Socialization of Culture and Coping with Discrimination Among American Indian Families: Examining Cultural Correlates of Youth Outcomes

Parental Emotion Socialization of Sadness as a Correlate for Clinical Improvement: A Longitudinal Study of Adolescents with a Range of Nonsuicidal Self-Injury

Engagement in nonsuicidal self-injury (NSSI) often begins in adolescence, and commonly occurs when a person is emotionally dysregulated. Parental emotion socialization (ES) plays a key role in shaping children's emotional expression, experience, and regulation. Longitudinal work is needed to understand how links between parental ES and adolescent clinical outcomes unfold over time. In this longitudinal study (N = 118; all assigned female at birth with a range of NSSI - from none to severe; age 12-17 years, Mage = 14.98 at the first assessment), for the Time 1 (T1) and Time 2 (T2) annual assessments; adolescents reported NSSI and adolescents and parents reported depressive symptoms. Parents (primarily mothers) reported on their supportive and unsupportive ES responses to youth expressions of sadness, anger, and happiness. We examined (1) concurrent relationships across time points, (2) longitudinal models (T1 to T2 change in parental ES and its associated T1 to T2 changes in adolescent clinical outcomes), and (3) prediction models (T1 parental ES predicting changes in adolescent clinical outcomes). Concurrent associations between parental supportive ES responses to sadness and anger were inversely related to adolescent's depressive symptoms and NSSI episodes. Longitudinal analyses showed that increases in unsupportive responses to sadness correspond with increases in depressive symptoms from T1 to T2. The findings underscore the importance of examining how parents respond to their children's emotions. Next steps are to investigate potential mechanisms of risk and consider interventions that enhance adaptive responses of parents to adolescents embroiled in negative emotional states.

Does self-care improve coping or does coping improve self-care? A structural equation modeling study

BACKGROUND

Support interventions often address both self-care and coping. Different approaches are used to promote self-care and coping so clarifying the intervention effect can guide clinicians and researchers to provide interventions that achieve benefit.

PURPOSE

To compare two models to determine whether self-care improves coping or coping improves self-care.

METHODS

We used cross-sectional data from 248 caregivers obtained at enrollment into a randomized controlled trial testing the efficacy of a support intervention. Factor scores for scales measuring caregiver demand, self-care, coping, stress appraisal, and mental health were derived from exploratory factor analysis. Structural equation models were analyzed using the factor scores as estimates of each construct. To control possible spurious effects caregiver age, gender, relationship with the patient, and income adequacy were included.

RESULTS

Both models were compatible with the data, but the self-care model was stronger than the coping model. That model had a non-significant chi square and an excellent fit to the data, χ2(4, N = 248) = 2.64, p = .62. The percentage of variance explained by the self-care model was 54 % for mental health, 42 % for stress appraisal, 10 % for avoidance coping, and 6 % for active coping. In the coping model the explained variance of stress appraisal dropped to 33 %, avoidance coping dropped to 0 %, and active coping dropped to 3 %.

CONCLUSIONS

The self-care model was strongest, illustrating that self-care decreases stress, promotes coping, and improves mental health. These results suggest that promoting self-care may be more effective in improving mental health than interventions aimed at improving coping.

Discrimination and school outcomes in first nation youth: The role of positive psychological characteristics

INTRODUCTION

Positive psychological characteristics have been found to be associated with discrimination and school outcomes separately; however, no work has examined these associations together or in North American Indigenous (NAI) populations. NAI adolescents experience high rates of racial discrimination. Because discrimination has a detrimental impact on academic outcomes it is critical to identify factors that could buffer this impact. The purpose of this study was to examine the indirect effect of racial discrimination on three distinct school outcomes (i.e., attitudes toward school, grades, and educational attainment goals) through the pathway of three positive psychological characteristics (i.e., satisfaction with life, subjective happiness, and self-compassion).

METHODS

First Nation adolescents living on a rural reserve in Eastern Canada (N = 106, Mage  = 14.6 years, 50.0% female) completed a pencil-and-paper survey in Spring 2017 as part of a larger community-based participatory research study.

RESULTS

In the model examining school attitudes, indirect effects through subjective happiness (b = -0.21, 95% confidence interval (CI): [-0.53, -0.03]) and self-compassion (b = -0.19, 95% CI: [-0.39, -0.04]), but not satisfaction with life, were significant. In the model examining grades, only the specific indirect effect through subjective happiness was significant (b = -0.27, 95% CI: [-0.59 -0.07]). Similarly, in the model examining school goals, only the indirect effect through subjective happiness was significant (b = -0.40, 95% CI: [-0.94, -0.08]). The direct effects of discrimination on school attitudes (b = 0.02, 95% CI: [-0.52, 0.56]), grades (b = 0.16, 95% CI: [-0.39, 0.71]), and school goals (b = -0.03, 95% CI: [-0.90, 0.84]) were not significant after controlling for positive psychological characteristics.

