Emotional support, negative interaction and major depressive disorder among African Americans and Caribbean Blacks: findings from the National Survey of American Life

Sustained mental health and functional responses to the COVID-19 pandemic in Black and White Veterans with psychosis or recent homelessness

The COVID-19 pandemic disproportionately impacted marginalized populations including Black Americans, people with serious mental illness, and individuals experiencing homelessness. Although the double disadvantage hypothesis would suggest that individuals with multiple minoritized statuses would experience worse psychosocial impacts from the pandemic, this may not be the case for vulnerable Black Veterans. The present study investigated the sustained mental health and functional responses to the pandemic in Black and White Veterans with psychosis or recent homelessness and in a control group of Veterans enrolled in the Department of Veterans Affairs healthcare services. Clinical interviews and questionnaires were administered remotely by telephone at five time points from May 2020 through July 2021, including a retrospective time point for March 2020 (i.e., before the pandemic started). Overall, there was a striking absence of systematic differences by race in the trajectories of psychiatric symptoms and functioning among Veterans during the study period. These findings are consistent with a report on initial responses to the pandemic that revealed only a few select differences by race among Veteran groups. The lack of racial disparities is inconsistent with the double disadvantage hypothesis. Although further investigation is needed, one possible interpretation is that the wrap-around services offered by the Veterans Health Administration may have mitigated expected differences by race among Veterans with psychosis or homelessness. Future research should continue to examine whether VA services mitigate disparities in mental health and psychosocial outcomes.

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.

Coping and Protective Factors of Mental Health: An Examination of African American and US Caribbean Black Women Exposed to IPV from a Nationally Representative Sample

Existing research continues to highlight the harm that intimate partner violence (IPV) can pose to health and well-being. However, little is done to understand the effectiveness of coping and protective mechanisms in helping women manage under adverse circumstances. The current study addresses the mental health of US Black women and the role of coping and protective moderators. An analysis of data from the National Survey of American Life (2001-2003), the most comprehensive survey on the health of US Blacks, was conducted. The association between severe physical intimate partner violence and mental health outcomes were confirmed. Resilience moderated the relationship between severe intimate partner violence and mood disorder among US Black women, but this differed between African American and Caribbean Blacks. Resilience, emotional family support, and spirituality reduced the likelihood of having a mental health condition for some African American and Caribbean Black women, while the opposite was found for religiosity. Demographic factors were also associated with mental health conditions and behaviors. The study draws our attention to potential coping and protective mechanisms that could be incorporated into counseling and intervention practices while recognizing factors that may be harmful to the mental health of individuals.

Black Nativity and Health Disparities: A Research Paradigm for Understanding the Social Determinants of Health

After more than a century of research and debate, the scientific community has yet to reach agreement on the principal causes of racialized disparities in population health. This debate currently centers on the degree to which "race residuals" are a result of unobserved differences in the social context or unobserved differences in population characteristics. The comparative study of native and foreign-born Black populations represents a quasi-experimental design where race is "held constant". Such studies present a unique opportunity to improve our understanding of the social determinants of population health disparities. Since native and foreign-born Black populations occupy different sociocultural locations, and since populations with greater African ancestry have greater genetic diversity, comparative studies of these populations will advance our understanding of the complex relationship between sociocultural context, population characteristics and health outcomes. Therefore, we offer a conceptual framing for the comparative study of native and foreign-born Blacks along with a review of 208 studies that compare the mental and physical health of these populations. Although there is some complexity, especially with respect to mental health, the overall pattern is that foreign-born Blacks have better health outcomes than native-born Blacks. After reviewing these studies, we conclude with suggestions for future studies in this promising area of social and medical research.

Racial differences in the psychosocial response to the COVID-19 pandemic in veterans with psychosis or recent homelessness

The COVID-19 pandemic continues to disproportionately impact people of color and individuals experiencing psychosis and homelessness. However, it is unclear whether there are differences by race in psychosocial responses to the pandemic in vulnerable populations. The double jeopardy hypothesis posits that multiply marginalized individuals would experience worse psychosocial outcomes. The present study investigated the clinical and functional initial responses to the pandemic in both Black (n = 103) and White veterans (n = 98) with psychosis (PSY), recent homelessness (RHV), and in a control group (CTL) enrolled in Department of Veterans Affairs (VA) healthcare services. Clinical interviews were administered via phone at two time points: baseline (mid-May through mid-August 2020) and follow-up (mid-August through September 2020). The baseline interview also included retrospective measures of pre-COVID status from January 2020. There were no significant differences between Black and White veterans in depression, anxiety, or loneliness. However, Black veterans did endorse more fears of contamination, F(1, 196.29) = 9.48, p = .002. Across all groups, Black veterans had better family integration compared to White veterans, F(1, 199.98) = 7.62, p = .006. There were no significant differences by race in social integration, work/role productivity, or independent living. In sum, there were few significant differences between Black and White veterans in initial psychosocial response to the pandemic. The lack of racial disparities might reflect the presence of VA's wrap-around services. The findings also highlight the robust nature of social support in Black veterans, even in the context of a global pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Chronic Stress, Coping, and Mental Health Among Older African Americans

OBJECTIVES

African Americans experience relatively low rates of mental disorder despite being disproportionately exposed to psychosocial stressors. Coping is an understudied area that may help explain the mental health resilience among this population.

METHODS

Using data from the National Survey of American Life, I use negative binomial logistic regression to investigate the relationships between stress exposure/appraisal, ten coping responses, and mental health among older African American adults.

RESULTS

Seven of 10 coping responses were predictive of psychological distress. I also found evidence of moderation for six responses. Active coping, instrumental social support, looking for something good in what has happened, and two measures of acceptance were protective against psychological distress associated with high levels of stress. Substance use generally exacerbated the association between stress and psychological distress.

DISCUSSION

Problem-focused coping and acceptance responses were effective coping strategies for older African Americans under high levels of stress exposure/appraisal.

Vicarious Discrimination, Psychosocial Resources, and Mental Health among Black Americans

Does hearing about or witnessing someone else experience discrimination harm individuals’ mental health? Using data from the Nashville Stress and Health Study, we answer this question by examining how vicarious discrimination impacts depressive symptoms, anxiety symptoms, and anger among black Americans. We also test whether mastery and self-esteem moderate the association between vicarious discrimination and each mental health outcome. Findings indicate experiencing vicarious discrimination via a family member has a similar impact on mental health to personally experiencing discrimination. While experiencing vicarious discrimination via a close friend also increased mental health problems, it appeared to be less harmful than personally experiencing discrimination. Moreover, self-esteem moderated the association between vicarious discrimination via a family member and via a close friend and mental health, while mastery did not. This study provides new insights into ways vicarious discrimination impacts health as well as the role that psychosocial resources play in shaping this relationship.

