A cascade model connecting life stress to risk behavior among rural African American emerging adults

Adapting an evidence-based mindfulness-based intervention for sheltered youth experiencing homelessness

OBJECTIVES

Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention, .b, has been shown to lower stress among youth. While a pilot study of .b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach.

METHODS

We used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the .b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications.

RESULTS

Adaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components.

CONCLUSIONS

Youth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability.

Developmental cascades in studies of adolescent and young adult substance use etiology: A systematic review

Introduction

Frequently, developmental cascade models are used to examine causal linkages between early family risk and substance use etiology. When framed with longitudinal data, cascade models contribute to understanding developmental etiology by parsing stability from change in multiple domains of influence. This systematic review examines the research methods used in cascade studies of substance use etiology.

Method

A systematic literature review involved four electronic literature databases (i.e., PsycINFO, MEDLINE, EMBASE, Web of Science). Specific terms referenced substance use etiology and developmental cascade effects. Inclusion requirements included cross-domain effects and repeated measures. Studies were eliminated based on including interventions or growth modeling that failed to differentiate time-specific effects. A risk assessment indicated adequate inter-rater reliability for the 18 studies included.

Results

Conceptually, there was little evidence supporting hypothesized cascade effects that involved cross-domain risk mechanisms linking early parental socialization with later substance use. Methodologically, studies were characterized by modest sample sizes, lack of power, and relatively small effect sizes (ESavg. = 0.05 [SD = 0.046], range 0.003 - 0.19). Only half of the studies conducted formal statistical tests of indirect effects linking early socialization with later substance use.

Conclusion

This review highlights there is very little evidence for developmental cascade effects involving early parental socialization and substance use etiology. Methodological and conceptual limitations may hamper detection of developmental cascade effects and further undermine our understanding of substance use etiology. Future studies may want to follow larger samples, over extended time frames and specify intermediate mechanism that contribute to vulnerability.

Stress Correlates Related to Depressive Symptoms Among Young Black Men in Southern California

Black men experience higher levels of chronic stress, life stressors, and discrimination due to oppressive social and economic conditions. Black men are at greater risk of depression, but most published research on stress and depression has focused on Black people in general, Black women, or older Black men. We sought to determine whether discrimination, perceived stress, major life stress, daily hassles, and social capital were associated with depressive symptoms in young Black men. Survey data were collected from April 2010 to March 2012 in Southern California from a convenience sample of Black men (N = 201). We used two-sample t tests and one-way analysis of variance (ANOVA) to examine the association of stress correlates with depressive symptoms. Logistic regression was conducted to estimate the likelihood of reporting depressive symptoms for each significant correlate. Over half of the sample reported depressive symptoms. Health status, perceived discrimination, urban hassles, perceived stress, and neighborhood trust and safety were significantly related to depressive symptoms. Those who reported higher perceived stress had higher odds of reporting depressive symptoms, whereas lower everyday discrimination experiences were associated with lower odds of depressive symptoms. Future studies should consider examining the effectiveness of embedding coping mechanisms for stress, including perceived discrimination, in health interventions for young Black men to prevent or reduce depression.

Puberty- and Menstruation-Related Stressors Are Associated with Depression, Anxiety, and Reproductive Tract Infection Symptoms Among Adolescent Girls in Tanzania

BACKGROUND

Puberty and menstruation are significant stressors for adolescent girls and young women in low-resource settings in sub-Saharan Africa. However, little is known about the impact of these stressors on girls' mental health and reproductive health.

METHODS

In 2018, a cross-sectional self-report survey was conducted with 581 adolescent girls and young women between 13 to 21 years old who had reached menarche and were attending secondary school in Moshi, Tanzania. Structural equation modeling was used to examine the relationships of puberty-related stressors and menstruation-related stressors (menstrual deficits, movement/activity difficulties, and menstrual symptoms) to depression, anxiety, and the likelihood of reporting reproductive tract infection (RTI) symptoms.

RESULTS

Puberty-specific stressors, menstrual symptoms, and menstrual deficits were associated with depression and anxiety. Movement/activity difficulties were associated with anxiety. Increases in menstrual symptoms, menstrual deficits, puberty stressors, and depression were associated with an increased likelihood of reporting a lifetime RTI. However, the relationship of puberty stressors and depression with RTIs was no longer significant in two of three models after correcting for Type I error.

CONCLUSIONS

Overall, puberty- and menstruation-related stressors were associated with mental health and symptoms of reproductive tract infections. This suggests there is an important relationship between stressors specific to adolescent girls and young women during puberty, mental health, and reproductive health. There is a need for adolescent-tailored interventions to reduce the negative impact of stressors among girls transitioning through puberty in sub-Saharan Africa.

What Are the Health Consequences of Upward Mobility?

