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Williams L, Oro V, Blackwell CK, Liu C, Miller EB, Ganiban J, Neiderhiser JM, DeGarmo DS, Shaw DS, Chen T, Natsuaki MN, Leve LD. Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence. Front Psychiatry 2024; 15:1325506. [PMID: 38694000 PMCID: PMC11062022 DOI: 10.3389/fpsyt.2024.1325506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/26/2024] [Indexed: 05/03/2024] Open
Abstract
Introduction Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence. Materials and Methods The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children's symptom classes. Other covariates included parent depressive symptoms at child ages 4-5 and child race and ethnicity. Results Analyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c' = .57) effects of socioeconomic stress on children's symptom class membership in the mediation analysis were significant (p <.001). Discussion Study findings suggest that intervening on modifiable bioecological stressors-including parenting behaviors and socioeconomic stressors-may provide important protective influences on children's internalizing symptom trajectories.
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Affiliation(s)
- Lue Williams
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Veronica Oro
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Chang Liu
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Elizabeth B. Miller
- NYU Grossman School of Medicine, New York University, New York, NY, United States
| | - Jody Ganiban
- Department of Psychological & Brain Sciences, George Washington University, Washington, DC, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - David S. DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tong Chen
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Ku S, Werchan DM, Feng X, Blair C. Trajectories of maternal depressive symptoms from infancy through early childhood: The roles of perceived financial strain, social support, and intimate partner violence. Dev Psychopathol 2024:1-14. [PMID: 38561991 DOI: 10.1017/s0954579424000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Although new mothers are at risk of heightened vulnerability for depressive symptoms, there is limited understanding regarding changes in maternal depressive symptoms over the course of the postpartum and early childhood of their child's life among rural, low-income mothers from diverse racial backgrounds. This study examined distinct trajectories of depressive symptoms among rural low-income mothers during the first five years of their child's life, at 6, 15, 24, and 58 months, using data from the Family Life Project (N = 1,292). Latent class growth analysis identified four distinct trajectories of maternal depressive symptoms, including Low-decreasing (50%; n = 622), Low-increasing (26%; n = 324), Moderate-decreasing (13%; n = 156), and Moderate-increasing (11%; n = 131) trajectories. Multinomial logistic regression demonstrated that higher perceived financial strain and intimate partner violence, and lower social support predicted higher-risk trajectories (Low-increasing, Moderate-decreasing, and Moderate-increasing) relative to the Low-decreasing trajectory. Compared to the Low-decreasing trajectory, lower neighborhood safety/quietness predicted to the Low-increasing trajectory. Moreover, lower social support predicted the Moderate-increasing trajectory, the highest-risk trajectory, compared to those in Moderate-decreasing. The current analyses underscore the heterogeneity on patterns of depressive symptoms among rural, low-income mothers, and that the role of both proximal and broader contexts contributing to distinct trajectories of maternal depressive symptoms over early childhood.
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Affiliation(s)
| | | | - Xin Feng
- The Ohio State University, Columbus, OH, USA
| | - Clancy Blair
- New York University School of Medicine, New York, NY, USA
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3
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Willis HA, Polanco-Roman L, Derella OJ, Zayde A. Emotional impacts of racial discrimination on caregiver-child dyads: Can mentalizing-focused parenting groups buffer against racism-related stress? Dev Psychopathol 2024:1-12. [PMID: 38477321 DOI: 10.1017/s095457942400049x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Black and Latinx caregivers face high risk for parenting stress and racism-related stress due to experiences of racial discrimination (RD). This study aimed to explore the associations between RD, parenting stress, and psychological distress in caregiver-child dyads, as well as the impact of a mentalizing-focused group intervention on caregivers' experiences of RD distress. Ethnoracially minoritized caregivers of children aged 5-17 years old participated in a non-randomized clinical trial (N = 70). They received either a 12-session mentalizing-focused group parenting intervention or treatment-as-usual in outpatient psychiatry. We assessed self-reported frequency and distress related to RD, parenting stress, and psychological distress at baseline (T1) and post-intervention (T2). Caregiver- and self-reported child psychological distress were also measured. The results showed that greater RD frequency and greater RD distress separately predicted higher overall parenting stress and parental role-related distress. Greater RD distress was linked to increased psychological distress in caregivers. Similarly, greater RD frequency and distress among caregivers were associated with higher caregiver-reported, but not self-reported, child psychological distress. No significant changes in RD distress were observed between T1 and T2 for either of the treatment groups. These findings highlight the exacerbating role of RD on parenting stress and psychological distress among ethnoracially minoritized caregivers and their children.
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Affiliation(s)
- Henry A Willis
- Department of Psychology, University of Maryland at College Park, College Park, MD, USA
| | | | - Olivia J Derella
- Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA
| | - Amanda Zayde
- Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA
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4
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Devakumar D, Selvarajah S, Abubakar I, Kim SS, McKee M, Sabharwal NS, Saini A, Shannon G, White AIR, Achiume ET. Racism, xenophobia, discrimination, and the determination of health. Lancet 2022; 400:2097-2108. [PMID: 36502848 DOI: 10.1016/s0140-6736(22)01972-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 12/13/2022]
Abstract
This Series shows how racism, xenophobia, discrimination, and the structures that support them are detrimental to health. In this first Series paper, we describe the conceptual model used throughout the Series and the underlying principles and definitions. We explore concepts of epistemic injustice, biological experimentation, and misconceptions about race using a historical lens. We focus on the core structural factors of separation and hierarchical power that permeate society and result in the negative health consequences we see. We are at a crucial moment in history, as populist leaders pushing the politics of hate have become more powerful in several countries. These leaders exploit racism, xenophobia, and other forms of discrimination to divide and control populations, with immediate and long-term consequences for both individual and population health. The COVID-19 pandemic and transnational racial justice movements have brought renewed attention to persisting structural racial injustice.
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Affiliation(s)
- Delan Devakumar
- Institute for Global Health, University College London, London, UK.
| | | | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Seoul National University, Seoul, South Korea
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | - Nidhi S Sabharwal
- Centre for Policy Research in Higher Education, National Institute of Educational Planning and Administration, New Delhi, India
| | | | - Geordan Shannon
- Institute for Global Health, University College London, London, UK
| | - Alexandre I R White
- Johns Hopkins University and Johns Hopkins School of Medicine, Baltimore, MD, USA
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5
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Volpert-Esmond HI, Landor AM, Bartholow BD. Immediate and delayed effects of everyday racial discrimination on mental health among Black college students: A mixed-methods approach. GROUP PROCESSES & INTERGROUP RELATIONS 2022. [DOI: 10.1177/13684302221131029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Experiences of racial discrimination significantly contribute to both mental and physical health outcomes. In this mixed-methods study, we examine both the immediate and delayed effect of discrimination experienced in daily life. Black students at a predominantly White university reported instances of racial discrimination, affect, anxiety, and depression several times per day over 4 weeks ( N = 114); this was followed by qualitative focus groups ( N = 25). Reporting an instance of discrimination corresponded with an acute decline in psychological wellbeing (higher negative affect, anxiety, and depression), consistent with previous work. However, this effect did not carry forward to later assessments during the same day or the following day as expected. Instead, positive affect temporarily increased in the hours following experiences of discrimination. Qualitative focus groups revealed social support, emotional reflection and processing, and feelings of taking action as important factors contributing to this bump in positive affect.
