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Mayorga NA, Manning KF, Viana AG, Buitron V, Argueta S, Zvolensky M. Evaluating the interactive impact of acculturative stress and anxiety sensitivity on behavioral health outcomes among Latinx during a period of high COVID-19 impact. Cogn Behav Ther 2024; 53:87-104. [PMID: 37929588 PMCID: PMC10841410 DOI: 10.1080/16506073.2023.2273794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
As a multi-systemic disease, COVID-19 infection engendered a rise in co-occurring mental and physical health symptoms, particularly affecting the Latinx population. The current work sought to evaluate the main and interactive influence of acculturative stress and anxiety sensitivity in terms of mental and physical health symptoms among 181 Latinx persons (30.4% female, Mage = 34.1 years, SD = 8.20). Data were collected during a period of high COVID-19 impact (2020-2021) and analyses included five separate, two-step hierarchical regressions that were conducted for each of the criterion variables: (1) fear of coronavirus; (2) somatic symptoms; (3) fatigue severity; (4) anxiety symptoms; and (5) depression symptoms. For all analyses, step 1 covariates included years living in the U.S. COVID-19 impact, gender identity, education, and work life distress and home life distress. Results revealed an interactive effect of anxiety sensitivity and acculturative stress on COVID-19 fear, unique main effects for both anxiety sensitivity and acculturative stress on COVID-19 related fear and somatic symptoms, and main effects for anxiety sensitivity alone in relation to fatigue severity, anxiety, and depression. Overall, this study represents an initial investigation of the associations between acculturative stress, anxiety sensitivity, and a range of salient COVID-19 related outcomes among Latinx persons.
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Kara F Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Victor Buitron
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Salma Argueta
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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Zare H, Ibe CA, Yang M, Porter G, Gaston M, Jones N, Jones W, Rose V, Balamani M, Woods DL, Gaskin DJ. Evaluating the Impact of the Prime Time Sister Circles ® Intervention on Reducing Depressive Symptoms Among African American Women with Uncontrolled Hypertension. J Gen Intern Med 2023; 38:2879-2887. [PMID: 37500950 PMCID: PMC10593703 DOI: 10.1007/s11606-023-08288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/15/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The Prime Time Sister Circles®, a randomized controlled trial (PTSC-RCT), assessed the impact of a community-based peer support program on hypertension management among African American women 40-75 years of age. While the PTSC-RCT was designed to evaluate changes in blood pressure control, subsequent sub-analyses revealed a high proportion of self-reported depressive symptoms in our sample. Accordingly, we conducted an ancillary investigation of the PTSC intervention on depression to ascertain its impact on reduced depressive symptoms in the study population. METHOD Depressive symptoms were measured using an adapted version of the Center for Epidemiologic Studies Depression Scale Revised (CES-D-10). We used unadjusted and adjusted fixed effect models. Data for this study came from the PTSC-RCT. We collected data between 2017 and 2018 in Washington, DC. We used a balanced analytical sample of 172 African American, English-speaking women between 40 to 75 years old with uncontrolled hypertension. INTERVENTION The intervention group participated in a 2-h, peer-based support group once a week for 13 weeks. A trained PTSC facilitator facilitated sessions with experts who delivered content on various topics, including psychosocial wellness (e.g., stress, depressive symptoms, anxiety management, and self-esteem), physical health (e.g., hypertension, inflammation, and heart disease), physical activity, and healthy nutrition. RESULTS Results from the fixed-effects models indicated that participants in the PTSC program exhibited a greater reduction in CES-D-10 score at three months (Coeff: -1.99, 95% CI: -3.49, -0.49) and at 15 months (Coeff: -2.38, 95% CI: -3.94, -0.83), as compared to those in the control group. CONCLUSIONS Evidence suggests that the Prime Time Sister Circles® intervention reduced depressive symptoms among African American women with low socioeconomic status and hypertension. TRIAL REGISTRATION NCT04371614.
