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Rastogi R, Woolverton GA, Lee RM, Yip T, Stevens C, Chen JA, Liu CH. Microaggression and discrimination exposure on young adult anxiety, depression, and sleep. J Affect Disord 2024; 363:141-151. [PMID: 39029681 PMCID: PMC11343644 DOI: 10.1016/j.jad.2024.07.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/10/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups. METHODS Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure. RESULTS Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (ORMicro = 1.42, ORDiscrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (ORDepress = 1.24, ORSleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents. LIMITATIONS Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences. CONCLUSIONS The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.
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Affiliation(s)
- Ritika Rastogi
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Richard M Lee
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Tiffany Yip
- Department of Psychology, Fordham University, New York, NY, USA
| | - Courtney Stevens
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychology, Willamette University, Salem, OR, USA
| | - Justin A Chen
- Department of Psychiatry, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA
| | - Cindy H Liu
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
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Browning ME, Lloyd-Richardson EE, Trisal AV, Satterfield S. Anxiety, OCD, Psychological Flexibility, and Depression: A Replication With Racially Minoritized University Students. Psychol Rep 2024:332941241269442. [PMID: 39066662 DOI: 10.1177/00332941241269442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
OCD and anxiety are both associated with depression and suicide, but there is a need for comprehensive assessment and screening of depression risk factors within ethnically and racially minoritized college students. In total, 128 university students were surveyed in 2022 in the northeastern United States who all endorsed at least one non-white racial identity. They completed measures of anxiety, depression, OCD symptoms and psychological flexibility. Results supported that anxiety and OCD symptoms were positively associated with high depression, and high psychological flexibility was associated with low depression. Results support continued screening and intervention for anxiety and OCD symptoms to address depression in diverse young adults. Future work should continue to assess the protective effects of targeting psychological flexibility constructs and to assess longitudinal impacts of OCD symptoms and anxiety on depression.
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Affiliation(s)
- Morgan E Browning
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA, USA
| | | | - Akshay V Trisal
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA, USA
| | - Sidney Satterfield
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA, USA
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Farewell CV, Schmiege SJ, Leiferman J. Racial Differences in Psychosocial Resources and Mental and Physical Health Outcomes during Pregnancy: A structural equation modeling approach. RESEARCH SQUARE 2024:rs.3.rs-4617998. [PMID: 39070611 PMCID: PMC11276014 DOI: 10.21203/rs.3.rs-4617998/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Objectives Poor prenatal health is of particular concern among minoritized individuals who may experience adverse social determinants of health contributing to the intergenerational transmission of health disparities. The purpose of this study was to investigate associations between psychosocial resources, and mental and physical health among a prenatal sample, and to explore if these relationships vary by race. Methods English-speaking pregnant individuals living in the United States were recruited using Centiment (n=340). Participants completed a 121-item cross-sectional survey. We conducted a single- and multi-group structural equation model to test hypothesized relationships, and then investigated differences by pregnant White individuals versus Black, Indigenous, and People of Color (BIPOC). Results Our final single-group model exhibited good model fit (χ2 (43) = 99.07, p<.01, CFI = 0.97, SRMR = 0.04, and RMSEA = 0. 06 (0.05 - 0.08)). After controlling for demographic characteristics and social determinants of health, higher levels of mindfulness were statistically significantly related to lower anxiety and depression scores (both p<.01). Higher levels of social supports were statistically significantly related to lower anxiety scores. Scale measurement invariance was confirmed for the multi-group model and the structural model was statistically significantly different between pregnant White individuals and BIPOC in this sample (Δ χ2 (27) = 116.71, p <.01). Conclusions Identification of core components of psychosocial resource interventions, consideration of upstream structural determinants, mindfulness and valued-living (MVL)-based strategies, cultural adaptation, and an emphasis on resilience rather than psychopathology may result in improved prenatal health among pregnant individuals traditionally underrepresented in research.