The Role of Church Support Networks in the Relationship between Discrimination and Psychiatric Disorders among Older African Americans

BACKGROUND

Few studies have examined the effects of discrimination on mental health specifically among older African Americans despite it being a common experience in this population. Further, knowledge on social resources, such as social relationships, that could mitigate the effects of discrimination is limited in this population. Given the historical and contemporaneous importance of the Black church in African American communities, church members are important support network members and a major source of social support for older African Americans.

PURPOSE

To address these knowledge gaps, this study will (1) examine the association between racial discrimination and psychiatric disorders; and (2) determine whether church relationships moderate the impact of racial discrimination on psychiatric disorders.

METHODS

Data from African American respondents aged 55 and older were drawn from the National Survey of American Life (N = 837). Church relationship variables included receipt of emotional support from, frequency of contact with, and subjective closeness to church members. Regression analyses were used to test the study aims.

RESULTS

Analyses indicated that more frequent experiences of racial discrimination were associated with meeting criteria for any DSM-IV disorder and a greater number of DSM-IV disorders. Significant interactions revealed that frequency of contact with and subjective closeness to church members mitigated the association between discrimination and meeting criteria for any 12-month disorder and number of 12-month disorders.

CONCLUSIONS AND IMPLICATIONS

Altogether, these findings support the literature on the detrimental effects of discrimination on the mental health of older African Americans and provide a more nuanced understanding of the role of church members in the lives of older African Americans. The study findings suggest that church relationships are effective stress coping resources for older African Americans dealing with discrimination. Given the importance and relevance of church members, initial clinical assessments should assess clients' level of religious involvement and relationships with church members.

Church-Based Emotional Support and Negative Interactions Among Older African Americans and Black Caribbeans

OBJECTIVES

This study investigates church-based informal social support among older African Americans and Black Caribbeans. In particular, we examine the correlates of receiving emotional support as well as negative interactions (e.g., criticisms) from church members.

METHODS

The analysis is based on the older African American (n = 829) and Black Caribbean (n = 271) subsample of the National Survey of American Life. The analysis utilizes multiple group structural equation modeling (SEM) to test a model of church support networks.

RESULTS

There were no significant differences between older African Americans and older Black Caribbeans in the frequency of service attendance, contact with church members (seeing, writing, talking), emotional support from church members, or negative interactions with church members. However, a comparison of SEM analysis indicates that the number and pattern of relationships are different. For instance, among African Americans church attendance was associated with emotional support, but among Black Caribbeans attendance did not have a direct or indirect effect on emotional support. Our findings also indicate that among older African Americans, women attend religious services more frequently and both receive emotional support and engage in negative interactions with church members more frequently than men. Among Black Caribbeans, however, men attend religious services less frequently than women but also have more negative interactions with church members.

DISCUSSION

For both African American and Black Caribbean older adults, church members are an important element of their social support networks. Our analysis also underscores the importance of contact with church members for receiving emotional support for both populations.

Examining racial differences in community integration between black and white homeless veterans

Black Americans are overrepresented in Veteran and non-Veteran homeless populations. Community integration remains a problem for many Veterans after they obtain housing, and Black Veterans may encounter additional difficulties due to systemic racism. However, no prior study has specifically examined whether there are racial differences in community integration; similarly, no study has considered racial differences in psychosocial correlates of community integration in homeless Veterans. Knowledge of these factors could inform the development of culturally congruent rehabilitative interventions for Black Veterans. Semi-structured clinical interviews were administered to Black (N = 99) and White (N = 49) homeless Veterans to examine relations among psychiatric symptoms, motivation, and community integration domains (e.g., social integration, work productivity, and independent living). There were no significant racial differences in independent living or work productivity. Black Veterans had better social integration with family compared to White Veterans. In addition, psychiatric symptoms were more strongly correlated with social integration for Black than White Veterans. The association between motivation and work productivity was also stronger for Black Veterans. Recovery-oriented interventions could harness family connections and better target psychiatric symptoms to improve community integration for Black Veterans. Work productivity may improve from interventions aimed at enhancing motivation for Black Veterans.

The effect of stress exposure on depressive symptoms and major depressive episode among US Afro-Caribbean women

PURPOSE

This study examines whether stress exposures experienced within and across various life domains (e.g., interpersonal, financial) are predictors of depression among Afro-Caribbean women, an understudied ethnic group within the US Black female population.

METHODS

A sample of Afro-Caribbean women (N = 878) was drawn from the National Survey of American Life (NSAL), the first nationally representative psychiatric epidemiology survey focused on the mental health of the US Afro-Caribbean and African American populations. Negative binomial regression analysis was conducted for depressive symptoms, and binary logistic regression results are presented for past-year and lifetime major depressive episode. Analyses examined the relative effect of five stress exposures on depression: major discrimination, everyday discrimination, past-month chronic stress, financial strain, and negative interactions with family.

RESULTS

Of the five stress exposures, chronic stress and financial strain were associated with increased risk for both recent (e.g., past week) and more distal (i.e., past-year and lifetime) experiences of depression. Though experiences with discrimination were associated with depression, its effects were attenuated when other stressors were taken into account.

CONCLUSIONS

Mental health prevention and intervention programs must address stress concerns that are chronic in nature and stressors that reflect financial instability for Afro-Caribbean women.

The Moderating Role of Race and Ethnicity in the Relationship Between Negative Family Interactions and Mental Health Among Older Adults

BACKGROUND AND OBJECTIVES

Studies generally show that negative social interactions are detrimental to mental health for older adults. Further, empirical evidence suggests that negative interactions may function differently in relation to mental health across racial/ethnic groups given their unique life circumstances and social conditions. This study examines whether the association between negative family interactions and mental health outcomes varies by race and ethnicity.

RESEARCH DESIGN AND METHODS

Samples of older African Americans, Caribbean Blacks, and non-Latino Whites aged 55 and older were drawn from the National Survey of American Life (N=1439). Mental health variables included depressive symptoms, any lifetime DSM-IV disorder, and number of lifetime DSM-IV disorders. Regression models were used to test the study aim.

RESULTS

Analyses indicated that negative interactions with family were positively associated with all three mental health outcomes. Several racial/ethnic differences emerged. The association between negative family interactions and depressive symptoms was stronger among Whites than African Americans. While negative family interactions were positively associated with number of disorders among Caribbean Blacks, negative interactions were unrelated to number of disorders among African Americans.