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Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- University of Maryland Global Campus (UMGC), Adelphi, USA.
| | - Chidinma A Ibe
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Gayle Porter
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
| | - Marilyn Gaston
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
| | - Nicole Jones
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wehmah Jones
- American Institutes for Research, Washington, DC, USA
| | - Vivienne Rose
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michele Balamani
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
- Baraka and Associates, Largo, MD, USA
| | - Denise L Woods
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
| | - Darrell J Gaskin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Stefana A, Langfus JA, Palumbo G, Cena L, Trainini A, Gigantesco A, Mirabella F. Comparing the factor structures and reliabilities of the EPDS and the PHQ-9 for screening antepartum and postpartum depression: a multigroup confirmatory factor analysis. Arch Womens Ment Health 2023; 26:659-668. [PMID: 37464191 PMCID: PMC10491522 DOI: 10.1007/s00737-023-01337-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/05/2023] [Indexed: 07/20/2023]
Abstract
To evaluate and compare the factor structure and reliability of EPDS and PHQ in antepartum and postpartum samples. Parallel analysis and exploratory factor analysis were conducted to determine the structure of both scales in the entire sample as well as in the antepartum and postpartum groups. McDonald's omega statistics examined the utility of treating items as a single scale versus multiple factors. Multigroup confirmatory factor analysis (MCFA) was utilized to test the measurement invariance between the antepartum and postpartum groups. Two-factor models fit best for the EPDS in both the antepartum and postpartum groups; however, the most reliable score variance was attributable to a general factor for each scale. MCFA provided evidence of weak invariance across groups regarding factor loadings and partial invariance regarding item thresholds. PHQ-9 showed a two-factor model in the antepartum group; however, the same model did not fit well in the postpartum group. EPDS should be preferred to PHQ-9 for measuring depressive symptoms in peripartum populations. Both scales should be used as a single-factor scale. Caution is required when comparing the antepartum and postpartum scores.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Joshua A Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Gabriella Palumbo
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Loredana Cena
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Alice Trainini
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Antonella Gigantesco
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Fiorino Mirabella
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy
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Baugh AD, Acho M, Arhin A, Barjaktarevic I, Couper D, Criner G, Han M, Hansel N, Krishnan J, Malcolm K, Namen A, Peters S, Schotland H, Sowho M, Zeidler M, Woodruff P, Thakur N. African American race is associated with worse sleep quality in heavy smokers. J Clin Sleep Med 2023; 19:1523-1532. [PMID: 37128722 PMCID: PMC10394362 DOI: 10.5664/jcsm.10624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
STUDY OBJECTIVES To examine the association of self-identified race with sleep quality in heavy smokers. METHODS We studied baseline data from 1965 non-Hispanic White and 462 African American participants from SPIROMICS with ≥ 20 pack-years smoking history. We first examined the Pittsburgh Sleep Quality Index's (PSQI) internal consistency and item-total correlation in a population with chronic obstructive pulmonary disease. We then used staged multivariable regression to investigate the association of race and sleep quality as measured by the PSQI) The first model included demographics, the second added measures of health status, and the third, indicators of socioeconomic status. We next explored the correlation between sleep quality with 6-minute walk distance and St. George's Respiratory Questionnaire score as chronic obstructive pulmonary disease-relevant outcomes. We tested for interactions between self-identified race and the most important determinants of sleep quality in our conceptual model. RESULTS We found that the PSQI had good internal consistency and item-total correlation in our study population of heavy smokers with and without chronic obstructive pulmonary disease. African American race was associated with increased PSQI in univariable analysis and after adjustment for demographics, health status, and socioenvironmental exposures (P = .02; 0.44 95%CI: .06 to .83). Increased PSQI was associated with higher postbronchodilator forced expiratory volume in 1 second and lower household income, higher depressive symptoms, and female sex. We identified an interaction wherein depressive symptoms had a greater impact on PSQI score for non-Hispanic White than African American participants (P for interaction = .01). CONCLUSIONS In heavy smokers, self-reported African American race is independently associated with worse sleep quality. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Study of COPD Subgroups and Biomarkers (SPIROMICS); URL: https://clinicaltrials.gov/ct2/show/NCT01969344; Identifier: NCT01969344. CITATION Baugh AD, Acho M, Arhin A, et al. African American race is associated with worse sleep quality in heavy smokers. J Clin Sleep Med. 2023;19(8):1523-1532.
