Cultural specificity of support sources, correlates and contexts: three studies of African-American and caucasian youth

Racial/ethnic differences in the beneficial effect of social support on sleep duration

STUDY OBJECTIVES

Social support (SS) is associated with better health outcomes, including sleep health. However, the specific sources of SS that benefit sleep are unclear, and whether these associations vary by race/ethnicity or age is unknown. The aim of this study was to examine cross-sectional associations between sources of SS (number of friends, financial, church attendance, and emotional support) and self-reported short sleep duration (< 7 hours) overall and by race/ethnic groups and age among a representative sample.

METHODS

Using National Health and Nutrition Examination Survey (NHANES) data, logistic regression (marginal standardization) and linear regression models were fit accounting for survey design and weights to test associations between sources of SS (number of friends, financial, church attendance, emotional support) and self-reported short sleep duration (< 7 hours) overall and by race/ethnic groups (Black, Hispanic, and White) and age (< 65 vs ≥ 65 years).

RESULTS

Among 3,711 participants, the mean (standard error) age was 57 (0.3) years and 37% slept < 7 hours. Black adults had the highest prevalence of short sleep (55%). Overall, participants with financial support compared with those without financial support had a lower prevalence of short sleep: 23% (confidence interval [CI]: 0.68, 0.87). As the number of SS sources increased, the prevalence of short sleep duration decreased and the racial disparity in sleep duration narrowed. Associations between financial support and sleep were most pronounced among Hispanic and White adults and adults < 65 years.

CONCLUSIONS

In general, financial support was associated with a healthier sleep duration, particularly among those < 65 years of age. Individuals with numerous sources of SS were less likely to be short sleepers. The benefits of SS on sleep duration varied by race. Targeting specific sources of SS may help to improve sleep duration among those most at risk.

CITATION

Johnson DA, Prakash-Asrani R, Lewis BD, Bliwise DL, Lewis TT. Racial/ethnic differences in the beneficial effect of social support on sleep duration. J Clin Sleep Med. 2023;19(7):1231-1238.

Exploring the Role of Social Support in Promoting Community Integration: An Integrated Literature Review

Community integration has emerged as a priority area among mental health advocates, policy makers, and researchers (Townley, Miller, & Kloos, 2013; Ware, Hopper, Tugenberg, Dickey, & Fisher, 2007). Past research suggests that social support influences community integration for individuals with serious mental illnesses (Davidson, Haglund, Stayner, Rakfeldt, Chinman, & Tebes, 2001; Davidson, Stayner, Nickou, Styron, Rowe, & Chinman, 2001; Wong & Solomon, 2002), but there has not yet been a systematic review on this topic. Therefore, the purpose of this paper was to explore the influence of social support on community integration through a review of the existing literature. An extensive literature search was conducted, resulting in 32 articles that met the search criteria. These articles were organized into three categories: defining community integration, supportive relationships, and mental health services. The search results are analyzed according to the types of support being provided. Article strengths, limitations, implications, and future directions are also addressed. Overall, the findings of this review suggest that social support, which may be provided by a variety of individuals and services, plays an important role in promoting community integration for individuals with serious mental illnesses. Therefore, as community mental health research and practice continues to promote community integration for individuals with serious mental illnesses, the mental health field should emphasize the importance of social support as a key factor influencing community integration.

Illicit Stimulant Use Development in Adolescence and Early Adulthood Among Juvenile Offenders: Risk Factors Predicting Heterogeneity

The objectives of this article are to identify groups of trajectories of stimulant use across adolescence and early adulthood among juvenile offenders and to identify risk factors predicting development. Group-based trajectory modeling was used to identify developmental subgroups of stimulant users during the study period. Multinomial logistic regression was used to examine baseline covariates’ relevance for predicting assignment to identified trajectory groups. A six-group model of stimulant use was found to best fit the data. Race, history of direct victimization at baseline, gender, low school commitment at baseline, low religiosity at baseline, and other substance use at baseline were all identified as predictors of trajectory group assignment. Juvenile offenders, particularly White and female offenders, are at elevated risk of illicit stimulant use during adolescence and early adulthood. Despite this, the vast majority of juvenile offenders in the sample had desisted by age 23, differing from research on other substances using this same sample.

