"I am a survivor!": Violently Injured Black Men's Perceptions of Labeling After a Violent Firearm Injury

Self-appraisal after a life-altering event is a critical process for individuals, often comprised by assigned labels that may not align with an individuals' perceptions of themselves or of their situation. Existing research within this victim-survivor dichotomy largely rests in the interpersonal violence space, with a victim assuming legal recourse and wrongdoing, and a survivor associating with positive personal characteristics like grit and resilience. Much existing literature on self-appraisal after interpersonal injury is heavily concentrated within the sexual violence literature, and this study applies these concepts to a sample of Black men injured by firearms. Ten Black men enrolled in a hospital-based violence intervention program (HVIP) were interviewed to understand how they label their experience of firearm injury, and if their perceptions aligned with common labels seen among other populations and/or in other areas of study (e.g., cancer, domestic violence). Each participant assigned themselves their own label, with three labels emerging: survivor, victim and survivor, and neither victim nor survivor. The results illustrate the nuance of experiences beyond the victim-survivor dichotomy, and how labels and personal identities may shift following injury into new terms and considerations of resilience and trauma processing. More research is warranted to understand the factors that shape self-labeling within this population, including influences of masculine norms, racialized stereotypes, community context, and availability of services. Findings support public awareness campaigns to reframe surviving violence as a strength, and for community partners and practitioners to increase access to culturally competent and trauma-informed mental healthcare.

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.

The impact of the COVID-19 pandemic experiences on college drinking via mental distress: Cross-sectional mediation moderated by race

BACKGROUND

The COVID-19 pandemic has been linked to stress, anxiety, and depression among college students, with heightened distress tied to greater drinking for some individuals. Emerging research suggests that these associations may differ across race, but few studies use adequate samples to examine this, particularly among college students, an at-risk population for both heavy drinking and mental distress. Specifically, pandemic-related stressors and mental distress may be higher among Black students than White students. The current study examined: (1) whether mental distress cross-sectionally mediates the association between pandemic-specific stressors and drinking and (2) whether race (Black or White) moderates these associations.

METHODS

A cross-sectional online survey of 400 college drinkers (43% White, 28% Black) in fall 2020 assessed pandemic-related stressors (e.g., losing a job, contracting COVID-19, changed living situation), mental distress (stress, anxiety, depression), and drinking (past-month drinking, perceived changes since the start of the pandemic).

RESULTS

Cross-sectional mediation models indicated that financial stressors and social distancing were linked to greater quantity and frequency of past-month drinking through greater mental distress. For perceived changes in drinking, only financial stressors were linked to drinking greater quantities and drinking more often (compared to pre-pandemic levels) via mental distress. Moderated mediation models among students identifying as White or Black revealed that changed living situation was a robust stressor across race. Financial stressors and social distancing were linked with greater distress only among White students, whereas essential worker status was a protective factor against distress only among Black students.

CONCLUSIONS

Select stressors were linked to increased drinking through greater mental distress, with differential risks across Black versus White students. Findings suggest campus administrators should focus on connecting students with resources (e.g., counseling centers and health promotion offices) during times of distress.

Can Early Disadvantage Be Overcome? A Life Course Approach to Understanding How Disadvantage, Education, and Social Integration Impact Mortality into Middle Adulthood Among a Black American Cohort

Health equity research has identified fundamental social causes of health, many of which disproportionately affect Black Americans, such as early life socioeconomic conditions, neighborhood disadvantage, and racial discrimination. However, the role of life course factors in premature mortality among Black Americans has not been tested extensively in prospective samples into later adulthood. To better understand how social factors at various life stages impact mortality, this study examines the effect of life course poverty, neighborhood disadvantage, and discrimination on mortality and factors that may buffer their effect (i.e., education, social integration) among the Woodlawn cohort (N = 1242), a community cohort of urban Black Americans followed since 1966. Taking a life course perspective, we analyze mortality data for deaths through age 58 years old, as well as data collected at ages 6, 16, 32, and 42. At age 58, 204 (16.4%) of the original cohort have died, with ages of death ranging from 9 to 58.98 (mean = 42.9). Cox proportional hazard models adjusting for confounders show statistically significant differences in mortality risk based on timing and persistence of poverty; those who were never poor or poor only in early life had lower mortality risk at ages 43-58 than those who were persistently poor from childhood to adulthood. Education beyond high school and high social integration were shown to reduce the risk of mortality more for those who did not experience poverty early in their life course. Findings have implications for the timing and content of mortality prevention efforts that span the full life course.

Alcohol Use and Physical Intimate Partner Violence Perpetration Among Black Men: The Moderating Effect of Interpersonal Social Support

Studies have consistently shown an association between alcohol use in adulthood and intimate partner violence (IPV) perpetration. Yet, no known studies have examined this relationship when considering social support as a potential moderator with a sample of Black men. To address this gap in knowledge, we examined the moderating role of interpersonal social support on alcohol use in adulthood and physical IPV perpetration among Black men. Data for 1,127 Black men were obtained from the National Epidemiologic Survey of Alcohol and Related Condition (NESARC, Wave 2). Descriptive and logistic regression models were run with weighted data using STATA 16.0. Results from logistic regression analyses revealed that alcohol use in adulthood significantly predicted IPV perpetration (odds ratio [OR] = 1.18, p < .001). Interpersonal social support significantly moderated (OR = 1.01, p = .002) the relationship between alcohol use and IPV perpetration among Black men. Additionally, age, income, and perceived stress were significantly associated with IPV perpetration among Black men. Our study findings highlight the role of alcohol use and social support in exacerbating IPV perpetration among Black men, and the need for culturally responsive interventions to address these public health concerns throughout the life course.