Health disparities by socioeconomic status (SES) have been extensively documented, but less is known about the physical health implications of achieving upward mobility. This article critically reviews the evolving literature in this area, concluding that upward mobility is associated with a trade-off, whereby economic success and positive mental health in adulthood can come at the expense of physical health, a pattern termed skin-deep resilience. We consider explanations for this phenomenon, including prolonged high striving, competing demands between the environments upwardly mobile individuals seek to enter and their environments of origin, cultural mismatches between adaptive strategies from their childhood environments and those that are valued in higher-SES environments, and the sense of alienation, lack of belonging, and discrimination that upwardly mobile individuals face as they move into spaces set up by and for high-SES groups. These stressors are hypothesized to lead to unhealthy behaviors and a dysregulation of biological systems, with implications for cardiometabolic health.

Pathways linking adverse environments to emerging adults' substance abuse and depressive symptoms: A prospective analysis of rural African American men

For African American emerging adult men, developmental challenges are evident in their escalating substance abuse and depressive symptoms; this is particularly true for men from low-resource communities. The present study tests a developmental model linking childhood adversity and contemporaneous contextual stressors to increases in emerging adults' substance use and depressive symptoms, indirectly, via increases in defensive/hostile relational schemas and social developmental risk factors (e.g., risky peers and romantic partners, lack of involvement in school or work). We also advance exploratory hypotheses regarding DNA methylation in the oxytocin receptor gene (OXTR) as a moderator of the effects of stress on relational schemas. Hypotheses were tested with three waves of data from 505 rural African American men aged 19-25 years. Adverse childhood experiences predicted exposure to emerging adult contextual stressors. Contextual stressors forecast increases in defensive/hostile relational schemas, which increased social developmental risk factors. Social developmental risk factors proximally predicted increases in substance abuse and depressive symptoms. OXTR DNA methylation moderated the effects of contextual stressors on defensive/hostile relational schemas. Findings suggest that early exposures to stress carry forward to affect the development of social developmental risk factors in emerging adulthood, which place rural African American men at risk for increased substance abuse and depressive symptoms during the emerging adult years.

The social anatomy of adverse childhood experiences and aggression in a representative sample of young adults in the U.S

Objective The current study assesses the effect of adverse childhood experiences on later aggression and violence across young adult relationships contexts, including intimate partners, friends, or strangers. Method Surveys were conducted with a nationally representative sample of young adults ages 18-32, drawn from the AmeriSpeak panel, a probability-based panel with coverage of 97% of U.S. households. The weighted study sample is 2284 young adult respondents, of whom 1561 reported being in an intimate partnership. Results Rates of verbal aggression perpetrated by young adults declined with the intimacy of the relationship, such that aggression against a partner (72%) exceeded aggression directed at friends (43%) and strangers (34%). Similar rates of physical violence (about 9%) were reportedly perpetrated against partners, friends, and strangers. Adjusting for a range of personal characteristics, both adverse childhood experiences and recent stressors in these young adult lives exhibited direct associations with verbal and physically aggressive outcomes. Conclusions In models of verbal and physical aggression across relationship contexts, childhood adversity exhibits lasting effects unaccounted for by important proximal life circumstances, including recent life stressors, mental health, and substance use behaviors. These results provide empirical insights for clinical treatment of young adults prone to aggressive conflicts as well as input to positive youth development programming to foster healthy approaches to conflict.

Preventive parenting intervention during childhood and young black adults' unhealthful behaviors: a randomized controlled trial

OBJECTIVE

Lifestyle variables such as drug use and excessive weight gain contribute to adult morbidity and mortality. This study was designed to determine whether participation in a preventive intervention designed to enhance supportive parenting can reduce drug use and body mass index (BMI) in young Black adults from disadvantaged neighborhoods.

METHOD

This study was conducted in the rural southeastern United States. Black parents and their 11-year-old children (517 families) were assigned randomly to the Strong African American Families (SAAF) prevention trial or a control condition. Data assessing neighborhood socioeconomic status and supportive parenting were obtained when the youths were ages 11 and 16. When youths were ages 19-21 and 25, drug use and BMI were measured.

RESULTS

As hypothesized, significant three-way interactions were detected among neighborhood disadvantage, prevention condition, and gender for BMI (B = 3.341, p = .009, 95% CI [0.832, 5.849]) and substance use (B = -0.169, p = .049, 95% CI [-0.337, -0.001]). Living in a disadvantaged neighborhood during adolescence was associated with increased drug use among young men in the control group (simple-slope = 0.215, p < .003) but not among those in the SAAF condition (simple-slope = 0.030, p = .650). Neighborhood disadvantage was associated with elevated BMI among young women in the control group (simple-slope = 3.343, p < .001), but not in the SAAF condition (simple-slope = 0.204, p = .820).