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Affiliation(s)
| | - Antoinette M. Landor
- Department of Human Development and Family sciences, University of Missouri, USA
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6
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Martin A, Partika A, Castle S, Horm D, Johnson AD. Both sides of the screen: Predictors of parents' and teachers' depression and food insecurity during COVID-19-related distance learning. EARLY CHILDHOOD RESEARCH QUARTERLY 2022; 60:237-249. [PMID: 35153375 PMCID: PMC8825345 DOI: 10.1016/j.ecresq.2022.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/16/2021] [Accepted: 02/03/2022] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic has placed unprecedented strains on both parents and teachers, both of whose mental and financial hardships have serious implications for young children's wellbeing. We drew on an existing cohort study of families with low incomes in Tulsa, OK when children were in their Spring of first grade in 2020. We surveyed parents and teachers - children's caregivers on both sides of the screen during distance learning - before and after the COVID-19 pandemic hit and schools were closed. We first compared the proportion of parents and teachers who were depressed and food-insecure before and after the pandemic struck. We then used pre-pandemic characteristics of parents and teachers in separate models to predict their depression and food insecurity during the pandemic. Results showed that rates of depression among both parents and teachers spiked after COVID-19, and food insecurity rates also increased among parents. For both parents and teachers, the strongest predictor of depression during COVID-19 was having experienced depression before the pandemic. Similarly, the strongest predictor of food insecurity during COVID-19 was having experienced food insecurity beforehand. These results point intervention efforts towards identifying the caregivers of children in low-income contexts whose mental and financial wellbeing are likely to be most compromised during this and perhaps future disasters.
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Affiliation(s)
- Anne Martin
- Independent Consultant, 237 West 11th St., 4A, New York, NY 10014
| | - Anne Partika
- Department of Psychology, Georgetown University, 303 White-Gravenor Hall, Washington, DC 20057
| | - Sherri Castle
- Early Childhood Education Institute, University of Oklahoma - Tulsa, 4502 E. 41st St., Room 4W-123, Tulsa, OK 74135
| | - Diane Horm
- Early Childhood Education Institute, University of Oklahoma - Tulsa, 4502 E. 41st St., Room 4W-123, Tulsa, OK 74135
| | - Anna D Johnson
- Department of Psychology, Georgetown University, 303 White-Gravenor Hall, Washington, DC 20057
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7
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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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8
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Rahman A, Sánchez M, Bursac Z, Whiting CY, de Dios MA, Cano M, Meek R, Taskin T, Shawon MSR, Vazquez V, Koly KN, Ullrich HS, Cano MÁ. Ethnic discrimination and psychological stress among Hispanic emerging adults: Examining the moderating effects of distress tolerance and optimism. INTERNATIONAL JOURNAL OF INTERCULTURAL RELATIONS : IJIR 2022; 86:217-226. [PMID: 36212111 PMCID: PMC9540438 DOI: 10.1016/j.ijintrel.2021.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Hispanic emerging adults are often exposed to ethnic discrimination, yet little is known about coping resources that may mitigate the effects of ethnic discrimination on psychological stress in this rapidly growing population. As such, this study aims to examine (1) the associations of ethnic discrimination, distress tolerance, and optimism with psychological stress and (2) the moderating effects of distress tolerance and optimism on the association between ethnic discrimination and psychological stress. Data were drawn from a cross-sectional study of 200 Hispanic adults ages 18-25, recruited from two urban counties in Arizona and Florida. Hierarchical multiple regression and moderation analyses were utilized to examine these associations and moderated effects. Findings indicated that higher optimism was associated with lower psychological stress. Conversely, higher ethnic discrimination was associated with higher psychological stress. Moderation analyses indicated that both distress tolerance and optimism moderated the association between ethnic discrimination and psychological stress. These study findings add to the limited literature on ethnic discrimination among Hispanic emerging adults and suggest that distress tolerance may be a key intrapersonal factor that can protect Hispanic emerging adults against the psychological stress often resulting from ethnic discrimination.
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Affiliation(s)
- Abir Rahman
- College of Public Health & Social Work, Florida International University, USA
- Cabell-Huntington Health Department, USA
| | - Mariana Sánchez
- College of Public Health & Social Work, Florida International University, USA
| | - Zoran Bursac
- College of Public Health & Social Work, Florida International University, USA
| | | | | | - Manuel Cano
- Department of Social Work, University of Texas at San Antonio, USA
| | - Robert Meek
- College of Public Health & Social Work, Florida International University, USA
| | - Tanjila Taskin
- College of Public Health & Social Work, Florida International University, USA
| | | | - Vicky Vazquez
- College of Public Health & Social Work, Florida International University, USA
| | - Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Helen Sanchez Ullrich
- Department of Psychological, Health, & Learning Sciences, University of Houston, USA
| | - Miguel Ángel Cano
- College of Public Health & Social Work, Florida International University, USA
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Jamison LE, Howell KH, Decker KM, Schwartz LE, Thurston IB. Associations between Substance Use and Depressive Symptoms among Women Experiencing Intimate Partner Violence. J Trauma Dissociation 2021; 22:540-554. [PMID: 33433303 DOI: 10.1080/15299732.2020.1869646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Associations between substance use and depression among women experiencing intimate partner violence (IPV) have received limited empirical attention. This study examined how demographics, frequency of IPV and problematic substance use were related to depressive symptoms among women exposed to recent IPV. Participants included 112 women (Mage = 32.26; 67% Black) recruited from community organizations in the U.S. Midsouth, many of whom had used substances (80.2%) and were living below the poverty threshold (71.3%). Results from a hierarchical multiple regression analysis revealed that, after accounting for age and income, more frequent IPV and more problematic tobacco use were associated with higher depressive symptoms. Neither alcohol nor illicit substance use were significantly associated with depressive symptoms. These findings highlight a meaningful connection between problematic tobacco use and depressive symptoms, indicating the potential benefits of incorporating tobacco use psychoeducation and cessation strategies into treatment programs for women experiencing depression in the context of IPV.
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Affiliation(s)
- Lacy E Jamison
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kathryn H Howell
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kristina M Decker
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Laura E Schwartz
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Idia B Thurston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA.,Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station, Texas, USA
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Čolić M, Araiba S, Lovelace TS, Dababnah S. Black Caregivers' Perspectives on Racism in ASD Services: Toward Culturally Responsive ABA Practice. Behav Anal Pract 2021; 15:1032-1041. [PMID: 34093981 PMCID: PMC8171225 DOI: 10.1007/s40617-021-00577-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2021] [Indexed: 12/15/2022] Open
Abstract
Significant racial and ethnic disparities in health care and service access exist. In the present article, we reviewed qualitative studies investigating the racism-related experiences of Black caregivers of children with autism spectrum disorder (ASD) in the U.S. health care system. Specifically, we examined institutional racism (i.e., systemic racism) and individual racism directed toward Black families when they seek diagnoses and services for their children with ASD. Additionally, we summarized culturally responsive and context-specific practice guidelines to work collaboratively with Black caregivers of children with ASD for applied behavior analysis practitioners.