Multidimensional social support and parenting among Black fathers: A profile-oriented approach

Though studies have examined the role of social support in the lives of Black men, less is known about the role and function of multi-domain social support as they navigate fatherhood. This investigation utilizes a profile-oriented approach to identify patterns of general and parenting-specific social support (i.e., family; peers; community) among a sample of 759 Black American fathers. Additionally, this study examines how identified support profiles are associated with Black fathers' parenting outcomes (i.e., stress, satisfaction, self-efficacy, and involvement). Latent class analyses identified 10 distinct social support profiles among Black fathers. Results also indicated that there was some profile variation in levels parenting outcomes. Findings suggest variation in the availability and utilization of general and parenting support among Black fathers.

Dual Pandemics: Race-Related COVID Stress and Mental Health Outcomes in Black Individuals

Black individuals have been disproportionately affected by the COVID-19 pandemic, likely due in part to historically rooted stressors that lie at the intersection of the COVID-19 pandemic and racism. We used secondary data from The Association of Black Psychologists' multi-state needs assessment of 2480 Black adults to examine the link between race-related COVID stress (RRCS) and mental health outcomes. We also examined the moderating roles of everyday discrimination, cultural mistrust, Black activism, Black identity, and spirituality/religiosity in these associations. T-tests revealed that several demographic and cultural factors are associated with RRCS endorsement. A series of regression analyses showed that endorsement of RRCS is associated with higher psychological distress and lower well-being, above and beyond several sociodemographic characteristics. While traditional cultural protective factors did not buffer against the effects of RRCS on mental health, cultural mistrust strengthened the positive association between RRCS and psychological distress; nonetheless, the association of cultural mistrusts with psychological distress was only seen in those who endorsed RRCS. We provide recommendations for policymakers, clinicians, and researchers to consider the impact of RRCS when addressing Black mental health and well-being in the age of COVID-19.

Resilient cultural practices for cognitive development during childhood within learning pathways with support from mediated mutual reciprocal theory

Introduction

This paper examines resilient cultural practices, informed by cultural values for cognitive development in socialisation during childhood within the learning pathways model. It argues that the active role of children in their learning is not well captured or explained by theories or even empirical data. Learning pathways as a model in this paper is significant because it orients thinking on the fact that all activities children engage in always have social, psychological, and physical implications for cognitive enrichment. The activities are driven by resilient cultural practices informed by cultural norms, beliefs, and values such as responsible leadership qualities and cultivating socio-emotional and moral balance. With the above reasoning, this paper is underpinned by an empirical study with six specific objectives supported by Mediated Mutual Reciprocity theory.

Methods

The study used a mixed research design and conveniently selected a sample of 73 parents and teachers whose ages ranged from 25-50 years. A questionnaire and an interview guide were used for data collection. The three-sections questionnaire was constructed to find out information about resilient cultural practices and cognitive development. The items in sections two and three were rated on a 5 points Likert scale based on the occurrence of practices and behaviours. The interview guide was constructed to find out information on the three learning pathways; physical, social and psychological that are relevant to children in African cultures. Data were analysed using frequency and proportions and Multiple Regression Analysis to aggregate scores for given conceptual components. Analysis of qualitative data followed the systematic process of thematic and content analysis.

Results

Based on qualitative findings, it was realised that African children are exposed to physical, social, and psychological pathways to learning. Quantitative results showed that 85.5% of respondents are high in their resilient cultural practices whereas 14.5% of them are low in resilient cultural practices. In the same line, 74.4% of respondents’ cognitive development is high while a proportion of 25.6% is low. The inferential statistics showed that resilient cultural practices are significantly predictive of cognitive processes, reasoning, skills, and strategies at a 0.000 level of significance.

Discussion

Based on the use of the principles of the Mediated Mutual Reciprocal Theory, the study affirms the importance of children’s contributory role in their learning and cognitive development. The link between pathways, resilient cultural practices, and cognitive development highlights the significance of children’s involvement in their development through participation.

Exploring the association between mental health climate and depression: the protective role of positive mental health and sense of belonging among Black college students

Objective: To explore relationships between mental health climate, positive mental health, sense of belonging, and depression among a U.S. national sample of Black college students. Participants: 1303 Black undergraduate and graduate students from 15 colleges and universities throughout the U.S. Methods: Data were from the 2018-2019 Healthy Minds Study. Analysis included hierarchical regression models. Results: A more positive perception of mental health climate and higher levels of both positive mental health and sense of belonging were significantly associated with lower levels of depression. Significant interactions existed between positive mental health and climate and sense of belonging and climate with buffering effects being most pronounced for students reporting high levels of positive mental health. Conclusion: Black college students' perceptions of an institution's mental health climate are associated with psychological outcomes. College health stakeholders should consider the buffering effects of protective factors on mental health when designing initiatives for Black college students.

Well-Being and Professional Efficacy Among Health Care Professionals: The Role of Resilience Through the Mediation of Ethical Vision of Patient Care and the Moderation of Managerial Support

Drawing on the Conservation of Resources theory, this study analyzes whether resilience could be related to healthcare providers' wellbeing and professional self-efficacy, both directly and indirectly, as mediated by ethical vision of patient care and moderated by managerial support in dealing with ethical issues. Overall, 315 Italian healthcare professionals employed in neuro-rehabilitation medicine or palliative care specialties participated in this multi-centered cross-sectional study. The following variables were investigated: resilience (Connor-Davidson Resilience Scale), wellbeing (Maugeri Stress Index-Reduced), professional self-efficacy (Maslach Burnout Inventory-General Survey), ethical vision of patient care and managerial support in dealing with ethical issues (Italian version of the Hospital Ethical Climate Survey). Overall, resilience was positively associated with healthcare providers' wellbeing and professional self-efficacy, directly and indirectly, as mediated by ethical vision of patient care. Highly resilient healthcare professionals who perceived the presence of a positive ethical vision of patient care in their workplace were more likely to experience greater wellbeing when managerial support in dealing with ethical issues was high (vs. low). Thus, these findings provide suggestions for tailored interventions sustaining healthcare professionals along their daily activity characterized by high-demanding and challenging situations.

