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Adamis AM, Cole DA, Olatunji BO. Intolerance of Uncertainty and Worry Prospectively Predict COVID-19 Anxiety and Distress: A 4-Year Longitudinal Study. Behav Ther 2024; 55:320-330. [PMID: 38418043 PMCID: PMC10902602 DOI: 10.1016/j.beth.2023.07.009] [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: 02/06/2023] [Revised: 05/17/2023] [Accepted: 07/04/2023] [Indexed: 03/01/2024]
Abstract
The COVID-19 pandemic precipitated an uptick in poor mental health outcomes, including coronavirus-related anxiety and distress. Preliminary research has shown that intolerance of uncertainty (IU) and worry proneness, two transdiagnostic risk factors for anxiety and related disorders, are associated cross-sectionally with pandemic-related fear and distress. However, the extent to which IU and worry proneness prospectively predict coronavirus-related anxiety and distress is unclear. Whether IU and worry may also interact in prospectively predicting coronavirus-related anxiety and distress is also unknown. To address this knowledge gap, the present study examined IU and trait worry as prospective predictors of the level and trajectory of coronavirus anxiety and COVID stress syndrome over time, as well as the extent to which worry moderated the relation between IU and pandemic-related outcomes. Participants (n = 310) who completed self-report measures of IU and trait worry in 2016 were contacted following the onset of COVID-19 in 2020 and completed biweekly measures of coronavirus anxiety and COVID stress syndrome for 30 weeks. Multilevel models revealed that IU assessed in 2016 significantly predicted the severity of both coronavirus anxiety and COVID stress syndrome throughout the study period in 2020. Worry also moderated the link between IU and coronavirus anxiety, such that individuals with high levels of trait worry and high IU in 2016 experienced the most coronavirus anxiety in 2020. Results suggest that IU and worry functioned as independent and interactive vulnerability factors for subsequent adverse psychological reactions to COVID-19. Clinical implications and future directions are discussed.
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Erving CL, Zajdel R, McKinnon II, Van Dyke ME, Murden RJ, Johnson DA, Moore RH, Lewis TT. Gendered Racial Microaggressions and Black Women's Sleep Health. SOCIAL PSYCHOLOGY QUARTERLY 2023; 86:107-129. [PMID: 38371316 PMCID: PMC10869115 DOI: 10.1177/01902725221136139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Gendered racial microaggressions reflect historical and contemporary gendered racism that Black women encounter. Although gendered racial microaggressions are related to psychological outcomes, it is unclear if such experiences are related to sleep health. Moreover, the health effects of gendered racial microaggressions dimensions are rarely investigated. Using a cohort of Black women (N = 400), this study employs an intracategorical intersectional approach to (1) investigate the association between gendered racial microaggressions and sleep health, (2) assess whether gendered racial microaggressions dimensions are related to sleep health, and (3) examine whether the gendered racial microaggressions-sleep health association persists after accounting for depressive symptoms and worry. Gendered racial microaggressions were associated with poor sleep quality overall and four specific domains: subjective sleep quality, latency, disturbance, and daytime sleepiness. Two gendered racial microaggressions dimensions were especially detrimental for sleep: assumptions of beauty/sexual objectification and feeling silenced and marginalized. After accounting for mental health, the effect of gendered racial microaggressions on sleep was reduced by 47 percent. Future research implications are discussed.
