian Community: Examining Denominational and Gender Differences

Depression among African American adults can diminish their daily functioning and quality of life. African American communities commonly uses religion and spirituality (R/S) to cope with life stressors; however, it is unclear whether R/S contribute to mental health risk or resilience. Since men and women differ in their R/S participation and Christian denominations have varying gender roles and expectations, it is critical to determine if they experience similar mental health effects. This study examines whether self-reported denominational affiliation predicts dissimilar odds of reporting elevated depressive symptoms among African American young adults and if these effects are different for women and men, using the National Longitudinal Study of Adolescent to Adult Health (Add Health). Results indicate that the odds of having elevated depressive symptoms are three times higher for Catholic women compared to Baptist women, but no denominational differences were found among men. This study highlights how unique denominational and gender subcultures within African American Christian communities may predict depression outcomes. Healthcare professionals and church-based outreach programs should consider the role of denomination and gender when designing and participating in efforts to support mental health equity.

Hope, Purpose, and Religiosity: The Impact of Psychosocial Resources on Trajectories of Depressive Symptoms Among Middle-Aged and Older Blacks

Objective: We assessed the effects of hope, purpose in life, and religiosity on trajectories of depressive symptoms among middle-aged and older Blacks, with a focus on age differences in these associations. Methods: Data come from 1906 respondents from the 2006-2016 Health and Retirement Study. Linear mixed models were estimated and included interactions between age and time and between age and each psychosocial resource. Results: Depressive symptoms decreased for Blacks ages 51-64, did not change for those 65-74, and increased among Blacks age 75+. Hope and purpose in life were inversely associated with symptom levels but were not associated with change over time in symptomology. Associations were stronger among the youngest age group and weakest among the oldest. Religiosity was unrelated to depressive symptoms. Discussion: Psychosocial resources protect against depressive symptoms in age-dependent ways among middle-aged and older Blacks. Differences in these effects may be related to aging, cohort, and selection effects.

Religious Involvement and Sleep Among Older African Americans

Objective: This study sought to determine whether religious involvement is associated with sleep quality in a nationally representative sample of older African Americans. Methods: The analytic sample included African American respondents aged 55+ from the National Survey of American Life-Reinterview (N = 459). Religious involvement variables included service attendance, reading religious texts, watching religious television programs, listening to religious radio programs, prayer, and subjective religiosity. Sleep outcomes were restless sleep and sleep satisfaction. Multiple linear regression analysis was used. Results: Watching religious television programs was associated with more restless sleep. Respondents who attended religious services less than once a year, at least once a week, or nearly every day reported greater sleep satisfaction than respondents who never attended religious services. Subjective religiosity was associated with lower sleep satisfaction. Discussion: The findings demonstrate the importance of examining a variety of religious involvement domains, which could point to different explanatory pathways between religious involvement and sleep.

Let Go and Let God: A Study of Religiosity and Depressive Symptoms in the Black Church

The purpose of this study was to examine the relationship between dimensions of religiosity (organizational, non-organizational, subjective) and depressive symptoms in the Black church. Surveys were administered to attendees of four churches in the northeastern U.S. The Multidimensional Measure of Religious Involvement for African Americans examined religiosity and the Patient Health Questionnaire-8 items assessed depressive symptoms. Logistic regression analysis was employed to examine the relationship between religiosity and depressive symptoms adjusting for potentially influential covariates. Participants reporting high organizational religiosity were significantly more likely to report non-significant depressive symptoms (adjusted odds ratio (AOR) = 1.80, 95% confidence interval (CI) = 1.05, 3.08) in comparison with those reporting low organizational religiosity, when controlling for potentially influential covariates. Our findings suggest that organizational religiosity may be protective against depression. These findings inform the development of initiatives seeking to reduce the burden of depression in the Black church.

Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting predictors of loneliness and social isolation, both before and during the pandemic. With the likelihood of future waves of COVID-19 and related restrictions, it must be a public health priority to address the root causes of loneliness and social isolation and, in particular, address the needs of specific groups such as carers or those living alone.