CONCLUSIONS

The results suggest that participation during childhood in a preventive intervention to enhance supportive parenting can ameliorate the effects of life in a disadvantaged neighborhood on men's drug use and women's BMI across ages 19-25 years. These findings suggest a possible role for parenting enhancement programs in narrowing health disparities.

Substance Use and Obesity Trajectories in African Americans Entering Adulthood

INTRODUCTION

The transition to adulthood can be stressful for minority adolescents, and many may cope through unhealthy behaviors, including substance use and obesity-related behaviors. This study tested substance use and obesity trajectories over time in African American youth, longitudinal associations of trajectories with mental and physical health in adulthood, and whether self-control and sex predict trajectories.

METHODS

Two longitudinal studies of 516 and 992 African American adolescents. In Study 1, substance use and obesity trajectories were assessed from ages 19 to 25 years. At age 25 years, internalizing and externalizing problems, metabolic syndrome, and inflammatory biomarkers were measured. In Study 2, substance use and obesity trajectories were assessed from ages 17 to 29 years. Depression, delinquency, diabetes, blood pressure, and inflammatory biomarkers were measured at age 29 years. Data analyses were conducted in 2017.

RESULTS

Across both studies, the majority of African American adolescents evinced poor health behavior trajectories (latent class growth analyses), with 23%-27% showing increasing substance use over time, 18%-27% showing increasing obesity over time, and 9%-11% showing increases in both. ANCOVAs for trajectory analyses revealed that males were more likely to evince increasing substance use, with females more likely to show increasing obesity. Substance use trajectories were associated with poorer mental health in adulthood; obesity trajectories with poorer physical health in adulthood. Those with good health behavior trajectories had higher self-control in early adolescence.

CONCLUSIONS

The transition to adulthood is a vulnerable period for many African Americans. Given the commonalities of substance use and obesity in their rewarding/stress-relieving properties, similar prevention efforts may help stem the rise of both in these youth.

Peer influence, Frontostriatal connectivity, and delay discounting in African American emerging adults

Prior research has demonstrated the importance of delay discounting in adverse health behaviors, such as addiction, attention deficit hyperactivity disorder, risk taking, and obesity. Nevertheless, the functional connectivity of neural circuitry associated with delay discounting and the ways in which the social environment may influence frontostriatal connectivity remain largely unknown, particularly in African Americans. Building on recent literature implicating frontostriatal connectivity during active delay discounting decision making and at rest, we used functional magnetic resonance imaging to assess the association between delay discounting and frontostriatal resting state connectivity (rsFC). We also examined the capacity of social relationships with parents and peers to longitudinally predict frontostriatal rsFC. The study cohort was composed of 91 rural African American emerging adults followed over a 6-year period. Greater (i.e., more positive) frontostriatal rsFC was associated with decreased delay discounting (i.e., less impulsive decision making). In addition, peer relationships at ages 20 and 21 significantly predicted frontostriatal rsFC at age 25 above and beyond parental influence. A significant indirect effect of peer affiliation on delay discounting through frontostriatal rsFC also emerged. These results indicate a role of frontostriatal connectivity in delay discounting decision making and highlight peers' unique influence on decision making behaviors through frontostriatal rsFC during emerging adulthood.

Racial discrimination, body mass index, and insulin resistance: A longitudinal analysis

OBJECTIVE

To examine prospective relations of perceived racial discrimination at ages 16-18 with body mass index (BMI) at ages 19-21 and insulin resistance (IR) at ages 25 and 27 among Black youth in the rural South, and to determine whether BMI connected discrimination to IR as a mediator.

METHOD

Participants were 315 African American adolescents in rural counties in Georgia who provided data on their perceptions of discrimination during adolescence. BMI was measured during a yearly home visit, and a certified phlebotomist drew a fasting blood sample from which IR was measured.

RESULTS

The data analysis, with all confounding variables controlled, revealed that, over time, (a) discrimination was associated positively with both BMI and IR; (b) BMI was associated positively with IR; and (c) BMI acted as a mediator connecting discrimination with IR.

CONCLUSIONS

The findings are consistent with the hypothesis that exposure to discrimination presages IR through its effects on BMI. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Trajectory classes of cannabis use and heavy drinking among rural African American adolescents: multi-level predictors of class membership

AIMS

To inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood and (b) examining associations between trajectory class membership and multi-level assessments of risk factors.

DESIGN

A prospective study spanning 9 years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress and psychosocial risk factors.

SETTING

Rural communities in the southeastern United States.

PARTICIPANTS

African American youth (n = 518).

MEASUREMENTS

Participants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors.

FINDINGS

Latent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all Ps < 0.05). A composite of selected risk factors discriminated class membership (all Ps < 0.05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19 years.

CONCLUSIONS

Rural African American youth's cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress differentiate class membership prognostically. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood.