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Affiliation(s)
- Aaron D. Baugh
- University of California San Francisco, San Francisco, California
| | - Megan Acho
- University of Michigan, Ann Arbor, Michigan
| | | | - Igor Barjaktarevic
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - David Couper
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Gerard Criner
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Meilan Han
- University of Michigan, Ann Arbor, Michigan
| | | | | | | | - Andrew Namen
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Stephen Peters
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Michelle Zeidler
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | | | - Neeta Thakur
- University of California San Francisco, San Francisco, California
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Phimphasone-Brady P, Page CE, Ali DA, Haller HC, Duffy KA. Racial and ethnic disparities in women's mental health: a narrative synthesis of systematic reviews and meta-analyses of the US-based samples. Fertil Steril 2023; 119:364-374. [PMID: 36702342 PMCID: PMC10754063 DOI: 10.1016/j.fertnstert.2023.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023]
Abstract
Over 2 decades of research indicate the significance of racial or ethnic disparities in mental illness in the United States. However, minoritized racial or ethnic groups tend to report overall lower prevalence rates of psychiatric disorders than White adults, although this varies depending on gender and race or ethnicity. We conducted a rigorous and systematic narrative synthesis on the differences in the prevalence rates and symptoms that differ across racial or ethnic women in depression, anxiety, eating disorders, and premenstrual syndrome or premenstrual dysphoric disorder. Seven systematic reviews and meta-analyses that examined racial/ethnic differences in depression and eating disorders were included. No review that examined racial/ethnic differences in anxiety or premenstrual syndrome or premenstrual dysphoric disorder met inclusion criteria. Methodological quality of the reviews, which was determined by the Assessment of Multiple Systematic Reviews criteria, revealed that the results of 5 reviews were rated as critically low confidence, one review was rated as low confidence, and one review was rated as high confidence. Findings were inconsistent across systematic reviews and meta-analyses because of the methodological differences in the original studies. Overall, racially or ethnically minoritized women generally report lower prevalence rates in depressive and eating disorders than the White women; however, they exhibit different or greater symptom presentation that could influence prevalence estimates depending on the diagnostic criteria followed. Methodological considerations are provided to strengthen the literature on racial or ethnic mental health disparities in women.
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Affiliation(s)
- Phoutdavone Phimphasone-Brady
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
| | - Chloe E Page
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Diab A Ali
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Heinrich C Haller
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Korrina A Duffy
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
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Shi J, Wang X, Zhao N, Kang C, Yang L, Zheng Y, Liu J, Feng L, Zhu X, Ma C, Wu W, Wang G, Hu J. Sex differences in residual somatic symptoms in patients with first-episode depression after acute-phase treatment. BMC Psychiatry 2023; 23:119. [PMID: 36814241 PMCID: PMC9948378 DOI: 10.1186/s12888-023-04612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Residual somatic symptoms (RSS) are common in depressed patients, predicting treatment effectiveness. However, sex differences in RSS have received little systematic study. This study was conducted to compare sex differences of RSS in patients with first-episode depression (FED). METHODS Nine hundred eighty-two patients with FED were selected and treated for 8 to 12 weeks. We evaluated the subjects' socio-demographic characteristics and residual depressive symptoms. Using the Patient Health Questionnaire-15 (PHQ-15) scale to assess residual somatic symptoms, the Sheehan Disability Scale (SDS) for the assessment of patients' function, the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) for quality of life. RESULTS The incidence of RSS with FED was 46.4%. For patients with residual symptoms, the age and age of onset in females were higher than males, but males had more years of education than females. The degree of "stomach pain" in females was more severe than in males, while "trouble sleeping" in males was more severe than that in females. Multiple regression analysis showed that the total Q-LES-Q-SF score was an independent influencing factor of RSS in both males and females, while the total SDS score only affected female RSS. CONCLUSIONS The prevalence of RSS in FED after acute-phase treatment is high. The symptom of "stomachache" is more pronounced in females, while "trouble sleeping" is more severe in males. Quality of life plays an essential role in RSS in both genders. Thus, sex needs to be considered when assessing the relationship between RSS and therapeutic effect in depression.
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Affiliation(s)
- Jingjing Shi
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Xiaohong Wang
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Na Zhao
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Chuanyi Kang
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Liying Yang
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Yue Zheng
- grid.11135.370000 0001 2256 9319Peking University Institute of Mental Health (Sixth Hospital), Beijing, China ,grid.11135.370000 0001 2256 9319National Clinical Research Center for Mental Disorders & NHC Key Laboratory of Mental Health, Peking University, Beijing, China
| | - Jiacheng Liu
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Lei Feng
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xuequan Zhu
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Caina Ma
- Harbin First Specialized Hospital, Heilongjiang Province, Harbin, China
| | - Wenyuan Wu
- grid.412793.a0000 0004 1799 5032Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, China
| | - Gang Wang
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jian Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001, China.
