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Turnamian MR, Liu RT. Gender identity and expression in relation to depression and anxiety in racial and ethnic minority youth: Evaluations of intersectionality in a population-based study. J Affect Disord 2023; 339:219-226. [PMID: 37437727 PMCID: PMC10529835 DOI: 10.1016/j.jad.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/06/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Transgender and gender non-conforming (TGNC) youth experience higher rates of depression and anxiety. Risk for these outcomes in racial and ethnic minority populations remains unclear. This study aimed to examine disparities in depression and anxiety at the intersection of race and ethnicity and TGNC status in a population-based sample. METHODS Data were from the 2019 Minnesota Student Survey. Students (n = 119,648) completed questions about their race, ethnicity, gender identity and expression, depression, and anxiety. RESULTS Within racial and ethnic groups, TGNC youth generally had greater risk for depression and anxiety. Significant associations for gender minority identity ranged from ORDepression = 2.25 for Black youth who do not identify as male to ORDepression = 5.08 for non-minority ethnicity youth who do not identify as female. For perceived gender expression in cisgender youth, significant associations ranged from ORDepression = 1.17 for Black youth assigned female at birth and ORAnxiety = 1.17 for other-minority ethnicity youth assigned female at birth to ORDepression = 1.46 for non-minority ethnicity youth assigned female at birth and ORAnxiety = 1.46 for American Indian/Alaskan Native youth assigned male at birth. Within-TGNC-youth comparisons yielded a few racial/ethnic differences relative to White peers. Significant differences ranged from ORAnxiety = 0.53 to ORAnxiety = 1.41 for cisgender females. LIMITATIONS The cross-sectional data limits our ability to test causation. CONCLUSIONS Multiple-minority youth were not universally at increased risk for depression and anxiety, indicating an intersectional framework is important for understanding risk for these outcomes in TGNC youth. Future research identifying potential risk and protective factors is needed to advance screening and treatment strategies for multiple-minority TGNC youth populations.
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Affiliation(s)
- Margarid R Turnamian
- Department of Psychiatry, Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America; Depression Clinical and Research Program, Massachusetts General Hospital, United States of America.
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, United States of America; Depression Clinical and Research Program, Massachusetts General Hospital, United States of America
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Nutor C, Dunlop A, Sadler O, Brennan PA. Prenatal Cannabis Use and Offspring Autism-Related Behaviors: Examining Maternal Stress as a Moderator in a Black American Cohort. J Autism Dev Disord 2023:10.1007/s10803-023-05982-z. [PMID: 37097527 PMCID: PMC10127191 DOI: 10.1007/s10803-023-05982-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
Prenatal cannabis use and maternal stress have been proposed as risk factors for autism spectrum disorder (ASD). Black mothers and mothers of lower socioeconomic status (SES) may be especially likely to experience high levels of stress. This study examined the impact of prenatal cannabis use and maternal stress (i.e., prenatal distress, racial discrimination, and lower SES) on child ASD-related behaviors in a sample of 172 Black mother-child pairs. We found that prenatal stress was significantly associated with ASD-related behaviors. Prenatal cannabis use did not predict ASD-related behaviors and did not interact with maternal stress to predict ASD-related behaviors. These findings replicate previous work on prenatal stress-ASD associations and add to the limited literature on prenatal cannabis-ASD associations in Black samples.
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Affiliation(s)
- C Nutor
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA.
