The Birth and Beyond (BABY) study: protocol for a birth cohort study investigating the social and environmental determinants of pregnancy-related outcomes in Black American families

INTRODUCTION

In the USA, Black birthing people and infants experience disproportionately worse pregnancy-related health outcomes. The causes for these disparities are unknown, but evidence suggests that they are likely socially and environmentally based. Efforts to identify the determinants of these racial disparities are urgently needed to elucidate the highest priority targets for intervention. The Birth and Beyond (BABY) study evaluates how micro-level (eg, interpersonal and family) and macro-level (eg, neighbourhood and environmental) risk and resiliency factors transact to shape birth person-infant health, and underlying psychobiological mechanisms.

METHODS AND ANALYSIS

The BABY study will follow 350 Black families (birthing parents, non-birthing parents and infants) from pregnancy through the first postpartum year, with research visits during pregnancy and at infant ages 6 and 12 months. Research visits comprise a combination of interview about a range of recent and life course stress and resiliency exposures and supports, psychophysiological (sympathetic, parasympathetic and adrenocortical) assessment and behavioural observations of parent-infant coregulatory behaviours. Spatial analyses are completed by mapping parent current and past residential addresses onto archival public data (eg, about neighbourhood quality and racial segregation). Finally, EMRs are abstracted for information about birthing parent relevant medical history, pregnancy conditions and infant birth outcomes. Analyses will evaluate the risk and resiliency mechanisms that contribute to pregnancy and birth-related outcomes for Black birthing people and their infants, and the protective role of individual, familial, cultural, and community supports.

ETHICS AND DISSEMINATION

The BABY study has been approved by the Institutional Review Board at Albany Medical Centre. The study team consulted with local organisations and groups comprised of stakeholders and community leaders and continues to do so throughout the study. Research results will be disseminated with the scientific and local community as appropriate.

Relationships Between Strong Black Woman Belief, Coping Behaviors, Perceived Social Support, and Psychological Distress Symptoms for Black Mothers After Stillbirth

INTRODUCTION

Psychological distress symptoms (symptoms of depression, anxiety, and posttraumatic stress) are common following stillbirth. Black women who experience stillbirth are less likely to seek support than White women, consistent with the strong Black woman (SBW) construct, which expects Black women to tolerate stress and trauma gracefully, without seeking help.

METHODS

In this cross-sectional study we sought to determine the relative contributions of SBW belief, perceived lack of social support, and culturally relevant coping behaviors to psychological distress symptoms in Black women bereaved by stillbirth. We partnered with a stillbirth support organization to recruit a sample of 91 Black women bereaved by stillbirth in the 3 years prior to study participation. The online study survey measured SBW belief, culturally relevant coping behaviors, perceived social support, and psychological distress symptoms along with sociodemographics, pregnancy history, and stillbirth characteristics. We used stepwise selection in multiple linear regression to determine the relative contributions of SBW belief, perceived social support, and coping behaviors to measures of psychological distress symptoms in our sample.

RESULTS

Higher SBW belief, lower perceived social support, and higher collective coping (coping behaviors involving other people) were associated with increases in all 3 measures of psychological distress symptoms, controlling for age and other traumatic events.

DISCUSSION

Further understanding of the influence of SBW belief on Black women's psychological distress following stillbirth may assist with the development of culturally appropriate interventions to mitigate psychological distress symptoms in this group.

Culturally Relevant Africultural Coping Moderates the Association Between Discrimination and Antiretroviral Adherence Among Sexual Minority Black Americans Living with HIV

Exposure to discrimination has been linked to lower HIV antiretroviral therapy (ART) adherence and poor HIV care outcomes among Black Americans. Coping has been shown to mitigate the harmful effects of discrimination on health behaviors, but the use of cultural relevant Africultural coping strategies is understudied as a moderator of the association between intersectional discrimination and ART adherence among Black Americans. We used adjusted logistic regression to test whether Africultural coping strategies (cognitive/emotional debriefing; collective; spiritual-centered; ritual-centered) moderated associations between multiple forms of discrimination (HIV, sexual orientation, race) and good ART adherence (minimum of 75% or 85% of prescribed doses taken, as measured by electronic monitoring in separate analyses) among 92 sexual minority Black Americans living with HIV. Mean adherence was 66.5% in month 8 after baseline (36% ≥ 85% adherence; 49% ≥ 75% adherence). Ritual-centered coping moderated the relationship between each of the three types of discrimination at baseline and good ART adherence in month 8 (regardless of the minimum threshold for good adherence); when use of ritual coping was low, the association between discrimination and adherence was statistically significant. The other three coping scales each moderated the association between racial discrimination and good ART adherence (defined by the 75% threshold); cognitive/emotional debriefing was also a moderator for both HIV- and race-related discrimination at the 85% adherence threshold. These findings support the benefits of Africultural coping, particularly ritual-centered coping, to help sexual minority Black Americans manage stressors associated with discrimination and to adhere well to ART.

Black Mothers in Racially Segregated Neighborhoods Embodying Structural Violence: PTSD and Depressive Symptoms on the South Side of Chicago

This study employs multi-level and mixed-methods approaches to examine how structural violence affects the health of low-income, single Black mothers. We use multilevel regression models to examine how feeling "trapped" in racially segregated neighborhoods with high levels of violence on the South Side of Chicago affects mothers' (N = 69) reports of posttraumatic stress disorder and depressive symptoms. The relationship between feeling "trapped" and variations in expression of mRNA for the glucocorticoid receptor gene NR3C1 using microarray assays was also examined. The regression models revealed that feeling "trapped" significantly predicted increased mental distress in the form of PTSD, depressive symptoms, and glucocorticoid receptor gene regulation. The mothers' voices revealed a nuanced understanding about how a lack of financial resources to move out of the neighborhood creates feelings of being "trapped" in dangerous situations.

