Examining Cultural Correlates of Active Coping Among African American Female Trauma Survivors

Controlling images and standards of beauty shapes body image: using a relational cultural approach to improve Black American women's well-being

OBJECTIVES

Controlling images and racialized stereotypical myths inform Eurocentric and cultural standards of beauty that shape Black American women's body image and well-being. Cultural responsiveness is crucial in understanding the lived experiences of Black American women, the systemic oppressive factors that subjugate them, and the impacts on their mental health.

DESIGN

An integrative review was conducted on controlling images and racialized stereotypes, standards of beauty, and body image to assess the contribution of these factors on Black American women's mental health, specifically, disordered eating, depression, and anxiety. Black Feminist and Intersectionality theories were used to conceptualize the role of controlling images and racialized stereotypes.

RESULTS

A conceptual model is offered, and a discussion is provided to explain the contribution of controlling images and racialized stereotypes on the manifestation of standards of beauty and Black American women's perceptions of body image which leads to poor mental health outcomes.

CONCLUSIONS

Cultural responsiveness in therapeutic settings is imperative, as providers must understand the intersecting effects of controlling images and racialized stereotypes on Black American Women's well-being. Relational Cultural Theory is offered as a therapeutic modality that invites practitioners to move beyond symptom reduction and basic 'helping' interventions and gives emphasis to a contextual and relational approach that aims to ameliorate the impacts of systemic oppression and gender and racial marginalization.

Use of the Strong Black Woman Construct in Research: An Integrative Review

This was an integrative review of the literature on research using the strong Black woman (SBW) construct. We searched for data-based articles that mentioned SBW and examined topical areas of investigation, health outcomes and other constructs associated with SBW, and methods used to assess SBW. We found 47 articles. SBW was used to study coping with trauma (n = 11) or perceived offense (n = 10), or engaging in health-seeking behaviors (n = 10). Eighteen studies suggested that SBW was linked to several major health conditions (eg, hypertension, obesity, heart disease) and depressive and anxiety symptoms. SBW was positively correlated with undesirable coping behaviors (eg, self-silencing, maladaptive perfectionism) and negatively associated with self-compassion and help-seeking. The most common method of assessing SBW was using a structured questionnaire (n = 21). Longitudinal studies to examine the impact of SBW belief on Black women's coping with hardship were lacking.

Cumulative Lifetime Violence and Bacterial Vaginosis Infection in Sexually Transmitted Infections: Findings From a Retrospective Cohort Study Among Black Women at Risk for HIV

Introduction

Bacterial vaginosis is the most common vaginal condition among women of reproductive age and has been associated with sexually transmitted infections. This study examines the association between cumulative lifetime violence exposure, bacterial vaginosis, and sexually transmitted infections among Black women at risk for HIV.

Methods

HIV-negative Black women in a retrospective cohort study (N=230) completed survey questions on cumulative violence (exposure to sexual or physical abuse before age 18 years and exposure to intimate partner violence or sexual violence [partner or other] after age 18 years and past year), bacterial vaginosis (lifetime and past year), and sexually transmitted infection diagnosis (lifetime and past year). Logistic regression models estimated the associations between cumulative violence, bacterial vaginosis, and sexually transmitted infections. Bacterial vaginosis was examined as a moderator in the association between cumulative violence and sexually transmitted infections.

Results

Many women reported cumulative violence exposure (40%), lifetime bacterial vaginosis diagnosis (53%), and lifetime sexually transmitted infection diagnosis (73%). Cumulative violence experience was significantly associated with increased adjusted odds of lifetime bacterial vaginosis diagnosis (AOR=1.98; 95% CI=1.10, 3.54). Lifetime bacterial vaginosis diagnosis (AOR=2.76; 95% CI=1.45, 5.22) and past-year bacterial vaginosis diagnosis (AOR=2.16; 95% CI=1.14, 4.10) were significantly associated with increased odds of lifetime sexually transmitted infection diagnosis. Lifetime bacterial vaginosis diagnosis (AOR=2.10; 95% CI=1.19, 3.70) and past-year bacterial vaginosis diagnosis (AOR=3.00; 95% CI=1.70, 5.31) were significantly associated with past-year sexually transmitted infection diagnosis. Lifetime bacterial vaginosis infection significantly increased the odds of lifetime sexually transmitted infection diagnosis with increasing cumulative violence exposure.