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Lee C, Min SH. Racial Differences in C-Reactive Protein, Depression Symptoms, and Social Relationships in Older Adults: A Moderated Network Analysis. Biol Res Nurs 2023:10998004231157767. [PMID: 36802354 DOI: 10.1177/10998004231157767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
INTRODUCTION We introduce moderated network analysis as an integrative approach to assess the moderation effects of race on the relationship between C-reactive protein (CRP) and depression symptoms in older adults. This study further explores how the observed relationships differ adjusting for social relationships. METHODS This secondary analysis of cross-sectional data from the National Social Life, Health, and Aging Project (2010-2011) includes 2,880 older adults. We used different depression symptom domains (depressed affect, low positive affect, somatic symptoms, and interpersonal problems) from the Center for Epidemiologic Studies-Depression Scale. Social relationships were assessed with measures of social integration, social support, and social strain. The moderated networks were constructed using the R-package mgm. The racial moderator was coded as White/African American racial groups. RESULTS In the moderated networks of CRP and depression symptoms, CRP-"interpersonal problems" edge was present only among African Americans. CRP-"somatic symptoms" edge was present in both racial groups with equal edge weights. After adjusting for social relationships, the aforementioned patterns remained the same, but the edge weights were attenuated. We additionally observed CRP-social strain and social integration-"depressed affect" edges only in African Americans. DISCUSSION Race may moderate the relationship between the CRP and depression symptoms in older adults and social relationships might be important covariates to consider while analyzing them. This study as an initiation point; future network investigations would benefit from leveraging more contemporary cohorts of older adults, gaining a large sample size with diverse racial/ethnic backgrounds, and important covariates. Several important methodological issues of the current study are addressed.
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Affiliation(s)
- Chiyoung Lee
- School of Nursing & Health Studies, University of Washington Bothell, Bothell, WA, USA
| | - Se Hee Min
- Columbia University School of Nursing, New York, NY, USA
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Brooks JL, Adams LB, Woods-Giscombé CL, Currin EG, Corbie-Smith GM. Factor analysis of the Center for Epidemiological Studies Depression Scale in American Indian women. Res Nurs Health 2022; 45:733-741. [PMID: 36161722 PMCID: PMC9922528 DOI: 10.1002/nur.22267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/20/2022] [Accepted: 08/27/2022] [Indexed: 11/08/2022]
Abstract
The Center for Epidemiological Studies Depression Scale (CES-D) is widely used to assess depressive symptoms in the general population. It lacks validation for widespread use within the American Indian population, however. To address this gap, we explored and confirmed the factor structure of the CES-D among a community sample of southeastern American Indian women. We analyzed data from a sample of 150 American Indian women ages 18-50 from a southeastern tribe who had complete responses on the CES-D as part of a larger cross-sectional, community-engaged study. We performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the measure's validity. We examined EFA models ranging from one to five factors, with the four-factor structure yielding the best overall model fit (CFI = 1.00, TLI = 0.99, RMSEA = 0.03). Differences between the four-factor EFA-retained structure from our sample and Radloff's four-factor structure emerged. Only the interpersonal factor was common to both factor structures. Our study findings confirm the validity of the original four-factor structure of the CES-D for younger adult American Indian women in the southeast. Contrasting findings with the EFA-retained structure, however, provide a more nuanced interpretation of our results.
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Affiliation(s)
- Jada L. Brooks
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leslie B. Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Emily G. Currin
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Giselle M. Corbie-Smith
- Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
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Coser AD, Kominsky TK, Garrett BA. Postpartum Depression in a Community Sample of American Indian Mothers. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09912-6. [PMID: 36190607 DOI: 10.1007/s10880-022-09912-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 10/10/2022]
Abstract
American Indian (AI) mothers experience high rates of postpartum depression (PPD). We evaluated the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) among AI mothers from a rural AI serving health system. We also investigated potential associations between EPDS scores and selected psychosocial factors (n = 315). Exploratory Factor Analysis (n = 157) showed that a one-factor structure best fits the data. A Confirmatory Factor Analysis was then conducted to examine the fit of the one-factor model (n = 158). Goodness-of-fit statistics showed overall poor model fit (RMSEA = .13) which may be suggestive of an indicator of depression among Natives not detected by the EPDS. Results of the multiple regression analysis were non-significant. The findings demonstrated that while the EPDS measured aspects of PPD, there may be additional aspects of depression specific to the AI women in our sample not captured by the EPDS. Limitations and directions for future research are discussed.