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Affiliation(s)
- Marija Čolić
- grid.410445.00000 0001 2188 0957Special Education Department, University of Hawaii at Manoa, 1776 University Ave., Wist Hall 120, Honolulu, HI 96822 USA
| | - Sho Araiba
- Positive Behavior Support Corporation, Honolulu, HI USA
| | - Temple S. Lovelace
- grid.255272.50000 0001 2364 3111Department of Counseling, Psychology, and Special Education, Duquesne University, Pittsburgh, PA USA
| | - Sarah Dababnah
- grid.411024.20000 0001 2175 4264School of Social Work, University of Maryland, Baltimore, MD USA
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Saban KL, Motley D, Shawahin L, Mathews HL, Tell D, De La Pena P, Janusek LW. Preliminary evidence for a race-based stress reduction intervention for Black women at risk for cardiovascular disease. Complement Ther Med 2021; 58:102710. [PMID: 33727090 DOI: 10.1016/j.ctim.2021.102710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/04/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Despite evidence that chronic stress, racism, and discrimination impact the well-being and the risk for cardiovascular disease (CVD) in Black women, there are few evidence-based interventions that improve well-being and reduce the risk for CVD in women of minority groups. The purpose of this pilot study was to evaluate the psychobehavioral and anti-inflammatory benefit of a race-based stress reduction program "Resilience, Stress, and Ethnicity (RiSE) for Black women at risk for CVD. METHODS Black women were recruited from the Chicagoland community and randomized to either the 8-week RiSE intervention (n = 40) or control group (n = 34). Participants were assessed for coping strategies, psychological distress, and blood levels of TNF-alpha and high sensitivity C-reactive protein (hsCRP) at baseline and at 4 and 8 weeks after baseline. RESULTS Participation in RiSE was associated with a more rapid decline in the use of avoidance coping (b = -0.3585, SE = 0.1705, p < .01). Reductions over time in TNF-alpha (b = -0.0163, SE = .0087, p = .08) and hsCRP (b= -0.4064, SE = 0.2270, p = .08) approached statistical significance. CONCLUSIONS Findings provide preliminary evidence in Black women at risk for CVD that RiSE contributes to decreases in avoidance coping. Although preliminary, these results suggest RiSE to be an effective intervention to promote improved coping associated with racism and discrimination in minorities.
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Affiliation(s)
- Karen L Saban
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S First Ave, Center for Translational Research and Education, Maywood, IL, 60153, United States.
| | - Darnell Motley
- University of Chicago, The Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, 6030 South Ellis Avenue, Chicago, IL, 60637, United States.
| | - Lamise Shawahin
- Governors State University, Division of Psychology and Counseling, 1 University Parkway, University Park, IL, 60484, United States.
| | - Herbert L Mathews
- Loyola University Chicago, Department of Microbiology and Immunology, 2160 S. First Ave., Center for Translational Research and Education, Maywood, IL, 60153, United States.
| | - Dina Tell
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S First Ave, Center for Translational Research and Education, Maywood, IL, 60153, United States.
| | - Paula De La Pena
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S First Ave, Center for Translational Research and Education, Maywood, IL, 60153, United States.
| | - Linda Witek Janusek
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S First Ave, Center for Translational Research and Education, Maywood, IL, 60153, United States.
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12
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Perceived Racial Discrimination and Depressed Mood in Perinatal Women: An Extension of the Domain Specific Stress Index. Womens Health Issues 2021; 31:254-262. [PMID: 33637396 DOI: 10.1016/j.whi.2020.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 12/10/2020] [Accepted: 12/23/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE The negative impact of stress on the mental health of perinatal women is well-established. Prior research using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) confirms three distinct stress domains: financial, relationship, and trauma. In 2013, an item assessing perceived racial discrimination was added to the Iowa PRAMS. Using the first phase of available data, we examine whether perceived racial discrimination represents an independent stress domain and assess its association with postpartum depressed mood. METHODS A principal component analysis of the Iowa PRAMS data (2013-2015: N = 2,805) evaluated stress and perceived racial discrimination. Logistic regression examined the effect of racial discrimination on postpartum depressed mood. RESULTS In Iowa, 4.4% of respondents perceived racial discrimination, with higher rates among non-Hispanic Black women and Hispanic women. The principal component analysis identified five stress domains: financial, relational, traumatic, emotional, and displacement. Perceived racial discrimination did not load onto any of these domains, suggesting that it represents an independent stress component. Logistic regression indicated that those who experienced perceived racial discrimination were twice as likely to have experienced depressed mood. CONCLUSIONS Racism, in the form of perceived racial discrimination among pregnant women, is a unique domain of stress that is significantly associated with an increased risk for depressed postpartum mood. Decreasing discrimination's effects on perinatal mental health could begin with ensuring respectful and compassionate health care during pregnancy and the postpartum period.
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13
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Williams AC, Jelsma E, Varner F. The role of perceived thought control ability in the psychological functioning of Black American mothers. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 91:246-257. [PMID: 33983773 PMCID: PMC9878470 DOI: 10.1037/ort0000540] [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] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The purpose of the study was to investigate the extent to which perceived thought control ability (PTCA) promotes the psychological functioning of Black American mothers, as well as moderates the negative effects of key stressors faced by this population, including discrimination experiences, financial strain, and parenting stress. METHODS An online survey was administered to 305 Black American mothers across the U.S. Participants completed measures of PTCA, psychological well-being (life satisfaction and emotional well-being), psychological distress (depressive and anxiety symptoms), and stressors (discrimination experiences, financial strain, and parenting stress). RESULTS Discrimination experiences, financial strain, and parenting stress were related to higher anxiety and depressive symptoms. Financial strain and parenting stress were also related to lower life satisfaction and emotional well-being. PTCA protected against the link between discrimination experiences and depressive symptoms (β = -.15, p < .001), discrimination experiences and anxiety (β = -.15, p < .001), and parenting stress on anxiety (β = .08, p = .04). PTCA also was associated with higher life satisfaction (β =.19, p = .001) and emotional well-being (β =.42, p < .001). CONCLUSIONS This study provides evidence that PTCA is a culturally relevant and practical psychological resource for psychological functioning among Black American mothers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Elizabeth Jelsma
- Department of Human Development and Family Sciences, University of Texas at Austin
| | - Fatima Varner
- Department of Human Development and Family Sciences, University of Texas at Austin
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Bocknek EL, Richardson PA, McGoron L, Raveau H, Iruka IU. Adaptive Parenting Among Low-Income Black Mothers and Toddlers' Regulation of Distress. Child Dev 2020; 91:2178-2191. [PMID: 32880916 DOI: 10.1111/cdev.13461] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Parenting differs in purpose and strategy according to cultural background (Brooks-Gunn & Markman, 2005; Iruka, LaForett, & Odom, 2012). The current study tests a unique latent factor score, Adaptive Parenting, that represents culturally-relevant, positive parenting behaviors: maternal coping with stress through reframing, maternal scaffolding of toddlers' learning during a low-stress task, and maternal commands during a high-stress task. Participants were Black mothers (N = 119; Mage = 27.78) and their 24- to 30-month-old toddlers. Families were part of a broader study examining family resilience among urban, low-income young children and their families. Results demonstrate that the proposed variables align on a single factor and positively predict toddlers' emotion regulation. Findings are discussed in the context of Black culturally-specific parenting processes.
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Experiences of Racial and Ethnic Discrimination Are Associated with Food Insecurity and Poor Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224369. [PMID: 31717419 PMCID: PMC6887985 DOI: 10.3390/ijerph16224369] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/01/2019] [Accepted: 11/05/2019] [Indexed: 01/14/2023]
Abstract
This study examines the associations of mothers’ experiences of discrimination (EODs) with household food insecurity (HFI), physical health, and depressive symptoms, while taking into account the influence of mothers’ Adverse Childhood Experiences (ACEs) and public assistance participation. Mothers (N = 1372) of young children under age 4 who self-identified as Latinx, Non-Latinx Black/African American and Non-Latinx white answered questions for a cross-sectional survey in an emergency room in a large children’s hospital in Philadelphia between 2016 and 2018. Logistic regression was used to model associations of EODs in specific settings with HFI, depressive symptoms, and physical health. Compared to those without EODs, mothers with EODs from police/courts and in workplaces had higher odds of HFI, AOR =2.04 (95% CI: 1.44–2.89) and AOR = 1.57 (95% CI: 1.18–2.11), respectively. Among Latinx mothers, EODs in school were associated with nearly 60% higher odds of HFI and nearly 80% higher odds of depressive symptoms. Latinx and Black mothers with EODs in workplaces had higher odds of HFI (AOR = 1.76, 95% CI: 1.21–2.56 and AOR = 1.46, 95% CI: 1.05–2.36, respectively), compared to mothers without EODs. Discrimination is associated with HFI, depressive symptoms, and poor health. Public health interventions intended to improve food security and health may be only partially effective without simultaneously addressing racism and discrimination.