Conclusions

Our findings support educating and screening Black women who experience cumulative violence for bacterial vaginosis to reduce the risk of untreated bacterial vaginosis and sexually transmitted infections.

Contributions to inclusive and impactful development and psychopathology science: interrogating ecology-linked vulnerability and resilience opportunities

Since its launch in a 1984 Special Issue of Child Development, significant contributions and insights have followed that have expanded our understanding of psychopathology and normal human growth and development. Despite these efforts, there are persistent and under-analyzed skewed patterns of vulnerability across and within groups. The persistence of a motivated forgetfulness to acknowledge citizens' uneven access to resources and supports, or as stated elsewhere, "inequality presence denial," is, at minimum, a policy, social and health practice problem. This article will examine some of these issues from the standpoint of a universal human vulnerability perspective. It also investigates sources of resistance to acknowledging and responding to the scholarship production problem of uneven representations of basic human development research versus psychopathology preoccupations by race. Collectively, findings suggest interesting "patchwork" patterns of particular cultural repertoires as ordinary social and scholarly traditions.

Cultural Predictors of Self-Esteem Among Black Women With Criminal Justice Involvement and Herpes Simplex Virus

Black women have disproportionately alarming HSV-2 infection rates yet receive little attention in sexual health literature. Using a strengths-based resilience framework, this study sought to determine culturally relevant protective predictors of self-esteem for Black women who are justice-involved and have HSV-2. The authors conducted secondary data analysis on data from the "Black Women in the Study of Epidemics (B-WISE) Project," a longitudinal prospective study investigating health disparities and health services utilization among Black women with justice involvement. At baseline, N = 151 Black women with HSV-2 who were incarcerated or on probation completed survey measures assessing self-esteem, ethnic identity affirmation and belonging, perceived social support, and John Henryism Active Coping. Hierarchical linear regression analyses revealed ethnic identity affirmation and belonging and John Henryism Active Coping were significant predictors of self-esteem at 6-month follow-up. Implications are provided for current health professionals.

Burnout and resilience during the COVID-19 outbreak: differences between male and female students

This research aims to determine the burnout levels of male and female students on the three subscales of Exhaustion (EX), Cynicism (CY), and Professional Efficacy (PE) and their resilience during the COVID-19 pandemic. This is a non-experimental quantitative, descriptive, and cross-sectional research conducted on students of Riau University. The snowball sampling method was used to obtain data from 131 students consisting of 69 female and 62 male through the distribution of an online questionnaire and analyzed using the independent sample t-test and Pearson Product Moment Correlation. The data distribution showed that burnout on the PE, EX, CY, and resilience is in the high, moderate, and low categories, respectively.

The data analysis showed that the burnout variable for the PE and EX indicators in female was higher than for men. Meanwhile, male's CY and resilience indicators were higher than female. This indicates significant differences in burnout and resilience between male and female during the pandemic. The results also showed that there is no correlation between PE and resilience as well as CY and resilience, while EX and resilience show a correlation. This finding shows the psychological condition of students in using distance learning during the pandemic. There is a need for strategies to be implemented to reduce the impact of the pandemic on students for better mental health.