DISCUSSION AND IMPLICATIONS

This study demonstrates the racial and ethnic differences in diverse aging populations and the importance of recognizing the heterogeneity of Black American population in minority research. Clinical practice should focus on reducing negative family interactions, and future research should examine whether psychosocial resources (e.g., stress appraisals, neighborhood social cohesion, and religious practices) can attenuate the association between negative family interactions and mental health for older African Americans.

Profiles of sleep and depression risk among Caribbean Blacks

Objectives: Sleep problems are associated with a host of psychiatric disorders and have been attributed to race disparities in health and wellness. Studies of sleep and mental health do not typically consider within-group differences among Blacks. Thus, our understanding of how the sleep-mental health relationship among Caribbean Blacks is limited. This study identified sleep profiles among Caribbean-born Blacks who reside in the United States.Design: Latent class analysis and data from the National Survey of American Life Re-interview study were used to identify and compare the associations between 'sleep quality classes,' sociodemographic factors, stress, and depression risk among Caribbean Blacks.Results: Two sleep quality classes were identified - 'good sleep quality' and 'poor sleep quality' - with each class demonstrating a complex pattern of sleep experiences, and illuminating the association between sleep and depression risk.Conclusions: Findings provide insight into the influence of sociodemographic factors and social stressors on the sleep experience of Caribbean Blacks and the importance of considering within-group differences to better understand risk and resilience among Caribbean Blacks living in the United States. Findings also highlight the importance of screening for sleep problems in an effort to reduce the burden of depression experienced by this population.

Social Network Typology and Serious Psychological Distress: Findings from the National Survey of American Life

This study examined the association between social network typology and serious psychological distress (SPD) across various adult developmental stages among African Americans. The sample for this study was drawn from the National Survey for American Life (N = 2,991). Network typology was identified using positive and negative family and church relationship indicators. Latent class distal outcome modeling was used to identify network typology and determine the association between network types and SPD. The findings indicate that network types and SPD were unassociated among respondents in the early adulthood group. In the middle and late adulthood group, respondents in the ambivalent and strained network types had higher SPD scores than respondents in the optimal type. Specific to the late adulthood group, respondents in the family-centered type had higher SPD scores than respondents in the optimal type. The findings are discussed in relation to prior research and practice implications.

"What Doesn't Kill You, Makes You Stronger": Psychosocial Resources and the Mental Health of Black Older Adults

A robust body of research has shown that Black Americans are less likely than Whites to have psychiatric disorders despite the social and economic disadvantage and systemic racism that they face. This mental health paradox has been demonstrated across all ages of the life course, including older adulthood. One of the prevailing explanations for the lower prevalence of psychiatric disorders among Blacks pertains to the influence of psychosocial resources on mental health. Psychosocial resources can directly or indirectly support mental health through physiological and psychological pathways. They can also mitigate the adverse effects of social stressors of discrimination and other stressors on psychological distress and mental illness. Black older adults may particularly benefit from psychosocial resources because they have had a lifetime of experiencing and overcoming adversity. Although this cycle of stress adaptation can wear away at the physical body, it may facilitate mental health resilience. In this chapter, we review research on the relationship between psychosocial resources and mental health. The chapter begins with a brief review of the Black-White mental health paradox and the mechanisms through which psychosocial resources operate to influence mental health. We then review research on intrapersonal, interpersonal, and community-level psychosocial resources that are particularly salient for Black Americans. Throughout the chapter we highlight research specifically focused on Black older adults and discuss the cultural relevance of each resource to their mental health and psychological functioning.

Negative interactions with extended family and church members and subjective well-being among older African American women

The purpose of this study was to determine whether negative interactions with family and church members are associated with indicators of subjective well-being (SWB) in a nationally representative sample of older African American women. The analytic sample (N = 537) was drawn from the National Survey of American Life. Linear regressions were used to assess the associations between negative interactions with family and church members and happiness, life satisfaction, and self-esteem. The negative interactions with family variable was inversely associated with happiness and self-esteem. Findings underscore the importance of social relationships and the quality of these relationships in women's well-being.

Hopelessness Among Middle-Aged and Older Blacks: The Negative Impact of Discrimination and Protecting Power of Social and Religious Resources

Background and Objectives

Hopelessness—a state of despair characterized by a negative outlook towards the future and a belief in insurmountable challenges—is a risk factor for major depression, cardiovascular disease, and all-cause mortality among older adults. It is also an understudied consequence of discrimination. Older blacks disproportionately report experiencing discrimination and, as a result, may be at greater risk of feeling hopeless. However, social and religious resources may protect against the adverse effects of discrimination. The current study examines whether social support, social engagement, religious attendance, and religiosity buffer the effects of self-reported everyday discrimination on hopelessness among a nationally representative sample of blacks.

Research Design and Methods

Using data from the 2010/2012 psychosocial assessment of the Health and Retirement Study, we regressed hopelessness on everyday discrimination, stratifying by 2 age groups, ages 51–64, representing middle-age (n = 1,302), and age 65 and older, representing old age (n = 887). Interaction terms tested whether each resource moderated the discrimination–hopelessness relationship controlling for depressive symptoms, socioeconomic status, and demographic characteristics.

Results

Greater reports of everyday discrimination were associated with higher levels of hopelessness for middle-aged and older blacks. For middle-aged blacks, the resources did not moderate the discrimination–hopelessness relationship; rather, higher levels of support (b = −0.294, p < .01), religiosity (b = −0.297, p < .001), religious attendance (b = −0.218, p < .05) were independently and inversely associated with hopelessness. For older blacks, higher levels of religiosity moderated the discrimination–hopelessness relationship (b = −0.208, p < .05) and higher levels of support (b = −0.304, p < .05) and social engagement (b = −0.236, p < .05) were independently and inversely associated with hopelessness.

Discussion and Implications

Findings suggest that self-reported everyday discrimination increases hopelessness among middle-aged and older blacks but social and religious resources may counterbalance its effects, in age-specific ways, to protect against hopelessness. Religiosity may be especially important for older blacks as a buffer against the negative consequences of discrimination on hopelessness.

Health may be compromised by social interactions depending on culture among postpartum Arab and Jewish Israeli women

Background

Social support is generally perceived to facilitate health in postpartum women; however, previous research shows that this is not always true. Social interactions intended to provide support can be perceived as negative and in turn, may have negative impacts on maternal health. The purpose of the present study was to asses if social support and negative interactions at one month after childbirth can predict maternal health four months after childbirth, and if this relationship is influenced by culture.