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Lavner JA, Stansfield BK, Beach SRH, Brody GH, Birch LL. Sleep SAAF: a responsive parenting intervention to prevent excessive weight gain and obesity among African American infants. BMC Pediatr 2019; 19:224. [PMID: 31277694 PMCID: PMC6610994 DOI: 10.1186/s12887-019-1583-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Responsive parenting interventions that shape parenting behaviors in the areas of sleep and soothing, appropriate and responsive feeding, and routines represent a promising approach to early obesity prevention and have demonstrated effectiveness in our previous trials. However, this approach has yet to be applied to the populations most at-risk for the development of early obesity, including African Americans. The Sleep SAAF (Strong African American Families) study is a two-arm randomized controlled clinical trial evaluating whether a responsive parenting intervention focused on promoting infant sleeping and self-soothing can prevent rapid weight gain during the first 16 weeks postpartum among first-born African American infants. The responsive parenting intervention is compared to a child safety control intervention. METHODS Three hundred first-time African American mothers and their full-term infants will be enrolled from one mother/baby nursery. Following initial screening and consent in the hospital, mothers and infants are visited at home by Community Research Associates for data collection visits at 1 week, 8 weeks, and 16 weeks postpartum and for intervention visits at 3 weeks and 8 weeks postpartum. The primary study outcome is a between-group comparison of infant conditional weight gain (CWG) scores from 3 weeks to 16 weeks; additional weight-related outcomes include differences in change in infants' weight for age over time and differences in infants' weight outcomes at age 16 weeks. Several other outcomes reflecting infant and maternal responses to intervention (e.g., sleeping, soothing, feeding, maternal self-efficacy, maternal depressive symptoms) are also assessed. DISCUSSION The Sleep SAAF trial can inform efforts to prevent rapid weight gain and reduce risk for obesity early in the lifespan among African Americans. TRIAL REGISTRATION NCT03505203 . Registered April 3, 2018 in clinicaltrials.gov .
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Affiliation(s)
| | | | - Steven R. H. Beach
- Department of Psychology and Center for Family Research, University of Georgia, Athens, USA
| | - Gene H. Brody
- Center for Family Research, University of Georgia, Athens, USA
| | - Leann L. Birch
- Department of Foods and Nutrition, University of Georgia, Athens, USA
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Assari S, Mistry R, Lee DB, Caldwell CH, Zimmerman MA. Perceived Racial Discrimination and Marijuana Use a Decade Later; Gender Differences Among Black Youth. Front Pediatr 2019; 7:78. [PMID: 30968004 PMCID: PMC6438901 DOI: 10.3389/fped.2019.00078] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 02/25/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Researchers have reported gender differences in the association between perceived racial discrimination (PRD) and substance use including marijuana use (MU). A limited number of longitudinal studies, however, have documented the long-term effect of PRD during adolescence on subsequent MU in young adulthood. Objective: In the current longitudinal study, we tested gender differences in the association between baseline PRD during adolescence and subsequent MU during young adulthood within Black population. Methods: A cohort of 595 Black (278 male and 317 female) ninth grade students were followed for 13 years from 1999 (mean age 20) to 2012 (mean age 33). Participants were selected from an economically disadvantaged urban area in the Midwest, United States. The independent variable was PRD measured in 1999. The outcome was average MU between 2000 and 2012 (based on eight measurements). Covariates included age, socio-demographics (family structure, and parental employment), and substance use by friends and parents. Gender was the focal moderator. Linear regression was used for statistical analysis. Results: In the pooled sample, PRD in 1999 was not associated with average MU between 2000 and 2012. We did, however, find an interaction effect between baseline PRD and gender on average MU, suggesting stronger association for males than females. In gender-specific models, baseline PRD predicted average MU between 2000 and 2012 for males, but not for females. Conclusion: Exposure to PRD during late adolescence may have a larger role on MU of male than female Black young adults. Although we found that males are more vulnerable to the effects of PRD on MU, PRD should be prevented regardless of race, gender, and other social identities. While PRD is pervasive among Black Americans, exposure to PRD increase the risk of MU for Black males. Hence, substance use prevention efforts for Black males, in particular, should emphasize coping with PRD.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Daniel B. Lee
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI, United States
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Williams DR. Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:466-485. [PMID: 30484715 PMCID: PMC6532404 DOI: 10.1177/0022146518814251] [Citation(s) in RCA: 382] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.
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Affiliation(s)
- David R Williams
- 1 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- 2 Department of African and African American Studies and of Sociology, Harvard University, Cambridge, MA, USA
- 3 Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Ai AL, Lee J. Childhood Abuse, Religious Involvement, and Lifetime Substance Use Disorders among Latinas Nationwide. Subst Use Misuse 2018; 53:2099-2111. [PMID: 29624121 DOI: 10.1080/10826084.2018.1455701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
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.
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Affiliation(s)
- Amy L Ai
- a Florida State University , Tallahassee , Florida , USA
| | - Jungup Lee
- b Department of Social Work , National University of Singapore , Singapore
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20
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Assari S, Caldwell CH. Teacher Discrimination Reduces School Performance of African American Youth: Role of Gender. Brain Sci 2018; 8:E183. [PMID: 30274393 PMCID: PMC6210327 DOI: 10.3390/brainsci8100183] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Gender may alter African Americans' vulnerability to discrimination. The type of outcomes that follow exposure to discrimination may also be gender-specific. Although teacher discrimination is known to deteriorate school performance, it is yet unknown whether male and female African American youth differ in the effect of teacher discrimination on school performance. Objective: This cross-sectional study explored the moderating role of gender on the effect of teacher discrimination on school performance in a national sample of African American youth. Methods: The National Survey of American Life-Adolescent Supplement (NSAL-A) enrolled a nationally representative sample (n = 810) of 13⁻17-year-old African American youth. Demographic factors, socioeconomic status, teacher discrimination, and school performance (grade point average, GPA) were measured. Linear multivariable regression models were applied for data analysis. RESULTS Males and females reported similar levels of perceived teacher discrimination. In the pooled sample, higher teacher discrimination was associated with lower school performance among African American youth (b = -0.35; 95% confidence interval (CI) = -0.49 to -0.22). Gender interacted with perceived teacher discrimination (b = 12; 95% CI = 0.24⁻2.02), suggesting a significant difference between males and females in the magnitude of the association between perceived teacher discrimination and GPA. In stratified models, perceived teacher discrimination was associated with worse school performance of females (b = -12; 95% CI = -0.03 to -2.78) but not males (b = 0.01; 95% CI = -0.07 to 0.08). CONCLUSION In line with previous studies, gender was found to alter the vulnerability of African American youth to perceived discrimination. African American boys and girls may differ in their sensitivity to the effects of teacher discrimination on school performance.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
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21
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Condon EM, Sadler LS. Toxic Stress and Vulnerable Mothers: A Multilevel Framework of Stressors and Strengths. West J Nurs Res 2018; 41:872-900. [PMID: 30019624 DOI: 10.1177/0193945918788676] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Toxic stress is associated with poor health outcomes that extend across the life span. Although caregivers can protect their children from toxic stress through supportive caregiving, this can be challenging for vulnerable mothers living in socioeconomically disadvantaged environments. We aim to advance the science of toxic stress prevention by exploring the stressors and strengths experienced by vulnerable mothers through application of a theoretical framework, Bronfenbrenner's bioecological model. Following Arksey and O'Malley's five-stage scoping study framework, 179 articles were included. Key information was abstracted and each article was reviewed for relevance to the bioecological model. Results revealed that the sources of stress and strength are multilayered, transactional, and have a complex influence on caregiving in families at risk of toxic stress. Future research should include empirical investigations of the complex relationships among these stressors and strengths, and the development of preventive interventions to support vulnerable families at risk of toxic stress.