DISCUSSION

Schools should foster positive emotions to enhance academic outcomes, especially for NAI youth who are more likely to experience racial discrimination.

A cross-sectional study on resilience, anxiety, depression, and psychoactive substance use among heterosexual and sexual minority adolescents in Nigeria

BACKGROUND

Mental health-related problems predispose alcohol and other psychoactive substances use as coping strategies. We assessed associations between resilience and anxiety symptoms, depressive symptoms, problematic alcohol, and multiple psychoactive substance use among sexual minority and heterosexual adolescents in Nigeria.

METHODS

This was a secondary analysis of a subset of data generated through an online cross-sectional study conducted between 16th and 31st of October 2020. Data extracted for adolescents in Nigeria age 13-19 years were: dependent variables (alcohol use using the CAGE test, multiple psychoactive substance use, depressive symptoms using the Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7 measure); independent variables (resilience using the Connor-Davidson resilience scale and sexual identity), and confounding factors (age and sex). Associations between dependent and independent variables were determined using multivariable logistic regression analyses after controlling for confounders.

RESULTS

Of the 1419 adolescent participants, 593 (42%) were sexual minority individuals, 533 (37.6%) had high depressive symptoms, 381 (26.8%) had high anxiety symptoms, 177 (12.5%) had problematic alcohol use and 389 (27.4%) used multiple psychoactive substances. Resilience was significantly associated with lower odds of anxiety (AOR:0.96, 95% CI: 0.94-0.97, p < 0.001) and depressive (AOR:0.94, 95% CI: 0.92-0.96, p < 0.001) symptoms, problematic alcohol use (AOR:0.97, 95% CI: 0.95-0.99, p = 0.002), and multiple psychoactive substance use (AOR:0.95, 95% CI: 0.93-0.96, p < 0.001). Sexual minority adolescents had significantly higher odds of anxiety (AOR:4.14, 95% CI: 3.16-5.40, p < 0.001) and depressive symptoms (AOR:4.79; 95% CI: 3.73-6.15, p < 0.001), problematic alcohol use (AOR:2.48, 95% CI: 1.76-3.49, p < 0.001), and multiple psychoactive substance use (AOR:5.69, 95% CI: 4.34-7.47, p < 0.001).

CONCLUSION

Sexual minority adolescents and adolescents with low resilience have a higher need for interventions to reduce the risk of anxiety, depression, and the use of alcohol and other psychoactive substances.

We Are Still Here: Omission and Perceived Discrimination Galvanized Civic Engagement Among Native Americans

Leading up to the 2020 U.S. presidential election, Native American organizations and tribes launched get-out-the-vote campaigns that motivated Native peoples to vote in record numbers and helped flip battleground states. We conducted four studies (total N = 11,661 Native American adults) to examine the social and cultural factors explaining this historic Native civic engagement (e.g., campaigning). Results revealed that the more participants identified as being Native, the more they reported (a) engaging in civic activities, including get-out-the-vote behaviors during the 2020 election (Study 1); (b) civic engagement more broadly across a 5-year period (pilot study, Study 2); and (c) intentions to engage in civic activities in the future (Study 3). Moreover, participants who more strongly identified as Native were more likely to recognize the omission of their group from society and perceive greater group discrimination, which both independently and serially predicted greater civic engagement. These results suggest that leveraging the link between Native identification and group injustices can motivate action.

Risk and Resilience Among Families in Urban AI/AN Communities: the Role of Young Adults

Urban American Indian/Alaska Native (AI/AN) young adults and their families are often geographically or socially distant from tribal networks and traditional social support. Young adults can be especially vulnerable to cultural and social disconnection, so understanding how AI/AN family functioning can augment resilience and protect against risk is important. This research precedes a preventive substance use intervention study and explores urban Native family functioning, emphasizing the role of young adults by analyzing data from 13 focus groups with urban AI/AN young adults (n = 32), parents (n = 25), and health providers (n = 33). We found that young adults can and want to become agents of family resilience, playing active roles in minimizing risks and strengthening family functioning in both practical and traditional ways. Also, extended family and community networks played a vital role in shaping family dynamics to support resilience. These resilience pathways suggest potential targets for intervention.

