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Simon KE, Buttram ME, Samuel KD, Doyle NA, Davis RE. Stigma Related to the Non-Medical Use and Diversion of Prescription Stimulant Drugs: Should We Care. Subst Use Misuse 2024; 59:1200-1209. [PMID: 38565901 DOI: 10.1080/10826084.2024.2330903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Non-medical use (NMU) and diversion of prescription stimulants are prevalent on college campuses. Diversion represents a primary source of acquisition for NMU among young adults. This study examined relationships between stigmatizing beliefs related to NMU and diversion of stimulant medications and engagement in these behaviors, as well as how such perceptions are associated with indicators of psychological distress among those who engage in these behaviors. METHODS Young adults (N = 384) were recruited from a large US university to participate in this cross-sectional electronic survey-based study. Relationships between stigma variables and NMU and diversion were assessed. Among those who engage in NMU and diversion, we tested relationships between stigma variables and indicators of psychological distress, using validated instruments. RESULTS Perceived social and personal stigmatic beliefs did not significantly predict NMU. However, perceived social and personal stigma of diversion significantly reduced diversion likelihood. For NMU, associations were found between stigma variables and indicators of psychological distress. Markedly, we found that as stigmatic perceptions of NMU increased, so did depressive, anxiolytic, and suicidal symptomatology among those who engage in NMU. CONCLUSIONS Stigmatization does not deter NMU; however, stigmatization is positively associated with psychological harm among those who engage in NMU. Interventions should be developed to reduce stigmatization in order to improve psychological health among those who engage in NMU. Stigmatic perceptions of diversion were not predictive of psychological harm, though they are negatively associated with diversion behavior.
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Affiliation(s)
- Kayla E Simon
- Department of Health, Human Performance, and Recreation, Substance Use and Mental Health Laboratory, University of Arkansas, Fayetteville, Arkansas, USA
| | - Mance E Buttram
- Department of Health, Human Performance, and Recreation, Center for Public Health and Technology, University of Arkansas, Fayetteville, Arkansas, USA
| | - Krishen D Samuel
- Department of Health, Human Performance, and Recreation, Substance Use and Mental Health Laboratory, University of Arkansas, Fayetteville, Arkansas, USA
| | - Nicole A Doyle
- College of Global Population Health, University of Health Sciences and Pharmacy, St. Louis, Missouri, USA
| | - Robert E Davis
- Department of Health, Human Performance, and Recreation, Substance Use and Mental Health Laboratory, University of Arkansas, Fayetteville, Arkansas, USA
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Ao MQ, Xia L, Wang XQ, Fang S, Yang BX, Liu Q, Chen J, Zhou SC, Li XY, Sun T, Lu B, Bao A, Luo D, Ruan J. Help-Seeking Intentions for Depression from Mental Health Professionals Among Community-Dwelling Persons in Central China. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:901-911. [PMID: 37277690 DOI: 10.1007/s10488-023-01277-8] [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] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
Understanding the intention of community residents to seek help from mental health professionals (MHPs) is essential in targeting interventions that promote the prevention and treatment of depression. This study aimed to investigate the current status of Chinese community populations' depression help-seeking intentions from MHPs and explore factors influencing the intentions. Data were used from a survey conducted in a city in central China (n = 919 aged 38.68 ± 17.34, 72.1% female). Help-seeking intentions, help-seeking attitude, depression stigma, family function and depressive symptoms were measured. The total mean score on the intent to seek help from MHPs was 11.01 ± 7.78 and most of respondents were unwilling to seek professional help. Multiple linear regression showed that participants who were students, held a positive help-seeking attitude and had low personal stigma were more likely to have the intention to seek help from MHPs. It is necessary to utilize effective interventions to improve community residents' intention to seek professional help. These include promoting the importance of seeking professional assistance, optimizing the quality of mental health services and altering residents' prejudice to seeking professional help.