Migration Stress, Poor Mental Health, and Engagement in Sex with High-Risk Partners: A Mediation Modeling Analysis of Data from Rural-to-Urban Migrants in China

BACKGROUND

There is a growing need for better understanding of mechanisms underpinning the relationship between migration stress and HIV risk behaviors for the development of HIV prevention and control policy.

METHODS

Survey data from a random sample of 1,293 Chinese rural-to-urban migrants were analyzed. Stress was assessed using the Domestic Migration Stress Questionnaire (DMSQ), mental health status was assessed using the Brief Symptoms Inventory (BSI), and having sex with high risk partners was assessed as if ever have had sex with high risk partners (e.g., sex workers, intravenous injection drug users, blood donors, persons infected with HIV, persons with sexually transmitted infection, and same gender partners) in the past year. The proposed relationship was tested using mediation modeling method.

RESULTS

Among the sample, 5.5% reported having had sex with high-risk partners in the past year. Mediation analysis indicated that the relationship between DMSQ scores and having sex with high-risk partners was mediated by BSI (coefficient =0.41, 95% CI [0.21, 0.65]), including its components of somatization (0.32 [0.15, 0.53]), obsessive-compulsive disorder (0.31 [0.07, 0.55]), depression (0.45 [0.23, 0.72]), anxiety (0.41 [0.23, 0.63]), and hostility (0.35 [0.17, 0.56]). Furthermore, the effect was more pronounced in males than in females.

CONCLUSION

The study findings provide new data advancing our understanding of the mechanism of engagement in risky sex, underscoring the need for the HIV prevention policies in China to pay more attention to mental health of the rural-to-urban migrant population.

Exposure to Parental Depression in Adolescence and Risk for Metabolic Syndrome in Adulthood

The psychosocial consequences of living with a depressed parent have been well characterized. Less well known, however, is how this exposure is predictive of later physical health problems. The present study evaluated how parental depression across youths' adolescence (ages 11-18) was associated with youth metabolic syndrome at age 25 (n = 391). Youth self-regulation and health behaviors were considered as possible moderators of the link between parental depression and youth metabolic syndrome. Analyses revealed that parental depression in adolescence was associated with a composite score reflecting metabolic syndrome components in early adulthood. Furthermore, self-regulation and health behaviors moderated this link, such that links between parental depression and the metabolic syndrome existed only for youth with low self-regulation or unhealthy behaviors.

Developmental pathways from maltreatment to risk behavior: Sexual behavior as a catalyst

Although delinquency, substance use, and sexual activity are established to be highly intercorrelated, the extant research provides minimal evidence in support of one particular sequence of risk behavior or on the cascade effects from maltreatment. The present study tested a longitudinal model incorporating maltreatment, deviant peers, sexual behavior, delinquency, and substance use to elucidate the sequential pathway(s) from maltreatment to each specific risk behavior throughout adolescence. Data came from a longitudinal study on the effects of maltreatment on adolescent development (N = 454) with four study assessments from early (Time 1 M age = 10.98) to late adolescence (Time 4 M age = 18.22). Results from the cross-lagged model showed a sequence from maltreatment to sexual behavior (Time 1), to delinquency (Time 2), to sexual behavior (Time 3), to substance use and delinquency (Time 4). These findings support sexual behavior as the initial risk behavior that is the catalyst for engagement in more advanced risk behaviors across adolescence.

The Role of Impulsivity in the Relation Between Negative Affect and Risky Sexual Behaviors

While risky sexual behavior associates with negative affect, and impulsivity often increases during negative affective states, little is known about the interrelations of these factors. This study examined whether impulsivity explained the relation between negative affect and risky sex among college students. Negative affect exhibited an indirect effect via impulsivity on number of sexual partners for both males and females, and on inconsistent condom use for females, but not males. Results suggest risky sex may serve to regulate negative affect, proposing the importance of negative affect in future strategies to reduce risky sex among young adults.

Associations between alcohol-use and depression symptoms in adolescence: Examining gender differences and pathways over time

Several studies examining alcohol use and depression in youth have focused on documenting prevalence of overlap, or temporal ordering in longitudinal samples. Fewer studies have examined pathways connecting alcohol use and depression over time. This study examined gender differences between depression and alcohol use across adolescence while examining peer and family pathways as possible mediators of effects. Data was collected longitudinally from 593 families from three urban public middle schools in the United States. Participants were recruited in 6th grade and followed through 9th grade. We examined gender differences using a nested model comparison approach. Results indicated the association between depression and alcohol use differs by gender. For males, depression and alcohol use were independent across adolescence, and no significant indirect pathways were observed. For females, bidirectional effects were found between alcohol use and depression, as well as an indirect effect from depression to alcohol use via peer deviance.