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Affiliation(s)
| | - Lois S Sadler
- 1 Yale School of Nursing, Orange, CT, USA.,2 Yale Child Study Center, New Haven, CT, USA
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Assari S, Mistry R, Caldwell CH. Perceived Discrimination and Substance Use among Caribbean Black Youth; Gender Differences. Brain Sci 2018; 8:E131. [PMID: 29987209 PMCID: PMC6071236 DOI: 10.3390/brainsci8070131] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 12/24/2022] Open
Abstract
Although perceived discrimination in Black youth is a risk factor for a wide range of negative mental health outcomes, recent research has suggested some gender differences in these associations. Gender differences in vulnerability to perceived discrimination among Caribbean Black youth is, however, still unknown. The current cross-sectional study investigated gender variations in the association between perceived discrimination and substance use (SU) in a national sample of Caribbean Black youth. Data came from the National Survey of American Life-Adolescents (NSAL-A), 2003⁻2004. This analysis included 360 Caribbean Black youth (165 males and 195 females) who were between 13 and 17 years old. Sociodemographic factors, perceived discrimination, and SU were measured. Logistic regressions were used for data analysis. Among Caribbean Black youth, a positive association was found between perceived discrimination and SU (odds ratio (OR) = 1.15 (95% confidence interval (CI) = 1.02⁻1.29)). A significant interaction was found between gender and perceived discrimination on smoking (OR = 1.23 (95% CI = 1.07⁻1.41)) suggesting that the association between perceived discrimination and smoking is larger for male than female Caribbean Black youth. The interaction between gender and perceived discrimination on SU was not statistically significant (OR = 1.32 (95% CI = 0.94⁻1.86)). While perceived discrimination increases SU in Caribbean Black youth, this effect is stronger for males than females, especially for smoking. While discrimination should be reduced at all levels and for all populations, clinicians may specifically address discrimination for SU prevention and treatment among male Caribbean Black youth.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
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Haynes T, Turner J, Smith J, Curran G, Bryant-Moore K, Ounpraseuth ST, Kramer T, Harris K, Hutchins E, Yeary KHCK. Reducing depressive symptoms through behavioral activation in churches: A Hybrid-2 randomized effectiveness-implementation design. Contemp Clin Trials 2018; 64:22-29. [PMID: 29170075 PMCID: PMC6364974 DOI: 10.1016/j.cct.2017.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/11/2017] [Accepted: 11/18/2017] [Indexed: 01/08/2023]
Abstract
Rural African Americans are disproportionately exposed to numerous stressors such as poverty that place them at risk for experiencing elevated levels of depressive symptoms. Effective treatments for decreasing depressive symptoms exist, but rural African Americans often fail to receive adequate and timely care. Churches have been used to address physical health outcomes in rural African American communities, but few have focused primarily on addressing mental health outcomes. Our partnership, consisting of faith community leaders and academic researchers, adapted an evidence-based behavioral activation intervention for use with rural African American churches. This 8-session intervention was adapted to include faith-based themes, Scripture, and other aspects of the rural African American faith culture (e.g. bible studies) This manuscript describes a Hybrid-II implementation trial that seeks to test the effectiveness of the culturally adapted evidence-based intervention (Renewed and Empowered for the Journey to Overcome in Christ: REJOICE) and gather preliminary data on the strategies necessary to support the successful implementation of this intervention in 24 rural African American churches. This study employs a randomized one-way crossover cluster design to assess effectiveness in reducing depressive symptoms and gather preliminary data regarding implementation outcomes, specifically fidelity, associated with 2 implementation strategies: training only and training+coaching calls. This project has the potential to generate knowledge that will lead to improvements in the provision of mental health interventions within the rural African American community. Further, the use of the Hybrid-II design has the potential to advance our understanding of strategies that will support the implementation of and sustainability of mental health interventions within rural African American faith communities. TRIAL REGISTRATION NCT02860741. Registered August 5, 2016.
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Affiliation(s)
- Tiffany Haynes
- Fay W. Boozman College of Health, Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 820-05, Little Rock, AR 72205, United States.
| | - Jerome Turner
- Boys, Girls, and Adults Community Development Center, 1112 U.S. Hwy 49, Marvell, AR 72366, United States.
| | - Johnny Smith
- 10,000 Black Men, 2008 Vaugine Street, Pine Bluff, AR 71601, United States.
| | - Geoffrey Curran
- College of Pharmacy, Department of Pharmacy Practice, 4301 W. Markham St., Slot 522, Little Rock, AR 72205, United States.
| | - Keneshia Bryant-Moore
- Fay W. Boozman College of Health, Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 820-05, Little Rock, AR 72205, United States.
| | - Songthip T Ounpraseuth
- Fay W. Boozman College of Health, Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 781, Little Rock, AR 72205, United States.
| | - Teresa Kramer
- Psychiatric Research Institute, Department of Psychiatry, University of Arkansas for Medical, 4301 W. Markham St., Little Rock, AR 72205, United States.
| | - Kimberly Harris
- Fay W. Boozman College of Health, Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 781, Little Rock, AR 72205, United States.
| | - Ellen Hutchins
- Fay W. Boozman College of Health, Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 820-05, Little Rock, AR 72205, United States.
| | - Karen Hye-Cheon Kim Yeary
- Fay W. Boozman College of Health, Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 820-05, Little Rock, AR 72205, United States.
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Darker Skin Tone Increases Perceived Discrimination among Male but Not Female Caribbean Black Youth. CHILDREN-BASEL 2017; 4:children4120107. [PMID: 29231903 PMCID: PMC5742752 DOI: 10.3390/children4120107] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 02/07/2023]
Abstract
Background: Among most minority groups, males seem to report higher levels of exposure and vulnerability to racial discrimination. Although darker skin tone may increase exposure to racial discrimination, it is yet unknown whether skin tone similarly influences perceived discrimination among male and female Caribbean Black youth. Objective: The current cross-sectional study tests the role of gender on the effects of skin tone on perceived discrimination among Caribbean Black youth. Methods: Data came from the National Survey of American Life-Adolescent Supplement (NSAL-A), 2003–2004, which included 360 Caribbean Black youth (ages 13 to 17). Demographic factors (age and gender), socioeconomic status (SES; family income, income to needs ratio, and subjective SES), skin tone, and perceived everyday discrimination were measured. Linear regressions were used for data analysis. Results: In the pooled sample, darker skin tone was associated with higher levels of perceived discrimination among Caribbean Black youth (b = 0.48; 95% Confidence Interval (CI) = 0.07–0.89). A significant interaction was found between gender and skin tone (b = 1.17; 95% CI = 0.49–1.86), suggesting a larger effect of skin tone on perceived discrimination for males than females. In stratified models, darker skin tone was associated with more perceived discrimination for males (b = 1.20; 95% CI = 0.69–0.72) but not females (b = 0.06; 95% CI = −0.42–0.55). Conclusion: Similar to the literature documenting male gender as a vulnerability factor to the effects of racial discrimination, we found that male but not female Caribbean Black youth with darker skin tones perceive more discrimination.