Religion and desistance from substance use among adolescent offenders: The role of cognitive functioning

BACKGROUND

Religious beliefs and practices have been shown to have some association with desistance from offending, as have cognitive processes, including emotion regulation, self-control, reasoning, learning, and empathy. Religious behaviours may, however, be moderated or mediated by cognitive abilities, but few studies take this into account.

AIM

The aim of this study was to assess the role of cognitive ability in any relationship between religious beliefs and behaviours and desistance from substance use among adolescents.

METHOD

Data were extracted from the Pathways to Desistance Study dataset (n = 1,354). Religious measures were self-rated importance of religion, helpfulness of religion in dealing with problems, and attendance at religious services. Cognitive measures were the Wechsler Abbreviated Scale of Intelligence and Trail Making Tests. A count of numbers of mind-altering substances used constituted the main substance measure. Control variables included sex, age, and age of onset of offending.

RESULTS

Mixed-effects longitudinal analyses revealed that religious behaviours did constitute a significant predictor of lower substance use for young people after a criminal conviction, after controlling for changes in employment, social support, and delinquent peer association, but only among those with average or above cognitive function.

CONCLUSIONS

These findings may explain why there have been some discrepancies in previous studies of religion and substance misuse. They may also have important implications for the training of anyone delivering programmes to young people in prison that have faith-based elements, including community faith group leaders and volunteers.

Racial/ethnic differences moderate associations of coping strategies and posttraumatic stress disorder symptom clusters among women experiencing partner violence: a multigroup path analysis

BACKGROUND

Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal).

METHODS

Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters.

RESULTS

The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans.

CONCLUSION

Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally informed PTSD treatments.

Social Support

Life transitions, such as university attendance, entail the reconstruction of relations between the individual and the environment. This study aimed to explore how perceptions of social support changed across time during the first semester of university, and how social support, coping strategies, and adjustment were interrelated among 390 first-year students in Beijing, China. Results indicated that overall levels of social support among students did not change significantly across the first term, but that support from different sources (parents, peers, teachers, siblings) showed distinctive patterns of change. Support was positively related to adjustment and to coping skills in a dynamic way, and an integrative structural equations model showed that the role of social support operated both directly in relation to adjustment and indirectly through its relations to coping styles. These findings were related both to previous research on the transition to university in the West and to unique factors within the Chinese context.

The Contribution of Africentric Values and Racial Identity to the Prediction of Drug Knowledge, Attitudes, and Use among African American Youth

This study investigated the relative contribution of cultural variables, in particular Africentric values and racial identity, to the prediction of drug use, drug knowledge, and drug attitudes in conjunction with individual, peer, and family domain variables. Data collected from 195 African American youth were used in this study. The results indicate that Africentric values were a significant, yet modest predictor of drug knowledge accounting for approximately 4% of the variance. Similarly, racial identity was a significant predictor of drug use and of drug attitudes accounting for approximately 2% and 8% of the variance, respectively. Also, gender, an individual domain variable, was a significant predictor of drug use, attitudes, and knowledge. Males reported more drug use, had attitudes more tolerant of drugs, and had less drug knowledge than females.

The Role of Ethnic Identification and Perceived Social Support in Latinos' Adjustment to College

This study examines the role of perceived social support and ethnic identification in Latinos'adjustment to college. Included were five sources of perceived support (family, general peer, Latino peer, faculty, and institutional) and five types of college adjustment (overall, social, emotional, academic, and attachment). The authors' perceived support model accounted for as much as 51% of the variance in attachment, with different types of support contributing uniquely to different types of adjustment. Perceived support mediated the relationship between ethnic identification and adjustment. Highly identified Latinos were less adjusted to college, in part because they perceived lower support than less identified Latinos. Important differences emerged between Latino peer support and general peer support for Latinos' college adjustment. Both individual differences and situational factors are emphasized. The implications of these findings for understanding Latinos' adjustment to college are discussed.

The Influence of Cultural Background on Students' Feelings about and Use of Social Support

This exploratory study addresses the little researched topic of cross-cultural differences in college students' use of social support. Israeli and Chinese students rated the importance and availability of various support functions and noted whom they turn to when faced with different problems. Findings show that while both Israelis and Chinese students view the various functions of social support as important, they utilize support differently. They almost never turn to a counsellor. Implications for student counselling are discussed.