Smoking in young adulthood among African Americans: Interconnected effects of supportive parenting in early adolescence, proinflammatory epitype, and young adult stress

We examined two potentially interacting, connected pathways by which parental supportiveness during early adolescence (ages 1-13) may come to be associated with later African American young adult smoking. The first pathway is between parental supportiveness and young adult stress (age 19), with stress, in turn, predicting increased smoking at age 20. The second pathway is between supportive parenting and tumor necrosis factor (TNF) gene methylation (i.e., TNFm), a proinflammatory epitype, with low levels indicating greater inflammatory potential and forecasting increased risk for smoking in response to young adult stress. In a sample of 382 African American youth residing in rural Georgia, followed from early adolescence (age 10-11) to young adulthood (age 20), supportive parenting indirectly predicted smoking via associations with young adult stress, IE = -0.071, 95% confidence interval [-0.132, -0.010]. In addition, supportive parenting was associated with TNFm measured at age 20 (r = .177, p = .001). Further, lower TNFm was associated with a significantly steeper slope (b = 0.583, p = .003) of increased smoking in response to young adult stress compared to those with higher TNFm (b = 0.155, p = .291), indicating an indirect, amplifying role for supportive parenting via TNFm. The results suggest that supportive parenting in early adolescence may play a role in understanding the emergence of smoking in young adulthood.

Neighborhood × Serotonin Transporter Linked Polymorphic Region (5-HTTLPR) interactions for substance use from ages 10 to 24 years using a harmonized data set of African American children

This study investigated the influences of neighborhood factors (residential stability and neighborhood disadvantage) and variants of the serotonin transporter linked polymorphic region (5-HTTLPR) genotype on the development of substance use among African American children aged 10-24 years. To accomplish this, a harmonized data set of five longitudinal studies was created via pooling overlapping age cohorts to establish a database with 2,689 children and 12,474 data points to span ages 10-24 years. A description of steps used in the development of the harmonized data set is provided, including how issues such as the measurement equivalence of constructs were addressed. A sequence of multilevel models was specified to evaluate Gene × Environment effects on growth of substance use across time. Findings indicated that residential instability was associated with higher levels and a steeper gradient of growth in substance use across time. The inclusion of the 5-HTTLPR genotype provided greater precision to the relationships in that higher residential instability, in conjunction with the risk variant of 5-HTTLPR (i.e., the short allele), was associated with the highest level and steepest gradient of growth in substance use across ages 10-24 years. The findings demonstrated how the creation of a harmonized data set increased statistical power to test Gene × Environment interactions for an under studied sample.

A differential susceptibility analysis reveals the "who and how" about adolescents' responses to preventive interventions: tests of first- and second-generation Gene × Intervention hypotheses

This study was designed to investigate a genetic moderation effect of dopamine receptor 4 gene (DRD4) alleles that have seven or more repeats (long alleles) on an intervention to deter drug use among rural African American adolescents in high-risk families. Adolescents (N = 291, M age = 17) were assigned randomly to the Adults in the Making (AIM) program or to a control condition and were followed for 27.5 months. Adolescents provided data on drug use and vulnerability cognitions three times after pretest. Pretest assessments of caregiver depressive symptoms, disruption in the home, and support toward the adolescent were used to construct a family risk index. Adolescents living in high-risk families who carried at least one DRD4 long allele and were assigned to the control condition evinced greater escalations in drug use than did (a) adolescents who lived in high-risk families, carried the DRD4 long allele, and were assigned to AIM, or (b) adolescents assigned to either condition who carried no DRD4 long alleles. AIM-induced reductions in vulnerability cognitions were responsible for the Family Risk × AIM × DRD4 status drug use prevention effects. These findings support differential susceptibility predictions and imply that prevention effects on genetically susceptible individuals may be underestimated.

Supportive Family Environments Ameliorate the Link Between Racial Discrimination and Epigenetic Aging: A Replication Across Two Longitudinal Cohorts

This study tested the hypothesis that supportive family environments during adolescence buffer exposure to racial discrimination, reducing its impact on biological weathering and its manifestation in cellular aging. Perceived racial discrimination, support in the family environment, and confounder variables were assessed for 3 consecutive years across adolescence in two independent cohorts of African American youth from rural Georgia. DNA was extracted from peripheral blood mononuclear cells collected during young adulthood. Patterns of methylation were used to index the epigenetic ages of these cells and the extent to which they differed from participants' chronological ages. Among youth in supportive family environments, exposure to higher levels of racial discrimination did not forecast greater epigenetic aging. Among youth in less supportive family environments, exposure to higher levels of racial discrimination did forecast greater epigenetic aging. The associations emerged independently of confounder variables, and the results were replicated across the two cohorts.

Variation in the oxytocin receptor gene moderates the protective effects of a family-based prevention program on telomere length

INTRODUCTION

Parent-child relationships with high conflict and low warmth and support are associated with later adverse behavioral and physiological child outcomes. These outcomes include shorter telomere lengths, the repetitive sequences at the ends of chromosomes that have been utilized as a biomarker for chronic stress. Our research group furthered this by exploring telomere length outcomes following a family-based prevention program and identified reduced telomere shortening 5 years post intervention among those originally exposed to nonsupportive parenting and randomized to the intervention condition. However, not all individuals respond equally, and a growing literature suggests genetic sensitivity to one's environment, with variations in the oxytocin receptor gene (OXTR) potentially influencing this sensitivity.