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Affiliation(s)
| | - Rachel Zajdel
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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3
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Burke LA, Chijioke S, Le TP. Gendered racial microaggressions and emerging adult Black women's social and general anxiety: Distress intolerance and stress as mediators. J Clin Psychol 2023; 79:1051-1069. [PMID: 36413584 DOI: 10.1002/jclp.23460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022]
Abstract
There is robust evidence that gendered racial microaggressions affect Black women's mental health. However, few studies have examined how this form of discrimination affects Black women's social anxiety in addition to their general anxiety, as well as the underlying mechanisms related to gendered racial microaggressions and anxiety. OBJECTIVE The purpose of this study was to examine the associations between gendered racial microaggressions stress (GRMS) and gendered racial microaggressions frequency (GRMF), and Black women's social anxiety and general anxiety symptoms. We also examined the mediating roles of distress intolerance and stress in these associations. METHOD One hundred and sixty-three Black women, between the ages of 18 and 25 years old, completed a cross-sectional survey. Regression analyses were used to examine the associations between gendered racial microaggressions and social anxiety and general anxiety, and mediation analyses examined the indirect effect of gendered racial microaggressions on the outcome variables through distress intolerance and stress. RESULTS GRMS was associated with greater social and general anxiety through the mechanisms of distress intolerance and stress. GRMF was associated with reduced social anxiety and was not associated with general anxiety. CONCLUSIONS Intervention efforts should be aimed to prevent the experience of gendered racial microaggressions to prevent subsequent stress and mental health outcomes for Black women.
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Affiliation(s)
- Lindsey A Burke
- Department of Psychology, The University of Maryland, College Park, Maryland, USA
| | - Sandra Chijioke
- Department of Psychology, The University of Maryland, College Park, Maryland, USA
| | - Thomas P Le
- Department of Psychology, The University of Maryland, College Park, Maryland, USA
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Qiu H, Lu H, Pei J, Zhang Y, Ma Y, Xing C, Wang X, Zhu X. Effects of chronic stress on smartphone addiction: A moderated mediation model. Front Public Health 2023; 11:1048210. [PMID: 36741954 PMCID: PMC9895953 DOI: 10.3389/fpubh.2023.1048210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
Introduction Based on the compensatory Internet use theory and diathesis-stress model, the present study explores the effects of chronic stress on smartphone addiction (SPA). As intolerance of uncertainty and emotion-related variables are important factors that affect addictive behavior, we explore the mediating role of intolerance of uncertainty and the moderating role of emotion differentiation. Methods We conducted a questionnaire survey of 286 participants (13.64% female; M age = 22.88; SD = 3.77; range = 17-39) on chronic stress, SPA, intolerance of uncertainty, and emotion differentiation. SPSS 28.0 was used to analyze the descriptive statistics and correlations and test the moderated mediation model. Results We find that (1) intolerance of uncertainty, SPA, and chronic stress are positively correlated with each other. Positive emotion differentiation is positively correlated with intolerance of uncertainty and negative emotion differentiation. (2) Intolerance of uncertainty plays a mediating role in chronic stress and SPA. (3) Positive emotion differentiation significantly moderates the relationship between chronic stress and SPA. Under the condition of low positive emotion differentiation, chronic stress is more effective in predicting SPA. Discussion These findings may contribute to intervention and prevention programs for SPA. Thus, the intervention and prevention of SPA can start from two directions-reduce the intolerance of uncertainty and enhance the ability to experience positive emotion differentiation.
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Affiliation(s)
- Huake Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Hongliang Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Jiawei Pei
- Outpatient Department, 969 Hospital of PLA, Hohhot, China
| | - Yajuan Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Yongjie Ma
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Chen Xing
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Xinlu Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China,*Correspondence: Xia Zhu ✉
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Hoggard LS, Volpe VV, Hatton VL, Jones SJ, Tikhonov AA, Davis SE. "Now I just need something sweet": Racism, emotional eating, and health among African Americans. Soc Sci Med 2023; 316:114947. [PMID: 35410763 DOI: 10.1016/j.socscimed.2022.114947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/21/2022] [Accepted: 03/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The Environmental Affordances Model theorizes that systemic racism disproportionately exposes African Americans in the United States to chronic everyday stressors (e.g., individual racism) while simultaneously shaping the availability of coping resources (e.g., fast food outlets) and engagement in self-regulatory strategies (e.g., emotional eating). Greater engagement in self-regulatory strategies is theorized to preserve mental health while contributing to medical morbidities and mortality. OBJECTIVE However, few studies have tested the Environmental Affordances Model, limiting our understanding of how the proposed pathways operate in the lives of African Americans. METHODS In the present study, the associations between systemic racism (institutional racism, cultural racism, neighborhood disadvantage), chronic everyday stressors (exposure to individual racism), emotional eating, and mental (anxiety symptomatology) and physical (self-rated overall physical health) health are assessed in a sample of 751 African Americans aged 18 to 88. RESULTS The path analysis reveals that institutional and cultural racism are both positively associated with individual racism. Neighborhood disadvantage is inversely associated with individual racism. Individual racism is significantly associated with greater anxiety symptomatology but is unrelated to self-rated overall physical health. Institutional and cultural racism are associated with emotional eating although individual racism and neighborhood disadvantage are not. Moreover, engagement in emotional eating exacerbates, rather than mitigates, the impacts of individual racism on anxiety symptomatology. CONCLUSIONS We conclude that institutional and cultural racism contribute to individual racism experiences and emotional eating whereas emotional eating exacerbates associations among individual racism and anxiety symptomatology.