A Systematic Review of Black People Coping With Racism: Approaches, Analysis, and Empowerment

This article reviews the current research literature concerning Black people in Western societies to better understand how they regulate their emotions when coping with racism, which coping strategies they use, and which strategies are functional for well-being. A systematic review of the literature was conducted, and 26 studies were identified on the basis of a comprehensive search of multiple databases and reference sections of relevant articles. Studies were quantitative and qualitative, and all articles located were from the United States or Canada. Findings demonstrate that Black people tend to cope with racism through social support (friends, family, support groups), religion (prayer, church, spirituality), avoidance (attempting to avoid stressors), and problem-focused coping (confronting the situation directly). Findings suggest gender differences in coping strategies. We also explore the relationship between coping with physical versus emotional pain and contrast functional versus dysfunctional coping approaches, underscoring the importance of encouraging personal empowerment to promote psychological well-being. Findings may help inform mental-health interventions. Limitations include the high number of American-based samples and exclusion of other Black ethnic and national groups, which is an important area for further exploration.

Coping strategies and resilience among patients with hypertension in Ghana

Background

Hypertension is associated with high morbidity and mortality and this has been linked to poor treatment and control rates. To optimize drug treatment, patient-centered strategies such as coping, resilience, and adherence to medication may improve control rates and decrease the morbidity and mortality associated with hypertension. This study, therefore, assessed coping skills and resilience among patients with hypertension in Ghana.

Methods

A cross-sectional study was conducted at Korle Bu Teaching Hospital. 224 consented patients with a diagnosis of hypertension were consecutively selected from the outpatient clinic. Questionnaires comprising socio-demographic characteristics, clinical parameters, Adult Resilience Measure, and the Africultural Coping Systems Inventory were administered. Data were analyzed using Stata version 16.1 and significance level was set at p-value of ≤ 0.05.

Results

The mean age of participants was 62.03 ± 11.40 years and the majority were female (63%). The overall coping strategy mean score was 43.13 ± 13.57. For resilience, median relational and personal resilience (PR) scores were 32 (IQR-7) and 39 (IQR-9), respectively. Increased systolic BP significantly increases the overall coping strategy score. Collective coping strategy and systolic BP significantly increased coping scores (95%CI = 0.05-3.69 vs. 95%CI = 0.58-5.31). Overall coping strategy significantly increased personal and relational resilience (RR) domain scores by 0.004 (95%CI = 0.002-0.01) and 0.005 (95%CI = 0.003-0.006) units, respectively. This study demonstrated that Cognitive and emotional debriefing coping strategy was mostly used by patients with hypertension.

Conclusion

Coping strategies had a positive and significant correlation with personal and RR, specifically collective and cognitive debriefing had a significant positive association with resilience among study participants. There is a need to actively put in measures that can improve the coping strategies and resilience among patients with hypertension to adjust to the long-term nature of the illness and treatment as this will promote better treatment outcomes.

Do gendered racial microaggressions influence the relationship between body appreciation and Black emerging adult women's condom use behaviors?

Background: Sexual protective behaviors, such as consistent condom use and intention, are important preventative measures against the transmission of HIV/AIDS and sexually transmitted infections. Current sexual health research has yet to explore the interaction between contextual factors, such as gendered racial microaggressions, and the role of personal factors (i.e., body appreciation) on Black women's sexual risk and protective behaviors in the United States. Guided by objectification theory, we hypothesized that sexually objectifying gendered racial microaggressions moderated the body appreciation and condom use behaviors relationship. Participants: The current study consisted of 114 Black emerging adult women in the southern United States. Results: Results showed significant interactions between the frequency of sexually objectifying gendered racial microaggressions and body appreciation on consistent condom use and condom use intention. Conclusion: Overall, these findings suggested the need for sexual health researchers and interventionists to further explore the influence of gendered racial microaggressions and body appreciation on condom use behaviors.

African-centered coping, resilience, and psychological distress in Black prostate cancer patients

OBJECTIVE

Blacks have the highest incidence and mortality rates for prostate cancer (PCa) in the U.S. Black PCa patients (PCaP) also report high psychological distress. Identifying culturally specific coping strategies that lower distress among Black PCaP could help improve psychological interventions for this group. African-centered coping (strategies unique to the structure of Black personality and the African-centered worldview) have been identified. We hypothesized that these coping strategies and resilience would be associated with lower psychological distress (anxiety and depression) in Black PCaP.

METHODS

Black PCaP (N = 95) completed a survey assessing African-centered coping strategies, resilience, anxiety, and depression. Multiple regression was employed to examine African-centered coping strategies and resilience as predictors of psychological distress.

RESULTS

Participants were aged M = 67 ± 9 years and 52% had late-stage PCa. Twenty percent met criteria for clinically significant anxiety, and 17% for depression. African-centered coping strategies were not associated with lower anxiety or depression, while resilience was associated with decreased anxiety (r = -0.45, p < 0.001) and depression (r = -0.54, p < 0.001). Mediation analyses did not support an indirect association among African-centered coping strategies, resilience, and anxiety and depression.