Psychosocial Predictors of Chronic Musculoskeletal Pain Outcomes and their Contextual Determinants Among Black Individuals: A Narrative Review

Black communities are disproportionally affected by Chronic Musculoskeletal Pain (CMP), but little is known about the psychological predictors of CMP outcomes and their contextual determinants among Black individuals. To address this gap, we conducted a narrative review of extant literature to (1) report the major conceptual models mentioned in prior work explaining the link between contextual determinants and psychological responses to pain among Black individuals with CMP; and (2) describe psychological factors related to CMP outcomes in this population that are highlighted in the literature. We searched 4 databases (APA PsycNet, PubMed/MEDLINE, Scopus, and Google Scholar) using the following search terms: musculoskeletal pain, chronic pain, mental health, psychological, coping, health disparities, contextual factors, conceptual models, psychosocial, Black, African American, pain, disability, and outcomes. We illustrate 3 relevant conceptual models - socioecological, cumulative stress, and biopsychosocial - related to contextual determinants and several psychological factors that influence CMP outcomes among Black individuals: (1) disproportionate burden of mental health and psychiatric diagnoses, (2) distinct coping strategies, (3) pain-related perceived injustice and perceived racial/ethnic discrimination, and (4) preferences and expectations related to seeking and receiving pain care. The detailed clinical and research implications could serve as a blueprint for the providers and clinical researchers to address health disparities and improve care for Black individuals with CMP. PERSPECTIVE: This narrative review illustrates conceptual models explaining the link between contextual determinants and psychological responses to pain among Black individuals with chronic musculoskeletal pain. We discuss 3 relevant conceptual models - socioecological, cumulative stress, biopsychosocial -, and 4 psychological factors: disproportionate burden of mental health, distinct coping strategies, perceived injustice/discrimination, preferences/expectations.

"Like a wake-up call for humankind": Views, challenges, and coping strategies related to public health measures during the first COVID-19 lockdown in Thailand

Following the first Thai COVID-19 case in January 2020, the Thai government introduced several non-pharmaceutical interventions (NPIs) in March 2020 (e.g., contact tracing, travel restrictions, closure of businesses, curfews, stay at home orders) to control COVID-19 transmissions. This study aimed to understand the views and experiences of a small number of Thai residents related to public health measures implemented during the first COVID-19 wave in Thailand. A total of 28 remote in-depth interviews with Thai residents (18-74 years old) were conducted between 8 May and 21 July 2020. Interviews were audio recorded, transcribed, and analysed using thematic analysis based on the Framework Method. Our results describe participants' views, challenges, and coping strategies relating to COVID-19 restrictions. Most participants expressed support for the introduction of strict public health measures, while some criticized lacking enforcement or rational of certain measures. Participants identified four major challenges, namely financial hardship; social isolation and loneliness; stigma and shaming; and fear of COVID-19 infection. Strategies adopted to address these challenges included practical coping strategies (e.g., reducing risks and fear of COVID-19 infection; mitigating financial, social, and mental health impacts), and embedded socio-cultural ways of coping (e.g., turning to religion; practicing acceptance; kindness, generosity and sharing ('Namjai'); 'making merit' ('Tham-bun')). The challenges identified from this study, in particular the role of stigma and discrimination, may be relevant to other infectious disease outbreaks beyond COVID-19. Findings from this study underscore the need for policies and interventions that mitigate the negative impacts of NPIs on the public, particularly on vulnerable groups, and highlight the importance of considering socio-cultural context to support community resilience in times of crisis. Our findings remain relevant in light of low COVID-19 vaccine availability and the potential need to implement further public health restrictions in Thailand and elsewhere against COVID-19 or future infectious disease threats.

Assessing family resilience for African American college students: Confirmatory factor analysis of the Family Resilience Assessment Scale

ObjectivePsychometric properties of the Family Resilience Assessment Scale and its utility for use with African American college students were examined. Participants: Subjects were 440 university students (M age = 21.65, SD = 6.17) who were enrolled during the 2018-2019 academic year and recruited during the fall and spring semesters. Methods: A single-group confirmatory factor analysis was employed to determine the best model for assessing family resilience in an African American college student population. Results: The model fit was poor and could not be respecified due to numerous item cross-loadings. Conclusions: Further research is needed to validate a measure that adequately assesses family resilience for African American students.

The Multidimensional Taxonomy of Individual Resilience

Theoretical work in resilience has continuously evolved to inform and respond to advances in empirical work. In order to further scientific inquiry, it must continue to do so. This narrative overview of the field of resilience science focuses on contemporary challenges confronted by theoretical models of individual resilience and proposes a taxonomic structure for resilience-the multidimensional taxonomy of individual resilience (MTIR). The goal of the MTIR is to articulate a systematic framework within which extant theoretical and empirical work can be nested. Consistent with existing work, the MTIR organizes resilience into two primary branches-manifested resilience and generative resilience. These two components are then organized into subdomains that demonstrate evidence of conceptual distinctiveness. The specification of the subdomains in the MTIR draws support from a diverse body of work on resilience across disciplines and in multiple global contexts. The MTIR makes several critical advances, including expanding and refining the definitions and components of resilience in psychology, providing a clearer framework for conceptualizing mixed profiles of resilience, and tempering assumptions regarding the relational dependencies across domains of resilience. Finally, the utility of the MTIR in organizing research in resilience and advancing theory-testing and development is discussed.