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Affiliation(s)
- Meng Qin Ao
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Lin Xia
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Xiao Qin Wang
- School of Nursing, Wuhan University, Wuhan, 430071, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shu Fang
- Department of Hepatopancreatobiliary Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bing Xiang Yang
- School of Nursing, Wuhan University, Wuhan, 430071, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Qian Liu
- School of Nursing, Wuhan University, Wuhan, 430071, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Jie Chen
- College of Nursing, Florida State University, Tallahassee, USA
| | - Si Chen Zhou
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Xin Yi Li
- School of Nursing, Wuhan University, Wuhan, 430071, China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Baili Lu
- Wuhan Mental Health Center, Wuhan, China
| | - Anyu Bao
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| | - Dan Luo
- School of Nursing, Wuhan University, Wuhan, 430071, China.
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
- Population and Health Research Center, Wuhan University, Wuhan, China.
| | - Juan Ruan
- Wuhan Mental Health Center, Wuhan, China.
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Walker HE, Wamser-Nanney R. Revictimization Risk Factors Following Childhood Maltreatment: A Literature Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2319-2332. [PMID: 35476548 DOI: 10.1177/15248380221093692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Revictimization research, to date, has primarily focused on sexual revictimization (i.e., child sexual abuse and adult sexual assault), which has resulted in a lack of understanding of trauma revictimization more generally. Specifically, it is unclear what factors are placing individuals with a history of child maltreatment (i.e., sexual abuse, physical abuse, and witnessing intimate partner violence [IPV]) at greater risk for subsequent adult victimization (i.e., sexual assault and IPV). Existing theoretical and empirical work on revictimization suggest that multiple risk factors are likely present within this framework (e.g., posttraumatic stress symptoms [PTSS], emotion dysregulation, and risk-taking behaviors). Prior research has suggested that PTSS are often linked with these other risk factors, and it is possible that the development of PTSS following child maltreatment may be related to the development or maintenance of additional factors that increase the likelihood of revictimization. The purpose of this review was to synthesize findings regarding risk factors that place maltreated individuals at greater risk for adult revictimization. Approximately 228 studies were identified following a thorough search of the peer-reviewed literature using multiple databases (PsycINFO, PILOTS, and Google Scholar). Each study was critically analyzed for relevance. The included studies were used in our review of prevalence, specific risk factors that have been identified, and unanswered questions in this literature. PTSS were noted to be particularly important in the revictimization framework, and thus, a novel model of revictimization was also proposed where PTSS are illustrated as being associated with the development and maintenance of other factors within the revictimization framework.
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Affiliation(s)
- Hannah E Walker
- Department of Psychological Sciences, University of Missouri- St. Louis, St. Louis, MO, USA
| | - Rachel Wamser-Nanney
- Department of Psychological Sciences, University of Missouri- St. Louis, St. Louis, MO, USA
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4
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Buckner JD, Zvolensky MJ, Ferrie ML, Morris PE. False safety behavior use among Black adults. Cogn Behav Ther 2023; 52:65-74. [PMID: 36562142 DOI: 10.1080/16506073.2022.2139291] [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: 12/24/2022]
Abstract
Anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to anxiety in predominantly White samples are related to anxiety among Black individuals. Yet, given less mental health service utilization and greater experience of some life stressors, Black persons may be especially at risk for using false safety behaviors (FSB; designed to decrease anxiety in the short term, but are associated with more longer-term mental health problems). We tested whether non-Hispanic/Latin Black persons (n = 133) reported greater FSB use than non-Hispanic/Latin White participants (n = 844) as well as whether FSB use was related to more mental health problems among Black participants. Data were collected online among undergraduates. Black participants did endorse more frequent FSB use, especially FSB-Avoidance and FSB-Body Sensations. Results indicate that among Black participants, FSB use was related to more anxiety, depression, and suicidal thoughts and behaviors. FSB may be an important behavioral vulnerability factor related to anxiety and associated mental health problems among Black young adults.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Health Institute, University of Houston, Houston, TX, USA
| | - Mara L Ferrie
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Paige E Morris