Race, Coping Style, and Substance Use Disorder Among Non-Hispanic African American and White Young Adults in South Florida

BACKGROUND

Despite their higher rates of stress, African American young adults tend toward similar or lower rates of substance misuse than their White counterparts. Arguably, such patterns derive from: (1) racial variations in the availability of coping strategies that mitigate stress; and/or (2) racial differences in the efficacy of available coping styles for reducing substance misuse.

OBJECTIVES

We assessed whether two coping style types-problem-focused and avoidance-oriented-varied by race (non-Hispanic African American vs. non-Hispanic White) and whether the effects of coping styles on substance misuse were moderated by race.

METHODS

Using data from a community sample of South Florida young adults, we employed logistic regression analyses to examine racial differences in coping style and to test if race by coping style interactions (race × problem-focused coping and race × avoidance-oriented coping) influenced the odds of qualifying for a DSM-IV substance use disorder, net of lifetime stressful events and sociodemographic controls.

RESULTS

We found that African American young adults displayed lower problem-focused coping, and higher avoidance-oriented coping, than did White young adults. Among both African American and White respondents, problem-focused coping was associated with reduced odds of illicit drug use disorder (excluding marijuana), and among Whites, avoidance-oriented coping was associated with increased odds of an aggregate measure of alcohol, marijuana, and other illicit drug use disorders. Among African Americans, however, avoidance-oriented coping was associated with lower odds of marijuana use disorder.

CONCLUSION

Substance misuse policies and practices that consider the sociocultural contexts of stress and coping are recommended.

The role of gender and race in the relation between adolescent distress tolerance and externalizing and internalizing psychopathology

Distress tolerance (DT) is an established construct contributing to the onset and maintenance of psychopathology in adulthood; however, few studies have examined the role of DT in older adolescent psychopathology. Emerging data suggest that gender and race may influence this relation. Therefore, the current study examined the relation between gender, race, and DT on parent-reported internalizing and externalizing DSM-oriented symptoms among a community sample of 128, 14-18 year old adolescents. Results indicated a moderating effect of gender on affective problems, such that females with low DT, but not males, displayed significantly greater affective problems. Findings also indicated a significant moderating effect of race, such that Caucasians with low DT, but not African Americans, displayed significantly higher somatic, oppositional defiant, and conduct problems. These findings suggest that DT is an important clinical variable in older adolescence, particularly among Caucasians and females.

Race, sex, and total knee replacement consideration: role of social support

OBJECTIVE

To determine whether there are racial differences in social support among patients with knee osteoarthritis (OA) and whether the impact of social support on patient preferences for total knee replacement (TKR) varies by race and sex.

METHODS

A total of 514 white and 285 African American patients with knee OA were surveyed. Logistic regression models were performed to determine if the relationship between willingness to undergo TKR and the interaction of patient race and sex was mediated by social support.

RESULTS

Compared to whites with knee OA, African American patients were less likely to be married (P < 0.001), reported less close friends/relatives (P < 0.001), and had lower Medical Outcomes Study Social Support Scale (MOS-SSS) scores (P < 0.001). African American patients were also less willing to undergo TKR (62% versus 80%; P < 0.001) than whites. The odds of willingness to undergo TKR were less in white females compared to white males when adjusted for recruitment site, age, income, and the Western Ontario and McMaster Universities Osteoarthritis Index score (odds ratio [OR] 0.57, 95% confidence interval [95% CI] 0.34-0.96). This difference was no longer significant when further adjusted for marital status, number of close friends/relatives, and MOS-SSS score, but the effect size remained unchanged (OR 0.60, 95% CI 0.35-1.02). The odds of willingness to undergo TKR remained much less in African American females (OR 0.35, 95% CI 0.19-0.64) and African American males (OR 0.28, 95% CI 0.14-0.54) compared to white males when controlled for sociodemographic, clinical, and social support measures.

CONCLUSION

African American patients reported less structural and functional social support than whites. Social support is an important determinant of preference for TKR surgery only among whites.

Cardiorespiratory fitness and cardiovascular risk in patients with ankylosing spondylitis: a cross-sectional comparative study

OBJECTIVE

To investigate the associations between cardiorespiratory fitness (CRF) and the level of cardiovascular (CV) risk factors in patients with ankylosing spondylitis (AS) and controls.