CONCLUSIONS

Contrary to hypotheses, African-centered coping strategies were not associated with psychological distress. However, as predicted, greater resilience was associated with lower anxiety and depression. These findings support the relevancy of resilience in Blacks' psychological adjustment to PCa. It might be worthwhile to explore African-centered coping strategies that help Black PCaP cope with distress.

Culturally informed shift-&-persist: A higher-order factor model and prospective associations with discrimination and depressive symptoms

OBJECTIVES

Based on the conceptual overlap between shift-&-persist (S&P) and culturally based strategies (critical civic engagement [CCE] and spiritually based coping), this study tests whether associations between these three previously disparate strategies are attributable to the existence of a higher-order coping construct: culturally informed S&P.

METHODS

Among 364 diverse minoritized youth (Mage = 18.79, 85.2% female), we tested for the existence of this higher-order factor through confirmatory factor analysis.

RESULTS

We found theoretical and empirical support for the existence of a higher-order factor structure and for our higher-order factor-culturally informed S&P. Culturally informed S&P promotes fewer depressive symptoms as a main effect in addition to completely protecting against the negative impact of discrimination on depressive symptoms when culturally informed S&P is high.

CONCLUSIONS

The current study illustrates relations between three previously distinct coping strategies through their association with culturally informed S&P. Results highlight culturally informed S&P's promotive and protective effects in the face of ethnic-racial discrimination. Implications for subsequent study of culturally based coping are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Racial/Ethnic Differences in Stress, Coping, and Distress Among Mothers With a Child in the ICU

BACKGROUND

Having a child in the intensive care unit (ICU) is a stressful event that can cause negative mental health outcomes for parents, but little is known about the experience of parental stress among members of racial/ethnic minority groups.

OBJECTIVE

To examine the stress and coping process in a racially/ethnically diverse sample of mothers of a child who was acutely admitted to an ICU.

METHODS

Participants (N = 103) completed a cross-sectional self-report survey; 86.4% completed it within a week of their child's ICU admission. Analysis of variance was used to examine racial/ethnic differences in perceived ICU-related stressors, coping behaviors, and distress level. Linear regression was used to examine the moderating effects of race/ethnicity on the relationships between stressors, coping behaviors, and distress.

RESULTS

Mothers across racial group experienced similar stressors during the acute phase of their child's ICU admission. African American mothers reported greater overall use of coping behaviors, particularly avoidance coping, and experienced higher levels of distress than did Hispanic or non-Hispanic White mothers. Hispanic mothers experienced the least distress. The interaction of race/ethnicity and emotion-focused coping moderated the stress and coping process.

CONCLUSIONS

Racial and ethnic diversity in sampling should be a priority in future studies of the stress and coping process of mothers with a child in an ICU. Critical care nurses should minimize known stressors for these mothers and encourage and support their preferred coping behaviors, recognizing that these may differ across racial/ethnic groups.

Transcriptomic analyses of black women in neighborhoods with high levels of violence

Chronic stress threatens an individual's capacity to maintain psychological and physiological homeostasis, but the molecular processes underlying the biological embedding of these experiences are not well understood. This is particularly true for marginalized groups, presenting a fundamental challenge to decreasing racial, economic, and gender-based health disparities. Physical and social environments influence genome function, including the transcriptional activity of core stress responsive genes. We studied the relationship between social experiences that are associated with systemic inequality (e.g., racial segregation, poverty, and neighborhood violence) and blood cell (leukocytes) gene expression, focusing on the activation of transcription factors (TF) critical to stress response pathways. The study used data from 68 women collected from a convenience sample in 2013 from the Southside of Chicago. Comparing single, low-income Black mothers living in neighborhoods with high levels of violence (self-reported and assessed using administrative police records) to those with low levels of violence we found no significant differences in expression of 51 genes associated with the Conserved Transcriptional Response to Adversity (CTRA). Using TELiS analysis of promoter TF-binding motif prevalence we found that mothers who self-reported higher levels of neighborhood stress showed greater expression of genes regulated by the glucocorticoid receptor (GR). These findings may reflect increased cortisol output from the hypothalamic-pituitary-adrenal (HPA) axis, or increased GR transcriptional sensitivity. Transcript origin analyses identified monocytes and dendritic cells as the primary cellular sources of gene transcripts up-regulated in association with neighborhood stress. The prominence of GR-related transcripts and the absence of sympathetic nervous system-related CTRA transcripts suggest that a subjective perception of elevated chronic neighborhood stress may be associated with an HPA-related defeat-withdrawal phenotype rather than a fight-or-flight phenotype. The defeat-withdrawal phenotype has been previously observed in animal models of severe, overwhelming threat. These results demonstrate the importance of studying biological embedding in diverse environments and communities, specifically marginalized populations such as low-income Black women.

Ethnic-racial Socialization, Perceived Neighborhood Quality, and Psychosocial Adjustment among African American and Caribbean Black Adolescents

Ethnic-racial socialization is employed by ethnic minority parents to support their children's psychosocial adjustment. These socialization messages may be associated differently with psychosocial adjustment for Black youth according to ethnicity and qualities of the neighborhood context. This research examined whether associations between ethnic-racial socialization messages and psychosocial adjustment vary by ethnicity and perceived neighborhood quality in a nationally representative sample of Black adolescents who participated in the National Survey of American Life Adolescent supplement study. The effects of promotion of mistrust messages varied by ethnicity, and the effects of egalitarianism messages varied depending on perceived neighborhood quality. These findings help clarify prior research which has yielded equivocal results for the effects of these messages for Black youth's psychosocial adjustment.