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Goreis A, Nater UM, Mewes R. Psychological Consequences of Chronic Ethnic Discrimination in Male Turkish Immigrants Living in Austria: A 30-Day Ambulatory Assessment Study. Ann Behav Med 2024; 58:111-121. [PMID: 37857265 PMCID: PMC10831213 DOI: 10.1093/abm/kaad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Chronic ethnic discrimination may be associated with negative psychological consequences in ethnic minority groups. However, little is known about the impact of acute discriminatory events on people who experience chronic ethnic discrimination. PURPOSE We examined the impact of chronic and acute ethnic discrimination on the daily lives of Turkish immigrants in Austria, a population often overlooked in discrimination research. METHODS Ninety male Turkish immigrants living in Austria (60 experiencing chronic and 30 infrequent ethnic discrimination) reported discriminatory events in real time for 30 days. Additionally, subjective stress, reactivity to daily hassles, affect, and maladaptive coping were assessed daily. RESULTS Participants experiencing chronic ethnic discrimination indicated higher daily values for stress, negative affect, reactivity to daily hassles, and anticipation and avoidance coping. Negative psychological states increased for all participants on days when discriminatory events occurred, but participants with chronic ethnic discrimination showed significantly stronger increases in maladaptive coping and reactivity to daily hassles, with the latter effect persisting until the next day. CONCLUSIONS Our study is the first to demonstrate interaction effects of chronic and acute ethnic discrimination on psychological factors in daily life. The results may advance the understanding of the mechanisms that lead to health disparities in ethnic minority populations and may inform the development of targeted interventions.
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Affiliation(s)
- Andreas Goreis
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
- University Research Platform “The Stress of Life – Processes and Mechanisms Underlying Everyday Life Stress”, University of Vienna, Vienna, Austria
| | - Urs M Nater
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
- University Research Platform “The Stress of Life – Processes and Mechanisms Underlying Everyday Life Stress”, University of Vienna, Vienna, Austria
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Eustis EH, LoPresti J, Aguilera A, Schueller SM. Cultural Responsivity in Technology-Enabled Services: Integrating Culture Into Technology and Service Components. J Med Internet Res 2023; 25:e45409. [PMID: 37788050 PMCID: PMC10582817 DOI: 10.2196/45409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 07/31/2023] [Accepted: 08/21/2023] [Indexed: 10/04/2023] Open
Abstract
Technology-enabled services (TESs) are clinical interventions that combine technological and human components to provide health services. TESs for mental health are efficacious in the treatment of anxiety and depression and are currently being offered as frontline treatments around the world. It is hoped that these interventions will be able to reach diverse populations across a range of identities and ultimately decrease disparities in mental health treatment. However, this hope is largely unrealized. TESs include both technology and human service components, and we argue that cultural responsivity must be considered in each of these components to help address existing treatment disparities. To date, there is limited guidance on how to consider cultural responsivity within these interventions, including specific targets for the development, tailoring, or design of the technologies and services within TESs. In response, we propose a framework that provides specific recommendations for targets based on existing models, both at the technological component level (informed by the Behavioral Intervention Technology Model) and the human support level (informed by the Efficiency Model of Support). We hope that integrating culturally responsive considerations into these existing models will facilitate increased attention to cultural responsivity within TESs to ensure they are ethical and responsive for everyone.
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Affiliation(s)
- Elizabeth H Eustis
- Center for Anxiety and Related Disorders, Boston University, Boston, MA, United States
| | - Jessica LoPresti
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Adrian Aguilera
- School of Social Welfare, University of California Berkeley, Berkeley, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Stephen M Schueller
- Department of Psychological Science, University of California Irvine, Irvine, CA, United States
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Majeno A, Molina KM, Frisard CF, Lemon SC, Rosal MC. Discrimination and Sleep: Differential Effects by Type and Coping Strategy. Ann Behav Med 2023; 57:442-452. [PMID: 36534964 PMCID: PMC10205141 DOI: 10.1093/abm/kaac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Discrimination has been posited as a contributor of sleep disparities for Latinxs. The strategy used to cope with discrimination may reduce or exacerbate its effects on sleep. This study examined whether different types of discrimination (everyday and major lifetime discrimination) were associated with sleep indices (quality, disturbances, efficiency) and whether coping strategy used moderated associations. METHOD Data of Latinx adults (N = 602; 51% women, 65% Dominican, Mage = 46.72 years) come from the Latino Health and Well-being Project, a community-based, cross-sectional study of Latinxs in Lawrence, MA. Multiple linear regressions were estimated separately for each sleep outcome. RESULTS Everyday discrimination was significantly associated with poorer sleep quality and greater disturbances; major lifetime discrimination was significantly associated with worse sleep across the three sleep indices. Coping strategy moderated associations between discrimination and sleep. Compared with Latinxs who used passive coping, those who used passive-active coping strategies had poorer sleep quality the more they experienced everyday discrimination. Latinxs who used any active coping strategy, compared with passive coping, had greater sleep disturbances the more frequently they experienced major lifetime discrimination. CONCLUSIONS Findings show that everyday discrimination and major lifetime discrimination are associated with different dimensions of sleep and suggest that coping with discrimination may require the use of different strategies depending on the type of discrimination experienced.