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Childhood Abuse, Religious Involvement, and Substance Abuse Among Latino-American Men in the United States. Int J Behav Med 2017; 23:764-775. [PMID: 27098665 DOI: 10.1007/s12529-016-9561-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Childhood abuse/victimization and subsequent substance abuse are significant behavioral health problems among developed countries. In the United States (U.S.), however, few studies have examined whether this early trauma exacerbates adulthood substance abuse, viewed as a negative coping strategy, among Latino-American men. Furthermore, little is known about how collectivist cultural factors (i.e., ethnic identity, social support, and religious involvement), indicating potentially positive coping resources, were related to substance abuse in this largest minority-male population. METHOD We investigated Latino-American men (N = 1127) in a nationally representative U.S. sample, using logistic regression analysis adjusting known demographic and acculturation correlates. RESULTS The results identified considerably elevated rates of childhood physical abuse/victimization (35.7 %) and lifetime substance abuse (17.3 %). Childhood physical (not sexual) abuse/victimization was positively associated with lifetime substance abuse, alongside age, being U.S.-born, and perceived discrimination. Latino-American men with lifetime substance abuse reported more religious coping. CONCLUSION Findings may contribute to the design of culturally competent behavioral care.
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Carter RT, Lau MY, Johnson V, Kirkinis K. Racial Discrimination and Health Outcomes Among Racial/Ethnic Minorities: A Meta-Analytic Review. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jmcd.12076] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Robert T. Carter
- Department of Counseling and Clinical Psychology, Teachers College; Columbia University
| | - Michael Y. Lau
- Department of Counseling and Clinical Psychology, Teachers College; Columbia University
- Now at The Chicago School of Professional Psychology; Washington DC
| | - Veronica Johnson
- Department of Counseling and Clinical Psychology, Teachers College; Columbia University
- Now at the Department of Psychology, John Jay College of Criminal Justice; City University of New York
| | - Katherine Kirkinis
- Department of Counseling and Clinical Psychology, Teachers College; Columbia University
- Now at Department of Counseling Psychology; University at Albany-State University of New York
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27
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Assari S, Lee DB, Nicklett EJ, Moghani Lankarani M, Piette JD, Aikens JE. Racial Discrimination in Health Care Is Associated with Worse Glycemic Control among Black Men but Not Black Women with Type 2 Diabetes. Front Public Health 2017; 5:235. [PMID: 28955703 PMCID: PMC5600936 DOI: 10.3389/fpubh.2017.00235] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
Background A growing body of research suggests that racial discrimination may affect the health of Black men and Black women differently. Aims This study examined Black patients with diabetes mellitus (DM) in order to test gender differences in (1) levels of perceived racial discrimination in health care and (2) how perceived discrimination relates to glycemic control. Methods A total of 163 Black patients with type 2 DM (78 women and 85 men) provided data on demographics (age and gender), socioeconomic status, perceived racial discrimination in health care, self-rated health, and hemoglobin A1c (HbA1c). Data were analyzed using linear regression. Results Black men reported more racial discrimination in health care than Black women. Although racial discrimination in health care was not significantly associated with HbA1c in the pooled sample (b = 0.20, 95% CI = −0.41 −0.80), gender-stratified analysis indicated an association between perceived discrimination and higher HbA1c levels for Black men (b = 0.86, 95% confidence intervals (CI) = 0.01–1.73) but not Black women (b = −0.31, 95% CI = −1.17 to −0.54). Conclusion Perceived racial discrimination in diabetes care may be more salient for glycemic control of Black men than Black women. Scholars and clinicians should take gender into account when considering the impacts of race-related discrimination experiences on health outcomes. Policies should reduce racial discrimination in the health care.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Daniel B Lee
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States.,Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Emily Joy Nicklett
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | | | - John D Piette
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States.,Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States.,Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States
| | - James E Aikens
- Department of Family Medicine, Michigan Medicine, Ann Arbor, MI, United States
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Haynes TF, Cheney AM, Sullivan JG, Bryant K, Curran GM, Olson M, Cottoms N, Reaves C. Addressing Mental Health Needs: Perspectives of African Americans Living in the Rural South. Psychiatr Serv 2017; 68:573-578. [PMID: 28142389 PMCID: PMC5646233 DOI: 10.1176/appi.ps.201600208] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Rural African Americans are disproportionately affected by social stressors that place them at risk of developing psychiatric disorders. This study aimed to understand mental health, mental health treatment, and barriers to treatment from the perspective of rural African-American residents and other stakeholders in order to devise culturally acceptable treatment approaches. METHODS Seven focus groups (N=50) were conducted with four stakeholder groups: primary care providers, faith community representatives, college students and administrators, and individuals living with mental illness. A semistructured interview guide was used to elicit perspectives on mental health, mental health treatment, and ways to improve mental health in rural African-American communities. Inductive analysis was used to identify emergent themes and develop a conceptual model grounded in the textual data. RESULTS Stressful living environments (for example, impoverished communities) and broader community-held beliefs (for example, religious beliefs and stigma) had an impact on perceptions of mental health and contributed to barriers to help seeking. Participants identified community-level strategies to improve emotional wellness in rural African-American communities, such as providing social support, improving mental health literacy, and promoting emotional wellness. CONCLUSIONS Rural African Americans experience several barriers that impede treatment use. Strategies that include conceptualizing mental illness as a normal reaction to stressful living environments, the use of community-based mental health services, and provision of mental health education to the general public may improve use of services in this population.
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Affiliation(s)
- Tiffany F Haynes
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - Ann M Cheney
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - J Greer Sullivan
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - Keneshia Bryant
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - Geoffrey M Curran
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - Mary Olson
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - Naomi Cottoms
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
| | - Christina Reaves
- Dr. Haynes and Dr. Bryant are with the Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences (UAMS), Little Rock (e-mail: ). Dr. Cheney, Dr. Sullivan, and Ms. Reaves are with the Center for Healthy Communities, School of Medicine, University of California, Riverside. Dr. Curran is with the Department of Pharmacy Practices, College of Pharmacy, UAMS, Little Rock. Dr. Curran is also with Health Services Research and Development, Central Arkansas Healthcare Systems, Department of Veterans Affairs, Little Rock. Dr. Olson and Ms. Cottoms are with Tri-County Rural Health Network, Helena, Arkansas
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Assari S, Moazen-Zadeh E, Caldwell CH, Zimmerman MA. Racial Discrimination during Adolescence Predicts Mental Health Deterioration in Adulthood: Gender Differences among Blacks. Front Public Health 2017; 5:104. [PMID: 28611972 PMCID: PMC5447045 DOI: 10.3389/fpubh.2017.00104] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 04/20/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the existing knowledge regarding the negative mental health consequences of perceived racial discrimination, very few researchers have used a longitudinal design with long-term follow-up periods to explore gender differences in this association over time. OBJECTIVE The current longitudinal study aimed to investigate gender differences in predictive role of an increase in perceived racial discrimination during adolescence for mental health deterioration a decade later when they are transitioning to young adulthood. METHODS Current study followed 681 Black youths for 18 years from 1994 (mean age 15) to 2012 (mean age 32). All participants spent their adolescence and transition to young adulthood in an economically disadvantaged urban area in the Midwest of the United States. Independent variable was perceived racial discrimination measured in 1999 and 2002. Outcomes were psychological symptoms (anxiety and depression) measured in 1999 and at end of follow-up (2012). Covariates included sociodemographics (age, family structure, and parental employment) measured in 1994. Gender was used to define groups in a multigroup structural equation model to test moderating effects. RESULTS Multigroup structural equation modeling showed that among male Black youth, an increase in perceived racial discrimination from age 20 to 23 was predictive for an increase in symptoms of anxiety and depression from age 20 to 32. Among female Black youth, change in perceived racial discrimination did not predict future change in depressive or anxiety symptoms. CONCLUSION While racial discrimination is associated with negative mental health consequences for both genders, male and female Black youth differ in regard to long-term effects of an increase in perceived discrimination on deterioration of psychological symptoms. Black males seem to be more susceptible than Black females to the psychological effects of an increase in racial discrimination over time.