METHODS

In a cross-sectional comparative study, CRF was measured with a maximal treadmill test for estimation of peak oxygen uptake. Metabolic syndrome (MS), body composition, traditional CV risk factors, and inflammatory markers were assessed. Multivariable linear regression models were used to study the associations between CRF and CV risk factors. All models were adjusted for age, sex, and smoking, and for inflammation when C-reactive protein (CRP) level or erythrocyte sedimentation rate (ESR) were not already included as dependent variables.

RESULTS

A total of 126 patients (mean ± SD age 47.9 ± 10.8 years) and 111 controls (mean ± SD age 52.1 ± 11.1 years) were included. There were significant inverse associations between CRF and body mass index, waist circumference, triglycerides, CRP level, and ESR (P < 0.001-0.03) for patients and controls. Also, significant associations were found between CRF and high-density lipoprotein (HDL) cholesterol (β = 0.03, P < 0.001) and blood pressure (BP; β = -0.9 for systolic and β = -0.6 for diastolic; P < 0.01) in controls, but these associations were not found in patients (β = 0, P = 0.69 for HDL cholesterol; β = -0.04, P = 0.87 for systolic pressure; and β = -0.14, P = 0.34 for diastolic pressure) (additional adjustments for medication). Higher CRF was associated with a lower risk for MS in both patients (odds ratio [OR] 0.91, P = 0.03) and controls (OR 0.89, P = 0.01).

CONCLUSION

CRF was associated with favorable levels of CV risk factors and lower risk of MS in both AS patients and controls. However, established findings of an association between CRF and BP and HDL cholesterol in healthy adults were not confirmed in AS patients.

Multi-level factors associated with pregnancy among urban adolescent women seeking psychological services

The purpose of this study was to examine the prevalence of pregnancy as well as multi-level factors (i.e., individual, family, and environment) associated with history of pregnancy among a sample of urban adolescent women seeking psychological services. Data were collected from a total of 264 sexually active, 13-18-year-old, adolescent women who participated in a larger HIV prevention study. Adolescents and one participating parent completed an audio computer-assisted self-interviewing survey. A total of 17.4% of participants reported a history of pregnancy. A multivariable logistic regression model suggests that after controlling for empirically derived sociodemographic and behavioral covariates, absence of father in the home, family support and cohesion, and neighborhood risk were positively related to pregnancy. This study is among the first to examine multi-level factors associated with pregnancy among adolescent women diagnosed with psychological disorders. Consideration of such factors is crucial both in terms of clinical practice and in the design of pregnancy prevention programs. Collaboration between physicians and mental health providers working with adolescent women is crucial and represents an ideal opportunity to promote parental involvement and access to supportive community resources, including pregnancy prevention programs for this vulnerable population of adolescents.

Social Support and Happiness in Immigrant Women in Spain

The association between perceived social support and happiness was investigated in women who are members of various associations in Malaga (Spain) that work with immigrant women. Based on the Social Convoy model, the association between sources of support, frequency of support, satisfaction with support, and happiness reported by women were examined. The main social support predictor of happiness was satisfaction with the support received. Thus, the best predictors of happiness were emotional support from the family and instrumental support from the indigenous population and associations. The best predictor of frequency of support was the frequency of informational support received from social services. These results may prove useful for developing lines of action or interventions centred on the social network and the functions that social support can fulfil among immigrant women.

Stress, coping, and depression: testing a new hypothesis in a prospectively studied general population sample of U.S.-born Whites and Blacks