Nurses' experiences of discrimination in health care: A qualitative study in Iran

BACKGROUND

Justice in health is one of the main concerns of health organizations, and discrimination in health care is one of the negative outcomes to achieving this goal. Hence, a full understanding of the phenomenon of discrimination in health care and adopting strategies to eliminate it is necessary. The present study was conducted to explore and describe the experiences of nurses of discrimination in health care.

MATERIALS AND METHODS

The present qualitative content analysis study was conducted between 2019 and 2020. Data were collected through semi-structured interviews with 18 participants (two physicians, three nursing supervisors, two head nurses, four clinical nurses, two nursing assistants, and three hospitalized patients) in one public and one private hospital in the city of Tehran. The participants were selected by purposive sampling, which continued until saturation of data. Data obtained were analyzed using the Graneheim and Lundman method.

RESULTS

Four main categories and 14 subcategories were extracted from data analysis: 1) habitual discrimination (everyday discrimination in health centers, ignoring patient rights, low levels of trust in medical staff); 2) interpersonal relationships (expectations of associates, respect for colleagues and friends, the possibility of the occurrence of similar situations, reciprocating people's favors); 3) shortage of health-care resources (shortage of medical equipment, heavy workload, infrastructure of medical centers, lack of access to physicians); and 4) favoritism (ethnicity, favoritism as a common method, and favoritism as the ultimate solution to treatment problems).

CONCLUSION

The present study revealed certain dimensions of discrimination in health care that remain hidden in many quantitative studies. It appears that health system managers will be able to move toward eliminating discrimination in health care. Thus, designing effective models to reduce discrimination in health care based on the underlying concepts of this study is recommended.

An Observational Approach to Examining White Parents' Racial Socialization Practices With Adolescent Youth

The racial socialization (RS) strategies used by White parents have received limited empirical attention. Thus, the current study examined the frequency and content of White parents' RS messages to their White children during an observed parent-child discussion task on discrimination when youth were 14 years old. Participants were 243 White caregivers and their adolescent children (47.7% female). Overall, parents provided few RS messages, but when they did, they often relayed egalitarian messages or messages minimizing racism. Other types of RS strategies that emerged included acknowledging racism targeting people of color, discriminatory attitudes, and false beliefs in reverse racism.

Combating the Conspiracy of Silence: Clinician Recommendations for Talking About Racism-Related Events With Youth of Color

Graphic videos of race-based violence, including police brutality toward Black people and anti-Asian hate crimes, have exploded over the past year. While documentation of these horrific acts has brought visibility to the pervasiveness of racial discrimination, it has also resulted in youth of color being exposed to racial stressors more than ever before across numerous social media and news platforms.^1-3 Beyond the significant race-related stress already experienced by youth in school contexts,⁴ this increased exposure to racism via media is concerning, as both direct and vicarious exposure to racial discrimination can compromise psychological well-being of youth and cause trauma-like symptoms, such as intrusive thoughts, vigilance, and depression.^3,5.

Perceived Racial/Ethnic Discrimination, Physical and Mental Health Conditions in Childhood, and the Relative Role of Other Adverse Experiences

Adverse childhood experiences (ACEs) are associated with poor health. Childhood experiences of racial/ethnic discrimination and other forms of racism may underlie or exacerbate other ACEs. We explored health-related associations with perceived racial/ethnic discrimination relative to other ACEs, using data from 2016-2019 National Survey of Children's Health, an annual cross-sectional, nationally representative survey. Parent responses for 88,183 children ages 6-17 years with complete data for ACEs (including racial/ethnic discrimination) were analyzed for associations between racial/ethnic discrimination, other ACEs, demographics, and physical and mental health conditions with weighted prevalence estimates and Wald chi-square tests. To assess associations between racial/ethnic discrimination and health conditions relative to other ACEs, we used weighted Poisson regressions, adjusted for exposure to other ACEs, age, and sex. We assessed effect modification by race/ethnicity. Prevalence of other ACEs was highest among children with racial/ethnic discrimination, and both racial/ethnic discrimination and other ACEs were associated with having one or more health conditions. Adjusted associations between racial/ethnic discrimination and health conditions differed by race/ethnicity (interaction P-values < 0.001) and were strongest for mental health conditions among Hispanic/Latino (adjusted prevalence ratio (aPR)=1.62, 95% confidence interval (CI): 1.24-2.10) and non-Hispanic/Latino Asian American (aPR=2.25, 95% CI: 1.37-3.71) children. Results suggest racial/ethnic discrimination and other ACEs are associated with child health conditions, with differences in relative associations by race/ethnicity. Public health efforts to prevent childhood adversity, including racial/ethnic discrimination and other forms of racism could be associated with improvements in child health.