We Are Our Sister's Keeper: The Experience of Black Female Clergy Responding to Intimate Partner Violence

Intimate partner violence (IPV) affects all populations, regardless of race, education, or socioeconomic status, but Black women experience higher rates of IPV (43.7%) in comparison with White women (34.6%). Although evidence indicates that faith-based organizations and clergy play key roles in preventing and responding to IPV among Black women, limited research has been conducted in this area, and existing studies have focused on Black male clergy leaders' response to IPV. Using transcendental phenomenology, we interviewed 12 Black female clergy regarding their role as responders to IPV among Black women in their congregation. Each clergy leader participated in a face-to-face interview. Data analysis followed the modified Van Kaam seven-step process. One overarching theme emerged-We Are Our Sister's Keeper, as well as three primary themes: Support Advocate, Spiritual Advisor, and Roadblocked Leader. The themes indicated that Black female clergy respond to the emotional and spiritual needs of Black women despite barriers (e.g., few outside resources, limited support from the Black church). The themes also suggested that clergy lack knowledge and training for responding to IPV. However, Black female clergy are passionate about providing holistic, culturally centered care by bridging the gap between the church and the community to better serve Black women who have experienced IPV. Findings support the importance of incorporating spiritual and emotional healing among this population when providing care and services. Further research is needed to develop interventions, such as a faith-based toolkit that incorporates community resources and guidance to better support Black female clergy leaders' ability to respond to IPV.

The Weight of Racial Discrimination: Examining the Association Between Racial Discrimination and Change in Adiposity Among Emerging Adult Women Enrolled in a Behavioral Weight Loss Program

BACKGROUND

Non-Hispanic Black (NHB) emerging adult (EA) women are at disproportionate risk for obesity but experience limited benefit from behavioral weight loss (BWL) programs. Race-related stress could play a role; the goal of this study was to examine the association between racial discrimination (RD) and early (3 months) changes in adiposity, and to explore potential protective factors, among EA in an adapted BWL program.

METHODS

This is an ancillary study of non-Hispanic White (NHW) and NHB EA women enrolled in an adapted BWL trial (N = 49; 55.1% NHB; Age 21.2 (2.1); BMI = 33.0 + 4.3 kg/m²). At baseline, group- and personal-level RD (RD-group and RD-personal), racial identity (NHB women only), vigilant coping, and social support were assessed via validated questionnaires. Weight and waist circumference were measured objectively at 0 and 3 months.

RESULTS

NHW women manifested greater reductions in waist circumference relative to NHB women (p = .004). RD-personal did not predict change in waist circumference at 3 months (p = .402); however, the association between RD-group and change in waist circumference was statistically significant (p = .015), such that reporting greater group-level discrimination predicted a smaller decrease in waist circumference; the model explained 22% of the variance. Social support and vigilant coping were not statistically significant in the model. Among NHB women only, higher racial identity-centrality predicted greater reduction in waist circumference (p = .019).

CONCLUSION

Findings suggest racial discrimination could contribute to greater cardiometabolic risk during this developmental period. Future research should examine how experiences of racial discrimination unfold in the daily lives of NHB women to inform mechanistic interventions to enhance health and well-being.

TRIAL REGISTRATION

NCT02736981. Low Intensity Weight Loss for Young Adults.

The relationship of public and private religiosity to African American women caregivers' use of alcohol for coping with caregiving burden

The number of African American women providing unpaid care to an older person is increasing. Multiple stresses are associated with the caregiving experience. This article examines the relationship of both public and private religiosity to the use of alcohol to cope with these stresses. Data were from the Black Rural and Urban Caregivers Mental Health and Functioning Study. This cross-sectional study included 521 midwestern urban (n = 256) and rural (n = 265) African American women who were caregivers of dependent African Americans age 65 years and older. Results of heiarchical multinomial logistic regression revealed that those who are younger, those living in an urban area, and those with lower levels of religious attendance were more likely to use alcohol to cope with the stresses of caregiving. Helping professionals can use a strengths perspective, which highlights the importance of emphasizing strengths to increase caregivers' personal power, the development of strong coping skills, and the improvement of social support systems to create a positive approach to self-care with a focus on community building.