Determinantes del Bienestar Subjetivo en Adultos Mexicanos durante el Primer periodo de Confinamiento por Covid-19

El confinamiento por Covid-19 tiene un impacto psicológico tanto negativo como positivo en las personas, por ello, se examinan las relaciones entre el estrés, apego, los valores culturales (individualismo-colectivismo) y la posible mediación de la resiliencia entre estas variables con el bienestar subjetivo durante la etapa inicial de pandemia en México, de marzo a mayo del 2020. Método: Con un diseño transversal de tipo correlacional participaron 287 adultos mexicanos hombres y mujeres con un rango de edad de 18 a 71 años (M= 35.16, DE= 14.14). Aplicándose en línea las escalas: estrés percibido, escala de apego, individualismo-colectivismo, resiliencia, y para bienestar subjetivo las escalas de satisfacción con la vida y de afecto positivo-negativo. Resultados: Los análisis mostraron impacto diferencial según sexo y rango de edad. Se aplicó un modelo de trayectorias el cual resultó con índices de ajuste aceptables lo que revela efectos conjuntos directos, indirectos y totales por lo que se comprueba el efecto mediador de la resiliencia. Conclusiones: es necesario dotar de habilidades para la vida para el manejo emocional que generen mayor bienestar en la población.

Coping Matters: An Examination of Coping among Black Americans During COVID-19

Using a critical race theory framework and a convergent mixed-method design, this study examined the relationship between coping with stress and psychological distress among Black U.S. Americans ( N = 155) during the COVID-19 pandemic in the context of race-based stressors (e.g., anti-Black racism). Path analysis revealed mixed support for hypotheses; avoidant coping was positively related to all measured facets of psychological distress, whereas socially supported coping was associated with none. Self-sufficient coping was negatively associated with only depressive symptoms. Qualitative analysis revealed four salient themes: (a) Race and the COVID-19 Pandemic, (b) Complex Pandemic Related Changes to Life, (c) Emotional Responses to the Pandemic, and (d) Coping with the COVID Pandemic. These themes suggested the pandemic disrupted participants’ ability to engage in, or effectively use, typically adaptive coping strategies and distress was exacerbated by fears for the safety of other Black U.S. Americans. Implications for training, practice, research, and advocacy are discussed.

Strengths despite stress: Social-structural stressors and psychosocial buffers of depressive symptoms among U.S. Black men

We examined the association between social-structural stressors-racial discrimination, incarceration, and unemployment-and depressive symptoms among 578 predominantly low-income urban Black men, ages 18-45. We also examined the extent to which two protective factors-social support and problem-solving coping-moderated the relationship between social-structural stressors and depressive symptoms. Results showed that more everyday racial discrimination and incarceration, but not unemployment, significantly predicted more depressive symptoms. The links between discrimination, incarceration, and depressive symptoms were stronger for men who reported lower levels of problem-solving coping and social support than those with higher levels. Our study suggests that interventions emphasizing protective factors may help Black men cope with some of the deleterious effects of racial discrimination and incarceration. It also underscores a need for structural interventions that reduce racial discrimination and incarceration. Depression among Black men is not simply a biomedical or psychological condition, but also a critical health equity issue. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Father-child attachment in Black families: Risk and protective processes

Theoretical and empirical work on Black fathering has been grounded in a deficit perspective. Scholarship has focused on absenteeism and incarceration of Black fathers, neglecting their positive roles as well as the structural inequalities and challenges Black fathers face. This paper highlights the significance of positive fathering in Black youth development, with a focus on the protective influences of attachment relationships. Structural and proximal processes that may support or undermine this relationship are delineated, as well as how theory and methods on attachment can be extended to support research on Black families and youth development. Culturally and contextually grounded research on Black fathering may lead to refinement in theory and measurement of attachment. Advancing research on father-child relationships in Black families requires greater attention to processes that promote positive fathering and strengthen father-child attachment bonds, particularly in the context of structural racism.

Diabetes Self-Management Education and Support Culturally Tailored for African Americans: COVID-19-Related Factors Influencing Restart of the TX STRIDE Study

Purpose

The purpose of this substudy was to determine the most acceptable way to restart the Texas Strength Through Resilience in Diabetes Education (TX STRIDE) study safely using remote technologies. Following the emergence of COVID-19, all in-person TX STRIDE intervention and data collection sessions were paused.

Methods

Qualitative descriptive methods using telephone interviews were conducted during the research pause. A structured interview guide was developed to facilitate data collection and coding. Forty-seven of 59 Cohort 1 participants were interviewed (mean age = 60.7 years; 79% female; mean time diagnosed with type 2 diabetes = 11 years).

Results

Data categories and subcategories were generated from the interview responses and included: personal experiences with COVID-19, effects of COVID-19 on diabetes self-management, psychosocial and financial effects of COVID-19, and recommendations for program restart. Although some participants lacked technological knowledge, they expressed eagerness to learn how to use remote meeting platforms to resume intervention and at-home data-collection sessions. Six months after the in-person intervention was paused, TX STRIDE restarted remotely with data collection and class sessions held via Zoom. A majority of participants (72.9%) transitioned to the virtual platform restart.

Conclusions

Qualitative findings guided the appropriate implementation of technology for the study, which facilitated a successful restart. High retention of participants through the study transition provides evidence that participants are invested in learning how to manage their diabetes despite the challenges and distractions imposed by COVID-19.