The scarcity of empirically supported explanations for the Black/White prevalence difference in depression in the U.S. is a conspicuous gap in the literature. Recent evidence suggests that the paradoxical observation of decreased risk of depression but elevated rates of physical illness among Blacks in the U.S. compared with Whites may be accounted for by the use of coping behaviors (e.g., alcohol and nicotine consumption, overeating) among Blacks exposed to high stress levels. Such coping behaviors may mitigate deleterious effects of stressful exposures on mental health while increasing the risk of physical ailments. The racial patterning in mental and physical health outcomes could therefore be explained by this mechanism if a) these behaviors were more prevalent among Blacks than Whites and/or b) the effect of these behavioral responses to stress was differential by race. The present study challenges this hypothesis using longitudinal, nationally-representative data with comprehensive DSM-IV diagnoses. Data are drawn from 34,653 individuals sampled in Waves 1 (2001-2002) and 2 (2004-2005) as part of the US National Epidemiologic Survey on Alcohol and Related Conditions. Results showed that a) Blacks were less likely to engage in alcohol or nicotine consumption at low, moderate, and high levels of stress compared to Whites, and b) there was a significant three-way interaction between race, stress, and coping behavior for BMI only (F = 2.11, df = 12, p = 0.03), but, contrary to the hypothesis, elevated BMI was protective against depression in Blacks at low, not high, levels of stress. Further, engagement in unhealthy behaviors, especially at pathological levels, did not protect against depression in Blacks or in Whites. In sum, the impact of stress and coping processes on depression does not appear to operate differently in Blacks versus Whites. Further research testing innovative hypotheses that would explain the difference in Black/White depression prevalence is warranted.

Dispositional Versus Situational Coping: Are the Coping Strategies African Americans Use Different for General Versus Racism-Related Stressors?

When faced with difficulties and problems, people use a variety of cognitive and behavioral strategies to cope, and culture influences the strategies that are chosen. Unfortunately, little is known about how culture influences coping because most research is done with White samples. As coping is a key determinant of a person’s adaptation to stressful life events, it is imperative that researchers develop a nuanced understanding of African American coping that is specific enough to guide prevention and intervention efforts. Thus, the aim of this study was to (a) investigate how African Americans differ from one another in the way they cope and (b) examine whether the strategies they typically use to cope (dispositional coping) differ from those used to cope with racism (situation-specific coping). Results indicate that African Americans cope differently depending on the type of stressor—they use one set of strategies generally but rely on a different set to cope with racism. Results also revealed gender and acculturation differences in how African Americans cope.

Race/Ethnicity and hypertension: the role of social support

BACKGROUND

Social support is an important determinant of health, yet understanding of its contribution to racial disparities in hypertension is limited. Many studies have focused on the relationship between hypertension and social support, or race/ethnicity and social support, but few have examined the inter-relationship between race/ethnicity, social support, and hypertension. The objective of this study was to determine whether the relationship between race/ethnicity and hypertension varied by level of social support.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) 2001-2006 were used to calculate the odds ratios (ORs) for the association between hypertension and race/ethnicity by levels of social support. Hypertension was defined as systolic blood pressure (BP) >or=140 mm Hg and/or diastolic BP >or=90 mm Hg or having been prescribed antihypertensive medication. Social support was defined by emotional and financial support, and marital status.

RESULTS

Black/white ORs of hypertension increased as social support decreased; that is, the race difference among those without social support was larger compared to those with social support. Contrarily, Mexican American/white ethnic differences were only observed among those with social support; Mexican Americans with social support had lower odds of hypertension than their white counterparts.

CONCLUSIONS

This study observed that the relationship between race (but not ethnicity) and hypertension varies by social support level. Results suggest there may be beneficial effects of social support on hypertension among blacks, however, the possible impact of social support on ethnic differences in hypertension remains unclear.

Perceived stress and resilience in Alzheimer's disease caregivers: testing moderation and mediation models of social support

OBJECTIVE

The study examined whether social support functioned as a protective, resilience factor among Alzheimer's disease (AD) caregivers. Moderation and mediation models were used to test social support amid stress and resilience.

METHOD

A cross-sectional analysis of self-reported data was conducted. Measures of demographics, perceived stress, family support, friend support, overall social support, and resilience were administered to caregiver attendees (N=229) of two AD caregiver conferences. Hierarchical regression analysis showed the compounded impact of predictors on resilience. Odds ratios generated probability of high resilience given high stress and social supports. Social support moderation and mediation were tested via distinct series of regression equations. Path analyses illustrated effects on the models for significant moderation and/or mediation.

RESULTS

Stress negatively influenced and accounted for most variation in resilience. Social support positively influenced resilience, and caregivers with high family support had the highest probability of elevated resilience. Moderation was observed among all support factors. No social support fulfilled the complete mediation criteria.

CONCLUSION

Evidence of social support as a protective, moderating factor yields implications for health care practitioners who deliver services to assist AD caregivers, particularly the promotion of identification and utilization of supportive familial and peer relations.