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Affiliation(s)
| | | | - Brady A Garrett
- Cherokee Nation, 19600 E. Ross St., Tahlequah, OK, 74464, USA
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Bossick AS, Bossick NR, Callegari LS, Carey CM, Johnson H, Katon JG. Experiences of racism and postpartum depression symptoms, care-seeking, and diagnosis. Arch Womens Ment Health 2022; 25:717-727. [PMID: 35504987 DOI: 10.1007/s00737-022-01232-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/20/2022] [Indexed: 11/02/2022]
Abstract
Postpartum depression (PPD) is common and disproportionately affects people of color. Experiences of emotional upset due to racism (EUR) may be an important predictor of PPD outcomes. Therefore, we aimed to determine if EUR during the 12 months before delivery was associated with PPD symptomology, asking for help for depression, and depression diagnosis among postpartum people of color (PPOC). We conducted a cross-sectional secondary data analysis among PPOC from 11 states and New York City using PRAMS data, 1/1/2015-12/31/2017. We assessed symptomology using an unvalidated PHQ-2. Logistic regression was performed without and with stratification by ethnicity (non-Hispanic PPOC vs Hispanic PPOC) to estimate whether EUR during 12 months before delivery was associated with (1) PPD symptoms, (2) asking for help for depression, and (3) depression diagnosis. Models adjusted for age, educational attainment, timely prenatal care, payment method, stress during pregnancy, and pre-pregnancy depression. Seventy-four thousand nine hundred nine (11.8%) PPOC reported EUR in the 12 months before delivery. After adjustment, EUR was associated with a 10.3 percentage point (%pt; 95% CI: 6.8, 13.8), 13.6%pt (95% CI: 8.8, 18.5), and 4.1%pt (95% CI: 1.4, 8.0) higher probability of positive PPD screening among all PPOC, non-Hispanic PPOC, and Hispanic PPOC, respectively. EUR was not associated with asking for help for depression but was associated with a higher prevalence of depression diagnosis among all PPOC (4.6%pt; 95% CI: 1.0, 8.4) and non-Hispanic PPOC (6.0%pt; 95% CI: 0.8, 11.2).Experiences of EUR are associated with an increased prevalence of PPD symptoms. Additional prospective research spanning the pre-pregnancy through postpartum periods is needed to examine the dynamic relationship between racism, symptomology, help-seeking, and diagnosis of depression.
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Affiliation(s)
- Andrew S Bossick
- Center of Innovation for Veteran-Centered and Value-Driven Care, U.S. Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D, VA Puget Sound Healthcare System, Seattle, WA, USA. .,Department of Health Services, University of Washington, Magnuson Health Sciences Center, 1959 NE Pacific StRoom H-680, Box 357660, Seattle, WA, 98195, USA.