Considering religion and spirituality in precision medicine

The emerging era of precision medicine (PM) holds great promise for patient care by considering individual, environmental, and lifestyle factors to optimize treatment. Context is centrally important to PM, yet, to date, little attention has been given to the unique context of religion and spirituality (R/S) and their applicability to PM. R/S can support and reinforce health beliefs and behaviors that affect health outcomes. The purpose of this article is to discuss how R/S can be considered in PM at multiple levels of context and recommend strategies for integrating R/S in PM. We conducted a descriptive, integrative literature review of R/S at the individual, institutional, and societal levels, with the aim of focusing on R/S factors with a high level of salience to PM. We discuss the utility of considering R/S in the suitability and uptake of PM prevention and treatment strategies by providing specific examples of how R/S influences health beliefs and practices at each level. We also propose future directions in research and practice to foster greater understanding and integration of R/S to enhance the acceptability and patient responsiveness of PM research approaches and clinical practices. Elucidating the context of R/S and its value to PM can advance efforts toward a more whole-person and patient-centered approach to improve individual and population health.

Associations of Depressive Symptoms With All-Cause and Cause-Specific Mortality by Race in a Population of Low Socioeconomic Status: A Report From the Southern Community Cohort Study

Depression is a leading cause of disability in the United States, but its impact on mortality rates among racially diverse populations of low socioeconomic status is largely unknown. Using data from the Southern Community Cohort Study, 2002-2015, we prospectively evaluated the associations of depressive symptoms with all-cause and cause-specific mortality in 67,781 Black (72.3%) and White (27.7%) adults, a population predominantly with a low socioeconomic status. Baseline depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale. The median follow-up time was 10.0 years. Multivariate Cox regression was used to estimate hazard ratios and 95% confidence intervals for death in association with depressive symptoms. Mild, moderate, and severe depressive symptoms were associated with increased all-cause (hazard ratio (HR) = 1.12, 95% confidence interval (CI): 1.03, 1.22; HR = 1.17, 95% CI: 1.06, 1.29; HR = 1.15, 95% CI: 1.03, 1.28, respectively) and cardiovascular disease-associated death (HR = 1.23, 95% CI: 1.05, 1.44; HR = 1.18, 95% CI: 0.98, 1.42; HR = 1.43, 95% CI: 1.17, 1.75, respectively) in Whites but not in Blacks (P for interaction < 0.001, for both). Mild, moderate, or severe depressive symptoms were associated with increased rates of external-cause mortality in both races (HR = 1.24, 95% CI: 1.05, 1.46; HR = 1.31, 95% CI: 1.06, 1.61; HR = 1.42, 95% CI: 1.11, 1.81, respectively; for all study subjects, P for interaction = 0.48). No association was observed for cancer-associated deaths. Our study showed that the association between depression and death differed by race and cause of death in individuals with a low socioeconomic status.

Religion and Spirituality among American Indian, South Asian, Black, Hispanic/Latina, and White Women in the Study on Stress, Spirituality, and Health

Social scientists have increasingly recognized the lack of diversity in survey research on American religion, resulting in a dearth of data on religion and spirituality (R/S) in understudied racial and ethnic groups. At the same time, epidemiological studies have increasingly diversified their racial and ethnic representation, but have collected few R/S measures to date. With a particular focus on American Indian and South Asian women (in addition to Blacks, Hispanic/Latinas, and white women), this study introduces a new effort among religion and epidemiology researchers, the Study on Stress, Spirituality, and Health (SSSH). This multi-cohort study provides some of the first estimates of R/S beliefs and practices among American Indians and U.S. South Asians, and offers new insight into salient beliefs and practices of diverse racial/ethnic and religious communities.