METHODS

We utilized data from African American youths (mean age 17) randomized to intervention (n = 100) or control condition (n = 91) with baseline assessments of genetic status and nonsupportive parenting, and 5-year follow-up assessments of telomere length.

RESULTS

We found a significant three-way interaction between nonsupportive parenting, intervention condition, and OXTR rs53576 genotype. OXTR GG individuals, who are suggested to be more sensitive to their social environment, exhibited significantly more variability, evidencing the shortest telomeres when exposed to nonsupportive parenting and randomized to the control condition, and similar telomere lengths to non at-risk groups when randomized to the intervention. In contrast, those with the A allele showed no statistical difference in telomere lengths across parental and intervention conditions. Subsequent analyses suggest that these findings may be mediated through chronic anger, whereby GG individuals exposed to nonsupportive parenting and randomized to the control condition had a greater increase in chronic anger by study follow-up, compared to those in the intervention, and this change associated with greater telomere shortening.

CONCLUSIONS

These findings highlight the importance of individual differences and potential role of genetic status in moderating the relationship between environmental contexts and biological outcomes.

Prevention effects ameliorate the prospective association between nonsupportive parenting and diminished telomere length

Telomere length (TL) is an indicator of general systemic aging, with diminished TL associated with several chronic diseases of aging and with heightened mortality risk. Research has begun to focus on the ways in which stress contributes to telomere attrition. The purposes of this study were (a) to establish whether exposure to nonsupportive parenting, defined as high levels of conflict and rancor with low levels of warmth and emotional support, at age 17 would forecast TL 5 years later; and (b) to determine whether participation in an efficacious family-centered prevention program could ameliorate any associations that emerged. Rural African American adolescents participated in the Adults in the Making (AIM) program or a control condition. Primary caregivers provided data on nonsupportive parenting during a pretest when adolescents were age 17. Adolescents provided data on anger at the pretest and at a posttest administered 7 months later. When the youths were age 22, TL was assayed from a blood draw. The results indicated that heightened nonsupportive parenting forecast diminished TL among young adults in the control condition but not among those who participated in AIM; socioeconomic status risk, life stress, and the use of alcohol and cigarettes at age 17, and blood pressure and body mass index at age 22, were controlled. Subsequent exploratory analyses suggested that AIM-induced reductions in adolescents' anger served as a mediator connecting group assignment to TL. The results suggest that the cellular-level sequelae of nonsupportive parenting and stress are not immutable.

Parent and youth dopamine D4 receptor genotypes moderate multilevel contextual effects on rural African American youth's risk behavior

The present investigation extends research on Gene × Environment interactions and youth risk behavior by linking multilevel contextual factors, such as community disadvantage and protective parenting practices, to both parental and youth dopamine D4 receptor (DRD4) genotypes. We expected community disadvantage to influence youth risk behavior via a series of indirect effects involving protective parenting and youth's planful future orientation when both parents' and youth's DRD4 status was considered. Genetic moderation processes also were tested to determine whether they conformed to a diathesis-stress or a differential susceptibility model. Hypotheses were investigated with data from 361 rural African American youth and their parents assessed 3 times when youth were ages 16 to 19. Community disadvantage interacted with parental DRD4 status to predict low levels of protective parenting. Protective parenting, in turn, interacted with youth DRD4 status to forecast increases in youth's planful future orientations, a proximal influence on changes in risk behavior. The Parental DRD4 × Community Disadvantage interaction, but not youth DRD4 × Protective Parenting, conformed to a differential susceptibility model. Indirect effect analyses revealed a significant indirect path linking community disadvantage to youth risk behavior through a series of multilevel Gene × Environment interaction processes.

Discrimination, racial identity, and cytokine levels among African-American adolescents

PURPOSE

Low-grade inflammation, measured by circulating levels of cytokines, is a pathogenic mechanism for several chronic diseases of aging. Identifying factors related to inflammation among African-American youths may yield insights into mechanisms underlying racial disparities in health. The purpose of the study was to determine whether (1) reported racial discrimination from ages 17-19 years forecasts heightened cytokine levels at the age of 22 years and (2) this association is lower for youths with positive racial identities.

METHODS

A longitudinal research design was used with a community sample of 160 African-Americans who were aged 17 years at the beginning of the study. Discrimination and racial identity were measured with questionnaires, and blood was drawn to measure basal cytokine levels. Ordinary least squares regression analyses were used to examine the hypotheses.