The relationship between health-related quality of life, perceived social support, and social network size in African Americans with aphasia: a cross-sectional study

Stroke significantly impairs health-related quality of life (HRQL). Stroke survivors with aphasia (SWA) experience lower HRQL than stroke survivors without aphasia (SSA) as a result of poorer communication and social functioning. The extent to which aphasia influences HRQL in African-Americans and the components of social functioning that are most important to HRQL warrants further exploration.There were two main objectives of this paper. The first was to survey HRQL domains of communication, physical, mental/emotional, role, and social functioning in African American SWA and SSA. The second was to examine if social support and social network predicted HRQL in SWA.A total of 39 African American adults (62.4 ± 11.10) participated in this descriptive cross-sectional case control study. Patient-reported outcome measures were used to assess HRQL, perceived social support, and social network in SWA, SSA, and normal-aging healthy controls (NAH). Data analysis included an ANOVA and moderator regression to determine if social support or social network predicted HRQL in SWA.SWA reported a significantly lower overall HRQL (p = <.000) than NAH adults. Communication HRQL was the hallmark difference found between SWA and SSA (p = <.000). Social support and social network were relatively similar among all three groups. However, social support and social network did not predict HRQL in SWA.Findings from this study suggest that social HRQL continues to be significantly lower in SWA; however, social support and social network factors do not drive differences among African-Americans. Moreover, communication HRQL remains the hallmark difference between SWA and SSA.

The "3 Es" of trauma-informed care in a federally qualified health center: Traumatic Event- and Experience-related predictors of physical and mental health Effects among female patients

Federally Qualified Health Centers (FQHCs) are a fast-growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the "3 E" conceptualization of trauma, certain Event- and Experience-related characteristics of a trauma predict victims' physical and mental health Effects. The "3 Es" have yet to be studied in female FQHC patients. The current study examined the prevalence of interpersonal trauma and interrelationships among traumatic Event-related factors (e.g., cumulative trauma by victim-perpetrator relationship), Experience-related factors (e.g., betrayal, resilience), and Effects (e.g., somatic symptoms, posttraumatic stress (PTS), anxiety/depression, mistrust, reduced sense of safety) among 138 predominantly Black (89.1%) women receiving care at an FQHC in the southeastern U.S. Roughly 65% of participants (n = 86) endorsed exposure to at least one type of interpersonal trauma. More cumulative trauma was significantly correlated with more somatic, PTS, and anxious/depressive symptoms, and a reduced sense of safety. Experiences of betrayal and/or resilience were better predictors of PTS and anxious/depressive symptoms and lack of safety than Event-related factors. Findings support the need for the implementation of trauma-informed care within community-based health centers. Healthcare providers should consider women's subjective experience of trauma when screening for exposure and providing trauma-sensitive care.

From Antiblackness to Cultural Health in Higher Education

Antiblackness has a long and storied history in higher education in the United States, and unfortunately, antiblack attitudes and practices continue in the 21st century. With implications for countering antiblackness in higher education and institutionalizing support for cultural health and wellness, we documented experiences of antiblackness in the African American Student Network (AFAM). AFAM was a weekly networking group, co-facilitated by Black faculty and graduate students, where Black undergraduates could come together and share their experiences. Participation in AFAM was associated with Black holistic wellness, and AFAM was a source of cultural health, where we conceptualized cultural health as having a sense of pride and resilience in one’s cultural background. We analyzed notes of 277 AFAM discussions from 2005–2006 to 2017–2018 using an adaptation of consensual qualitative research methods to identify four domains of antiblackness: racial trauma (n = 51), racial microaggressions (n = 34), racial rejection (n = 33), and systemic racism (n = 25). In moving from antiblackness to cultural health, we advocate for institutional resources in higher education, such as an institute for cultural health on campus, that values the cultures of Black students and students of color, and that focuses on building communities in which students can generate a wellspring of pride and resilience in their cultural backgrounds.

Coping and adaptation to dementia family caregiving: A pilot study

Family caregivers of Black older adults with dementia are at risk for cognitive decline and premature death. Reducing this risk and filling the void of culturally responsive interventions for caregivers requires the development of participant informed models of care that promote group strengths such as effective coping. In this pilot study, Black family caregivers (n=30) completed a survey comprised of a demographic questionnaire, various measures of function, self-efficacy, social support, and coping. Study findings point to a well-educated population with underlying health concerns such as obesity, hypertension, and diabetes that may be complicated by caregiving stress. Common coping strategies used by participants included spiritual coping (80%), use of past experiences (80%), and information gathering (75%). Clinicians can support dementia family caregivers by promoting spiritual coping and self-care, as well as providing reference resources about respite and managing challenging behaviors. Power analysis suggests a future sample size of 385.

The Effect of Contextualized Racial and Gendered Stressors, Social Support, and Depression on Hypertension Illness Perceptions and Hypertension Medication Adherence in Young African American Women With Hypertension

BACKGROUND

Poor adherence to hypertensive medication has been suggested to be a major contributor to uncontrolled hypertension (HTN) in African Americans. The impact that social determinants have on the various patient-level factors, including HTN beliefs, mental well-being, and social support, may provide insight into the development and tailoring of culturally targeted interventions, thus improving adherence.

OBJECTIVE

The aim of this study was to examine the relationships of exposures to contextualized racial and gendered stressors, social support, and depressive symptoms with HTN illness perceptions and blood pressure (BP) medication adherence.

METHODS

Participants (N = 85) were hypertensive African-American women aged 18 to 45 years (mean [SD], 39.2 [5.4] years) recruited from the community setting and outpatient medical clinics in a large metropolitan city. Hypertension illness beliefs were assessed using the 8-item Brief Illness Perception Questionnaire ("How much does your blood pressure affect your life?") and medication adherence was assessed with the 7-item Adherence to Refills and Medication Scale ("How often do you forget to take your BP medicine?"). Logistic regression analyses were performed to examine the associations with medication adherence and linear regression analyses were performed to examine the associations of continuous variables and HTN illness perceptions.