Social Network Typology and Serious Psychological Distress: Findings from the National Survey of American Life

This study examined the association between social network typology and serious psychological distress (SPD) across various adult developmental stages among African Americans. The sample for this study was drawn from the National Survey for American Life (N = 2,991). Network typology was identified using positive and negative family and church relationship indicators. Latent class distal outcome modeling was used to identify network typology and determine the association between network types and SPD. The findings indicate that network types and SPD were unassociated among respondents in the early adulthood group. In the middle and late adulthood group, respondents in the ambivalent and strained network types had higher SPD scores than respondents in the optimal type. Specific to the late adulthood group, respondents in the family-centered type had higher SPD scores than respondents in the optimal type. The findings are discussed in relation to prior research and practice implications.

Religion and Mental Health in Racial and Ethnic Minority Populations: A Review of the Literature

Religion has been an important source of resiliency for many racial and ethnic minority populations. Given the salience, sociohistorical context, and importance of religion in the lives of black and Latino Americans, this literature review focuses on the mental health and well-being outcomes of religion among black and Latino Americans across the adult life course and specifically in later life. This review provides an overview of religious participation and religiosity levels and an in-depth discussion of extant research on the relationship between the multiple dimensions of religiosity and mental health in these 2 populations. Racial differences between blacks, Latinos, and non-Latino whites are also examined. Suggestions for limitations of the current literature and future directions for research on religion and mental health in racial/ethnic minority populations, especially older minorities, are proposed.

Death Anxiety, Religious Doubt, and Depressive Symptoms across Race in Older Adults

The purpose of this study is to investigate the direct and indirect relationships among death anxiety, religious doubt, and depressive symptoms in older adults. This study also investigates race as a moderator for these relationships. This study used data from the Religion, Aging, and Health Survey. Participants identified as Christian, identified as Black or White, lived in a non-institutionalized household within the U.S., were retired, and spoke English. Using PROCESS, results revealed that religious doubt partially mediated the relationship between death anxiety and depressive symptoms. Furthermore, moderated mediation models revealed that race moderated the relationship between religious doubt and depressive symptoms. Specifically, there was significant, positive relationship between religious doubt and depressive symptoms for participants who identified as Black but not White. Results highlight how religious doubt can influence depressive outcomes among the geriatric communities of color. Limitations and future directions are also discussed.

Mental health care treatment seeking among African Americans and Caribbean Blacks: what is the role of religiosity/spirituality?

OBJECTIVES

As adults increase in age, the likelihood for using mental health care services decrease. Underutilization, expecially among racial/ethnic minorities such as African American and Caribbean Blacks, can result in a decrease in quality of life, as well as significant costs to families, employers, and health systems.

METHODS

The study explored the differences in relationships between mental health care usage and strength of religious/spiritual beliefs between African American and Caribbean Black older adults (54 years or older) and adults (18-53 years) using data from the National Survey of American Life (NSAL). Descriptive statistics and logistic regression analyses were conducted using Stata version 13.1.

RESULTS

Subjective ratings about the strength of religious/spiritual beliefs (OR = 1.26; 95 CI: 0.99, 1.61), age (OR = 0.62; 95 CI: 0.48, 0.81), and sex (OR = 1.59; 95 CI: 1.25, 2.02) were significantly associated with the odds of seeking mental health care. Additionally, persons living in the South were less likely to seek mental health care services (OR = 0.47; 95 CI: 0.37, 0.60).

CONCLUSION

Strong religious/spiritual beliefs may promote mental health care usage. Future studies should examine the strength of religious/spiritual beliefs on mental health care usage among different demographic groups.

Childhood Abuse, Religious Involvement, and Lifetime Substance Use Disorders among Latinas Nationwide

BACKGROUND

Childhood abuse is a major behavioral health concern and imposes lasting sequelae on mental and physical health, including lifetime substance use disorders (LT-SUD). Yet, gender-specific research examining this early trauma and substance use in Latina-Americans (Latinas) is scarce. No study has explored the relationship between collectivist cultural factors and LT-SUD in this largest minority-female subgroup of the United States' population.

OBJECTIVES

Based on coping theory, this study investigated the association between childhood abuse, cultural factors, and LT-SUD among Latinas nationwide.