Methods

This prospective longitudinal cohort study included randomly selected Arab (n = 203) and Jewish (n = 202) women who attended Mother and Child Health Clinics in Northern Israel one month after giving birth. The women were interviewed at one and four months after childbirth using a questionnaire including measures of health (self-reported health (SRH) and health problems), socioeconomic and demographic status, obstetric characteristics, social support, negative social interactions and perceptions of customs and traditions intended to help the mother cope after childbirth. Multivariable regressions were run to identify the variables predicting health four months after childbirth.

Results

The response rate for both interviews was 90%. Negative social interactions one month after childbirth significantly predicted health problems in Arab and Jewish women (Beta 0.20 and 0.37 respectively) and SRH among Arab women only (odds ratio (OR) 0.32, confidence interval (CI) 0.19–0.54) four months after childbirth. Social support at one month after childbirth significantly predicted better SRH in both Jewish and Arab women four months after childbirth (OR 2.33, CI 1.38–3.93 and 1.59, CI 1.01–2.46 respectively) and fewer health problems only among Jewish women (Beta − 0.37).

Conclusions

Social support and negative social interactions appear to be predictive of health in postpartum women. Associations varied between Arabs and Jews, indicating that social support may be more important for predicting health among Jewish women and negative interactions may be more important among Arab women. Healthcare practitioners should be aware of the cultural context and social circumstances of postpartum women to ensure they receive the social support and care they need.

Social Support, Everyday Discrimination, and Depressive Symptoms Among Older African Americans: A Longitudinal Study

Background and Objectives

The purpose of the study was to explore the long-term effects of everyday discrimination on depressive symptoms among older African Americans, as well as the moderating role of social support in this association.

Research Design and Methods

Mixed-effects negative binomial regression analyses were performed on data selected from 6 waves of the Health and Retirement Study (2006-2016; baseline N = 1,144). The number of depressive symptoms was calculated based on an 8-item Center for Epidemiologic Studies Depression measure. Everyday discrimination was measured using a 6-item scale. Contact with and perceived support from extended family and friends were assessed.

Results

Older African Americans who experienced more frequent perceived discrimination had more depressive symptoms over time. Significant interactions between discrimination and perceived support from extended family and friends were found, indicating that among older African Americans who reported higher support from extended family and friends, perceived discrimination was positively associated with depressive symptoms over time. However, perceived discrimination and depressive symptoms were not longitudinally related among those who reported lower levels of perceived support.

Discussion and Implications

This is one of the few studies to examine the effects of discrimination on depressive symptoms over time and the first longitudinal study to test the role of social support in coping with discrimination in older African Americans. This study extends cross-sectional works on discrimination and mental health, indicating that experiences of discrimination can result in worse mental health over time. The significant interactions are consistent with the resource mobilization framework, which suggests that individuals who are more negatively affected by discrimination (more depressive symptoms) are more likely to reach out to friends and family to cope with discrimination.

Social Relationships and Salivary Telomere Length Among Middle-Aged and Older African American and White Adults

OBJECTIVES

A common mechanism underlying premature morbidity may be accelerated biological aging as reflected by salivary telomere length (STL). This study examined the extent to which social relationships, both positive and negative, can be protective or confer risk relative to biological aging.

METHOD

Data from the Health and Retirement Study and multiple regression were used to examine cross-sectional associations between STL, self-reported social support, and negative interaction (e.g., conflict, criticism) with family in a nationally representative sample of African American and non-Hispanic White middle-aged and older adults (N = 4,080).

RESULTS

Social support from family was associated with shorter STL. Negative interaction with family had no main effect on STL but interactions characterized by high social support and more frequent negative interactions were associated with longer STL. Negative interaction with family was negatively associated with STL for African Americans and Whites but the magnitude of the effect was greater for African Americans.

DISCUSSION

Study findings highlight the role of social relationships in physiological deterioration among middle-aged and older adults and identify a potential mechanism whereby race is linked to accelerated biological aging. Findings highlight the importance of considering positive and negative aspects of social relationships to understand the consequences of social connections for cellular aging in diverse populations.

Patterns of Social Connectedness and Psychosocial Wellbeing among African American and Caribbean Black Adolescents

Adolescents are connected to multiple and interrelated settings (e.g., family, school), which interact to influence their development. Using the National Survey of American Life-Adolescent (NSAL-A), a nationally representative cross-sectional survey, this study examined patterns of social connection and Black adolescents' wellbeing and whether social connection-wellbeing links differed by ethnicity and gender. The sample included 1170 Black adolescents ages 13-17 (69% African American, 31% Caribbean Black, 52% female, mean age 15). Latent profile analysis was used to identify profiles of adolescent connections across family, peer, school, religion, and neighborhood settings. Four profiles of social connection emerged: unconnected, minimal connection, high family connection, and well-connected. The profiles differed in life satisfaction, self-esteem, mastery, coping, perceived stress, and depressive symptoms. The well-connected profile, characterized by connection to all five settings, had significantly higher life satisfaction, self-esteem, mastery, and coping, and lower perceived stress compared to the unconnected and minimal connection profiles and lower depressive symptoms than the unconnected profile. The well-connected profile also had better self-esteem and coping compared to the high family connection profile. The youth in the unconnected profile had significantly lower self-esteem and mastery and significantly higher depressive symptoms than the minimally connected youth. Moderation analyses showed no differences by ethnicity. However, differences by gender were observed for the association between connectedness and life satisfaction. The results support the critical need to examine connectedness across multiple settings and within group heterogeneity among Black youth to develop strategies to promote their psychosocial wellbeing.

Social stress, obesity, and depression among women: clarifying the role of physical activity

Objective: This study examined the role of stress in the association among physical activity, obesity, and depression among women. The extent to which physical activity moderated these relationships was also examined. Design: Data from the National Survey of American Life (N = 3235) and multivariable regression analyses were used to examine the effects of chronic stress, material hardship, racial discrimination, and physical activity on obesity and depression among African American, Caribbean Black and White women. Results: Stress was not related to body mass index (BMI) for African American or White women, but chronic stress was associated with higher BMI for Caribbean Black women. Stress was associated with depressive symptoms, but there was variation by the type of stressor under consideration. Physical activity was associated with fewer depressive symptoms and lower BMI, but the relationships varied by type of stressor and race/ethnicity. Physical activity moderated the effect of chronic stress on depressive symptoms and BMI, but only for African American women who reported high levels of chronic stress. Among White women, physical activity moderated the effect of racial discrimination on BMI for those who reported experiencing both high and low levels of discrimination. Conclusion: This study was the first to document physical activity as a moderator in the relationship among stress, depression, and obesity using a nationally representative sample of racially/ethnically diverse women. Findings provide insight into the role of stress in relation to depression and obesity while highlighting heterogeneity among Black Americans.