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Psychiatry and Psychology Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Ehsan Moazen-Zadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Assari S, Lankarani MM. Discrimination and Psychological Distress: Gender Differences among Arab Americans. Front Psychiatry 2017; 8:23. [PMID: 28265246 PMCID: PMC5316930 DOI: 10.3389/fpsyt.2017.00023] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/31/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Despite the existing knowledge on the association between discrimination and poor mental health, very few studies have explored gender differences in this association in Arab Americans. OBJECTIVE The current study aimed to investigate whether gender moderates the association between the experience of discrimination and psychological distress in a representative sample of Arab Americans in Michigan. METHODS Using data from the Detroit Arab American Study (DAAS), 2003, this study recruited Arab Americans (337 males, 385 females) living in Michigan, United States. The main independent variable was discrimination. The main outcome was psychological distress. Covariates included demographic factors (age), socioeconomic status (education, employment, and income), and immigration characteristics (nativity and years living in United States). Gender was the focal moderator. We used multivariable regression with and without discrimination × gender interaction term. RESULTS In the pooled sample, discrimination was positively associated with psychological distress [B = 0.62, 95% confidence interval (CI) = 0.22-1.03, p = 0.003]. We found a significant gender × discrimination interaction in the pooled sample (B = 0.79, 95% CI = 0.01-1.59, p = 0.050), suggesting a stronger association in males than females. In our gender-specific model, higher discrimination was associated with higher psychological distress among male (B = 0.87, 95% CI = 0.33-1.42, p = 0.002) but not female (B = 0.18, 95% CI = -0.43 to 0.78, p = 0.567) Arab Americans. CONCLUSION While discrimination is associated with poor mental health, a stronger link between discrimination and psychological symptoms may exist in male compared to female Arab Americans. While efforts should be made to universally reduce discrimination, screening for discrimination may be a more salient component of mental health care for male than female Arab Americans.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Vargas ED, Winston NC, Garcia JA, Sanchez GR. Latina/o or Mexicana/o?: The Relationship between Socially Assigned Race and Experiences with Discrimination. SOCIOLOGY OF RACE AND ETHNICITY (THOUSAND OAKS, CALIF.) 2016; 2:498-515. [PMID: 27709119 PMCID: PMC5047666 DOI: 10.1177/2332649215623789] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Discrimination based on one's racial or ethnic background is one of the oldest and most perverse practices in the United States. While much of this research has relied on self-reported racial categories, a growing body of research is attempting to measure race through socially-assigned race. Socially-assigned or ascribed race measures how individuals feel they are classified by other people. This paper draws on the socially assigned race literature and explores the impact of socially assigned race on experiences with discrimination using a 2011 nationally representative sample of Latina/os (n=1,200). While much of the current research on Latina/os has been focused on the aggregation across national origin group members, this paper marks a deviation by using socially-assigned race and national origin to understand how being ascribed as Mexican is associated with experiences of discrimination. We find evidence that being ascribed as Mexican increases the likelihood of experiencing discrimination relative to being ascribed as White or Latina/o. Furthermore, we find that being miss-classified as Mexican (ascribed as Mexican, but not of Mexican origin) is associated with a higher likelihood of experiencing discrimination compared to being ascribed as white, ascribed as Latina/o, and correctly ascribed as Mexican. We provide evidence that socially assigned race is a valuable complement to self-identified race/ethnicity for scholars interested in assessing the impact of race/ethnicity on a wide range of outcomes.
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Affiliation(s)
- Edward D. Vargas
- Center for Women’s Health and Health Disparities Research, University of Wisconsin-Madison
| | - Nadia C. Winston
- Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College
| | - John A. Garcia
- Emeritus Professor at both the (ICPSR-Institute for Social Research-ISR (the University of Michigan), and School of Government and Public Policy (University of Arizona)
| | - Gabriel R. Sanchez
- Department of Political Science and RWJF Center for Health Policy, University of New Mexico
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Abstract
Despite suggestions in the literature that depression has serious consequences, few studies have examined specific health and psychosocial outcomes of depression in Black single mothers. The purpose of this study was to estimate paths in a just-identified theoretical model of outcomes of depression for Black single mothers based on theoretical propositions and empirical findings. The model included the variables, depressive cognitions, depressive symptomatology, perceived social support, and positive health practices. Five direct and two indirect hypothesized relationships were estimated using structural equation modeling. A nonprobability sample of convenience of 159 Black single mothers aged 18 to 45 years was recruited for the study. This study used a cross-sectional correlational design. The participants responded in person or via the U.S. mail to the Center for Epidemiologic Studies-Depression scale, the Depressive Cognition Scale, the Personal Resource Questionnaire 85-Part 2, and the Personal Lifestyle Questionnaire. Beta and Gamma path coefficients were statistically significant for four out of five hypothesized direct relationships within the model ( p < .01). The direct path between depressive cognitions and positive health practices was not supported (Gamma = -.11, p > .05). The two indirect paths were weak but statistically significant ( p < .01). Depressive symptoms and perceived social support were outcomes of depressive cognitions. Positive health practices was not a direct outcome of depressive cognitions. Perceived social support and positive health practices were outcomes of depressive symptoms.
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Affiliation(s)
- Rahshida L Atkins
- 1 University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A, Gupta A, Kelaher M, Gee G. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0138511. [PMID: 26398658 PMCID: PMC4580597 DOI: 10.1371/journal.pone.0138511] [Citation(s) in RCA: 1175] [Impact Index Per Article: 130.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/30/2015] [Indexed: 12/20/2022] Open
Abstract
Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.
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Affiliation(s)
- Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Jehonathan Ben
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Nida Denson
- School of Social Sciences and Psychology, University of Western Sydney, Sydney, New South Wales, Australia
| | - Amanuel Elias
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Naomi Priest
- Australian Centre for Applied Social Research Methods, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alex Pieterse
- Division of Counseling Psychology, University at Albany, State University of New York, New York, New York, United States of America
| | - Arpana Gupta
- Oppenheimer Center for Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Margaret Kelaher
- Centre for Health Policy Programs and Economics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Gilbert Gee
- Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, California, United States of America
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Zhang W, Hong S. Perceived discrimination and psychological distress among Asian Americans: does education matter? J Immigr Minor Health 2014; 15:932-43. [PMID: 22767300 DOI: 10.1007/s10903-012-9676-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Using data from the National Latino and Asian American Study, this work examines if and how perceived everyday discrimination is associated with psychological distress among Asian Americans and whether this association varies by important structural factors as education and place of education. Findings reveal that perception of discrimination is associated with increased levels of psychological distress. Most importantly, education moderates the discrimination-distress association such that the detrimental effect of discrimination is stronger for Asian Americans with college or more levels of education than for Asian Americans with less than college levels of education. Place of education further conditions the moderating effect of education: The foreign-educated Asian Americans with higher levels of education are affected most negatively by discrimination compared to others. This study highlights (1) the significant joint role of education and place of education in conditioning the relationship between perceived discrimination and psychological distress, and (2) unique features of education in improving our understanding of Asian Americans' mental health.
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Affiliation(s)
- Wei Zhang
- Department of Sociology, The University of Hawaii at Manoa, Honolulu, HI 96822, USA.