METHODS

Using the National Latino and Asian American Study we performed three-step logistic regressions to investigate LT-SUD for 1,427 Latinas, following three preplanned steps: (1) childhood physical and sexual abuse (CPA and CSA) with LT-SUD; (2) known correlates as controls; and (3) cultural strength factors.

RESULTS

The prevalence rates of CPA and CSA were 28.0% and 18.4%, and that of LT-SUD was 4.8%. Religious attendance at a weekly level was negatively related to LT-SUD. Alongside English proficiency, discrimination, and social support, however, CPA and religious coping were positively associated with LT-SUD. Conclusion/Importance: Childhood physical abuse is an early risk factor for long-term substance use, viewed as a negative coping strategy. Religious attendance may have potential protection for Latinas. The victimization history may lead to coexisting positive (e.g., pursing social support, religious coping) and negative (e.g., SUD) coping behaviors within Latino communities.

A qualitative comparison of DSM depression criteria to language used by older church-going African-Americans

OBJECTIVE

Depression in late life is associated with substantial suffering, disability, suicide risk, and decreased health-related quality of life. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), a depression diagnosis is derived from a constellation of symptoms that may be described differently by different people. For example, the DSM language may be inadequate in capturing these symptoms in certain populations such as African-Americans, whose rates of depression misdiagnosis is high.

METHODS

This study reports the findings from a church-based, qualitative study with older African-Americans (n = 50) regarding the language they use when discussing depression and depression treatment, and how this compares to the DSM-IV depression criteria. Content analyses of the in-depth discussions with African-American male and female focus group participants resulted in a deeper understanding of the language they used to describe depression. This language was then mapped onto the DSM-IV depression criteria.

RESULTS

While some words used by the focus group participants mapped well onto the DSM-IV criteria, some of the language did not map well, such as language describing irritability, negative thought processes, hopelessness, loneliness, loss of control, helplessness, and social isolation.

CONCLUSIONS

The focus group setting provided insight to the language used by older, church-going African-Americans to describe depression. Implications include the advantages of using qualitative data to help inform clinical encounters with older African-Americans.

Church and Family Support Networks and Depressive Symptoms among African Americans: Findings from the National Survey of American Life

Aims:

We examined the associations between informal social support from church members and social support from extended family members and depressive symptoms within a national probability sample of African American adults ranging in age from 18 to 93.

Methods:

This analysis used data from the National Survey of American Life and accounted for religious service attendance and various demographic variables that have known associations with and are consequential for mental health.

Results:

Frequency of contact with church and family members and emotional support from family were inversely associated with depressive symptoms, and negative church and family interactions were positively associated with depressive symptoms. Emotional support from church members, however, was unrelated to depressive symptoms.

Conclusion:

This study underscores the important contributions of church relationships to depressive symptoms among African Americans across the adult life span, and confirms that these associations are independent of family relationship factors and religious service attendance.

A Risk Typology for Depression in African Americans

Studies report that African Americans are likely to experience severe, chronic, and disabling depressive symptoms leading to poor depression outcomes. There are several psychosocial and sociocultural factors that individually contribute to depression in African Americans (i.e. chronic stress, negative life events, negative social interaction, social support, and religiosity). However, African Americans are a heterogeneous population and the identification of subpopulations with distinct constellations of multiple co-occurring risk and protective factors may offer greater explanatory potential into depression burden for African Americans. This study used data from the American's Changing Lives Survey to identify risk types for depression in a national sample of African American adults and older adults (n = 1174). Latent class analysis results revealed a risk typology that included 3 distinct risk patterns for African Americans. Individuals in the High Protective/Low Risk Type (41%) had high levels of religiosity and social support. Those in the Moderate Protection/Low Risk Type (44%) had moderate levels of religiosity and social support. The Low Protection/Low Risk Type (15%) had low organizational and non-organizational religiosity and relatively low social support. All three types were marked by relatively low risk factors (i.e. negative events, financial stress, and negative social interaction). Multinomial logistic regression results suggested associations between demographic characteristics (i.e. gender, age, education, marital status), depressive symptoms, and risk type. Study results have implications for the development of depression interventions that are targeted to a specific risk type and tailored to the demographic profile of individuals likely to experience poor depression outcomes.