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Sadeh N, Bounoua N. Race moderates the impact of intolerance of uncertainty on mental health symptoms in Black and White community adults. J Anxiety Disord 2023; 93:102657. [PMID: 36455413 PMCID: PMC9839518 DOI: 10.1016/j.janxdis.2022.102657] [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: 03/04/2022] [Revised: 08/20/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022]
Abstract
Racism increases the amount of uncertainty in daily life, which may differentially affect the mental health of individuals from racial minority groups who score high on trait intolerance of uncertainty (IU), or the tendency to experience uncertainty as highly aversive. We examined associations between trait IU and current symptoms of common mental disorders in community samples of Black (N = 125) and White (N = 125) adults ages 18-55 who were matched on age, gender, and educational attainment. Given that data were collected between 2017 and 2021, we also examined pandemic exposure as a moderator of these associations. No mean differences emerged between Black and White adults on trait IU measured with the Intolerance of Uncertainty Scale-12 or on current psychiatric symptoms assessed with the Structured Clinical Interview for DSM-5. Trait IU was more strongly associated with current psychiatric symptoms in Black than White adults, a racial difference that dissipated following pandemic exposure. Present results extend prior work by suggesting the dispositional tendency to find uncertainty aversive is a stronger predictor of mental health symptoms in Black than White adults outside the context of pandemic-related stress. Implications of these findings for understanding the impact of racial- and pandemic-related environmental uncertainty on mental health is discussed.
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Affiliation(s)
- Naomi Sadeh
- University of Delaware, Department of Psychological and Brain Sciences, USA.
| | - Nadia Bounoua
- University of Delaware, Department of Psychological and Brain Sciences, USA
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Soltani S, Noel M, Neville A, Birnie KA. Intolerance of Uncertainty in Pediatric Chronic Pain: Dyadic Relationships Between Youth and Parents. THE JOURNAL OF PAIN 2022; 23:1581-1593. [PMID: 35470088 DOI: 10.1016/j.jpain.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/27/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
The current study used a dyadic analytic approach (actor-partner interdependence models) to assess the stability and interrelationships of intolerance of uncertainty (IU) among a cohort of youth with chronic pain and their parents (n = 156 dyads). Relationships between parent and youth IU, parent and youth pain interference, and parent and youth internalizing mental health symptoms were examined. At baseline and follow-up, youth and parents completed psychometrically-sound questionnaires to assess their respective IU, pain characteristics, and clinical outcomes (pain interference, anxiety, depressive, and posttraumatic stress symptoms). Our findings support the construct stability of IU over time, as well as intrapersonal (ie, actor) effects of IU on follow-up youth pain interference and mental health symptoms and parents' mental health symptoms (but not parent pain interference). There were no interpersonal (ie, partner) effects over time between youth and parent IU or between youth and parent IU and pain interference or mental health symptoms. These findings align with previous research evidencing IU as a transdiagnostic risk factor for a range of mental health concerns and extend previous findings by showing the stability of parent and youth IU over time and its potential predictive relevance to outcomes in a clinical sample of youth with chronic pain. PERSPECTIVE: This article presents dyadic analyses assessing intrapersonal and interpersonal associations between intolerance of uncertainty (IU) and pain and mental health symptoms in youth with chronic pain and their parents. Analyses evidenced short-term construct stability of IU and intrapersonal (but not interpersonal) effects of IU on pain and mental health symptoms.