RESULTS

The sample was predominantly nonadherent (81.2%). In the adjusted multivariable regression model, systolic BP (odds ratio, 0.95; P = .05) and the "Consequence" dimension of HTN beliefs (odds ratio, 0.76; P = .02) were associated with medication adherence. In the adjusted linear regression model, systolic BP (β = 0.22, P < .01) and depressive symptoms (β = 1.11, P < .01) were associated with HTN illness beliefs.

CONCLUSIONS

Assessing beliefs and the mental well-being before initiating BP medications is essential for adherence and BP control.

Where Our Bright Star Is Cast: Religiosity, Spirituality, and Positive Black Development in Urban Landscapes

Social science research offers a particular, narrow view of the lived experiences of Black urban-residing people. When the religious and spiritual lives of Black urban residents are viewed through this narrow lens, the diversity of religious and spiritual experiences and the connections between everyday life and positive outcomes, such as compassion, hope, liberation, joy, etc., become flattened, doing a disservice to the very people whose experiences we aim to understand. We contend that understanding the link between religiosity, spirituality, and positive development among Black urban-residing people requires us to pay attention to the ways that faith helps Black people to navigate the sequelae of five distinct sociopolitical features of urban life. We propose a conceptual framework that links these sociopolitical factors to religiosity, spirituality, and positive development among Black youth and adults residing in urban spaces. We conclude with recommendations applicable to the study of Black urban religiosity and spirituality.

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

Polygenic and environmental influences on the course of African Americans' alcohol use from early adolescence through young adulthood

The study examined (a) whether alcohol use subgroups could be identified among African Americans assessed from adolescence through early adulthood, and (b) whether subgroup membership was associated with the interaction between internalizing symptoms and antisocial behavior polygenic risk scores (PRSs) and environmental characteristics (i.e., parental monitoring, community disadvantage). Participants (N = 436) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city. Youths reported on the frequency of their past year alcohol use from ages 14-26. DNA was obtained from participants at age 21. Internalizing symptoms and antisocial behavior PRSs were created based on a genome-wide association study (GWAS) conducted by Benke et al. (2014) and Tielbeek et al. (2017), respectively. Parental monitoring and community disadvantage were assessed at age 12. Four classes of past year alcohol use were identified: (a) early-onset, increasing; (b) late-onset, moderate use; (c) low steady; and (d) early-onset, decreasing. In high community disadvantaged settings, participants with a higher internalizing symptoms PRS were more likely to be in the early-onset, decreasing class than the low steady class. When exposed to elevated community disadvantage, participants with a higher antisocial behavior PRS were more likely to be in the early-onset, increasing class than the early-onset, decreasing and late-onset, moderate use classes.

The Ties That Bind and Unbound Ties: Experiences of Formerly Homeless Individuals in Recovery From Serious Mental Illness and Substance Use

This report explores the nature and quality of social ties of formerly homeless individuals in recovery from serious mental illness and substance abuse and how these ties relate to experiences of community. Using grounded theory and cross-case analysis techniques, we analyzed 34 qualitative interviews conducted with predominantly racial/ethnic minority individuals receiving mental health services. Participants described a range of involvement and experiences in the mental health service and mainstream communities indicating a combination of weak or strong ties in these communities. Across participants, two broad themes emerged: ties that bind and obstacles that "get in the way" of forming social ties. Salient subthemes included those related to family, cultural spaces, employment, substance abuse, stigma and mental health service providers and peers. The current study integrates our understanding of positive and negative aspects of social ties and provides a theoretical framework highlighting the complexity of social ties within mainstream and mental health service communities.

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.

Spiritual Well-Being and Psychological Adjustment: Mediated by Interpersonal Needs?

Spiritual well-being has been shown to reduce suicidal behavior, depressive symptoms, and hopelessness. Thwarted interpersonal needs have been shown to increase risk of suicidal behavior. This paper aims to explore the interrelationships among spiritual well-being, thwarted interpersonal needs, and negative outcomes including suicidal ideation, hopelessness, and depressive symptoms among African American women. Sixty-six African American women (M = 36.18; SD = 11.70), from a larger study of women who had experienced interpersonal violence within the past year, completed self-report questionnaires. Mediation analyses revealed that thwarted belongingness, but not perceived burdensomeness, significantly mediated the relations between spiritual well-being and the three outcomes. This study provides the first examination of the role of thwarted interpersonal needs on the link between spiritual well-being and negative psychological outcomes. Spiritual well-being serves a protective role against feelings of social isolation, which may reduce one's risk of negative psychological outcomes. Treatments that bolster a sense of spirituality and social connectedness may reduce suicidal ideation, hopelessness, and depressive symptoms.

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.

Financial Strain, Negative Interactions, and Mastery: Pathways to Mental Health Among Older African Americans

This study examines the impact of financial strain, social support, and negative interactions on depressive symptoms among African Americans and the role of mastery as a mediator in these relationships. Structural equation modeling and baseline data from the Americans' Changing Lives Study were used to test these relationships among a sample of African Americans aged 50 to 96 years (N = 583). Findings illustrate the mechanistic pathways whereby financial strain is associated with depressive symptoms. Moreover, the study findings give further credence to the notion that positive and negative aspects of social relationships are distinctive with respect to social status factors, financial strain, and their relationship to depressive symptoms. This research suggests that mastery is an important mechanism linking negative interaction to mental health. The collection of findings provide a number of provocative departures from research conducted primarily using White samples and identifies important areas of intervention with older African Americans.

Is Religious Coping a Moderator Of Perceived Control and Panic Symptoms in African American Adults?