"All I know is that there is a lot of discrimination": Older African immigrants' experiences of discrimination in the United States

Discrimination is implicated in the disproportionate burden of disease and health disparities in racial/ethnic minorities. This qualitative descriptive study explored the experiences of discrimination and its impact on the health of older African immigrants. Semi-structured interviews were conducted with 15 participants. Three main themes and six sub-themes were identified. These included: (1) types of discrimination which were: (a) accent-based, (b) unfair treatment during routine activities, (c) experience with systems; (2) consequences of discrimination; and (3) surviving and thriving with discrimination: (a) "blind eye to it", (b) reacting to it, (c) avoiding it. These themes described common experiences of discrimination, current strategies used to deal with discrimination, and the impact of discrimination on this sample. Health care providers should be aware of discrimination experiences, how to assess for it, and identify when to refer patients to appropriate community resources that include mental health, employment, cultural groups and legal services.

Black Pregnant Women "Get the Most Judgment": A Qualitative Study of the Experiences of Black Women at the Intersection of Race, Gender, and Pregnancy

BACKGROUND

Pronounced racial disparities in maternal and infant health outcomes persist in the United States. Using an ecosocial and intersectionality framework and biopsychosocial model of health, we aimed to understand Black pregnant women's experiences of gendered racism during pregnancy.

METHODS

We conducted semistructured interviews with 24 Black pregnant women in New Haven, Connecticut. We asked women about their experience of being pregnant, experiences of gendered racism, and concerns related to pregnancy and parenting Black children. Transcripts were coded by three trained analysts using grounded theory techniques.

RESULTS

Women experienced gendered racism during pregnancy-racialized pregnancy stigma-in the form of stereotypes stigmatizing Black motherhood that devalued Black pregnancies. Women reported encountering assumptions that they had low incomes, were single, and had multiple children, regardless of socioeconomic status, marital status, or parity. Women encountered racialized pregnancy stigma in everyday, health care, social services, and housing-related contexts, making it difficult to complete tasks without scrutiny. For many, racialized pregnancy stigma was a source of stress. To counteract these stereotypes, women used a variety of coping responses, including positive self-definition.

CONCLUSIONS

Racialized pregnancy stigma may contribute to poorer maternal and infant outcomes by way of reduced access to quality health care; impediments to services, resources, and social support; and poorer psychological health. Interventions to address racialized pregnancy stigma and its adverse consequences include anti-bias training for health care and social service providers; screening for racialized pregnancy stigma and providing evidence-based coping strategies; creating pregnancy support groups; and developing a broader societal discourse that values Black women and their pregnancies.

Facing the Ills of Unemployment: The Role of Religiosity and Social Support

The study examined the role of religiosity and social support in coping with mental health problems associated with unemployment among 362 Ghanaian youths. Through a cross-sectional survey, participants' mental health (i.e., depression, cognitive distortions, and suicidality), religiosity, and degree of social support were assessed. The data revealed significant buffering effects of religiosity on mental health problems associated with unemployment. Social support had direct, but not buffering, effects on mental health. The findings highlight the need to promote religiosity as a coping mechanism for the adverse effects of unemployment, especially in the absence of immediate economic interventions.

False-positive mammography and mammography screening intentions among black women: the influence of emotions and coping strategies

Introduction: Abnormal mammograms confirmed as benign are known as false-positive mammography (FPM) results. Research indicates that a history of FPM results may be linked to diagnostic delays in Black women, yet much of the research on FPM has focused on White women.Objectives: The purpose of this study was to examine: 1) The influence of FPM on breast cancer (BrCa) screening beliefs and intentions among Black women and 2) Whether emotional states, personality traits or coping behaviors altered the previously described relationships.Design: BrCa-free, Black women, aged 40 and older who completed screening mammograms in 2016 were recruited for a case-control study from 2016 to 2017. Women with FPM results were cases, and women with normal results served as matched controls. Print surveys assessing demographics, personality traits, emotions, BrCa screening history, BrCa beliefs, and africentric coping behaviors were mailed to participants. The final sample consisted of 118 respondents (55 cases, 63 controls). Ordinary least squares (OLS) models were constructed. Personality traits and emotions were tested as mediators and coping behaviors as moderators of the relationship between FPM results and BrCa beliefs.Results: FPM status was associated with a higher perception of barriers to mammography, and an elevated perception of barriers was associated with lower intentions to complete mammography. Collective coping behaviors functioned as a moderator and were associated with a decreased perception of mammography barriers in women with FPM results.Conclusions: FPM status had a detrimental impact on mammography intention indirectly through the perception of mammography barriers, but the use of africentric coping behaviors moderated the relationship between FPM status and perceived barriers to mammography. Culturally specific research focused on Black women is needed to explore influences on BrCa screening beliefs and mammography completion in this population.

Mental health challenges in academia: comparison between students of the various educational levels in Ghana

BACKGROUND

Students continue to face significant mental health challenges that vary in severity and type. It is, therefore, imperative that researchers and clinicians pay more attention to efforts aimed at improving the mental well-being of students.

AIMS

This study examined the differences between Ghanaian students of the various educational levels on some mental health variables and the psychosocial factors of suicidal ideation.