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Dean KE, Long ACJ, Trinh NH, McClendon J, Buckner JD. Treatment Seeking for Anxiety and Depression Among Black Adults: A Multilevel and Empirically Informed Psycho-Sociocultural Model. Behav Ther 2022; 53:1077-1091. [PMID: 36229108 DOI: 10.1016/j.beth.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 02/24/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Black adults with anxiety and/or depressive disorders underutilize outpatient psychotherapy and pharmacological treatment compared to White adults. Notably, anxiety and depressive disorders tend to be chronic and Black individuals with these disorders experience greater functional impairment than White individuals. Documented racial disparities in mental health treatment initiation indicate a need for research that addresses culture-specific barriers to treatment. This review paper critically evaluates existing theoretical models of treatment seeking among Black adults to inform a novel integrated, culturally contextualized model. This model extends previous ones by incorporating factors relevant to treatment seeking among Black adults (e.g., racial identity, perceived discrimination, medical mistrust) and critically examines how these factors intersect with key factors at three levels of influence of the treatment seeking process: the individual level, the community level, and the societal level. We posit interactions among factors at the three levels of influence and how these may impact treatment seeking decisions among Black adults. This model informs suggestions for enhancing interventions designed to support outpatient service use among Black adults.
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Affiliation(s)
| | | | - Nhi-Ha Trinh
- Massachusetts General Hospital/Harvard Medical School
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Marks LR, Schimmel-Bristow A, Harrell-Williams LM, Hargons C. Racial Discrimination and Risky Sex: Examining Cognitive-Emotional Factors in Black College Students. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221092662] [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
Using the lifespan biopsychosocial model of cumulative vulnerability and minority health as a theroretical lens, the present study proposed two models to test the relationships among racial discrimination, cognitive–emotional factors, and risky sexual behaviors in a sample of 302 Black college students in the United States. Our models provided support for some of the hypothesized direct and indirect pathways. As expected, overt racial discrimination and subtle racial discrimination (i.e., racial microaggression) were both positively related to cognitive–emotional factors (i.e., anxiety, depression, hopelessness, and hostility). Racial microaggressions were significantly positively related to risky sexual behaviors, but overt racial discrimination was not. Hostility was the only cognitive–emotional factor that facilitated an indirect, significant effect from racial microaggressions to risky sexual behaviors. Potential implications are discussed for practice, training programs, and future counseling psychology research with Black college students using the lifespan biopsychosocial model of cumulative vulnerability and minority health.
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Affiliation(s)
- Laura Reid Marks
- Florida State University, Department of Educational Psychology and Research, Combined Counseling and School Psychology Program, Tallahassee, FL, USA
- University of Memphis, Department of Counseling, Educational Psychology, and Research, Memphis, TN, USA
| | - Allison Schimmel-Bristow
- University of Memphis, Department of Counseling, Educational Psychology, and Research, Memphis, TN, USA
| | - Leigh M. Harrell-Williams
- University of Memphis, Department of Counseling, Educational Psychology, and Research, Memphis, TN, USA
| | - Candice Hargons
- University of Kentucky, Department of Educational, School, and Counseling Psychology, Lexington, KY, USA
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Hubbard SA, Lakey B, Jones SCT, Cage JL. Black Racial Identity, Perceived Support, and Mental Health Within Dyadic Relationships. JOURNAL OF BLACK PSYCHOLOGY 2022. [DOI: 10.1177/00957984221079209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Black racial identity (BRI), particularly centrality and private regard, have been linked to mental health and are often theorized to reflect trait-like and situational influences. We estimated the strength of trait and dyadic relationships (a type of situation) for BRI and its links to subclinical anxiety and depression. Black university students ( N = 110) rated their BRI, mental health, and perceived support when with or thinking about three relationship partners (e.g., mothers, friends). Variance components analyses estimated the strength of trait and dyadic effects. All constructs had significant trait and dyadic components. Participants with higher trait private regard and centrality reported better mental health than those with lower BRI. Additionally, BRI varied depending upon which partner was rated (dyadic effects). When a participant experienced high private regard or centrality with a partner, the participant had low subclinical depression and anxiety in that relationship. When a participant had high BRI and mental health when with a partner, the participant saw the partner as highly supportive. Findings suggest the importance of supportive others for adaptive BRI.