Extant research has established a strong association between perceived control and anxiety; however, limited work has examined perceived control within the context of fear-based anxiety disorders and in ethnic minority populations. Further, scant attention has been paid to protective factors that may moderate the relationship between perceived control and anxiety. The current study investigated the relationship between perceived control, positive religious coping, and panic-related fears in a community-based African American adult sample ( N = 91, mean age = 38, 91% female). Results from hierarchical linear regression indicated that perceived control significantly predicted all panic subscales (i.e., total panic symptoms, agoraphobic fears, social phobia fears, interoceptive fears); however, positive religious coping moderated only the relationship between perceived control and agoraphobic fears. Simple slopes analyses revealed that increased levels of positive religious coping resulted in a strengthened negative relationship between perceived control and agoraphobic fears.

Psychosocial Implications of Homophobia and HIV Stigma in Social Support Networks: Insights for High-Impact HIV Prevention Among Black Men Who Have Sex With Men

Black men who have sex with men (BMSM) bear an increasingly disproportionate burden of HIV in the United States. The Centers for Disease Control and Prevention recommends high-impact combination prevention for populations at high risk for HIV infection, such as BMSM. However, few scholars have considered the types of behavioral interventions that combined with biomedical prevention could prove effective for mitigating the epidemic among BMSM. Between June 2013 and May 2014, we conducted three in-depth interviews each with 31 BMSM, interviews with 17 community stakeholders, and participant observation in New York City to understand the sociocultural and structural factors that may affect the acceptance of and adherence to oral preexposure prophylaxis among BMSM and to inform an adherence clinical trial. BMSM and community leaders frequently described condomless sex as a consequence of psychosocial factors and economic circumstances stemming from internalized homophobia resulting from rejection by families and religious groups. BMSM revealed that internalized homophobia and HIV stigma resulted in perceived lack of self- and community efficacy in accepting and adhering to preexposure prophylaxis. Our results indicate that addressing internalized homophobia and fostering emotional social support in peer networks are key elements to improve the effectiveness of combination prevention among BMSM.

Satisfaction With Life, Coping, and Spirituality Among Urban Families

BACKGROUND

Urban families face many challenges that affect life satisfaction, including low income, limited access to resources, and unstable neighborhoods.

PURPOSE

To investigate life satisfaction and identify potential mediators: neighborhood stability, emotional coping strategies, religion, and spirituality.

METHODS

A convenience sample of families presenting to an urban primary care clinic for routine care filled out an anonymous, voluntary survey that included demographic data, the Satisfaction with Life Scale (SWLS), the Spiritual Inventory and Beliefs Scale, and an emotional coping inventory.

RESULTS

127 individuals filled out the survey. Life satisfaction was high (21.3 ± 9). Families in the lowest quartile of the SWLS were 4.5 times as likely to have a child with a chronic medical illness. SWLS correlated with strategy planning (r = 0.24, P < .01), external practices of religion (r = 0.23, P < .01), and humility (r = 0.18, P < .05).

CONCLUSIONS

Encouraging patients' involvement in religion and certain coping strategies, especially among those families coping with children with special health care needs, may improve life satisfaction.

'Read me to resilience': Exploring the use of cultural stories to boost the positive adjustment of children orphaned by AIDS

The study explored whether and how culturally sensitive stories can encourage resilience in young children orphaned by AIDS. The purpose of the investigation was allied to the paradigm of positive psychology, which focuses on the promotion of potential strengths to buffer children against adversity, as well as on social ecological understandings of resilience, which emphasise that social ecologies have a duty to facilitate children's positive adjustment to adversity. A pre-post-intervention evaluation was used to gather qualitative data on orphaned children's resilience to AIDS-related adversity by employing participatory visual methods. The intervention, called Read-me-to-Resilience (Rm2R), consisted of telling 22 culturally sensitive stories to the children. We compared the pre- and post-intervention data for each participant before thematically analysing the total findings. Our analysis indicates that the children's resilience had been bolstered in the period between the pre-test and post-test. We conclude that culturally relevant stories could be used by South African caregivers, service providers, and educators as an accessible, inexpensive and ready-made tool to directly empower children who have been orphaned by AIDS.

Healing pathways: longitudinal effects of religious coping and social support on PTSD symptoms in African American sexual assault survivors

African American women are at a slightly increased risk for sexual assault (A. Abbey, A. Jacques-Tiaura, & M. Parkhill, 2010). However, because of stigma, experiences of racism, and historical oppression, African American women are less likely to seek help from formal agencies compared to White women (Lewis et al., 2005; S. E. Ullman & H. H. Filipas, 2001) and/or women of other ethnic backgrounds (C. Ahrens, S. Abeling, S. Ahmad, & J. Himman, 2010). Therefore, the provision of culturally appropriate services, such as the inclusion of religion and spiritual coping, may be necessary when working with African American women survivors of sexual assault. Controlling for age and education, the current study explores the impact of religious coping and social support over 1 year for 252 African American adult female sexual assault survivors recruited from the Chicago metropolitan area. Results from hierarchical linear regression analyses reveal that high endorsement of religious coping and social support at Time 1 does not predict a reduction in posttraumatic stress disorder (PTSD) symptoms at Time 2. However, high social support at Time 2 does predict lower PTSD at Time 2. Also, it is significant to note that survivors with high PTSD at Time 1 and Time 2 endorse greater use of social support and religious coping. Clinical and research implications are explored.