Impostor Phenomenon and Psychological Well-Being: The Moderating Roles of John Henryism and School Racial Composition Among Black College Students

The impostor phenomenon (IP), or erroneous cognitions of intellectual incompetence, is a risk factor for poor psychological adjustment among Black emerging adults. Grounded in Lazarus and Folkman's Stress and Coping Framework, the current study investigated John Henryism's active coping and institutional racial composition as moderators of the association between IP and indicators of psychological well-being among 266 Black students (77% women; M _age = 19.87) attending predominately White institutions (PWIs) and historically Black colleges/universities (HBCUs). Hierarchical moderation regression analyses revealed that IP was associated with decreases in well-being indicators among students attending PWIs and HBCUs. Moreover, students who attended PWIs and reported higher levels of John Henryism (+1 SD) were most vulnerable to increases in social anxiety, particularly at higher levels of IP. Results suggest that the interaction between IP, John Henrysim, and institutional racial composition may negatively influence psychological well-being. We discuss how these findings can be used to inform clinical and educational practices to best support Black college students.

The mPOWERED Electronic Learning System for Intimate Partner Violence Education: Mixed Methods Usability Study

Background

Nurse practitioners are a common resource for victims of intimate partner violence (IPV) presenting to health care settings. However, they often have inadequate knowledge about IPV and lack self-efficacy and confidence to be able to screen for IPV and communicate effectively with patients.

Objective

The aim of this study was to develop and test the usability of a blended learning system aimed at educating nurse practitioner students on topics related to IPV (ie, the mPOWERED system [Health Equity Institute]).

Methods

Development of the mPOWERED system involved usability testing with 7 nurse educators (NEs) and 18 nurse practitioner students. Users were asked to complete usability testing using a speak-aloud procedure and then complete a satisfaction and usability questionnaire.

Results

Overall, the mPOWERED system was deemed to have high usability and was positively evaluated by both NEs and nurse practitioner students. Respondents provided critical feedback that will be used to improve the system.

Conclusions

By including target end users in the design and evaluation of the mPOWERED system, we have developed a blended IPV learning system that can easily be integrated into health care education. Larger-scale evaluation of the pedagogical impact of this system is underway.

Racial discrimination, John Henryism coping, and behavioral health conditions among predominantly poor, urban African Americans: Implications for community-level opioid problems and mental health services

The current study examined the relationship between John Henryism Active Coping (JHAC), experiences of racial discrimination, and behavioral health outcomes in a community sample of 319 Black adults. Assessments included primary health care screenings as well as self-reported survey questions to assess JHAC, experiences of discrimination, and self-reported behavioral health. Logistic regression models, adjusted for control variables, found a significant relationship between JHAC and having an opioid problem (odds ratio [OR] = 0.95, p = 0.003) and needing mental health services (OR = 0.95, p < 0.001), such that higher levels of coping were associated with lower odds of reporting an opioid problem and needing mental health services. Notably, racial discrimination was not significantly independently associated with behavioral health. Implications for interventions and community programming are discussed.

My strong, Black daughter: Racial/ethnic differences in the attributes mothers value for their daughters

OBJECTIVES

The Strong Black Woman (SBW) ideal, which emphasizes self-reliance and strength, is considered an influential cultural image for many Black women. Research on how the SBW ideal may be reflected in maternal socialization is largely theoretical or qualitative.

METHODS

Guided by cultural models of parenting, we tested for racial/ethnic differences in the importance and meaning of SBW-related attributes among 194 low-income, Black (22%), White (20%), and Latina (57%) families. Mothers (M = 41.6 years) and daughters (M = 15.4 years) completed semistructured interviews, q-sort tasks, and self-report measures. Group differences were examined with analysis of covariance, logistic regression, and multigroup path models.