Social support from friends and depression among African Americans: The moderating influence of education

BACKGROUND

This cross-sectional study examined the association between various characteristics of friendships and 12-month major depressive disorder (MDD) and whether these associations vary by education level among African Americans.

METHODS

The analytic sample included 3434 African American respondents drawn from the National Survey of American Life: Coping with Stress in the 21st Century. Logistic regression analyses were performed to test the associations between friendship characteristics (i.e., frequency of contact, subjective closeness, receipt of support, provision of support) and 12-month MDD. Interaction terms between education and each of the four friendship variables were used to test whether these associations varied by education level. Analyses adjusted for sociodemographic factors and chronic health problems.

RESULTS

Frequency of contact and subjective closeness were negatively associated with 12-month MDD. An interaction between education and contact indicated that contact was negatively associated with MDD among high education respondents but unrelated to MDD among low education respondents. The interactions between education and receipt of support and education and provision of support demonstrated that receipt and provision of support were negatively associated with MDD among high education respondents but was positively associated with MDD among low education respondents.

LIMITATIONS

Given the cross-sectional design, it is not possible to make causal inferences.

CONCLUSION

This investigation provides an important first step to understanding within-group differences in how social relationships function as both a risk and protective factor for MDD among African Americans.

Improving the Living, Learning, and Thriving of Young Black Men: A Conceptual Framework for Reflection and Projection

Black men experience disproportionate mental health challenges due to their exposure to severe psychosocial stressors. Yet, the mental health challenges of Black men have largely been left out of national conversations. Strong theoretical frameworks are important when generating dialogue about the mental health of Black men, as it helps to validate the work on a larger scale while also grounding the work for more practical use. This paper presents the conceptual framework for a five-year initiative aimed at improving the living, learning, and thriving of young Black men through a social media intervention that improves their mental health, expands their definitions of manhood, and helps them to engage in social support. The Young, Black Men, Masculinities, and Mental Health (YBMen) project is a social media-based, health promotion program that targets mental health (e.g., depressive symptoms), masculine norms (e.g., definitions of manhood), and social support for young Black men using culturally-sensitive, age-appropriate, and gender-specific popular culture. The YBMen project has been successfully implemented with over 150+ Black men since 2014; findings demonstrate improved mental health outcomes, progressive definitions of manhood, and stronger social relationships. Reflections from the past and projections for the future are discussed.

Discrimination, Serious Psychological Distress, and Church-Based Emotional Support Among African American Men Across the Life Span

Objective

This study tested whether church-based social support buffers the negative effects of discrimination on serious psychological distress (SPD) among three age groups-early, middle, and late adulthood-of African American men.

Methods

Negative binominal regression analyses for discrimination and SPD were performed using data from 1,271 African American men from the National Survey of American Life.

Results

Discrimination was positively associated with SPD for all age groups. An interaction between church-based support and discrimination indicated that under conditions of high levels of support from congregants, discrimination, and SPD were positively correlated. However, discrimination and SPD were unrelated for low levels of church-based support. Further, the interaction was significant for men aged 18-34 and 55 or older but not significant for men aged 35-54.

Discussion

This is the first study to document relationships among discrimination, SPD, and church-based support in a nationally representative sample of African American men. Overall, rather than revealing a stress-buffering function, findings were consistent with the resource mobilization perspective of social support, indicating that higher levels of assistance from church networks are provided when individuals experience high levels of both discrimination and SPD.

A Social Relations and Networks Perspective of Depressive Symptoms in Older African Americans Relative to Two Other Ethno-racial Groups

BACKGROUND AND OBJECTIVES

Family ties and role relationships through their effects on exchanges of resources and social support are critical health contexts for older African Americans. We studied the influence of affect-based (positive or negative) social relations and respondent-role network centrality on depressive symptoms in older African Americans compared to two ethno-racial groups, Black Caribbeans and Non-Hispanic Whites.

RESEARCH DESIGN AND METHODS

We used data from the multigenerational 2004 National Survey of American Life Family Connections across Generations and Nations Study (NSAL 3-Gen). For respondents aged 50 years or older, we used tie affect (positive or negative) to code family role relations and two-mode (where an entity or thing is connected to a different type of entity, here individuals are connected to role relations) family networks. We used survey linear regressions to probe the independent association of relations and networks on depressive symptoms among older African Americans as compared to Black Caribbeans and Non-Hispanic Whites.

RESULTS

Negative and positive relations are significantly associated with depressive symptoms, but there were some ethno-racial differences. For example, the negative Father relation is significantly associated with greater depressive symptoms among African Americans, but not in Black Caribbeans and Non-Hispanic Whites. Negative two-mode networks (connections from individuals to role relations) are significantly associated with depressive symptoms among African Americans and in the two comparison ethno-racial groups, while there is no significant association between positive networks and depressive symptoms.

DISCUSSION AND IMPLICATIONS

We found that negative relations had larger effects on depressive symptoms than positive ones, and conversely that negative networks had larger effects than positive networks. Simultaneously modeling social relations and networks could potentially enhance our understanding of the links between social structure, and depressive symptoms among older adults in African American and other ethno-racial minorities.

Conflict with Mothers and Siblings During Caregiving: Differential Costs for Black and White Adult Children

Objectives

Family conflict has been found to play a role in caregivers' psychological well-being; however, few studies have considered race differences in the prevalence and consequences of caregiving conflict. In this paper, we use mixed-methods to examine differences in the experiences of conflict among Black and White adult children caring for mothers.

Methods

Quantitative and qualitative data were collected from 279 adult-child caregivers (213 White; 66 Black).

Results

Multilevel modeling revealed that conflict with mothers predicted depressive symptoms among Black, but not White caregivers, whereas there were not statistically significant race differences in the effects of conflict with siblings. However within-model tests showed stronger effects of conflict with mothers than siblings for Black caregivers, and stronger effects of conflict with siblings than mothers for White caregivers. Qualitative data revealed that Black caregivers' conflict with mothers resulted from their inability to meet their mothers' needs, inducing concern and sadness. White children's conflict stemmed from mothers' resistance to unwanted assistance and requests for support that children considered excessive, evoking irritation and frustration.

Discussion

This study highlights ways in which the experiences of caregivers reflect broader patterns of differences between Black and White families in both intergenerational cohesion and health disparities in midlife.

Church and Family Support Networks and Depressive Symptoms among African Americans: Findings from the National Survey of American Life

Aims:

We examined the associations between informal social support from church members and social support from extended family members and depressive symptoms within a national probability sample of African American adults ranging in age from 18 to 93.

Methods:

This analysis used data from the National Survey of American Life and accounted for religious service attendance and various demographic variables that have known associations with and are consequential for mental health.