METHODS

Three hundred and fifty-seven (357) participants consisting of junior (92 students) and senior (99 students) high school students, undergraduates (86 students) and postgraduates (80 students) were involved in this cross-sectional study.

RESULTS

The study revealed that high school students had higher academic stress, depression and suicidal ideation and they used more coping strategies compared to university students. Depression, age, and educational levels were the factors that facilitated suicidal ideation, with spiritual and ritual centred coping strategy and religion (Islam) serving as a buffer for suicidal ideation among students. These factors varied with different educational levels.

CONCLUSIONS

High school students experienced significant mental health problems compared to university students-this has direct implications on their academic and psychosocial development. The study recommends that mental health facilities be provided and managed by professionals, especially in high schools.

Stigma and Forgiveness in Ghanaian Mothers of Children with Autism Spectrum Disorders (ASD)

This study explored stigma experiences of mothers of children with ASD and forgiveness as their coping response. Semi-structured interviews were conducted with 6 mothers of children with ASD. Results of this study found several noteworthy themes including, feelings of mother, family/societal reactions, forgiveness factors, and impact of forgiveness. Mothers reported significant stigmatization from families and society. Some expressed their feelings towards themselves, others and God, and finally recounted the use of forgiveness as a coping resource which contributed significantly to their well-being. Findings from this study contribute to the emerging literature on forgiveness as a coping resource for persons who are offended. Implications for clinical practice, intervention and policy are discussed.

The Misunderstood Schema of the Strong Black Woman: Exploring Its Mental Health Consequences and Coping Responses Among African American Women

The internalization of the Strong Black Woman (SBW) schema is associated with negative psychological outcomes. However, not much is known about the mechanisms through which this schema leads to poor health. We examined the direct associations between the SBW schema and depression, anxiety, and loneliness. We also tested four mediators—maladaptive perfectionism, self-compassion, and two Africultural coping strategies of collective coping and spiritual coping—between the schema and psychological outcomes. Moreover, we examined serial mediation effects. A total of 222 African American women participated in an online survey. Structural equation modeling was conducted, and after controlling for age, family income, and level of education, the direct associations were supported, and the mediator roles of maladaptive perfectionism, self-compassion, and collective coping but not spiritual coping were supported. For serial mediation effects, the SBW schema was first positively associated with maladaptive perfectionism, which was associated with low self-compassion and low use of collective coping, which in turn were correlated with negative psychological outcomes. Racial, economic, and structural inequalities that maintain the SBW schema need to be examined and removed. Clinical interventions should focus on reducing maladaptive perfectionism and increasing self-compassion and collective coping among those who have internalized the schema. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684319883198

Loving myself through thick and thin: Appearance contingent self-worth, gendered racial microaggressions and African American women's body appreciation

Contrary to previous literature, recent studies have indicated that African American women are reporting similar rates of body dissatisfaction as their European American counterparts. Yet, little is known about contextual factors, such as gendered racial microaggressions and their association with body appreciation, and whether appearance contingent self-worth accounts for this relationship. Consistent with intersectionality theory, this study examined appearance-contingent self-worth as a mediator between stress related to experiencing sexually objectifying gendered racial microaggressions and body appreciation. African American emerging adult women (N = 143), predominately from the Southern United States, completed a self-report measure of gendered racial microaggressions, appearance contingent self-worth, and body appreciation. Results demonstrated that appearance contingent self-worth, at least in part, mediated the relationship between stress related to gendered racial microaggressions and African American women's appreciation for their bodies. It is imperative future body image interventions aimed at African American emerging adult women address factors, such as appearance contingent self-worth and gendered racial microaggressions, in their efforts improve body appreciation.

Gendered Racial Microaggressions and Traumatic Stress Symptoms Among Black Women

We investigated the relations between gendered racial microaggressions (i.e., subtle gendered racism), gendered racial socialization, and traumatic stress symptoms among Black women. We hypothesized that gendered racial microaggressions would be significantly associated with traumatic stress symptoms and that gendered racial socialization would moderate the relations between gendered racial microaggressions and traumatic stress symptoms. Participants were 226 Black women from across the United States who completed an online survey. Results from a hierarchical multiple regression analysis indicated that a greater frequency of gendered racial microaggressions was significantly associated with greater traumatic stress symptoms; internalized gendered racial oppression moderated the relations between gendered racial microaggressions and traumatic stress symptoms. The results of this study can inform future research on Black women’s experiences of gendered racism and the role of gendered racial socialization in their lives. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/page/pwq/suppl/index

College Students' Coping and Psychological Help-Seeking Attitudes and Intentions

The relationship between college students' coping and psychological help-seeking attitudes and intentions was examined. Seven hundred and nineteen students participated (180 men, 537 women, and two individuals who did not indicate their gender). Questionnaires were completed online and included the Brief COPE and Beliefs About Psychological Services scales. It was found that for students with previous counseling experience, coping by means of greater use of support seeking and less use of avoidant coping strategies was associated with greater intent to seek psychological help, greater stigma tolerance, and greater belief in psychologists' expertness. Problem-focused coping was unrelated to psychological help-seeking attitudes and intentions among these students. For students without previous counseling experience, coping by means of greater use of support seeking (emotional support, instrumental support, and venting), greater use of problem-focused coping (active coping, positive reframing, religion, and planning), and less use of avoidant coping strategies (denial, substance use, behavioral disengagement, and self-blame) was associated with greater stigma tolerance and greater belief in psychologists' expertness. For these students, coping behaviors were not related to intentions to seek counseling.