RESULTS

Black adolescents were not described by mothers or adolescents as possessing more SBW-related attributes (e.g., strong-willed, independent, assertive) compared to adolescents of other racial/ethnic groups; however, tests of moderation indicate group differences in how mothers perceived these attributes. Black adolescents with high SBW-related attributes were viewed by their mothers as showing leadership, whereas White and Latina adolescents with these attributes were viewed by mothers as having externalizing problems. Black mothers also rated these attributes as more important for young adult women to possess compared to other mothers. Finally, Black mothers described self-reliance as the critical developmental task for their daughter more than White and Latina mothers.

CONCLUSIONS

Findings suggest attributes consistent with the SBW ideal are valued by Black mothers more than Latina and White mothers from similar communities and provide empirical support about the potential importance of the SBW ideal in how Black mothers raise their daughters. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Childhood Sexual Abuse and Suicidal Ideation Among Bipolar Patients: Existential But Not Religious Well-Being as a Protective Factor

Individuals diagnosed with bipolar disorder (BD) are at an increased risk of Suicidal ideation, attempts, and death. Moreover, a strong association exists between childhood sexual abuse (CSA) and suicidal ideation among individuals with BD. Yet growing evidence suggests that existential well-being (EWB) may be a protective factor against suicidality. In this study, adult BD patients (N = 112) provided data on CSA, religious well-being (RWB; spiritual life in relation to God), EWB (purpose/meaning in life), and suicidal ideation. Participants were between 19 and 65 years of age. The majority was female and described their race/ethnicity as African American. Results indicated that CSA was negatively associated with EWB and was not related to RWB. Further, EWB mediated the association between CSA and suicidal ideation, whereas RWB did not. Having meaning/purpose in life may serve as a protective factor against suicidal ideation among individuals with BD who experienced CSA, whereas having a relationship/belief in God may not serve the same function.

Still I rise: The need for self-validation and self-care in the midst of adversities faced by Black women with HIV

OBJECTIVES

Psychosocial factors of trauma and abuse, racial discrimination, HIV stigma, and gender-related stressors (e.g., prioritizing others' needs) have been associated with antiretroviral treatment (ART) nonadherence and poor viral suppression among Black women living with HIV (BWLWH). To inform the development of an intervention addressing these psychosocial factors to improve ART adherence, the authors sought the insight of BWLWH.

METHOD

Qualitative semistructured interviews were conducted with 30 BWLWH to gather information on their experiences with trauma, racism, HIV stigma, gender-related stressors, ART adherence, and coping strategies, and their insights on the proposed intervention. Participants' interviews were audio-recorded, transcribed, and coded using thematic content analysis and grounded theory.

RESULTS

Participants shared (a) their experiences with trauma/abuse, racism, HIV-stigma, gender-related stress, and medication adherence; (b) coping strategies they use (e.g., social support, awareness [acknowledging systemic racism], assertiveness, selective disclosure of HIV status, and prioritizing the self); (c) how each of these adversities relate to their medication adherence and how they found ways to self-validate and practice self-primacy and self-care, including medication adherence in spite of adversities; and (d) enthusiasm for the proposed intervention.

CONCLUSIONS

Culturally adapted interventions are needed to improve the health of BWLWH by enhancing coping strategies for the multiple adversities they face and promoting self-validation, self-primacy, and self-care in spite of adversities. (PsycINFO Database Record

Mental Health Referrals Reduce Recidivism in First-Time Juvenile Offenders, But How Do We Determine Who is Referred?

While psychiatric disorders are common among juvenile delinquents, many mental health problems go undetected, increasing the likelihood for persistent difficulties. This is the first known study to examine mental health referral rates and recidivism in the juvenile justice system. In addition to the study, we review juvenile justice mental health screening to improve detection and treatment. Juvenile criminal records in conjunction with behavioral health screenings were analyzed to determine differences in referrals and recidivism among first time offenders. Recidivism rates were significantly lower (p = 0.04) and time to recidivism was significantly longer (p = 0.03) for those referred specifically for mental health services than for those without any referrals, even after adjusting for offense severity. While black youths had a significantly higher recidivism rate (p = 0.02) and a shorter time to recidivism (p = 0.009) than white youths, there was no significant difference between races when referred specifically for mental health services. Among the groups studied, black youths had the most profound positive effect from mental health referrals (p < 0.0001). This study indicates the importance of detecting mental health problems among juvenile delinquents, especially for black offenders. The apparent protective effect of mental health interventions necessitates screening that better identifies underlying psychosocial factors rather than strict reliance upon diagnostic criteria and self-report. Broader or even universal mental health referrals for juvenile offenders could reduce future legal system involvement and costs to society. We review potential reasons that mental health problems go undetected and provide recommendations.