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Affiliation(s)
- Sultan A. Hubbard
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Brian Lakey
- Department of Psychology, Grand Valley State University, Allendale, MI, USA
| | - Shawn C. T. Jones
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Jamie L. Cage
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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8
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Li XY, Liu Q, Chen P, Ruan J, Gong X, Luo D, Zhou Y, Yin C, Wang XQ, Liu L, Yang BX. Predictors of Professional Help-Seeking Intention Toward Depression Among Community-Dwelling Populations: A Structural Equation Modeling Analysis. Front Psychiatry 2022; 13:801231. [PMID: 35280177 PMCID: PMC8907597 DOI: 10.3389/fpsyt.2022.801231] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background A low intention of professional help seeking hinders the effective treatment of depression. The factors are from the perspectives of the social, family, and individual; however, an understanding of how they interact to predict professional help-seeking intention (PHSI) is not clear. Objectives The objectives of the study was to investigate PHSI toward depression in a Chinese community-dwelling population and construct a predictive model of the PHSI to explore the various factors involved. Methods Stratified random sampling and Kish table methods were used to identify 2,000 community residents. Participants completed a series of questionnaires to measure general characteristics, PHSI, professional help-seeking attitude, depression stigma, depression knowledge, family function, and depression symptoms. Analyses included descriptive statistics and Pearson correlation analysis using SPSS 26.0 and a Structural Equation Model using Amos 22.0. Results The score of the PHSI was 14.92 ± 9.574. Professional help-seeking attitude (r = 0.291, p < 0.001) and depression knowledge (r = 0.077, p = 0.002) were positively related to PHSI, while a negative correlation was found between stigma (r = -0.149, p < 0.001) and PHSI. The model of the PHSI indicated a good fit with a CMIN/DF = 2.740 and RESEA = 0.032. The total effect of the influencing factors on the PHSI was listed in the following order: professional help-seeking attitude (0.676) > stigma (-0.143) > depression knowledge (0.088) > depression symptoms (-0.009) > family function (0.005). The total effect of depression knowledge on PHSI included a direct negative effect (Beta = -0.266, p < 0.001) and an indirect positive effect (0.354) through professional help-seeking attitude and stigma. Also, depression knowledge was negatively associated with stigma (Beta = -0.153, p < 0.001). Depression symptoms were negatively associated with family function (Beta = -0.282, p < 0.001), depression knowledge (Beta = -0.252, p < 0.001), and stigma (Beta = -0.102, p < 0.001), indicating that people with less severe depression symptoms had good family function, depression knowledge, and higher stigma. Family function contributed a positive effect on depression knowledge directly (Beta = 0.145, p < 0.001) and a totally positive effect (0.033) on stigma. Conclusion The PHSI toward depression is low among Chinese community residents. Professional help-seeking attitude, depression knowledge, and family functioning were facilitators of PHSI, and stigma and the severity of depression symptoms were barriers to PHSI. This study provides reference for the development of policies and guidelines to promote community residents to actively seek professional mental health help. Future policies can focus on multicollaboration among the government, mental health services, and families to increase the mental health resources, improve family functioning, enhance mental health literacy (MHL) of the public, and reduce depression stigma to ease the burden of this mental health issue.