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Affiliation(s)
- Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, Calgary, Alberta, Canada
| | - Alexandra Neville
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn A Birnie
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Kogan CS, Noorishad PG, Ndengeyingoma A, Guerrier M, Cénat JM. Prevalence and correlates of anxiety symptoms among Black people in Canada: A significant role for everyday racial discrimination and racial microaggressions. J Affect Disord 2022; 308:545-553. [PMID: 35460740 DOI: 10.1016/j.jad.2022.04.110] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Anxiety disorders are highly prevalent worldwide but vary significantly by country and ethnoracial background. Minimal published data exist on the prevalence of clinically significant anxiety among Black people in Canada and none using validated measures. Therefore, this study sought to establish the frequency of clinically significant anxiety symptoms among a sample of Black people living in Canada as well as examine the association with two forms of racism (racial discrimination and racial microaggressions). METHODS Data collected from the Black Community Mental Health project in Canada was analyzed. Participants provided (N= 845) sociodemographic information and completed measures assessing anxiety symptomology (GAD-7), everyday racial discrimination, racial microaggressions, and resilience. Prevalence of anxiety symptomatology was determined across sociodemographic variables as well as categories of everyday racial discrimination and racial microaggressions. Two regression models were conducted to examine the relationship between anxiety symptoms and the two forms of racism controlling for sociodemographic factors. RESULTS Overall, nearly a third of participants endorsed clinically significant levels of anxiety symptoms, with higher rates observed among men, unemployed people, those with higher education, people who are separated, and those with no reported family history of mental health problems. Logistic regression models demonstrated that, except for those reporting the greatest frequency of racial discrimination, there is a general linear trend such that those experiencing higher levels of racial discrimination or racial microaggressions are increasingly more likely to present with anxiety symptoms when compared to those reporting low levels of discrimination or microaggressions. Psychological resilience afforded nominal protection but only against exposure to racial microaggressions. CONCLUSIONS Rates of clinically significant anxiety are higher among Black people in Canada than reported previously. Both racial discrimination and racial microaggressions predicted higher rates of anxiety symptoms. The results are discussed in relation to previous findings from the US that report similar findings.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada.
| | | | | | | | - Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada.
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Davis TM, Settles IH, Jones MK. Standpoints and Situatedness: Examining the Perception of Benevolent Sexism in Black and White Undergraduate Women and Men. PSYCHOLOGY OF WOMEN QUARTERLY 2022. [DOI: 10.1177/03616843211043108] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Racial differences in benevolent sexism have been underexplored. To address this gap, we used standpoint theory as a framework to examine race-gender group differences in the endorsement of benevolent sexism and how cultural factors (i.e., egalitarianism, religiosity, and racial identity) and inequality factors (i.e., experiences with racial discrimination and support for social hierarchies) might mediate this relationship. Among 510 Black and white undergraduate women and men, we found racial differences, such that Black women and men had higher endorsement of benevolent sexism than white women and men. Further, there was a gender difference for only white participants, with white men endorsing these attitudes more than white women. For Black women, religiosity and racial identity mediated the relationship between their race-gender group and greater benevolent sexism compared to white women, but only religiosity mediated the relationship for Black men. Neither inequality mediator accounted for benevolent sexism differences; however, both were associated with white women’s lower benevolent sexism, as was egalitarianism. Given these findings, we discuss implications for benevolent sexism theory, the possibility that cultural factors may shape Black women and men’s standpoint by establishing group-based norms and expectations around benevolently sexist behavior, and suggest culturally appropriate methods to reduce sexism.