John Henryism Active Coping as a Cultural Correlate of Substance Abuse Treatment Participation Among African American Women

The rates of illicit drug use among African American women are increasing, yet African American women are least likely to participate in treatment for substance use disorders when compared to women of other racial groups. The current study examined family history of substance use, perceived family support, and John Henryism Active Coping (JHAC) as correlates to seeking treatment for substance abuse. The underlying theoretical frame of JHAC (James et al., 1983) suggests that despite limited resources and psychosocial stressors, African Americans believe that hard work and self-determination are necessary to cope with adversities. The current study is a secondary data analyses of 206 drug-using African American women (N=104 urban community women with no criminal justice involvement and N=102 women living in the community on supervised probation) from urban cities in a southern state. It was expected that African American women with a family history of substance abuse, higher levels of perceived family support, and more active coping skills would be more likely to have participated in substance abuse treatment. Step-wise logistic regression results reveal that women on probation, had children, and had a family history of substance abuse were significantly more likely to report participating in substance abuse treatment. Perceived family support and active coping were significant negative correlates of participating in treatment. Implication of results suggests coping with psychosocial stressors using a self-determined and persistent coping strategy may be problematic for drug-using women with limited resources.

Stress and Coping among Black Women Employed in Non-professional Service and Professional Occupations in Florida and Georgia

Culture enhances the ability to address the stressors related to ethnicity/race, employment, and lifestyle. From this interaction, two coping patterns emerge: individualist-oriented or collectivist-oriented, of which women prefer the latter. However, there is limited knowledge about the impact of ethnicity/race on the coping strategies of Black working women in the USA. Therefore, the purpose of this cross-sectional survey was to examine the coping strategies of two groups of Black women, those who work in non-professional service-related jobs and those employed as professionals. We explored Black women from two southern states, Florida and Georgia, in their use of coping strategies for everyday stressors. A modified version of Lazarus and Folkman's Transactional Model was used as the framework of this study. The sample for this cross-sectional survey consisted of 313 Black women employed in non-professional service jobs and 343 in professional roles. The thoughts and actions related to coping in everyday stressors were measured with The Ways of Coping Questionnaire.

Is John Henryism a resilience factor in women experiencing intimate partner violence?

BACKGROUND

Research suggests that posttraumatic stress disorder (PTSD) and depression are two common mental health problems in intimate partner violence (IPV) survivors. Research has found that while Black women consistently report higher rates of victimization than White women, they also report less severe PTSD and depressive symptoms, suggesting that Black IPV survivors might be more resilient to PTSD and depression than are White survivors.

DESIGN

We implemented a correlational study with 81 Black and 100 White female survivors of IPV to determine if John Henryism (JH; i.e., a predisposed active coping mechanism) contributes to the resilience observed in Black IPV survivors.

METHODS

Participants completed the John Henryism Active Coping Scale, Center for Epidemiological Studies Depression Scale, Davidson Trauma Scale, and the Abusive Behavior Inventory.

RESULTS

Results demonstrated that White woman endorsed more severe depressive symptoms as compared to Black women. Severity of PTSD symptoms and JH was not significantly different between races. JH did not moderate the relationship between race and depression; however, for PTSD, JH was found to be protective of PTSD in White women, while demonstrating little impact on Black women.

CONCLUSIONS

The implications of these findings are discussed in terms of the minority stress model.