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Hunte HER, King K, Hicken M, Lee H, Lewis TT. Interpersonal discrimination and depressive symptomatology: examination of several personality-related characteristics as potential confounders in a racial/ethnic heterogeneous adult sample. BMC Public Health 2013; 13:1084. [PMID: 24256578 PMCID: PMC3845526 DOI: 10.1186/1471-2458-13-1084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 11/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests that reports of interpersonal discrimination result in poor mental health. Because personality characteristics may either confound or mediate the link between these reports and mental health, there is a need to disentangle its role in order to better understand the nature of discrimination-mental health association. We examined whether hostility, anger repression and expression, pessimism, optimism, and self-esteem served as confounders in the association between perceived interpersonal discrimination and CESD-based depressive symptoms in a race/ethnic heterogeneous probability-based sample of community-dwelling adults. METHODS We employed a series of ordinary least squares regression analyses to examine the potential confounding effect of hostility, anger repression and expression, pessimism, optimism, and self-esteem between interpersonal discrimination and depressive symptoms. RESULTS Hostility, anger repression, pessimism and self-esteem were significant as possible confounders of the relationship between interpersonal discrimination and depressive symptoms, together accounting for approximately 38% of the total association (beta: 0.1892, p < 0.001). However, interpersonal discrimination remained a positive predictor of depressive symptoms (beta: 0.1176, p < 0.001). CONCLUSION As one of the first empirical attempts to examine the potential confounding role of personality characteristics in the association between reports of interpersonal discrimination and mental health, our results suggest that personality-related characteristics may serve as potential confounders. Nevertheless, our results also suggest that, net of these characteristics, reports of interpersonal discrimination are associated with poor mental health.
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Affiliation(s)
- Haslyn E R Hunte
- School of Public Health, Social & Behavioral Sciences, Robert C, Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV 26506-9190, USA.
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Huot KL, Lutfiyya MN, Akers MF, Amaro ML, Swanoski MT, Schweiss SK. A population-based cross-sectional study of health service deficits among U.S. adults with depressive symptoms. BMC Health Serv Res 2013; 13:160. [PMID: 23634983 PMCID: PMC3662567 DOI: 10.1186/1472-6963-13-160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 04/22/2013] [Indexed: 12/01/2022] Open
Abstract
Background Depression is a psychiatric condition that affects approximately one in five U.S. adults in their lifetime. No study that we know of has examined depressive symptoms and health service deficits in rural compared with non-rural populations. Four factors constitute the variable health service deficits: did not have health insurance, did not have a healthcare provider, deferred medical care because of cost and did not have a routine medical exam, all within the last 12 months. The aim of this study was to ascertain the prevalence of health service deficits in rural versus non-rural adults with depressive symptoms. Examining depressive symptoms by health service deficits is important because it allows us to approximate those with the condition who might not be receiving care for it. By analyzing national, population-based data, this study sought to fill in some important epidemiological gaps regarding depressive symptoms and health service deficits. Methods For this analysis the population of interest was U.S. adults identified as currently having depressive symptoms using the PHQ-8 criteria. Behavior Risk Factor Surveillance Survey 2006 data were used in this analysis. Health service deficits was the primary dependent variable. Multivariate logistic regression analysis was performed to examine health service deficits experienced by adults with depression controlling for socioeconomic status, race and ethnicity and geographic locale (rural or non-rural). Results Logistic regression analysis yielded that U.S. adults currently having depressive symptoms who were of low socioeconomic status, Hispanic ethnicity, or living in a rural locale were more likely to have at least one health service deficit. Conclusion Analyzing data collected by a large surveillance system such as BRFSS, allows for an analysis incorporating an array of covariates not available from clinically-based data such as electronic health records. By identifying clinically depressed U.S. adults who also have at least one health service deficit, we were able to ascertain those most likely not receiving care for this debilitating condition. We believe community pharmacists are well suited to assist in connecting depressed, vulnerable populations with appropriate and needed care. This care would be best provided by an inter-professional team led by a primary care provider.
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Affiliation(s)
- Krista L Huot
- Essentia Institute of Rural Health, Duluth, MN 55803, USA
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Odom EC, Vernon-Feagans L, Crouter AC. Nonstandard Maternal Work Schedules: Implications for African American Children's Early Language Outcomes. EARLY CHILDHOOD RESEARCH QUARTERLY 2013; 28:379-387. [PMID: 23459591 PMCID: PMC3580868 DOI: 10.1016/j.ecresq.2012.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In this study, observed maternal positive engagement and perception of work-family spillover were examined as mediators of the association between maternal nonstandard work schedules and children's expressive language outcomes in 231 African American families living in rural households. Mothers reported their work schedules when their child was 24 months of age and children's expressive language development was assessed during a picture book task at 24 months and with a standardized assessment at 36 months. After controlling for family demographics, child, and maternal characteristics, maternal employment in nonstandard schedules at the 24 month timepoint was associated with lower expressive language ability among African American children concurrently and at 36 months of age. Importantly, the negative association between nonstandard schedules and children's expressive language ability at 24 months of age was mediated by maternal positive engagement and negative work-family spillover, while at 36 months of age, the association was mediated only by negative work-family spillover. These findings suggest complex links between mothers' work environments and African American children's developmental outcomes.
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Nicdao EG, Noel LT, Ai AL, Plummer C, Groff S. Post disaster resilience: Racially different correlates of depression symptoms among hurricane Katrina-Rita volunteers. DISASTER HEALTH 2013; 1:45-53. [PMID: 28228986 PMCID: PMC5314885 DOI: 10.4161/dish.23077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 11/30/2012] [Indexed: 11/19/2022]
Abstract
The present analyses examined the differential risks of and protective factors against depressive symptoms of African American and Non-Hispanic White American student volunteers, respectively after Hurricanes Katrina and Rita (H-KR). A total sample of 554 student volunteers were recruited from mental health professional programs at five universities located in the Deep South, namely areas severely impacted by H-KR during fall semester 2005. The response rate was 91% (n = 505). African American respondents (n = 299) and Non-Hispanic White Americans (n = 206) completed the survey questionnaires. Respondents retrospectively provided information on peritraumatic emotional reactions and previous trauma that were recalled by H-KR and H-KR stressors. African American respondents reported higher levels of depressive symptoms (65.2%) than their Non-Hispanic White counterparts (34.8%). Hierarchical regression analyses revealed that disaster related stressors affected African Americans (p < 0.001), but not Non-Hispanic Whites. However, African Americans who experienced peritraumatic positive emotions had lower depression levels. Lower rates of recollection of prior traumas during H-KR were reported by African American respondents, whereas previous trauma recollections predicted symptoms among Non-Hispanic White Americans (p < 0.05). Exhibiting more optimism had lower depression levels among Non-Hispanic White Americans. Peritraumatic negative emotion was the only shared risk for depressive symptoms of both groups. Findings underscore racially different levels of depressive symptoms that may contribute to varying degrees of resilience among student volunteers. Future research and practice may address these racial differences by understanding the risk factors for depressive symptoms to develop appropriate interventions for racial groups, and cultivating the protective factors that contribute to resilience from traumatic experiences.
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Affiliation(s)
- Ethel G Nicdao
- Department of Sociology; University of the Pacific; Stockton, CA USA
| | - La Tonya Noel
- College of Social Work; Florida State University; Tallahassee, FL USA
| | - Amy L Ai
- College of Social Work; Florida State University; Tallahassee, FL USA
| | - Carol Plummer
- School of Social Work; University of Hawaii; Honolulu, HI USA
| | - Sara Groff
- College of Social Work; Florida State University; Tallahassee, FL USA
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Abstract
Numerous studies document the adverse impact of racial discrimination on African Americans' health outcomes, but few have focused on HIV risk. We examined the relationship between racial discrimination and sexual risk in a sample of 526 Black heterosexual men and tested the hypothesis that social support would moderate this relationship. Participants in the predominantly low-income urban sample ranged in age from 18 to 45. High social support had a buffering impact on the relationship between racial discrimination and sexual risk. Among men reporting high racial discrimination, those with more social support reported less sexual risk than men with low social support. Men who reported high racial discrimination and low social support reported more sexual risk than men in any of the other groups. The study highlights social support as an important but understudied protective factor that may reduce sexual risk for Black heterosexual men who report high levels of racial discrimination.
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