Cultural Identity, Africultural Coping Strategies, and Depression as Predictors of Suicidal Ideations and Attempts Among African American Female College Students

Suicide prevention is a growing health concern in America for many minority groups. Although experts agree suicide is associated with cultural practices and beliefs, there is limited evidence on how African American women cultural values and practices influence their low rates of suicide. This study explores cultural identity, Africultural coping strategies, and depression as predictors of suicidal ideations and attempts among African American female college students. It was hypothesized that suicidal ideations and attempts are negatively related to cultural identity and Africultural coping styles, but positively related to depression. One hundred and thirty-seven African American female students were administered a battery of measures assessing cultural identity, coping strategies, and suicidal ideations and attempts. Results revealed that Africultural coping strategies and depression emerged as significant predictors of suicidal ideation and attempts. Results are discussed in terms of African American culture as a buffer to possible suicidal behavior in African American women.

Emerging Black Scholars: Critical Reflections on the Impact of the Association of Black Psychologists

This article highlights two Student Circle members’ reflections on how the Association of Black Psychologists (ABPsi) has had an impact on their development as emerging scholars, clinicians, and advocates in African (Black) psychology. The emerging scholars share their personal training experiences at a predominately White institution and historical Black college/university. Reflections also include how ABPsi members and scholarly works have influenced their identities as future African (Black) psychologists. In addition, the history, meaning, and personal experience with jegnaship will be discussed. Finally, this reflection concludes with a call to action for students to get involved in shaping the future of ABPsi.

Key Concepts, Theories, and Issues in African/Black Psychology: A View From the Bridge

An impressive body of psychological literature exists that attests to the amount of intellectual labor put forth by Black psychologists in developing and implementing unique approaches to understanding people of African descent. Yet the impact of these contributions made by Black psychologists have often been marginalized and rendered invisible within the overall context of Black intellectual thought. The absence leaves a void in the literature for those seeking an accurate account of the ideas that shape contemporary Black thought. This cursory review of the psychological literature attempts to fill that void by examining some of the major issues, concepts, and themes addressed in African/Black psychology, as well as identifying a few neglected areas and offering suggestions for future research directions in the discipline.

Study protocol: a randomized control trial of African American families fighting parental cancer together

Background

African American adults experience a disproportionate burden and increased mortality for most solid tumor cancers and their adolescent children are negatively impacted by the illness experience. The purpose of this randomized clinical trial is to evaluate the efficacy of a culturally sensitive family-based intervention program developed for African American families coping with solid tumor parental cancer using an intention-to-treat approach. Primary outcome is adolescent depressive symptoms at end of treatment.

Methods

A sample of 172 African American families will be enrolled from two diverse oncology centers (Helen Graham Cancer Center in Newark, DE, and Kimmel Cancer Center in Philadelphia, PA). Eligible families will be randomized either to a 5-session intervention Families Fighting Cancer Together (FFCT) or a 5-session parent-only psycho-educational (PED) program. Assessments will occur at weeks 0 (baseline), 8 (end-of-treatment), 24, and 52.

Discussion

Treatments to help African American adolescents cope with the impact of parental cancer are scarce and urgently needed. If successful, this proposed research will change the nature of intervention support options available to African Americans, who are overrepresented and underserved by existing services or programs.

Trial registration

This project is registered with ClinicalTrials.gov (Protocol #: NCT03567330).

The Development of a Culturally Adapted Pilot Intervention for African American Family Members of Homicide Victims: A Preliminary Report

African Americans are disproportionately impacted by homicide in the United States. Individuals who have lost a relative to homicide often experience symptoms of complicated grief. The objective of this study was to explore the impact of a culturally tailored psychoeducational pilot intervention whose development was informed by a conceptual model of coping for African American survivors of homicide victims and was designed to (a) educate participants about the manifestation of complicated grief and symptoms and (b) help participants develop ways to cope with their grief. Pre- and post-test results indicate preliminary support for this encouraging intervention in achieving its intended outcomes to help participants identify complicated grief symptoms, supports, and services to help them manage their grief. Implications for posthomicide research and practice are discussed.

Coping with Pain in the Face of Healthcare Injustice in Patients with Sickle Cell Disease

To evaluate the pain coping strategies of patients with sickle cell disease (SCD) who experience healthcare injustice from either physicians or nurses during medical visits for pain management. It is unknown how patients' coping with pain relates to their experiences of healthcare injustice from physicians or nurses. This descriptive comparative study included adult outpatients with SCD who completed the PAINReportIt^®, Healthcare Justice Questionnaire^©, and Coping Strategies Questionnaire-SCD. Data were analyzed using independent t tests. Frequent coping strategies of patients who experienced healthcare justice from physicians were praying-hoping and from nurses were praying-hoping, calming self-statements, diverting attention, and increasing behavioral activity. In contrast, frequent coping strategies of patients who experienced healthcare injustice from physicians were catastrophizing and isolation and from nurses were isolation. Patients who experienced healthcare justice used different sets of pain coping strategies than those who experienced healthcare injustice during medical visits for pain management.