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Affiliation(s)
- Xin Yi Li
- School of Nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- School of Nursing, Wuhan University, Wuhan, China
| | - Pan Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Juan Ruan
- Wuhan Mental Health Center, Wuhan, China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dan Luo
- School of Nursing, Wuhan University, Wuhan, China
| | - Yang Zhou
- Wuhan Mental Health Center, Wuhan, China
| | - Cong Yin
- Wuhan Mental Health Center, Wuhan, China
| | | | | | - Bing Xiang Yang
- School of Nursing, Wuhan University, Wuhan, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
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Boukpessi TB, Kpanake L, Gagnier JP. Willingness to Use Mental Health Services for Depression Among African Immigrants and White Canadian-Born People in the Province of Quebec, Canada. J Immigr Minor Health 2021; 23:320-328. [PMID: 32740883 DOI: 10.1007/s10903-020-01061-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Studies suggest that non-Caucasian immigrants to Canada are less likely than Canadian-born people to use mental health services. To meet the mental health needs of ethnocultural minorities, insights into their help-seeking attitudes are of great concern. This study examined the willingness of African immigrants and White Canadian-born to seek care for depression from conventional mental health services. African immigrants (N = 262) and White Canadian-born people (N = 250) living in Montreal, Canada, indicated their willingness to use mental health services under different conditions varying as a function of four factors: the severity of symptoms, the waiting time for first consultation, the type of care offered in the mental health service, and whether informal sources of help were available. Seven qualitatively different positions were identified: Never Consult (18% of the African immigrants and 1% of the White Canadian-born people); Hesitant (18% of the African immigrants and 7% of the White Canadian-born people); Depends on Waiting Time (16% of the African immigrants); Depends on Waiting Time and Symptoms (22% of the African immigrants); Depends on Symptoms (36% of the White Canadian-born people and 6% of the African immigrants); Willing to consult (33% of the White Canadian-born people and 2% of the African immigrants); Certain to Consult (9% of the White Canadian-born people and 4% of the African immigrants), while 14% of participants in each group did not express any position. African immigrants were more likely to underuse mental health services, compared with White Canadian-born people. The above diversity of positions strongly suggests that the design and implementation of interventions to reduce disparities in African immigrants' use of mental health care must not be "one size fits all" but must be tailored to address these immigrants' differing attitudes and needs.
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Affiliation(s)
| | - Lonzozou Kpanake
- University of Québec - TELUQ, 5800, Rue Saint-Denis, Bureau 1105, Montréal, QC, H2S 3L5, Canada
| | - Jean-Pierre Gagnier
- Université du Québec à Trois-Rivières, 3351, Boulevard des Forges, Trois-Rivières, QC, G8Z 4M3, Canada
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Mental Health Help-Seeking in Adolescence: An Exploration of Variables Associated with Help-Seeking Intent in Schools. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09426-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Racial discrimination as a mediator of racial disparities in insomnia disorder. Sleep Health 2020; 6:543-549. [PMID: 32928711 PMCID: PMC7485499 DOI: 10.1016/j.sleh.2020.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/18/2022]
Abstract
Study Objectives Racial and ethnic minorities are more likely to suffer from insomnia that is more severe; however, few studies have examined mechanisms by which racial disparities in severity of insomnia disorder may arise. One potential mechanism for disparities in insomnia severity is perceived discrimination. This study tested discrimination as a mediator in the relationship between race and insomnia. Methods Participants were recruited from communities in the Detroit metropolitan area and were diagnosed with insomnia disorder using the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). The final sample included 1,458 individuals. Insomnia symptom severity was assessed via the Insomnia Severity Index and self-reported racial discrimination was evaluated using a single item. Racial discrimination was tested as a mediator in the relationship between race and insomnia symptom severity. Individuals were categroized as either White or a racial minority (i.e., non White individuals), with sensitivity analyses examining Black individuals and non-Black racial minority groups. Results Consistent with our hypothesis, racial discrimination was a significant mediator accounting for 57.3% of the relationship between race and insomnia symptom severity. Sensitivity analyses indicated that the indirect effect of racial discrimination was stronger in the non-Black racial minority group compared to Black individuals. Conclusions These results provide support that racial discrimination is likely an important mechanism by which racial and ethnic sleep disparities exist. Implications for prevention, intervention, and treatment of insomnia in racial minorities to reduce health disparities are discussed.
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