| | - A Dunlop
- Department of Gynecology and Obstetrics, Emory University, 1365 E Clifton Rd NE, Atlanta, GA, 30322, USA
| | - O Sadler
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - P A Brennan
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
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Wang C, Malaktaris A, McLean CL, Kelsven S, Chu GM, Ross KS, Endsley M, Minassian A, Liu L, Hong S, Lang AJ. Mitigating the health effects of systemic racism: Evaluation of the Race-Based Stress and Trauma Empowerment intervention. Contemp Clin Trials 2023; 127:107118. [PMID: 36796623 PMCID: PMC10389054 DOI: 10.1016/j.cct.2023.107118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Disparities in physical and mental health among Black, Indigenous, and People of Color (BIPOC) are well-documented and mirrored in the Veteran population. Chronic stress due to racism and discrimination is one possible mechanism driving these negative health outcomes. The Race-Based Stress and Trauma Empowerment (RBSTE) group is a novel, manualized, health promotion intervention designed to address the direct and indirect impacts of racism among Veterans of Color. This paper describes the protocol of the first pilot randomized controlled trial (RCT) of RBSTE. This study will examine the feasibility, acceptability, and appropriateness of RBSTE compared to an active control (an adaptation of Present-Centered Therapy; PCT) in a Veterans Affairs (VA) healthcare setting. A secondary aim is to identify and optimize strategies for holistic evaluation. METHODS Veterans of Color (N = 48) endorsing perceived discrimination and stress will be randomized to RBSTE or PCT; both groups will be delivered in 8 weekly, 90-min virtual group sessions. Outcomes will include measures of psychological distress, discrimination and ethnoracial identity, holistic wellness, and allostatic load. Measures will be administered at baseline and post-intervention. CONCLUSION This study will inform future interventions targeting identity-based stressors and represents an important step in advancing equity for BIPOC in medicine and research. CLINICAL TRIAL REGISTRATION NUMBER NCT05422638.
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Affiliation(s)
- Clarice Wang
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Anne Malaktaris
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Caitlin L McLean
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Skylar Kelsven
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Gage M Chu
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Keisha S Ross
- VA St. Louis Health Care System, 915 N. Grand Blvd, St. Louis, MO 63106, USA.
| | - Maurice Endsley
- VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA.
| | - Arpi Minassian
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
| | - Lin Liu
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Suzi Hong
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Ariel J Lang
- University of California San Diego, Department of Psychiatry, 9500 Gilman Dr., La Jolla, CA 92093, USA; VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
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Anandavalli S, Borders LD, Kniffin LE. "Because Here, White is Right": Mental Health Experiences of International Graduate Students of Color from a Critical Race Perspective. Int J Adv Couns 2021; 43:283-301. [PMID: 34054168 PMCID: PMC8142606 DOI: 10.1007/s10447-021-09437-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 11/30/2022]
Abstract
To examine the mental health experiences of international graduate students of Color (IGSC) as they navigate through a multitude of systemic barriers, the researchers interviewed eight IGSC in the U.S. Adopting a critical race perspective, the researchers sought to address a persistent gap in the counseling literature, and explore how systemic influences of racism, xenophobia, and discriminatory policies impacted the mental health of IGSC. Three distinct themes emerged from phenomenological analysis of the participants’ interviews in the current study: cross-cultural challenges, surviving racism and anti-immigrant sentiment, and mental health and wellness. Implications for how professional counselors can support IGSC as they navigate through multiple challenges are emphasized.
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Affiliation(s)
- S Anandavalli
- Present Address: Clinical Mental Health Counseling, Southern Oregon University, 1250 Siskiyou Blvd, Ashland, OR 97520 USA.,Counseling and Educational Development, The University of North Carolina at Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412 USA
| | - L DiAnne Borders
- Counseling and Educational Development, The University of North Carolina at Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412 USA
| | - Lori E Kniffin
- Present Address: Leadership Studies Fort, Hays State University, Hays, KS USA.,Department of Educational Leadership and Cultural Foundations, The University of North Carolina at Greensboro, 1400 Spring Garden Street, NC 27412 Greensboro, USA
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Starks SM, Hankerson SH, Collins PY. Shifting the Policy Paradigm to Achieve Equity. Psychiatr Clin North Am 2020; 43:439-450. [PMID: 32773073 DOI: 10.1016/j.psc.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article offers a brief history of mental health policies that have shaped current inequities in health care financing and service delivery. Mental health has a unique position within the health care system given the pervasive nature of stigma associated with illness; race and ethnicity often amplify this burden. The acknowledgment of disparities in mental health and the development of policies that address the needs of minority groups are relatively recent phenomena. Highlighted are legislative actions that have influenced reforms of the health care landscape. This text outlines opportunities to advance a targeted, community-based approach to mental health policy development.