The Role of Stressful Life Events and Cultural Factors on Criminal Thinking among African American Women Involved in the Criminal Justice System

African American women are positioned at the intersection of multiple disadvantaged statuses and disproportionately impacted by criminal justice policies, as evinced by their increased likelihood of incarceration. Yet, they continue to be overlooked in mainstream criminological research. Using data from 418 African American women in the B-WISE (Black Women in a Study of Epidemics) project, the current study investigates the relationship between several prominent stressors occurring in five social contexts and criminal thinking as a coping strategy. Findings indicate that criminal thinking may be one maladaptive coping mechanism to manage stressors, such as gendered racism, financial stress, and network loss, that occur across these multiple social contexts for African American women in prison and on probation. Spirituality, on the other hand, seems to operate as a buffer. Implications for practice include promoting programs that strengthen a sense of collective identity in the community, as well as hiring more African American women who could provide additional culturally-competent behavioral health services in criminal justice professions.

Examining Africentric Cultural Values, Ethnic Identity, and Substance Use Abstinence in Low-Income, Early Adolescent, African American Girls

An examination of cultural protective factors that foster substance use abstinence among low-income, early adolescent, African American girls may be helpful in understanding how to promote resilience and reduce negative health outcomes. This study examined the relations between Africentric cultural values, ethnic identity, and substance use abstinence among 196 low-income African American early adolescent girls (age 11-14 years). Results of logistic regressions revealed that Africentric values were negatively linked to cigarette and alcohol abstinence. Results also showed a significant positive interaction between Africentric cultural values and ethnic identity exploration that contributed to increased cigarette and alcohol abstinence. Implications for research and practice with African American early adolescent girls are discussed.

Examining How Racial Discrimination Impacts Sleep Quality in African Americans: Is Perseveration the Answer?

BACKGROUND

African Americans experience more problematic and disordered sleep than White Americans. Racial discrimination has been implicated in this disparity. However, the mechanisms by which discrimination disrupts sleep are unclear. It has been theorized that Perseverative Cognition (PC), characterized by recurrent patterns of reflective (i.e., rumination) and anticipatory (i.e., worry) negative thinking about personally relevant stressors, may reflect the functional mechanism linking discrimination to sleep. The present study is the first to empirically examine the dual components of PC as a candidate functional mechanism in the association between racial discrimination and subjective sleep quality.

PARTICIPANTS

Sixty-eight self-identified African American college students (55.9% female; M_age = 20.18, SD = 2.93) were recruited at a large predominantly white public university in the Midwest.

METHODS

The participants completed the Perceived Ethnic Discrimination Questionnaire (PEDQ), Pittsburgh Sleep Quality Index (PSQI), Penn State Worry Questionnaire (PSWQ), and Ruminative Responses Scale (RRS).

RESULTS

After adjusting for age, gender, and social class, results revealed a significant indirect effect of racial discrimination (RD) on subjective sleep quality through rumination, 95% CI [.008, .125], but not worry. RD was positively associated with rumination, b =.50, SE =.16, p = .003, and rumination, in turn, was positively associated with poorer sleep quality, b = .09, SE = .04, p = .012.

CONCLUSIONS

As both RD and poor sleep quality have been directly linked to heart disease, diabetes, depression, and a number of other maladies, our findings suggest that RD, sleep, and coping strategies (e.g., rumination) employed to manage RD experiences may be important targets for addressing racial disparities in health.

Do not forget culture when implementing mental health interventions for violence survivors

Abstract Armed conflict has positioned Colombia as the country with the second highest internal displacement of citizens. This situation has forced government projects and international cooperation agencies to intervene to mitigate the impact of violence; however, the coping strategies implemented by the country’s minorities are still unknown. The study objective is to describe the coping strategies and their relation with mental health within Afro-descendant culture in Colombia and the effects that armed conflict has on these coping mechanisms, through a phenomenological study involving focus groups and interviews with experts. Rituals and orality have a healing function that allow Afro-Colombian communities to express their pain and support each other, enabling them to cope with loss. Since the forced displacement, these traditions have been in jeopardy. Armed conflict prevents groups from mourning, generating a form of latent pain. Afro-Colombians require community interventions that create similar spaces for emotional support for the bereaved persons in the pre-conflict period. Thus, it is essential to understand the impact of this spiritual and ritualistic approach on mental health issues and the relevance of narrative and community interventions for survivors.

Reintegration of Women Post Obstetric Fistula Repair: Experience of Family Caregivers

In northern Ghana, families traditionally function as the main provider of care. The role of family, however, is becoming increasingly challenged with the social shifts in Ghanaian culture moving from extended kinship to nuclear households. This has implications for the care of women post obstetric fistula (OF) repair and their family members who assist them to integrate back into their lives prior to developing the condition. This research is part of a larger critical ethnographic study which explores a culture of reintegration. For this article, we draw attention to the findings related to the experience of family caregivers who care for women post OF repair in northern Ghana. It is suggested that although family caregivers are pleased to have their family member return home, there are many unanticipated physical, emotional, and economic challenges. Findings lead to recommendations for enhancing the reintegration process and the need for adequate caregiving support.

Linking Racial-Ethnic Socialization to Culture and Race-Specific Coping Among African American College Students

In addition to the use of coping strategies generally shared by all Americans, research has shown that African Americans tend to make use of culture and race-specific coping styles that distinguish them from other racial/ethnic group populations. These coping styles are important for the negotiation of multiple types of stressors. Little has been written on the antecedents of culture and race-specific coping (i.e., Africultural coping and John Henryism). This exploratory online investigation sought to determine if childhood racial-ethnic socialization (i.e., a cultural practice and protective factor) experiences predicted present self-reported culture and race-specific coping among a group of African American college students ( N = 191). Results indicated that past racial socialization messages encouraging participants to engage in positive cross-racial interactions (i.e., cross-racial relationship messages) were positively predictive of spiritual-centered and collective coping. Racial socialization messages that prescribed how participants should cope with racism were negatively associated with prolonged, active high-effort coping (i.e., John Henryism). Ethnic socialization messages emphasizing participation in African American cultural activities (i.e., African American heritage messages) positively predicted spiritual-centered, collective, and ritual-centered coping. Finally, ethnic socialization messages encouraging participants to have respect for authority figures, retain close relationships with family members, and maintain a collectivistic orientation (i.e., African American cultural values messages) were negatively predictive of John Henryism. Taken together, childhood racial-ethnic socialization experiences are an important resource for coping during college.