Results:

Frequency of contact with church and family members and emotional support from family were inversely associated with depressive symptoms, and negative church and family interactions were positively associated with depressive symptoms. Emotional support from church members, however, was unrelated to depressive symptoms.

Conclusion:

This study underscores the important contributions of church relationships to depressive symptoms among African Americans across the adult life span, and confirms that these associations are independent of family relationship factors and religious service attendance.

A Risk Typology for Depression in African Americans

Studies report that African Americans are likely to experience severe, chronic, and disabling depressive symptoms leading to poor depression outcomes. There are several psychosocial and sociocultural factors that individually contribute to depression in African Americans (i.e. chronic stress, negative life events, negative social interaction, social support, and religiosity). However, African Americans are a heterogeneous population and the identification of subpopulations with distinct constellations of multiple co-occurring risk and protective factors may offer greater explanatory potential into depression burden for African Americans. This study used data from the American's Changing Lives Survey to identify risk types for depression in a national sample of African American adults and older adults (n = 1174). Latent class analysis results revealed a risk typology that included 3 distinct risk patterns for African Americans. Individuals in the High Protective/Low Risk Type (41%) had high levels of religiosity and social support. Those in the Moderate Protection/Low Risk Type (44%) had moderate levels of religiosity and social support. The Low Protection/Low Risk Type (15%) had low organizational and non-organizational religiosity and relatively low social support. All three types were marked by relatively low risk factors (i.e. negative events, financial stress, and negative social interaction). Multinomial logistic regression results suggested associations between demographic characteristics (i.e. gender, age, education, marital status), depressive symptoms, and risk type. Study results have implications for the development of depression interventions that are targeted to a specific risk type and tailored to the demographic profile of individuals likely to experience poor depression outcomes.

The mediating effect of neighbor relationship between community social support and elderly's subjective well-being in China

This study aimed to investigate the relationship between community social support, neighbor relationship, and the subjective well-being of the elderly in China. Structural equation modeling was used to test the hypothesized model based on a sample of 2732 senior adults from 2010 Chinese General Social Survey. Results showed that community social support could indirectly affect the subjective well-being of the elderly through the complete mediating effect of neighbor relationship, although there was no significant correlation between community social support and the elderly's subjective well-being. Implications for theory, social work, and social policy were discussed.

Family and Friendship Networks and Obsessive-Compulsive Disorder Among African Americans and Black Caribbeans

Although there is a large literature on the influence of social support on mental health there is limited research on social support and OCD. This is especially the case for African Americans and Black Caribbeans. This study examines the relationship between family and friendship networks and the prevalence of OCD. The analysis is based on the National Survey of American Life a nationally representative sample of African Americans and Black Caribbeans. Variables included frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions (conflict, criticisms) with family members. The results indicated that only negative interaction with family members was significantly associated with OCD prevalence. African Americans and Black Caribbeans with more frequent negative interactions with family members had a higher likelihood of having OCD. Subjective closeness and frequency of contact with family and friends was not protective of OCD. Overall the findings are consistent with previous work which finds that social support is an inconsistent protective factor of psychiatric disorders, but negative interactions with support network members is more consistently associated with mental health problems.

Extended family and friendship support and suicidality among African Americans

PURPOSE

This study examined the relationship between informal social support from extended family and friends and suicidality among African Americans.

METHODS

Logistic regression analysis was based on a nationally representative sample of African Americans from the National Survey of American Life (N = 3263). Subjective closeness and frequency of contact with extended family and friends and negative family interaction were examined in relation to lifetime suicide ideation and attempts.

RESULTS

Subjective closeness to family and frequency of contact with friends were negatively associated with suicide ideation and attempts. Subjective closeness to friends and negative family interaction were positively associated with suicide ideation and attempts. Significant interactions between social support and negative interaction showed that social support buffers against the harmful effects of negative interaction on suicidality.

CONCLUSIONS

Findings are discussed in relation to the functions of positive and negative social ties in suicidality.

The effect of migration on social capital and depression among older adults in China

PURPOSE

An estimated 9 million elderly people accompanied their adult children to urban areas in China, raising concerns about their social capital and mental health following re-location. The aim of this study was to examine the effect of migration on social capital and depression among this population.

METHODS

Multistage stratified cluster sampling was applied to recruit the migrant and urban elderly in Hangzhou from May to August, 2013. Data were collected from face-to-face interviews by trained college students using a standardized questionnaire. Social capital measurements included cognitive (generalized trust and reciprocity) and structure (support from individual and social contact) aspects. Depression was measured by Geriatric Depression Scale-30 (GDS-30). Chi-square tests and binary logistic regression models were used for analysis.

RESULTS

A total of 1248 migrant elderly and 1322 urban elderly were eligible for analysis. After adjusting for a range of confounder factors, binary logistic regression models revealed that migrant elderly reported significantly lower levels of generalized trust [OR = 1.34, 95% CI (1.10-1.64)], reciprocity [OR = 1.55, 95% CI (1.29-1.87)], support from individual [OR = 1.96, 95% CI (1.61-2.38)] and social contact [OR = 3.27, 95% CI (2.70-3.97)]. In the full adjusted model, migrant elderly were more likely to be mentally unhealthy [OR = 1.85, 95% CI (1.44-2.36)] compared with urban elderly.

CONCLUSIONS

Migrant elderly suffered from a lower mental health status and social capital than their urban counterparts in the emigrating city. Attention should focus on improving the social capital and mental health of this growing population.

African American Extended Family and Church-Based Social Network Typologies

We examined social network typologies among African American adults and their sociodemographic correlates. Network types were derived from indicators of the family and church networks. Latent class analysis was based on a nationally representative sample of African Americans from the National Survey of American Life. Results indicated four distinct network types: ambivalent, optimal, family centered, and strained. These four types were distinguished by (a) degree of social integration, (b) network composition, and (c) level of negative interactions. In a departure from previous work, a network type composed solely of nonkin was not identified, which may reflect racial differences in social network typologies. Further, the analysis indicated that network types varied by sociodemographic characteristics. Social network typologies have several promising practice implications, as they can inform the development of prevention and intervention programs.

Ethnic and Nativity Differences in the Social Support-Physical Health Association Among Black Americans

Despite an abundant literature on social support and health, relatively less is known about how support and its impact on physical health vary within the Black population. Using the National Survey of American Life (NSAL), this paper examines which sources and types of support are associated with physical health among African Americans, U.S.-born Caribbean Blacks and foreign-born Caribbean Blacks. The results showed that for U.S.-born Caribbean Blacks, being married was especially beneficial to health. Closeness to family was associated with better health while negative interactions with family members was associated with worse health for African Americans and foreign-born Caribbean Blacks. Different sources of instrumental support affected all three groups. Overall, the findings reveal that, among Black Americans, the association between social support and physical health is contingent upon ethnicity, nativity, and the ways in which social support and health are operationalized.