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Affiliation(s)
- Steven M Starks
- Department of Clinical Sciences, University of Houston College of Medicine, Health 2 Building, 4849 Calhoun Road, Room 6014, Houston, TX 77201-6064, USA.
| | - Sidney H Hankerson
- Columbia University, Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Pamela Y Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington Schools of Medicine and Public Health, 1959 Northeast Pacific Street, Box 356560, Seattle, WA 98195-6560, USA; Department of Global Health, University of Washington Schools of Medicine and Public Health, 1959 Northeast Pacific Street, Box 356560, Seattle, WA 98195-6560, USA
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Abstract
Postpartum depression (PPD) has been described as the most common complication experienced postpartum, affecting about 10-15 % of all new mothers. Factors like a history of mental illness, and experienced recent adverse life events has been associated with an increased risk for developing PPD. Immigrant women in Western countries have been found to have a marked higher prevalence of PPD compared to the general population. In Norway the prevalence of PPD in the general population has been found to be around 8-10 %, and among Pakistani immigrants a rate of 7.6 % was found. Somali people in Norway are the second largest immigrant group in Norway with a non-Western background. No study on PPD and associated factors among Somali women has been found in the literature. The aim of the study was to assess PPD and associated factors among Somali women in greater Oslo region, Norway. A cross-sectional survey was conducted; recruiting new mothers through all maternity wards in the Oslo region. Data was collected with interview-administrated questionnaires. PPD was assessed using Edinburgh Postnatal Depression Scale (EPDS), defining those scoring ≥10 to have a possible PPD. Of the 80 eligible women identified, 39 (49 %) consented to participate, and completed the study. Of the 39 respondents 3 (7.7 %) were assessed to have a possible PPD. Most important associated factors found were history of mental illness, having experienced technical assistance during delivery, self-rated health and experienced economical problems last 12 months. A low prevalence of PPD was found, and both the prevalence and its associated factors should be interpreted with caution. The associated factors do not have enough power to give any strength to the associations. However, some of the results can be used in develop new hypotheses with regard to PPD among Somali women as immigrants in a Western society.
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Benítez CIP, Sibrava NJ, Wood LK, Bjornsson AS, Zlotnick C, Weisberg R, Keller MB. Posttraumatic stress disorder in African Americans: a two year follow-up study. Psychiatry Res 2014; 220:376-83. [PMID: 25086766 PMCID: PMC4351655 DOI: 10.1016/j.psychres.2014.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 07/08/2014] [Accepted: 07/11/2014] [Indexed: 11/27/2022]
Abstract
The present study was a prospective, naturalistic, longitudinal investigation of the two year course of posttraumatic stress disorder (PTSD) in a sample of African Americans with anxiety disorders. The study objectives were to examine the two year course of PTSD and to evaluate differences between African Americans with PTSD and anxiety disorders and African Americans with anxiety disorders but no PTSD with regard to comorbidity, psychosocial impairment, physical and emotional functioning, and treatment participation. The participants were 67 African Americans with PTSD and 98 African Americans without PTSD (mean age 41.5 years, 67.3% female). Individuals with PTSD were more likely to have higher comorbidity, lower functioning, and they were less likely to seek treatment than those with other anxiety disorders but no PTSD. The rate of recovery from PTSD over two years was 0.10 and recovery from comorbid Major Depressive Disorder was 0.55. PTSD appears to be persistent over time in this population. The rates of recovery were lower than what has been reported in previous longitudinal studies with predominantly non-Latino Whites. It is imperative to examine barriers to treatment and factors related to treatment engagement for this population.
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Affiliation(s)
- Carlos I. Pérez Benítez
- Department of Educational and Psychological Studies, University of Miami, Coral Gables, Fl, USA,Correspondence concerning this article should be addressed to Carlos I. Pérez Benítez, Department of Educational and Psychological Studies, University of Miami, 1507 Levante Avenue, 318-B Max Orovitz Bldg., Coral Gables, FL, 33146, USA. Telephone: 305.284.1146, Fax: 305.284.3003,
| | - Nicholas J. Sibrava
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Laura Kohn Wood
- Department of Educational and Psychological Studies, University of Miami, Coral Gables, Fl, USA
| | | | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Risa Weisberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Martin B. Keller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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