RESULTS

After controlling for socioeconomic risk, life stress, depressive symptoms, and body mass index, racial discrimination (β = .307; p < .01), racial identity (β = -.179; p < .05), and their interaction (β = -.180; p < .05) forecast cytokine levels. Youths exposed to high levels of racial discrimination evinced elevated cytokine levels 3 years later. This association was not significant for young adults with positive racial identities.

CONCLUSIONS

High levels of interpersonal racial discrimination and the development of a positive racial identity operate jointly to determine low-grade inflammation levels that have been found to forecast chronic diseases of aging, such as coronary disease and stroke.

Unemployment and depression among emerging adults in 12 states, Behavioral Risk Factor Surveillance System, 2010

INTRODUCTION

The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults.

METHODS

Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Responses to the Patient Health Questionnaire-8 provided data about the prevalence of depression. Bivariate relationships were assessed using χ(2) tests, and multivariable adjusted odds ratios were calculated with logistic regressions. Sociodemographic variables were sex, race/ethnicity, marital status, and education. In addition, logistic regression models adjusted for health insurance status, disability, smoking, and body mass index. The analyses were completed using SAS 9.3 survey procedures to account for the complex sampling design.

RESULTS

Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults.

CONCLUSION

The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health-focused interventions.

Catecholamine levels and delay discounting forecast drug use among African American youths

AIMS

To test hypotheses about the contributions of the catecholamines epinephrine and norepinephrine [which serve as biological markers of life stress through sympathetic nervous system (SNS) activation], delay discounting and their interaction to the prediction of drug use among young African American adults.

DESIGN

A 1-year prospective study that involved assessment of SNS activity and collection of self-report data involving delay discounting and drug use.

SETTING

Rural communities in the southeastern United States.

PARTICIPANTS

A total of 456 African Americans who were 19 years of age at the beginning of the study.

MEASUREMENTS

At age 19, participants provided overnight urine voids that were assayed for epinephrine and norepinephrine. Participants were also assessed for hyperbolic temporal discounting functions (k) and drug use. At age 20, the participants again reported their drug use.

FINDINGS

Linear regression analyses revealed that (i) catecholamine levels at age 19 forecast increases in drug use [B = 0.087, P < 0.01, 95% confidence interval (CI) = 0.025, 0.148] and (ii) among young men, catecholamine levels interacted positively with delay discounting to forecast increases in drug use (simple slope = 0.113, P < 0.001, 95% CI = 0.074, 0.152).

CONCLUSIONS

Higher urinary catecholamine concentrations in their adulthood predict higher levels of drug use a year later among young African American men in the United States who engage in high, but not low, levels of delay discounting.

Cumulative socioeconomic status risk, allostatic load, and adjustment: a prospective latent profile analysis with contextual and genetic protective factors

The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental precursors to this pattern. Hypotheses were tested with a representative sample of 443 African American youths living in the rural South. Cumulative SES risk and protective processes were assessed at ages 11-13 years; psychological adjustment was assessed at ages 14-18 years; genotyping at the 5-HTTLPR was conducted at age 16 years; and allostatic load (AL) was assessed at age 19 years. A latent profile analysis identified 5 profiles that evinced distinct patterns of SES risk, AL, and psychological adjustment, with 2 relatively large profiles designated as focal profiles: a physical health vulnerability profile characterized by high SES risk/high AL/low adjustment problems, and a resilient profile characterized by high SES risk/low AL/low adjustment problems. The physical health vulnerability profile mirrored the pattern found in the adult health disparities literature. Multinomial logistic regression analyses indicated that carrying an s allele at the 5-HTTLPR and receiving less peer support distinguished the physical health vulnerability profile from the resilient profile. Protective parenting and planful self-regulation distinguished both focal profiles from the other 3 profiles. The results suggest the public health importance of preventive interventions that enhance coping and reduce the effects of stress across childhood and adolescence.

Protective Parenting, Relationship Power Equity, and Condom Use Among Rural African American Emerging Adult Women

Sexually transmitted infections disproportionately affect African Americans, particularly young women. The influence of a set of interrelated protective parenting processes-instrumental and emotional support, sexual risk communication, and encouragement of goals for employment or education-on emerging adult women was examined. Parenting was hypothesized to affect consistent condom use through its association with women's reports of power equity in their intimate relationships. Hypotheses were tested with 135 sexually active women 18 to 21 years of age living in rural southern communities. Structural equation modeling indicated that (a) parenting processes predicted women's self-reported relationship power equity and consistent condom use, and (b) relationship power equity predicted consistent condom use. Limited support emerged for a mediational role of relationship power equity in explaining the influence of parenting on consistent condom use. Parental involvement and young women's establishment of personal control in their intimate relationships are important goals for sexual risk reduction programs.