Ethnic and gender variations in the associations between family cohesion, family conflict, and depression in older Asian and Latino adults

To examine the associations between family conflict, family cohesion and late-life depression in Latino and Asian populations and test if these associations vary by race/ethnicity and gender. We used a subsample of older adults from the National Latino Asian American Study (N = 395). All analyses were weighted and adjusted for individual and clinical characteristics. Greater family cohesion was associated with decrease in risk for depression in Latino and Asian older adult populations (OR: 0.68, 95% CI: 0.54, 0.84). These associations varied by gender, with men being more sensitive to family cohesion and family conflict than women. Asian older adults were more sensitive to family conflict, whereas Latino older adults were more sensitive to family cohesion. The quality of family relationships is strongly associated with late-life depression. Further research is needed to better understand the complex interplay between social support, ethnicity, and gender in latelife depression outcomes.

Family, friends, and 12-month PTSD among African Americans

PURPOSE

Despite a growing literature on the influence of social support on mental health, little is known about the relationship between social support and specific psychiatric disorders for African Americans, such as PTSD. This study investigated the relationship between social support, negative interaction with family and 12-month PTSD among African Americans.

METHODS

Analyses were based on a nationally representative sample of African Americans from the National Survey of American Life (n = 3315). Social support variables included emotional support from family, frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions with family.

RESULTS

Results indicated that emotional support from family is negatively associated with 12-month PTSD while negative interaction with family is predictive of 12-month PTSD. Additionally, a significant interaction indicated that high levels of subjective closeness to friends could offset the impact of negative family interactions on 12-month PTSD.

CONCLUSIONS

Overall, study results converged with previously established findings indicating that emotional support from family is associated with 12-month PTSD, while, negative interaction with family is associated with increased risk of 12-month PTSD. The findings are discussed in relation to prior research on the unique association between social support and mental health among African Americans.

Family Economic Stress, Quality of Paternal Relationship, and Depressive Symptoms among African American Adolescent Fathers

This study examined the association between perceived family economic stress, quality of father-son relationships, and depressive symptoms among African American adolescent fathers. Data were collected during pregnancy from 65 African American adolescents who were first-time fathers, ages 14-19. Results from multiple regression analyses indicated that higher paternal relationship satisfaction was associated with fewer depressive symptoms among adolescent fathers. Additionally, depressive symptoms were higher among adolescent fathers who reported experiencing higher levels of conflict with their fathers. Further, paternal conflict moderated the effect of perceived family economic stress on depressive symptoms. That is, among adolescent fathers experiencing low levels of conflict with their fathers, high perceived family economic stress was associated with more depressive symptoms. Study findings suggest that the risk for depressive symptoms is highest among adolescent fathers experiencing low family economic stress and highly conflictual relations with their fathers. These results highlight the complexities of paternal relationships and perceived economic stressors on depressive symptoms during pregnancy for African American adolescent fathers. The importance of expanding research on influential familial relationships and economic stressors on adolescent African American fathers is discussed.

Family and friendship informal support networks and social anxiety disorder among African Americans and Black Caribbeans

BACKGROUND

This study explores relationships between Social Anxiety Disorder (SAD) and quality and frequency of involvement with family and friends.

METHODS

Data are from a nationally representative sample of African American and Black Caribbean adults (n = 5191), the National Survey of American Life. SAD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview.

RESULTS

Findings indicated that among both populations, close supportive ties with family members and friends are protective against meeting criteria for SAD. Negative interactions with family (e.g., conflicts), however, are a risk factor for SAD among both African Americans and Black Caribbeans. For African Americans, an interaction indicates that the relationship between negative interaction and social anxiety is much stronger among African Americans who are not emotionally close to their families. For Caribbean Blacks, an interaction suggests that the odds of meeting criteria for SAD were higher among Black Caribbeans who had high negative interaction with family as well as low levels of friendship closeness.

LIMITATIONS

The cross-sectional nature of the study does not allow for causal attributions for findings.

CONCLUSIONS

This study demonstrates that SAD may impact black ethnic subgroups differently, which has important implications for understanding the nature, etiology, and treatment of this disorder.

The association between organizational behavior factors and health-related quality of life among college teachers: a cross-sectional study

Background

College teachers in China are confronted with a lot of pressure from teaching, researching and living. They are suffering from impaired physical and mental health. The purpose of this study was to investigate the relationships between organizational behavior factors and college teachers’ health related quality of life (HRQOL), and to confirm whether they are positive resources for improving teachers’ HRQOL.

Methods

A cross-sectional survey was conducted in Shenyang, China, from January to April 2014. Participants were composed of 965 teachers randomly selected from five representative colleges in Shenyang. Self-administrated questionnaires containing the 36-item Short-Form Health Survey (SF-36), the Chinese version Psychological Capital Questionnaire (PCQ), and scales assessing group identification, POS, and psychological empowerment were used to measure HRQOL and organizational behavior variables of college teachers. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of organizational behavior variables on college teachers’ HRQOL.

Results

The mean (SD) scores of physical component summary (PCS) and mental component summary (MCS) among college teachers were 71.43 (14.70) and 65.46 (16.55) respectively in the study population. Hierarchical multiple regression analysis showed that group identification (β = 0.121, P < 0.001) and PsyCap (β = 0.336, P < 0.001) were significant predictors of PCS, while group identification (β = 0.107, P < 0.001), POS (β = 0.124, P = 0.003), psychological empowerment (β = 0.093, P = 0.017) and PsyCap (β = 0.421, P < 0.001) were significant predictors of MCS.

Conclusion

Chinese college teachers experienced relatively low level of HRQOL and their mental quality of life (QOL) were impaired more seriously than physical QOL. Organizational behavior factors (PsyCap, group identification, POS and psychological empowerment) were strong predictors of college teachers’ HRQOL and are positive resources for improving teachers’ HRQOL. The enhancement of college teachers’ PsyCap, group identification, POS and psychological empowerment at work should be incorporated in the strategy of protecting and improving college teachers’ physical and mental QOL.

Negative social interactions and incident hypertension among older adults

OBJECTIVE

To determine if negative social interactions are prospectively associated with hypertension among older adults.