Psychometric evaluation of the shortened resilience scale among Alzheimer's caregivers

The purpose of this study was to evaluate psychometric properties of the shortened Resilience Scale (15-item version RS15) among a sample of Alzheimer's caregivers. Self-reported data were collected from 229 participants at 2 Alzheimer's caregiver conferences. RS15 principal axis factoring indicated a single-dimensional solution with all items loaded. Reliability was strong. Convergent validity for the RS15 was suggested through its correlations with stress, family support, and friend support. Odds ratios showed significant likelihoods of high resilience given low stress and high social support. The results confirmed the RS15 to be a psychometrically sound measure that can be used to appraise the efficacy of adaptability among Alzheimer's caregivers.

An Exploration of the Influence of Dispositional Traits and Appraisal on Coping Strategies in African American College Students

This study explored the correlates of self-reported coping strategies from both an appraisal (e.g., severity, impact, desirability of the event, as well as perceived stress) and a dispositional (e.g., preferred/typical coping style, self-concept clarity, self-esteem, emotion regulation, problem-solving style, anxiety) perspective. Participants were 211 African American undergraduate and graduate students from diverse socioeconomic backgrounds. The results indicated that dispositional traits (especially problem-solving style) are associated uniquely with preferred/typical coping styles. The results also provided modest evidence that dispositional traits and subjects' appraisals (e.g., challenge, harm/threat, impact) are predictive of subjects' coping strategies in specific ongoing stressful situations. The general findings from this study appear to mirror research on Caucasian subjects.

Family support and mental health in pregnant women experiencing interpersonal partner violence: an analysis of ethnic differences

This study investigated the relationship between family support and mental health in a community sample of pregnant women experiencing interpersonal partner violence (IPV). This study also examined how family support may differentially affect mental health in Black and White women experiencing IPV. A total of 110 participants (32 Black and 78 White) were obtained from the first time period of a longitudinal study examining the effects of domestic violence on women. The model was supported (chi2 = 142.55; df = 72, p > .001, RMSEA = .07). Black women had better mental health than White women. However, ethnicity was not a significant predictor of family support. Implications from this study highlight the need for further research on the role of family support in the lives of physically abused women as well as the need to incorporate cross cultural perspectives when examining this issue.

Adolescents coping with mom's breast cancer: developing family intervention programs

The purpose of this pilot study was to gain a deeper understanding of how adolescents are affected by their mothers' breast cancer and to discover their opinions about how future intervention programs should be designed. Three focus groups were conducted with a total of 10 adolescents. Findings indicate that adolescents' lives had been complicated by their mothers' illness, as they often felt burdened with additional roles and responsibilities. Adolescents suggested that future intervention programs should have the following elements: Adolescent group comprised of boys and girls within 4 months of cancer diagnosis; psychoeducation; target coping skills sensitive to girls and boys of different ethnic and racial backgrounds; and after the adolescent groups, have multiple-family therapy groups that promote shared family understanding and open communication between parents and adolescents.

Racial identity, parental support, and alcohol use in a sample of academically at-risk African American high school students

This study examined racial identity and parental support as predictors of alcohol use in a sample of 488 African American adolescents. Two dimensions of racial identity were investigated: (1) racial centrality (i.e., the significance that one places on race in defining oneself) and (2) private regard (i.e., the extent to which one feels positively about Black people). In addition, perceived support from mothers and fathers was examined. Multivariate results showed that private regard and father support were associated with less self-reported alcohol use after partialling out the effects of age and gender. An interaction between the two racial identity dimensions was also found such that private regard was associated with less alcohol use for adolescents who reported that race was a more central part of their identity.

Social structural influences on emotional support from parents early in life and adult health status

The authors' purpose in this study was to identify social structural predictors of receiving emotional support from parents early in life and structural factors responsible for variations in the associations between early parental support and adult health status. Data from a US representative sample of 2,786 adults aged 25-74 years suggest that men, non-Whites, and individuals from socioeconomically advantaged families report having received higher levels of early parental support. Furthermore, these analyses suggest that although adult health status is predicted by early parental support in general, health status among adults is particularly sensitive to levels of support received from a same-sex parent during childhood. These findings emphasize the pervasive influence of gender in American society and add focus to researchers' understanding of the long-term health effects of early parental support.