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Affiliation(s)
- Tangier M. Davis
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Isis H. Settles
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Department of Afroamerican and African Studies, University of Michigan, Ann Arbor, MI, USA
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Pinciotti CM, Riemann BC, Abramowitz JS. Intolerance of uncertainty and obsessive-compulsive disorder dimensions. J Anxiety Disord 2021; 81:102417. [PMID: 33991818 DOI: 10.1016/j.janxdis.2021.102417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/23/2021] [Accepted: 05/04/2021] [Indexed: 01/23/2023]
Abstract
Intolerance of uncertainty (IU), which can include prospective (i.e., desire for predictability) and inhibitory (i.e., uncertainty paralysis) IU, is widely understood to be a central underlying component of obsessive-compulsive disorder (OCD). IU has several treatment implications, yet research on the differences in IU underlying OCD dimensions is limited and does not account for covarying effects of overlapping symptoms, shared variance in IU, demographic variables, and comorbid psychiatric conditions like generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). A sample of 974 patients with diagnosed OCD enrolled in residential, partial hospitalization, and intensive outpatient treatment programs for OCD and anxiety completed self-report measures of OCD symptoms and IU at admission. Structural equation modeling included prospective. inhibitory IU, and common IU and covariates (i.e., race, ethnicity, level of care, and comorbid GAD and PTSD) as predictors of four common OCD dimensions found that contamination and unacceptable thoughts symptoms evidenced a unique relationship with IU. Specifically, whereas a common IU factor predicted all four OCD symptom dimensions, inhibitory IU uniquely predicted contamination and unacceptable thoughts symptoms over and above covarying effects. Individuals with contamination and unacceptable thoughts symptoms may be more likely to feel "paralyzed" by uncertainty due to overreliance on overt immediate rituals, outright avoidance, rumination, or difficulties with emotion regulation, and may benefit from additional psychoeducation, problem-solving, and accountability. Broadly, individuals with OCD may benefit from explicit discussions about IU-related expectancies and disconfirmation of fears.
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Affiliation(s)
| | - Bradley C Riemann
- Rogers Behavioral Health, 34700 Valley Rd., Oconomowoc, WI, 53066, USA
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, 235 E. Cameron Ave, Chapel Hill, NC, 27514, USA
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11
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Relations between racial stress and critical consciousness for black adolescents. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1016/j.appdev.2020.101184] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Geronimi EMC, Richards A, Gramszlo C, Woodruff-Borden J. A Preliminary Investigation of Cognitive Features Associated With Worry Among African American Youth. JOURNAL OF BLACK PSYCHOLOGY 2019. [DOI: 10.1177/0095798419870076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although knowledge of the cognitive factors that place children at risk for worry has grown, little is known about these processes within African American youth. The present study investigated cognitive factors associated with worry in a sample of 47 African American children, ages 8 to 13. Participants completed self-report measures of worry, intolerance of uncertainty, positive and negative beliefs about worry, and negative problem orientation. Results supported the hypothesis that cognitive factors demonstrated significant positive associations with worry. Based on a model predicting worry from all cognitive factors, negative beliefs about worry emerged as the only individual predictor. This is the first study to examine cognitive factors associated with worry in an African American sample of children and provides initial support for the applicability of these cognitive factors in future examinations of worry within this population. Future research should continue to explore cognitive as well as other factors that predispose African America children to worry.
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Hollingsworth DW, Gauthier JM, McGuire AP, Peck KR, Hahn KS, Connolly KM. Intolerance of Uncertainty Mediates Symptoms of PTSD and Depression in African American Veterans With Comorbid PTSD and Substance Use Disorders. JOURNAL OF BLACK PSYCHOLOGY 2018. [DOI: 10.1177/0095798418809201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a major health concern among veterans, specifically African American veterans, and is commonly comorbid with other negative mental health outcomes including substance use disorders (SUD) and symptoms of depression. The current study examined intolerance of uncertainty as a mediator of the relationship between PTSD and depression symptoms in a sample of African American veterans with a dual diagnosis of PTSD and SUD. Participants included 113 African American veterans who were in treatment for PTSD and SUD at a Veterans Affairs Medical Center. Five mediation analyses were conducted to examine the mediational effect of intolerance of uncertainty on the relationship between PTSD symptom clusters (i.e., total, hyperarousal, numbness, avoidance, and intrusion) and depression symptoms. Findings indicated that intolerance of uncertainty mediated the relationship between four of the five mediation models (i.e., total symptoms, hyperarousal, numbness, and intrusion). These results imply that for African American veterans, higher levels of certain PTSD symptoms were associated with higher levels of intolerance of uncertainty, which in turn were related to increased levels of depression symptoms.