METHOD

This is a secondary analysis of data from the 2006 and 2010 waves of the Health and Retirement Study, a survey of community-dwelling older adults (age > 50 years). Total average negative social interactions were assessed at baseline by averaging the frequency of negative interactions across 4 domains (partner, children, other family, friends). Blood pressure was measured at both waves. Individuals were considered to have hypertension if they reported use of antihypertensive medications, had measured average resting systolic blood pressure of 140 mmHg or higher, or measured average resting diastolic blood pressure of 90 mmHg or higher. Analyses excluded those who were hypertensive at baseline and controlled for demographics, personality, positive social interactions, and baseline health.

RESULTS

Twenty-nine percent of participants developed hypertension over the 4-year follow-up. Each 1-unit increase in the total average negative social interaction score was associated with a 38% increased odds of developing hypertension. Sex moderated the association between total average negative social interactions and hypertension, with effects observed among women but not men. The association of total average negative interactions and hypertension in women was attributable primarily to interactions with friends, but also to negative interactions with family and partners. Age also moderated the association between total average negative social interactions and hypertension, with effects observed among those ages 51-64 years, but not those ages 65 or older.

CONCLUSION

In this sample of older adults, negative social interactions were associated with increased hypertension risk in women and the youngest older adults.

Family factors contribute to general anxiety disorder and suicidal ideation among Latina Americans

PURPOSE

Despite a rapidly growing Latina/o American population, little is known about modifiable factors that could protect Latinas against major psychiatric disorders. The present study explored psychosocial risk (Negative Interaction) and protective factors (Family Cohesion, Social Support, Religious Involvement, Racial and Ethnic Identity) for major depressive disorder (MDD), general anxiety disorder (GAD), and suicidal ideation (SI) among Latinas participating in the first national mental health epidemiological survey of Latina Americans.

METHOD

We conducted three sets of logistic regressions, predicting outcomes for 1,427 Latinas identified in the National Latino and Asian American Study (NLAAS), the first nationally representative, epidemiological study of Latino and Asian Americans living in the United States. These analyses followed preplanned steps: Model 1 used known predictors as controls and Model 2 added psychosocial risk and predictive factors beyond the known predictors.

RESULTS

For each outcome examined, psychosocial risk and protective factors produced a significantly better model fit in Model 2 than sociodemographic and acculturation variables known to predict mental health outcomes in Model 1. Negative Interactions were associated with increased likelihood of GAD and SI, whereas Family Cohesion seemed to be protective against GAD. No psychosocial factors predicted MDD.

CONCLUSIONS

Differential protective and risk factors for major psychiatric disorders suggest that assessment and intervention may need certain sex-specific components in order to improve health care and prevention for Latinas.

The effects of identification with a support group on the mental health of people with multiple sclerosis

OBJECTIVE

Multiple sclerosis (MS) is associated with various psychological problems, including depression and anxiety. Whilst MS support groups are intended to improve mental health, this goal is not always achieved. Taking a social identity approach, we hypothesise that it is the level of subjective identification with a support group (rather than simply support group membership per se) that positively affects the mental health of people with MS.

METHODS

152 individuals with MS were recruited via UK MS support groups and completed a questionnaire. This included measures of support group identification, depression, anxiety and satisfaction with life, as well as control variables (education level and age).

RESULTS

Analyses revealed that, as hypothesised, support group identification was significantly linked to depression, anxiety and satisfaction with life. Moreover, group identification explained a significant amount of variance in addition to that explained by education and age on each health outcome. Repeating the analysis to compare each of the three main sub-types of MS revealed these effects to be present for individuals with relapsing-remitting (RR) and Primary Progressive (PP) MS, but not for those with secondary progressive (SP) MS.

CONCLUSIONS

We suggest that identifying highly with an MS support group has important positive outcomes for MS patients' mental health. This has implications for practicing clinicians: people with MS (particularly RRMS and PPMS) should be encouraged to engage with support groups, but more must be done to ensure they subjectively identify with these groups, rather than merely attend them.

A new psychological intervention: "512 Psychological Intervention Model" used for military rescuers in Wenchuan Earthquake in China

OBJECTIVE

We sought to compare the efficacy of the "512 Psychological Intervention Model" (that is, "512 PIM", a new psychological intervention) with debriefing on symptoms of post-traumatic stress disorder (PTSD), anxiety and depression of Chinese military rescuers in relation to a control group that had no intervention.

METHOD

We conducted a randomized controlled trial with 2,368 military rescuers 1 month after this event and then at follow-up 1, 2 and 4 months later to evaluate changes in symptoms of PTSD, anxiety and depression based on DSM-IV criteria, respectively.

RESULTS

Baseline analysis suggested no significant differences between the study groups. Severity of PTSD, anxiety and depression decreased over time in all three groups, with significant differences between the groups in symptoms of PTSD (P < 0.01). Compared with the debriefing and control group, significant lower scores of PTSD and positive efficacy in improving symptoms of re-experiencing, avoidance and hyperarousal were found in the "512 PIM" group.

CONCLUSION

"512 PIM" was an effective psychological intervention for military rescuers in reducing symptoms of PTSD, anxiety and depression after a crisis.

[Screening for depression in an elderly population living at home. Interest of the Mini-Geriatric Depression Scale]

BACKGROUND

Depression is the most usual mental disorder in the elderly, but underdiagnosed and undertreated. Its prevalence is variable. Symptoms of depression present in the elderly can be masked and difficult to recognize. The purpose of this study was to examine prevalence and risk factors for depression in elderly living in their home.

METHODS

A cross-sectional study of randomly selected homes in randomly selected geographical islets was carried out Monastir City (Tunisia). Questionnaire-based interviews were conducted among the elderly aged more than 65 years living in their home. Depression symptoms were assessed using a Mini-Geriatric Depression Scale. The relationship between the risk of depression and sociodemographic and health-related variables was studied using logistic regression.

RESULTS

Out of 598 (female 66 %, mean (SD) age 72.3 (7.4) years) elderly persons interviewed, 136 (22.7 %) were screened to have a Mini-Geriatric Depression Scale more than or equal to 1. Multiple logistic regression analysis revealed that the following were significant (P<0.01) independent predictors of risk of depression: female sex (OR=2.36 [95 % CI=1.43-3.94]), having a low level of education (OR=4.02 [95 % CI=1.38-11.65]), disability (OR=3.50 [95 % CI=1.94-6.46]), a history of stroke (OR=2.90 [95 % CI=1.20-7.72]) and the use of hypnotic medications (OR=2.47 [95 % CI=1.38-4.42]).

CONCLUSION

This study suggests that the risk of depression is a common psychiatric disorder in elderly living in their home, and underlines the usefulness of the Mini-Geriatric Depression Scale to detect the risk of depression in the elderly. This clinical approach should be encouraged in all medical practices to improve the prognosis of depression in the elderly.