Does Religious Involvement Mitigate the Effects of Major Discrimination on the Mental Health of African Americans? Findings from the Nashville Stress and Health Study

Several decades of scholarly research have revealed the significant toll of discrimination experiences on the well-being of African Americans. Given these findings, investigators have become increasingly interested in uncovering any potential resources made available to African Americans for mitigating the psychosocial strains of discrimination. The current study contributes to this literature by testing whether various indicators of religious involvement—e.g., church attendance, prayer, and religious social support—buffer the noxious effects of major discrimination experiences on the mental health outcomes (i.e., depression and life satisfaction) of African Americans. We analyze data from the African American subsample (n = 627) of Vanderbilt University’s Nashville Stress and Health Study, a cross-sectional probability sample of adults living in Davidson County, Tennessee between the years 2011 and 2014. Results from multivariate regression models indicated (1) experiences of major discrimination were positively associated with depression and negatively associated with life satisfaction, net of religious and sociodemographic controls; and (2) religious social support offset and buffered the adverse effects of major discrimination on both mental health outcomes, particularly for those respondents who reported seeking support the most often. We discuss the implications and limitations of our study, as well as avenues for future research.

Social Status, Discrimination, and Minority Individuals' Mental Health: a Secondary Analysis of US National Surveys

OBJECTIVES

Our study measured minority individuals' social status factors and frequency of discrimination experiences, in order to delineate social mechanisms linking race/ethnicity to mental status (specifically, to current mood/anxiety disorder and self-rated mental health).

METHODS

In this nationally representative secondary research, our data analyses drew on the cross-sectional "Collaborative Psychiatric Epidemiology Surveys," dating 2001-2003. The sample for the final model numbered 9368 respondents (2016 Asians, 2676 Latinos, 4676 blacks).

RESULTS

Across races/ethnicities, better mental health was associated with male gender, higher income, marriage, more education, and less-frequent discrimination experiences; discrimination experiences could impair health, especially among blacks. Marriage's strong contribution to Asians' mental health did not hold among blacks; education's contribution to Latinos' mental health did not hold among blacks either. Blacks' mental health was unaffected by immigration status, but Asian and Latino immigrants showed less-robust mental health than native-born counterparts.

CONCLUSIONS

Across the three racial/ethnic groups studied, differences were noted in relationships between self-reported mental health status and the employed social status and discrimination factors.

A review of sociocultural factors that may underlie differences in African American and European American anxiety

Preliminary evidence indicates there may be differences in the prevalence and severity of anxiety in African Americans and European Americans. A number of sociocultural risk and protective factors have been suggested to contribute to these group differences, such as salience of physical illnesses, discrimination, stigma toward mental illness, religiosity, and ethnic identity. In this paper, the literature concerning each of these factors is reviewed. Overall, the strongest evidence was found for ethnic identity and stigma toward mental illness as factors underlying group differences in anxiety. Ethnic identity and stigma toward mental illness consistently differed by racial group and were associated with anxiety in African Americans. Ethnic identity may buffer against the negative consequences of anxiety, reducing prevalence rates in African Americans. Stigma toward mental illness may decrease African Americans willingness to report anxiety symptoms, reducing overall prevalence rates but increasing the severity of treated cases. The research regarding discrimination, salience of physical illnesses, and religiosity was less clear. Much more research is required, but the findings of this review suggest that future studies should put particular emphasis on stigma toward mental illness and ethnic identity as important factors in understanding African American anxiety outcomes.