Older and Wiser? Age Moderates the Association Between Discrimination and Depressive Symptoms in American Indians and Alaska Natives

Objectives: To examine age differences in the association between discrimination and depressive symptoms among urban American Indians and Alaska Natives (AI/AN). Methods: A sample of 303 urban AI/AN (18-78 years old) reported on lifetime and past-week experiences of racial discrimination and depressive symptoms. Depressive symptoms were regressed on racial discrimination, age, and their interaction, adjusting for demographic factors and other life stressors. Results: Lifetime and past-week discrimination were significantly associated with depressive symptoms, and these associations were stronger among younger than older adult AI/AN. Discussion: The results are consistent with prior reports in other populations, but this is the first such study to focus on AI/AN, and it highlights the importance of considering life course perspectives. Conclusions are limited by the cross-sectional nature of the data. Longitudinal and qualitative work is needed to understand why discrimination may have a stronger effect on mental health for younger than older AI/AN.

Cultural socialization in childhood: Analysis of parent-child conversations with a direct observation measure

Cultural factors influence the development of all children. Yet, current knowledge of explicit cultural socialization processes in childhood remains limited, mainly by failing to incorporate the experiences of young children. To address this critical gap, the authors introduce the OMERS-Peds task, an observational measurement designed to systematically identify and compare the content of cultural messages passed down from caregivers to offspring during early school age years. The OMERS-Peds was administered to mothers and children (n = 275) from three diverse racial/ethnic backgrounds (African American (n = 153), Hispanic (n = 61), and non-Hispanic White (n = 61)) within the longitudinal Multidimensional Assessment of Preschoolers (MAPS) Study. The OMERS-Peds coding system was used to rate how strongly families endorsed 5 key constructs: family culture, religion, identity, ethnicity, and race. A series of χ2 statistic tests were used to compare scores across racial/ethnic backgrounds, and within families (between children and their mothers). Analyses revealed that in the cultural socialization conversations occurring in early childhood, parents and children prioritize talking about their family's culture and religion. Independent of their racial/ethnic backgrounds, mothers and children seldom discussed race and ethnicity. Contrary to research with older children, differences were mainly identified within families, rather than across racial/ethnic groups. Findings support the need to include children's perspectives in the assessments of cultural socialization, as opposed to relying primarily on parent reports, and highlight the importance of having an observational methodology that allows researchers to examine parent-child bidirectional interactions during early school age years in a systematic manner. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Justice and unintentional discrimination in health care: A qualitative content analysis

BACKGROUND:

Discrimination in health care is a common phenomenon whose complete understanding has always been a major concern of health-care systems to control and reduce it. This study aimed to explore the experiences of unintentional discrimination and related factors in health-care providers.

MATERIALS AND METHODS:

This qualitative study was conducted with a content analysis approach in 2019. Data were collected through semi-structured interviews with 13 health-care providers including two physicians, three nursing supervisors, two head nurses, four staff nurses, and two nurse aides in two general hospitals in Tehran, Iran. Participants were selected through purposeful sampling. The obtained data were analyzed by Graneheim and Lundman method.

RESULTS:

Three main categories and eight subcategories were obtained from the data analysis: (1) forced discrimination (superiors' pressures and executive orders, occupational concerns, and fear of the superiors); (2) guided discrimination (professional challenges, managers' policymaking, and lack of medical ethics knowledge); and (3) lack of resources (workforce shortage and lack of medical equipment).

CONCLUSION:

The results of this study suggest that health-care providers such as doctors and nurses are unintentionally forced to provide discriminatory care on some occasions. Knowing and managing these unwanted factors can partly counteract unintentional discrimination. Thus, preventing the factors that lead to superiors' pressures and occupational forces and improving the medical ethics knowledge should be considered by health-care managers.

Unpacking the Mascot Debate: Native American Identification Predicts Opposition to Native Mascots

While major organizations representing Native Americans (e.g., National Congress of American Indians) contend that Native mascots are stereotypical and dehumanizing, sports teams with Native mascots cite polls claiming their mascots are not offensive to Native people. We conducted a large-scale, empirical study to provide a valid and generalizable understanding of Native Americans’ ( N = 1,021) attitudes toward Native mascots. Building on the identity centrality literature, we examined how multiple aspects of Native identification uniquely shaped attitudes toward mascots. While Native Americans in our sample generally opposed Native mascots, especially the Redskins, attitudes varied according to demographic characteristics (e.g., age, political orientation, education) and the strength of participants’ racial–ethnic identification. Specifically, stronger Native identification (behavioral engagement and identity centrality) predicted greater opposition. Results highlight the importance of considering the unique and multifaceted aspects of identity, particularly when seeking to understand Native people’s attitudes and experiences.