Perceived discrimination among African American adolescents and allostatic load: a longitudinal analysis with buffering effects

This study was designed to examine the prospective relations of perceived racial discrimination with allostatic load (AL), along with a possible buffer of the association. A sample of 331 African Americans in the rural South provided assessments of perceived discrimination from ages 16 to 18 years. When youth were 18 years, caregivers reported parental emotional support and youth assessed peer emotional support. AL and potential confounder variables were assessed when youth were 20. Latent growth mixture modeling identified two perceived discrimination classes: high and stable, and low and increasing. Adolescents in the high and stable class evinced heightened AL even with confounder variables controlled. The racial discrimination to AL link was not significant for young adults who received high emotional support.

Causes, coping, and culture: a comparative survey study on representation of back pain in three Swiss language regions

Introduction

This study intends to contribute to a research tradition that asks how causal attributions of illnesses affect coping behavior. Causal attributions are understood as the most important element of illness representations and coping as a means to preserve quality of life. The issue is applied to a condition so far often neglected in research on illness representations–back pain–and a third concept is added to the picture: culture.

Aim

The aim of this study is (a) to explore the causal factors to which persons with back pain attribute the further course of their illness, (b) to find out whether the attributed causes are predictors of coping maxims, and (c) to find out whether cultural factors affect attributions and coping and moderate the relationship between the two.

Methods

A total of 1259 gainfully employed or self-employed persons with recent episodes of back pain were recruited in the three language regions of Switzerland. They were asked to complete a structured online interview, measuring among many other variables attributed causes, coping maxims, and affiliation to one of the Swiss micro-cultures (German-, French- or Italian-speaking).

Results

Attributed causes of the illness that can be influenced by a patient go along with more active coping styles. Cultural affiliation impacts on coping maxims independently, but culture moderates the relationship of attributed causes and coping maxims only in two of twenty possible cases.

Implications

The results show that cultural differences can be analytically incorporated in the models of illness representations. Results may help to improve healthcare providers’ communication with patients and plan public health campaigns. The approach to micro-cultural differences and the substantive relationships between alterability of causes and activity in coping may help the further development of models of illness representations.

Correlates of Emotional Support and Negative Interaction Among African Americans and Caribbean Blacks

This study explores the relationship of family and demographic factors to the frequency of receiving emotional support and the frequency of engaging in negative interactions with family members (i.e., criticism, burden, and being taken advantage of). The study uses the ambivalence framework and data from the National Survey of American Life, a national sample of African Americans and Caribbean Blacks (Caribbean Blacks). Overall, no significant differences were found between African Americans and Caribbean Blacks in the frequency of emotional support or negative interaction; several significant correlates (e.g., age, family closeness) were found for both groups. However, a number of unique associations were also demonstrated (e.g., marital status, frequency of family contact), indicating differences in the ways that these variables operate within the two populations. These and other findings are discussed in relation to the ambivalence framework and subgroup differences in family phenomena within the Black population.

Positive adjustment to poverty: How family communities encourage resilience in traditional African contexts

In the main, resilience literature explains positive adjustment to adversity in ways that are biased towards western culture. Although studies of resilience among African Americans have reported the importance of kinship, a typically Africentric concept, no studies have explored how family communities promote youths’ positive adjustment, particularly in contexts of poverty. Family communities are a feature of traditional African culture and comprise extended family members, both alive and deceased. We draw on 14 case studies to illustrate how positive adjustment to poverty was facilitated by appreciative attachment to this community. Each case comprised a resilient black South African student who had adjusted well to the complex challenges associated with poverty. An inductive comparison of their resilience processes, as recounted by each participant in narrative and visual form, demonstrated how their positive adjustment was supported by resilience-supporting transactions within their family community. Specifically, expectation-dominated and example-focused transactions, arising from the family community’s accentuation of mutuality, supported resilience. As such, we conclude that black youth resilience follows communal pathways as emphasised by Africentric culture, in general, and kinship systems, in particular, but urge continued critical investigation of the influence of family communities on youths’ resilience.

A 12-Year Content Analysis of the Journal of Black Psychology (2000-2011)

A content analysis was conducted of research published in the Journal of Black Psychology ( JBP) during a 12-year period (2000-2011). A total of 276 articles were classified into 17 content categories. Similar to the previous JBP content analysis, the most frequently published authors and institutions were identified and ranked. The most highly cited articles were also identified. In addition, gender-focused articles and articles involving racial/ethnic group comparisons were identified. The most popular areas of research and publication in the JBP were in mental health and well-being, personality and identity (i.e., racial identity), culture, and physiological functioning and health psychology. These four categories accounted for 57% of the articles published. Results of this content analysis indicate a sharp increase in research on mental health and culture, while other areas remained consistent with the previous JBP content analysis. The dearth of African-centered psychological research was also noted. Implications for the field of Black psychology in the areas of African-centered research, defining Black psychology, and conducting race comparative research are discussed.

Black students’ recollections of pathways to resilience: Lessons for school psychologists

Drawing on narrative data from a multiple case study, I recount the life stories of two resilient Black South African university students to theorize about the processes that encouraged these students, familiar with penury and parental illiteracy, to resile. I aimed to uncover lessons for school psychologists about resilience, and their role in its promotion, from these students’ recollections. To this end, I first synthesize what the resilience literature reports as generic processes of resilience. Thereafter, I illustrate how these processes were common to the students’ stories of resilience, drawing attention to how Africentricism shaped these processes. The understanding of resilience that flows from this case study illustrates the more recent contentions that resilience theory needs to account for the influence of culture on positive adjustment and translate this into culturally sensitive interventions towards resilience. The broad implications for school psychologists include recognition that resilience processes are nuanced by the socio-cultural ecology in which youths are situated and awareness that resilience processes require multiple ecosystemic partners. For school psychologists working with students of African descent, the importance of understanding how resilience processes are informed by an Africentric world view is foregrounded, along with attentiveness to the caveats implicit in this lesson.