Ethnic Identity and Regional Differences in Mental Health in a National Sample of African American Young Adults

Prior research has found that a strong positive ethnic identity is a protective factor against anxiety and depression in African Americans. In this study, ethnic identity is examined in a geographically representative sample of African American young adults (n = 242), using the Multigroup Ethnic Identity Measure (MEIM) (Phinney in J Adolescent Res 7:156-76, 15). The two-factor structure of the measure (Roberts et al. in J Early Adolescence 19:301-22, 1) was analyzed using a structural equation model and displayed an acceptable fit only when multiple error terms were correlated. A multigroup confirmatory factor analysis revealed measurement equivalence of the two-factor structure between African Americans from Southern and non-Southern regions of the USA. We found that significantly higher levels of ethnic identity were present among African American in the South compared to other regions, and region significantly predicted total ethnic identity scores in a linear regression, even when controlling for gender, age, urbanicity, and years of education. Furthermore, among African Americans, living in the South was significantly correlated with less help-seeking for diagnosed depression, anxiety, and/or obsessive-compulsive disorder, where help-seeking was defined as obtaining a diagnosis by a professional. The role of ethnic identity and social support are discussed in the context of African American mental health.

Social participation and depression in old age: a fixed-effects analysis in 10 European countries

We examined whether changes in different forms of social participation were associated with changes in depressive symptoms in older Europeans. We used lagged individual fixed-effects models based on data from 9,068 persons aged ≥50 years in wave 1 (2004/2005), wave 2 (2006/2007), and wave 4 (2010/2011) of the Survey of Health, Ageing and Retirement in Europe (SHARE). After we controlled for a wide set of confounders, increased participation in religious organizations predicted a decline in depressive symptoms (EURO-D Scale; possible range, 0-12) 4 years later (β = -0.190 units, 95% confidence interval: -0.365, -0.016), while participation in political/community organizations was associated with an increase in depressive symptoms (β = 0.222 units, 95% confidence interval: 0.018, 0.428). There were no significant differences between European regions in these associations. Our findings suggest that social participation is associated with depressive symptoms, but the direction and strength of the association depend on the type of social activity. Participation in religious organizations may offer mental health benefits beyond those offered by other forms of social participation.

Social support from church and family members and depressive symptoms among older African Americans

OBJECTIVE

This study examined the influence of church- and family-based social support on depressive symptoms and serious psychological distress among older African Americans.

METHODS

The analysis is based on the National Survey of American Life. Church- and family-based informal social support correlates of depressive symptoms (CES-D) and serious psychological distress (K6) were examined. Data from 686 African Americans aged 55 years or older who attend religious services at least a few times a year are used in this analysis.

RESULTS

Multivariate analysis found that social support from church members was significantly and inversely associated with depressive symptoms and psychological distress. Frequency of negative interactions with church members was positively associated with depressive symptoms and psychological distress. Social support from church members remained significant but negative interaction from church members did not remain significant when controlling for indicators of family social support. Among this sample of churchgoers, emotional support from family was a protective factor and negative interaction with family was a risk factor for depressive symptoms and psychological distress.

CONCLUSION

This is the first investigation of the relationship between church- and family-based social support and depressive symptoms and psychological distress among a national sample of older African Americans. Overall, the findings indicate that social support from church networks was protective against depressive symptoms and psychological distress. This finding remained significant when controlling for indicators of family social support.

Urban vs Rural Residence and the Prevalence of Depression and Mood Disorder Among African American Women and Non-Hispanic White Women

IMPORTANCE

There is a paucity of research among African Americans and rural residents. Little is known about the association between urbanicity and depression or about the interaction of urbanicity, race/ethnicity, and sex on depression and mood disorder prevalence.

OBJECTIVE

To examine the interaction of urbanicity and race/ethnicity on lifetime and 12-month major depressive disorder (MDD) and mood disorder prevalence for African American women and non-Hispanic white women.

DESIGN, SETTING, AND PARTICIPANTS

The US National Survey of American Life data were used to examine the interaction of urbanicity and race/ethnicity on lifetime and 12-month diagnoses of DSM-IV MDD and mood disorder among female respondents, who included noninstitutionalized African American, Caribbean black, and non-Hispanic white women in the United States between February 2001 and June 2003. Participants included 1462 African American women and 341 non-Hispanic white women recruited from the South because all suburban and rural National Survey of American Life respondents resided in this region. Bivariate multiple logistic regression and adjusted prevalence analyses were performed. Urban, suburban, or rural location (assessed via Rural-Urban Continuum Codes), self-reported race/ethnicity, and sociodemographic factors (age, education, household income, and marital status) were included in the analysis.