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Affiliation(s)
- David W. Hollingsworth
- Fairfield University, Fairfield, CT, USA
- University of Mississippi Medical Center, Jackson, MS, USA
- G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA
| | - Jami M. Gauthier
- University of Mississippi Medical Center, Jackson, MS, USA
- G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA
| | - Adam P. McGuire
- University of Mississippi Medical Center, Jackson, MS, USA
- G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA
- Central Texas Health Care System, Waco, TX, USA
| | - Kelly R. Peck
- University of Mississippi Medical Center, Jackson, MS, USA
- G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA
- University of Vermont, Burlington, VT, USA
| | | | - Kevin M. Connolly
- Alvin C. York Veterans Affairs Medical Center, Murfreesboro, TN, USA
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Carleton RN, Desgagné G, Krakauer R, Hong RY. Increasing intolerance of uncertainty over time: the potential influence of increasing connectivity. Cogn Behav Ther 2018; 48:121-136. [DOI: 10.1080/16506073.2018.1476580] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- R. Nicholas Carleton
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, Canada
| | - Gabrielle Desgagné
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, Canada
| | - Rachel Krakauer
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, Canada
| | - Ryan Y. Hong
- Department of Psychology, National University of Singapore, Singapore
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15
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Nagendra A, Twery BL, Neblett EW, Mustafic H, Jones TS, Gatewood D, Penn DL. Social cognition and African American men: The roles of perceived discrimination and experimenter race on task performance. Psychiatry Res 2018; 259:21-26. [PMID: 29024856 DOI: 10.1016/j.psychres.2017.09.074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 07/08/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Abstract
The Social Cognition Psychometric Evaluation (SCOPE) study consists of a battery of eight tasks selected to measure social-cognitive deficits in individuals with schizophrenia. The battery is currently in a multisite validation process. While the SCOPE study collects basic demographic data, more nuanced race-related factors might artificially inflate cross-cultural differences in social cognition. As an initial step, we investigated whether race, independent of mental illness status, affects performance on the SCOPE battery. Thus, we examined the effects of perceived discrimination and experimenter race on the performance of 51 non-clinical African American men on the SCOPE battery. Results revealed that these factors impacted social cognitive task performance. Specifically, participants performed better on a skills-based task factor in the presence of Black experimenters, and frequency of perceived racism predicted increased perception of hostility in negative interpersonal situations with accidental causes. Thus, race-related factors are important to identify and explore in the measurement of social cognition in African Americans.
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Affiliation(s)
- Arundati Nagendra
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA.
| | - Benjamin L Twery
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA
| | - Enrique W Neblett
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA
| | - Hasan Mustafic
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA
| | - Tevin S Jones
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA
| | - D'Angelo Gatewood
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA
| | - David L Penn
- Department of Psychology, University of North Carolina, 235 E Cameron Ave., Chapel Hill, NC, 27599, USA; School of Psychology, Australian Catholic University, 115 Victoria Parade Fitzroy, Melbourne, VIC 3065, Australia
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16
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Neblett EW, Bernard DL, Banks KH. The Moderating Roles of Gender and Socioeconomic Status in the Association Between Racial Discrimination and Psychological Adjustment. COGNITIVE AND BEHAVIORAL PRACTICE 2016. [DOI: 10.1016/j.cbpra.2016.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A, Gupta A, Kelaher M, Gee G. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0138511. [PMID: 26398658 PMCID: PMC4580597 DOI: 10.1371/journal.pone.0138511] [Citation(s) in RCA: 1189] [Impact Index Per Article: 132.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/30/2015] [Indexed: 12/20/2022] Open
Abstract
Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.