Race and self-esteem: meta-analyses comparing whites, blacks, Hispanics, Asians, and American Indians and comment on Gray-Little and Hafdahl (2000)

These meta-analyses examine race differences in self-esteem among 712 datapoints. Blacks scored higher than Whites on self-esteem measures (d = 0.19), but Whites scored higher than other racial minority groups, including Hispanics (d = -0.09), Asians (d = -0.30), and American Indians (d = -0.21). Most of these differences were smallest in childhood and grew larger with age. Blacks' self-esteem increased over time relative to Whites', with the Black advantage not appearing until the 1980s. Black and Hispanic samples scored higher on measures without an academic self-esteem subscale. Relative to Whites, minority males had lower self-esteem than did minority females, and Black and Hispanic self-esteem was higher in groups with high socioeconomic status. The results are most consistent with a cultural interpretation of racial differences in self-esteem.

Social support in pregnant and parenting adolescents: research, critique, and recommendations

ISSUE AND PURPOSE: Adolescent pregnancies continue to occur at an alarming rate in the United States, resulting in adverse outcomes for both the adolescent and her baby. Since social support has been shown to improve pregnancy and parenting outcomes, a critique of research in this area is presented.

SOURCES

Published literature.

CONCLUSIONS

Multisite research studies, which are longitudinal in design, are needed, with particular attention paid to variations in the need for social support by stage of adolescence.

Social embeddedness and psychological well-being among African Americans and whites

Using data from the National Medical Expenditure Survey, a household survey of more than 18,000 respondents, this study examined racial and gender differences in social embeddedness, an indicator of community well-being and social support. The study hypothesized that higher levels of social embeddedness would be found among African Americans than among Whites and that the association between social embeddedness and psychological well-being would be stronger among African Americans than among Whites. African American men reported themselves more socially embedded overall than White men and, in one instance, their social involvement was especially important in predicting psychological well-being. African American women were more likely than White women to report attending meetings of churches and community groups, but otherwise were less socially involved than White women. There was no evidence of a difference between African American and White women in strength of the connection between social embeddedness and psychological well-being. African American social involvement is more selective than previously believed and generalizations must be qualified on the basis of gender.

Religious coping, ethnicity, and ambulatory blood pressure

OBJECTIVE

To investigate the relationship between religious coping, ethnicity, and ambulatory blood pressure (ABP) measured during daily life.

METHODS

A 24-hour ABP was obtained from 155 men and women (78 African American and 77 white) on a typical workday. ABP was averaged over awake and sleep periods, and clinic BP was also assessed. Psychosocial measures of coping style, negative affect, social support, stress, and health behaviors were completed before ABP measurement.

RESULTS

Multiple regression analyses, controlling for demographic variables, revealed a significant religious coping by ethnicity interaction for ABP (p < .01) and clinic BP (p < .05). Religious coping was not related to BP among whites. Among African Americans, however, higher levels of religious coping were associated with lower awake (p < .05) and sleep (p < .01) ABP. Social support satisfaction also was related to lower awake ABP among African Americans, but it did not mediate the relationship between religious coping and ABP.

CONCLUSIONS

The results of this study extend previous findings by showing that, among African Americans, religious coping and BP are related during daily activities as well as in the clinic. Lower 24-hour BP load may be a pathway through which religiosity and cardiovascular health are related.

Quality and ecology of adversity as common mechanisms of risk and resilience

This paper proposes common mechanisms to explain the effects of adversities and of resources that promote resilience. Adversities threaten the satisfaction of basic human needs and the acquisitions of competencies to carry out valued social roles. Adversities can also be characterized in terms of their ecological properties of occurrence in time, and place. Resilience resources at the individual, microsystem and macro levels reduce the negative effects of adversities through their effects on satisfaction of basic human needs and their effects on the occurrence of adversities. The effects of resilience resources are described as preventive, protective and promotive. Implications are presented for the development of interventions to promote resilience.

Help-seeking comfort and receiving social support: the role of ethnicity and context of need

Examined help-seeking comfort and receiving social support among Latinos, African Americans, and European Americans across two contexts: in a communitywide emergency (Hurricane Andrew) and 2 years later in a nonemergency situation. In general, help-seeking comfort was a strong predictor of received support. Notwithstanding many similarities between the groups, the effects of ethnicity differed according to the context. In emergency, all groups reported similarly high levels of help-seeking comfort and received support. In nonemergency, help-seeking comfort declined for blacks and whites but not for Latinos. Although all ethnic groups reported receiving less social support in nonemergency, the decline in received support across contexts was most dramatic for Latinos. Situational, cultural, and differential resource loss explanations are offered to account for the findings.