Differential sensitivity to prevention programming: a dopaminergic polymorphism-enhanced prevention effect on protective parenting and adolescent substance use

OBJECTIVE

The purpose of this study was to investigate a genetic moderation effect of dopamine receptor-4 gene (DRD4) alleles that have 7 or more repeats on the efficacy of a preventive intervention to deter rural African American adolescents' substance use.

METHODS

Adolescents (N = 502, M age = 16 years) were assigned randomly to the Strong African American Families-Teen (SAAF-T) program or to a control condition and were followed for 22 months. Adolescents provided data on substance use, and both adolescents and their primary caregivers provided data on intervention-targeted protective parenting practices.

RESULTS

Male adolescents who carried at least one allele of DRD4 with 7 or more repeats who were assigned to the control condition evinced more substance use across 22 months than did (a) carriers of at least one allele of DRD4 with 7 or more repeats who were assigned to SAAF-T or (b) adolescents assigned to either condition who carried two alleles of DRD4 with 6 or fewer repeats. These findings were mediated by DRD4 × SAAF-T interaction effects on increases in intervention-targeted protective parenting practices, a mediated moderation effect.

CONCLUSIONS

The results imply that prevention effects on health-relevant outcomes for genetically susceptible individuals, such as carriers of at least one allele of DRD4 with 7 or more repeats, may be underestimated.

Life stress, the dopamine receptor gene, and emerging adult drug use trajectories: a longitudinal, multilevel, mediated moderation analysis

This study was designed to examine the prospective relations of life stress and genetic status with increases in drug use. African Americans (N = 399) in rural Georgia (Wave 1 mean age = 17 years) provided three waves of data across 27.5 months and a saliva sample from which the dopamine receptor D4 (DRD4) gene was genotyped. Multilevel growth curve modeling analysis indicated that emerging adults manifested the highest escalations in drug use when they reported high life stress and carried an allele of DRD4 with 7 or more repeats (7 + R allele). In addition, emerging adults who reported high life stress and carried the 7 + R allele evinced the largest increases in two proximal risk factors for drug use: affiliations with drug-using companions and drug use vulnerability cognitions. Furthermore, when the Gene × Environment interaction effects on the increases in affiliations with drug-using companions and vulnerability cognitions were entered into the model forecasting drug use, the Life Stress × DRD4 Status interaction on drug use became nonsignificant in the presence of the risk mechanisms. This finding provides an example of "second generation" Gene × Environment interaction research in which the interaction's effects on proximal risk mechanisms account for its effects on outcomes.

The Adults in the Making program: long-term protective stabilizing effects on alcohol use and substance use problems for rural African American emerging adults

OBJECTIVE

This report addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk.

METHOD

African American youths (M age, pretest = 17.7 years) were assigned randomly to the AIM (n = 174) or control (n = 173) group. Past 3-month alcohol use, past 6-month substance use problems, risk taking, and susceptibility cognitions were assessed at pretest and at 6.4, 16.6, and 27.5 months after pretest. Pretest assessments of parent-child conflict, affiliations with substance-using companions, and perceived racial discrimination were used to construct a contextual risk factor index.

RESULTS

A protective stabilizing hypothesis was supported; the long-term efficacy of AIM in preventing escalation of alcohol use and substance use problems was greater for youths with higher pretest contextual risk scores. Consistent with a mediation-moderation hypothesis, AIM-induced reductions over time in risk taking and susceptibility cognitions were responsible for the AIM × contextual risk prevention effects on alcohol use and substance use problems.

CONCLUSIONS

Training in developmentally appropriate protective parenting processes and self-regulatory skills during the transition from adolescence to emerging adulthood for rural African Americans may contribute to a self-sustaining decreased interest in alcohol use and a lower likelihood of developing substance use problems.

Family-centered program deters substance use, conduct problems, and depressive symptoms in black adolescents

OBJECTIVES

The present research addressed the following important question in pediatric medicine: Can participation in a new family-centered preventive intervention, the Strong African American Families-Teen (SAAF-T) program, deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents across 22 months?

METHODS

Data were collected from 502 black families in rural Georgia, assigned randomly to SAAF-T or an attention control condition. The prevention condition consisted of 5 consecutive meetings at community facilities with separate, concurrent sessions for caregivers and adolescents followed by a caregiver-adolescent session in which families practiced skills they learned in the separate sessions. Adolescents self-reported conduct problem behaviors, substance use, substance use problems, and depressive symptoms at ages 16 years (pretest) and 17 years 10 months (long-term assessment).

RESULTS

Adolescents who participated in SAAF-T evinced lower increases in conduct problem behavior, substance use, substance use problems, and depressive symptom frequencies than did adolescents in the attention control condition across the 22 months between pretest and long-term assessment.

CONCLUSIONS

This is the first study to demonstrate efficacy in a prevention program designed to deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents. Because SAAF-T is a manualized, structured program, it can be easily disseminated to public health agencies, schools, churches, boys' and girls' clubs, and other community organizations.