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Affiliation(s)
- Angelina Majeno
- Department of Psychological Science, University of California–Irvine, Irvine, CA, USA
| | - Kristine M Molina
- Department of Psychological Science, University of California–Irvine, Irvine, CA, USA
| | - Christine F Frisard
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Stephenie C Lemon
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros C Rosal
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Crane RS, Callen-Davies R, Francis A, Francis D, Gibbs P, Mulligan B, O’Neill B, Pierce Williams NK, Waupoose M, Vallejo Z. Mindfulness-Based Stress Reduction for Our Time: A Curriculum that is up to the Task. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231162604. [PMID: 37051461 PMCID: PMC10084571 DOI: 10.1177/27536130231162604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/29/2023] [Accepted: 02/14/2023] [Indexed: 04/14/2023]
Abstract
There is current heightened public consciousness of the intersecting challenges of social and racial injustice, other forms of inequity, and the climate and biodiversity crisis. We examine how these current realities influence how we engage as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Program (MBP) teachers and researchers. Although Kabat-Zinn developed MBSR as a vehicle to enable engagement with both the individual and the collective drivers of distress and flourishing, predominant research and practice trends within the MBP field have prioritised individual wellbeing, and have not been accessible to the full societal demographic. Furthermore, there is increasing recognition that the systemic social inequities that influence access to public services have not been addressed in the MBP field. In response, there is now an increasing trend exploring how MBP participation can influence 'bigger than self' concerns, with research, practice and theory suggesting that the inner personal transformation that mindfulness practice enables, supports individuals to compassionately reconnect to self, other and the natural world in ways that foster prosocial behaviour change, and enables awareness building of personal bias and conditioning. In this paper we present perspectives on ways of both retaining fidelity to the existing MBSR program, and simultaneously embracing anti-oppression teaching methods and content, and an inclusive recognition of the micro, meso and macro causes and conditions that drive distress and flourishing. We are a group of racially diverse MBP teachers and trainers from both sides of the Atlantic, who are engaged in training initiatives with people from Black, Latinex, Indigenous, Asian, and People of Color communities.
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Affiliation(s)
- Rebecca S. Crane
- Centre for Mindfulness Research and Practice, Bangor University, Bangor, UK
- The Mindfulness Network, Barnet, UK
- Rebecca S. Crane, Centre for Mindfulness Research and Practice, Bangor University, Brigantia Building, College Rd, Bangor LL57 2DG, UK.
| | - Robert Callen-Davies
- Centre for Mindfulness Research and Practice, Bangor University, Bangor, UK
- Aneurin Bevan University Health Board, Wales, UK
| | | | - Dean Francis
- Urban Mindfulness Foundation, London, UK
- Sussex Mindfulness Centre, Brighton, UK
- British Association of Mindfulness Based Approaches (BAMBA), Ashford, UK
| | - Pauline Gibbs
- Centre for Mindfulness Research and Practice, Bangor University, Bangor, UK
- The Mindfulness Network, Barnet, UK
- Freelance Mindfulness Teacher and Trainer, London, UK
- The Mindfulness Initiative, London, UK
| | - Beth Mulligan
- Center for Mindfulness, University of California San Diego, La Jolla, CA, USA
| | - Bridgette O’Neill
- Centre for Mindfulness Research and Practice, Bangor University, Bangor, UK
- The Mindfulness Network, Barnet, UK
- Sussex Mindfulness Centre, Brighton, UK
| | | | - Michael Waupoose
- Center for Mindfulness, University of California San Diego, La Jolla, CA, USA
- UW Health Mindfulness Program, Madison, WI, USA
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