MAIN OUTCOMES AND MEASURES

Lifetime and 12-month MDD and mood disorder assessed via the World Mental Health Composite International Diagnostic Interview.

RESULTS

Compared with urban African American women, rural African American women had a significantly lower odds of meeting criteria for lifetime (odds ratio [OR], 0.39; 95% CI, 0.23-0.65) and 12-month (OR, 0.29; 95% CI, 0.18-0.46) MDD and for lifetime (F = 0.46; 95% CI, 0.29-0.73) and 12-month (F = 0.42; 95% CI, 0.26-0.66) mood disorder. However, the interaction of urbanicity and race/ethnicity suggested that rural non-Hispanic white women had a significantly higher odds of meeting criteria for lifetime (OR, 2.76; 95% CI, 1.22-6.24) and 12-month (OR, 9.48; 95% CI, 4.65-19.34) MDD and for lifetime (OR, 2.27; 95% CI, 1.06-4.87) and 12-month (OR, 5.99; 95% CI, 3.01-11.94) mood disorder than rural African American women. Adjusted prevalence analyses revealed significantly lower rates of lifetime (4.2%) and 12-month (1.5%) MDD among rural African American women than their urban counterparts (10.4% vs 5.3%; P ≤ .01). The same pattern was found for mood disorder, with rural African American women experiencing significantly lower rates of lifetime (6.7%) and 12-month (3.3%) mood disorder when compared to urban African American women (13.9% vs 7.6%; P ≤ .01) Conversely, rural non-Hispanic white women had significantly higher rates of 12-month MDD (10.3%) and mood disorder (10.3%) than their urban counterparts (3.7% vs 3.8%; P ≤ .01).

CONCLUSIONS AND RELEVANCE

Rural residence differentially influences MDD and mood disorder prevalence among African American women and non-Hispanic white women. These findings offer a first step toward understanding the cumulative effect of rural residence and race/ethnicity on women's depression prevalence, suggesting the need for further research in this area.

Chronic Medical Conditions and Major Depressive Disorder: Differential Role of Positive Religious Coping among African Americans, Caribbean Blacks and Non-Hispanic Whites

BACKGROUND

This study was aimed to investigate the main and buffering effects of positive religious coping on the association between the number of chronic medical conditions and major depressive disorder (MDD) among African Americans, Caribbean Blacks and Non-Hispanic Whites.

METHODS

This cross-sectional study used data from the National Survey of American Life, 2001 and 2003. This study enrolled 3,570 African Americans, 1,438 Caribbean Blacks and 891 Non-Hispanic Whites. Number of chronic conditions and positive religious coping were independent variables, 12-month MDD was the outcome and socio-economic characteristics were controls. We fitted the following three ethnic-specific logistic regressions for data analysis. In Model I, we included the number of chronic conditions and controls. In Model II, we added the main effect of religious coping. In Model III, we included an interaction between religious coping and number of chronic conditions.

RESULTS

Based on Model I, number of chronic conditions was associated with higher odds of 12-month MDD among all race/ethnic groups. Model II showed a significant and negative association between religious coping and MDD among Caribbean Blacks (odds ratio [OR] =0.55, 95% confidence Interval [CI] =0.39-0.77), but not African Americans or Hispanic Whites. Model III suggested that, only among Caribbean Blacks, the effect of chronic medical conditions on MDD is smaller in the presence of high positive religious coping (OR for interaction = 0.73, 95% CI = 0.55-0.96).

CONCLUSIONS

Although the association between multiple chronic conditions and MDD may exist regardless of race and ethnicity, race/ethnicity may shape how positive religious coping buffers this association. This finding sheds more light onto race and ethnic differences in protective effects of religiosity on mental health of populations.