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Affiliation(s)
- Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Jehonathan Ben
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Nida Denson
- School of Social Sciences and Psychology, University of Western Sydney, Sydney, New South Wales, Australia
| | - Amanuel Elias
- Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Naomi Priest
- Australian Centre for Applied Social Research Methods, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alex Pieterse
- Division of Counseling Psychology, University at Albany, State University of New York, New York, New York, United States of America
| | - Arpana Gupta
- Oppenheimer Center for Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Margaret Kelaher
- Centre for Health Policy Programs and Economics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Gilbert Gee
- Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, California, United States of America
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Kertz SJ, Bakhti R, Stevens KT, Curewitz A. Testing Cognitive and Emotion-Focused Models of Worry in Black and White Samples. Cogn Behav Ther 2015; 44:353-64. [PMID: 25730261 DOI: 10.1080/16506073.2015.1013055] [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: 10/23/2022]
Abstract
Several models have been proposed to conceptualize worry. Broadly, the models can be classified as cognitive (including the Avoidance Model, the Intolerance of Uncertainty Model, and the Metacognitive Model) and emotion-focused (including Emotion Dysregulation and Acceptance-Based models). Although these models have received strong empirical investigation in primarily non-Hispanic White samples, no known study has examined the applicability to racial and ethnic minority groups. The current study compared the proportion of variance explained by cognitive and emotion-focused models of worry in White and Black samples. Results indicated that cognitive and emotion-focused models significantly predicted worry in both Black and White samples. However, the overall amount of variance in worry explained by the models was less for Black samples. Specifically, controlling for gender, the cognitive models explained 53% of the variance in worry in the White sample compared with 19% in the Black sample. Similarly, the emotion-focused models explained 34% of the variance in worry in the White sample but only 13% in the Black sample. These findings suggest that well-established conceptual frameworks for worry failed to explain the bulk of the variance in worry in Black samples, leaving much unknown. Additional research is needed to identify key variables that may further explain worry in ethnic minority samples.
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Affiliation(s)
- Sarah J Kertz
- a Department of Psychology, Southern Illinois University , Life Science II 6502, Carbondale , IL 62901 , USA
| | - Rinad Bakhti
- a Department of Psychology, Southern Illinois University , Life Science II 6502, Carbondale , IL 62901 , USA
| | - Kimberly T Stevens
- a Department of Psychology, Southern Illinois University , Life Science II 6502, Carbondale , IL 62901 , USA
| | - Alana Curewitz
- a Department of Psychology, Southern Illinois University , Life Science II 6502, Carbondale , IL 62901 , USA
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A preliminary exploration of the moderating role of valued living in the relationships between racist experiences and anxious and depressive symptoms. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2014.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Markell HM, Newman MG, Gallop R, Gibbons MBC, Rickels K, Crits-Christoph P. Combined medication and CBT for generalized anxiety disorder with African American participants: reliability and validity of assessments and preliminary outcomes. Behav Ther 2014; 45:495-506. [PMID: 24912462 PMCID: PMC4260926 DOI: 10.1016/j.beth.2014.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/13/2014] [Accepted: 02/13/2014] [Indexed: 11/28/2022]
Abstract
Using data from a study of combined cognitive behavioral therapy (CBT) and venlafaxine XR in the treatment of generalized anxiety disorder (GAD), the current article examines the reliability and convergent validity of scales, and preliminary outcomes, for African American compared with European American patients. Internal consistency and short-term stability coefficients for African Americans (n=42) were adequate and similar or higher compared with those found for European Americans (n=164) for standard scales used in GAD treatment research. Correlations among outcome measures among African Americans were in general not significantly different for African Americans compared with European Americans. A subset of patients with DSM-IV-diagnosed GAD (n=24 African Americans; n=52 European Americans) were randomly selected to be offered the option of adding 12 sessions of CBT to venlafaxine XR treatment. Of those offered CBT, 33.3% (n=8) of the African Americans and 32.6% (n=17) of the European Americans accepted and attended at least one CBT treatment session. The outcomes for African Americans receiving combined treatment were not significantly different from European Americans receiving combined treatment on primary or secondary efficacy measures.