Spiritual Well-Being as a Mediator of the Relation between Culture-Specific Coping and Quality of Life in a Community Sample of African Americans

This study examines the antecedent factors affecting the quality of life of African Americans. A theoretical model is proposed that identifies the effects of culture-specific coping and spiritual well-being as predictors of quality of life. A sample of 281 African Americans was administered a battery of questionnaires that examined the constructs of interest. The theoretical model was tested within a structural equation—modeling framework to identify both direct and indirect effects. Results indicate overall model fit, with both culture-specific coping and spiritual well-being as significant predictors of quality of life. Spiritual well-being partially mediated the effects of culture-specific coping on quality of life. The article concludes with a discussion of the study's findings in relation to quality of life issues for African Americans.

Examining the Role of Culture-Specific Coping as a Predictor of Resilient Outcomes in African Americans From High-Risk Urban Communities

This investigation examined the role of culture-specific coping in relation to resilient outcomes in African Americans from high-risk urban communities. Participants (N = 385) were administered a survey questionnaire packet containing measures of culture-specific coping, traditional resilience factors (cognitive ability, social support, and familial factors), and resilient outcomes (physical, psychological, social, and environmental quality of life). Structural equation modeling was used to test the degree to which culture-specific coping would uniquely contribute to the prediction of quality of life above and beyond traditional predictive factors of resilience. Findings indicated that spiritual and collective coping were statistically significant predictors of quality of life outcomes above and beyond the traditional predictive factors. Overall, the findings indicated that both traditional and cultural factors were predictors of resilient outcomes (i.e., positive quality of life indicators) for African Americans.

Africentric Cultural Values, Psychological Help-Seeking Attitudes, and Self-Concealment in African American College Students

This study investigated the relationships among Africentric cultural values (i.e., the extent to which an individual adheres to a worldview emphasizing communalism, unity, harmony, spirituality, and authenticity), favorable psychological help-seeking attitudes, perceived counseling stigma, and selfconcealment (i.e., the tendency to withhold personal, sensitive information that is perceived as negative or upsetting) in a sample of African American college students. The authors found that for both African American women and men, higher degrees of Africentric cultural values were associated with greater perceived stigma about counseling and greater self-concealment. In addition, findings indicated that neither favorable psychological help-seeking attitudes nor perceived counseling stigma significantly mediated the relationship between Africentric cultural values and self-concealment behavior. Implication of the findings and future research directions are discussed.

Subjective Stress and Coping Resources Interact to Predict Blood Pressure Reactivity in Black College Students

This study examined the effects of subjective stress and coping resources on blood pressure reactivity. Sixty-nine Black college students (mean age = 23.58 years) completed the Life Experiences and Stress Scale to explore the subjective stressfulness associated with life events, the Coping Orientations to Problems Experienced Scale to measure usual ways of coping, and a standardized serial addition laboratory challenge during which blood pressure was assessed. Multiple regression analyses revealed that the interactive effects of subjective stress and coping resources predicted diastolic blood pressure reactivity (both p < .025) but not systolic blood pressure reactivity (both p > .10). These significant interaction effects indicated that higher levels of problem-focused coping were related to more marked diastolic blood pressure changes under conditions of high subjective stress and that emotion-focused coping was associated with less exaggerated diastolic blood pressure changes under conditions of low subjective stress. These findings highlight the potential contribution of psychosocial factors to blood pressure reactivity in Blacks.

Independent and Interdependent Self-Construals, Individualism, Collectivism, and Harmony Control in African Americans

The authors investigated the relationships among independent and interdependent self-construals (i.e., self-conceptualizations), dimensions of individualism and collectivism, and aspects of harmony control (i.e., the degree to which individuals are flexible in recognizing that their personal power stems from spiritual, social, and contextual forces) in a sample of 240 African American community college students. Results revealed that independent and interdependent self-construals and dimensions of individualism and collectivism were differentially related to various harmony control dimensions. Implications of the findings are discussed.

Interethnic Group and Intraethnic Group Racism: Perceptions and Coping in Black University Students

This study explored perceived racism and the usual ways of coping with these perceptions in a sample of 269 Black university students (53% female). Perceptions of inter- and intragroup racism were assessed with the Life Experiences and Stress scale, and coping was measured with the Coping Orientations to Problems Experienced scale. A principal component analysis suggested that inter- and intragroup racism were separable constructs. Correlation analyses revealed that inter- and intragroup racism were negatively associated with self-deception.Relative to females, t-test analyses indicated that males perceived more inter- and intragroup racism. The t-test analyses also revealed that females were more likely than males to use emotion-focused and religious coping responses, when negotiating perceptions of inter- and intragroup racism; and, when negotiating perceptions of intragroup racism, males were more likely than females to use alcohol as a coping response. The limitations of the study and directions for future research are discussed.