Racial differences in adolescent coping and self-esteem

Racial differences in coping strategies and self-esteem were examined for 361 male and female adolescents in Grades 7-12. Coping strategies were assessed with the Adolescent Coping Orientation for Problem Experiences (J. M. Patterson & H. I. McCubbin, 1986). Self-esteem was assessed by the Coopersmith Self-Esteem Inventory (S. Coopersmith, 1987). Multivariate analysis revealed racial differences in adolescent coping strategies of ventilating feelings, seeking diversions, developing self-reliance, avoiding problems, seeking spiritual support, investing in close friends, engaging in demanding activities, solving family problems, and relaxing. In particular, African American adolescents reported using diversions, self-reliance, spiritual support, close friends, demanding activities, family problems, and relaxation more frequently than Caucasian adolescents did. Implications for professionals and recommendations for future research are discussed.

Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents

The psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) were investigated in 222 urban, largely African-American adolescents (68%). High internal consistency was demonstrated, and factor analysis confirmed the three subscale structures of the MSPSS: family, friends, and significant other. Correlations with a family caring scale supported the discriminant validity of the Family subscale. These results confirm the reliability, validity, and utility of the MSPSS with an urban, largely African-American adolescent sample. Implications of the findings are discussed.

Resilience among urban African American male adolescents: a study of the protective effects of sociopolitical control on their mental health

Resilience refers to the notion that some people succeed in the face of adversity. In a risk-protective model of resilience, a protective factor interacts with a risk factor to mitigate the occurrence of a negative outcome. This study tested longitudinally the protective effects of sociopolitical control on the link between helplessness and mental health. The study included 172 urban, male, African American adolescents, who were interviewed twice, 6 months apart. Sociopolitical control was defined as the beliefs about one's capabilities and efficacy in social and political systems. Two mental health outcomes were examined--psychological symptoms and self-esteem. Regression analysis to predict psychological symptoms and self-esteem over time were conducted. High levels of sociopolitical control were found to limit the negative consequences of helplessness on mental health. The results suggest that sociopolitical control may help to protect youths from the negative consequences of feelings of helplessness. Implications for prevention strategies are discussed.

Substance use and its relationship to depression, anxiety, and isolation among youth living with HIV

Reductions from lifetime to recent levels of substance use, the time since HIV diagnosis, physical health symptoms, CD4 counts, emotional distress, and social supports were examined among 227 (20% female; 22% African American, 27% Anglo, 35% Latino) youth living with HIV (YLH) ages 13 to 24 years. Substance use pervaded the lives of these youth. Male YLH had used more drugs., more often, and for longer periods than women. However, there had been major reductions in use. Being male, having high emotional distress, and having fewer negative social supports were significantly associated with greater reductions in substance use. There was a trend for the length of time that an individual was seropositive being associated with reductions in substance use. The counterintuitive findings suggest that there must be a re-examination of the role of the social support networks of youth living with HIV, as well as the ways in which emotional distress interacts with risk behaviors.

Spirituality, psychological well-being, and HIV symptoms for African Americans living with HIV disease

The purpose of this descriptive cross-sectional study was to explore the contribution of spiritual well-being and human immunodeficiency virus (HIV) symptoms to psychological well-being measured by depression, hope, and state-trait anxiety in a sample of 117 African-American men and women with a mean age of 38 years living with HIV disease. Of the respondents, 26% had acquired immunodeficiency syndrome (AIDS), and 74% were HIV seropositive. Each participant completed a sociodemographic questionnaire, the Sign and Symptom Checklist for Persons with HIV Disease, the Spiritual Well-Being Scale, the Nowotny Hope Scale, State-Trait Inventory, and the Beck Depression Inventory. The findings suggest that existential well-being, a spiritual indicator of meaning and purpose, more than religious well-being, was significantly related to the participants' psychological well-being. In addition, HIV symptoms were found to be significant predictors of psychological well-being. These findings support the need for nurses to continue exploring ways to integrate and support spirituality within the domains of clinical practice.