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Affiliation(s)
- Hannah M. Markell
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104
| | - Michelle G. Newman
- Department of Psychology, Pennsylvania State University, 111 Moore Building, University Park, PA 16802
| | - Robert Gallop
- Department of Mathematics, West Chester University, 25 University Avenue, West Chester, PA 19383
| | | | - Karl Rickels
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104
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Lee DB, Neblett EW, Jackson V. The Role of Optimism and Religious Involvement in the Association Between Race-Related Stress and Anxiety Symptomatology. JOURNAL OF BLACK PSYCHOLOGY 2014. [DOI: 10.1177/0095798414522297] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study examined the associations between individual, institutional, and cultural race-related stress and somatic and cognitive anxiety. We adopted a risk and resilience framework to investigate the protective role of optimism and religious involvement in the race-related stress-anxiety link. A total of 171 African American young adults completed measures of race-related stress, optimism, religious involvement, and anxiety symptomatology. Institutional race-related stress was positively associated with cognitive and somatic anxiety. Optimism moderated the association between individual race-related stress and cognitive anxiety. Religious involvement enhanced the protective function of optimism in the association between individual and cultural race-related stress and cognitive anxiety. These results illustrate the utility of a multidimensional framework for understanding the impact of race-related stress on anxiety symptomatology. Moreover, the pattern of findings suggests that high religious involvement and high optimism may produce the most advantageous outcomes with respect to the association between race-related stress and anxiety in African American young adults.
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Affiliation(s)
- Daniel B. Lee
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Veronica Jackson
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Fergus TA, Wu KD. The intolerance of uncertainty scale: measurement invariance, population heterogeneity, and its relation with worry among self-identifying White and Black respondents. Assessment 2012; 20:555-64. [PMID: 22984142 DOI: 10.1177/1073191112460272] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although it is understood that assessment tools require evaluation using diverse samples, such evaluations are relatively rare. There are obstacles to such work, but it remains important to pursue psychometric data in broad samples. As such, we evaluated measurement invariance and population heterogeneity of two versions of a widely used measure in the anxiety literature--the Intolerance of Uncertainty Scale (IUS)--among self-identifying White (N = 1,185) and Black (N = 301) students. Data from multiple-groups confirmatory factor analysis supported the equivalence of the equal form and factor loadings of both IUS versions in White and Black respondents. However, specific IUS items functioned differently in the two groups, with more IUS items appearing biased in the full-length relative to the short-form version. Correlations between IUS factors and worry were equivalent among White and Black respondents. We discuss the implications of these results for future research.
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Przeworski A, Newman MG, Pincus AL, Kasoff MB, Yamasaki AS, Castonguay LG, Berlin KS. Interpersonal pathoplasticity in individuals with generalized anxiety disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2011; 120:286-98. [PMID: 21553942 PMCID: PMC3206596 DOI: 10.1037/a0023334] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Recent theories of generalized anxiety disorder (GAD) have emphasized interpersonal and personality functioning as important aspects of the disorder. We examined heterogeneity in interpersonal problems in 2 studies of individuals with GAD (n = 47 and n = 83). Interpersonal subtypes were assessed with the Inventory of Interpersonal Problems-Circumplex (Alden, Wiggins, & Pincus, 1990). Across both studies, individuals with GAD exhibited heterogeneous interpersonal problems, and cluster analyses of these patients' interpersonal characteristics yielded 4 replicable clusters, identified as intrusive, exploitable, cold, and nonassertive subtypes. Consistent with our pathoplasticity hypotheses, clusters did not differ with GAD severity, anxiety severity, or depression severity. Clusters in Study 2 differed on rates of personality disorders, including avoidant personality disorder, further providing support for the validity of interpersonal subtypes. The presence of interpersonal subtypes in GAD may have important implications for treatment planning and efficacy.
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Affiliation(s)
- Amy Przeworski
- Department of Psychological Sciences, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-7123, USA.
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