| | | | - Lisa S Callegari
- Center of Innovation for Veteran-Centered and Value-Driven Care, U.S. Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D, VA Puget Sound Healthcare System, Seattle, WA, USA.,Department of Health Services, University of Washington, Magnuson Health Sciences Center, 1959 NE Pacific StRoom H-680, Box 357660, Seattle, WA, 98195, USA.,Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Cathea M Carey
- Center of Innovation for Veteran-Centered and Value-Driven Care, U.S. Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D, VA Puget Sound Healthcare System, Seattle, WA, USA
| | - Hannah Johnson
- Department of Health Services, University of Washington, Magnuson Health Sciences Center, 1959 NE Pacific StRoom H-680, Box 357660, Seattle, WA, 98195, USA
| | - Jodie G Katon
- Center of Innovation for Veteran-Centered and Value-Driven Care, U.S. Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D, VA Puget Sound Healthcare System, Seattle, WA, USA.,Department of Health Services, University of Washington, Magnuson Health Sciences Center, 1959 NE Pacific StRoom H-680, Box 357660, Seattle, WA, 98195, USA
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11
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Vujanovic AA, Webber HE, McGrew SJ, Green CE, Lane SD, Schmitz JM. Distress tolerance: prospective associations with cognitive-behavioral therapy outcomes in adults with posttraumatic stress and substance use disorders. Cogn Behav Ther 2022; 51:326-342. [PMID: 34994673 PMCID: PMC8986561 DOI: 10.1080/16506073.2021.2007995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/13/2021] [Indexed: 11/03/2022]
Abstract
74Distress tolerance (DT; perceived or actual ability to tolerate aversive physical or emotional states) is related to both posttraumatic stress disorder (PTSD) symptoms and substance use disorders (SUD). This investigation evaluates self-report and behavioral measures of DT as potential predictors of PTSD and SUD cognitive-behavioral therapy outcomes. Participants included 41 treatment-seeking adults (53.7% women; 73.2% African American; Mage = 44.90, SD = 9.68) who met at least four symptoms of DSM-5 PTSD and DSM-IV substance dependence, assessed via structured interviews. At baseline (pre-treatment), participants completed the Distress Tolerance Scale (DTS), Mirror-Tracing Persistence Task (MTPT), Breath Holding task, and Paced Auditory Serial Addition Task. The Clinician-Administered PTSD Scale for DSM-5 severity scores and percent days of primary substance use, measured via Timeline Follow-back, were used as indicators of PTSD symptoms and substance use, respectively. Covariates included treatment condition, baseline PTSD symptom severity, and baseline substance use. Lower perceived DT at baseline (DTS total score) was associated with higher PTSD symptom severity at end-of-treatment. Lower behavioral DT at baseline (MTPT duration) was associated with higher substance use at the conclusion of treatment (i.e. proportion of number of use days to total number of days between two final treatment sessions).
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Affiliation(s)
| | | | | | | | - Scott D. Lane
- University of Texas Health Science Center at Houston
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12
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Manning K, Mayorga NA, Nizio P, Heggeness LF, Kauffman BY, Garey L, Zvolensky MJ. Exploring Fatigue Sensitivity in terms of Mental Health and Fatigue Severity among a Racially and Ethnically Diverse Sample with Severe Fatigue. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2022; 10:136-145. [PMID: 36339280 PMCID: PMC9629796 DOI: 10.1080/21641846.2022.2085455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/12/2022] [Indexed: 06/11/2023]
Abstract
Background Fatigue sensitivity, or the misattribution that fatigue symptoms will lead to negative personal consequences, is one individual difference factor related to adverse behavioral health consequences. Methods The current study investigated whether fatigue sensitivity was related to panic symptoms, depression, as well as fatigue severity among 166 persons of diverse racial/ethnic backgrounds with severe fatigue. Results As hypothesized, fatigue sensitivity was statistically significantly related to greater panic symptoms, general depression, and fatigue severity. These results were evident over the variance explained by age, sex, neuroticism, and somatic symptoms. Conclusions This work is the first to evaluate fatigue sensitivity in terms of behavioral health outcomes among a racial/ethnically diverse sample with severe fatigue.
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Affiliation(s)
- Kara Manning
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Pamella Nizio
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Luke F. Heggeness
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
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13
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Lau SCL, Drake BF, Sanders-Thompson VL, Baum CM. Racial Variation in the Association Between Domains of Depressive Symptomatology and Functional Recovery in Stroke Survivors. J Racial Ethn Health Disparities 2022; 10:1058-1066. [PMID: 35378721 DOI: 10.1007/s40615-022-01293-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of the study was to investigate the relationships between various domains of depressive symptomatology and functional recovery in Black and White stroke survivors. METHODS Black (n = 181) and White (n = 797) stroke survivors from the Stroke Recovery in Underserved Population database were included. Four domains of depressive symptomatology (depressed affect, positive affect, somatic symptoms, interpersonal difficulties) were measured by the Center for Epidemiologic Studies Depression Scale at discharge; functional recovery was measured by the Functional Independence Measure at discharge and 3-month follow-up. Multivariable linear regression analyses examined the relation between race and functional recovery, and the association between depressive symptomatology and functional recovery by race. RESULTS Three-month functional recovery was greater among White stroke survivors than Black survivors. Affective symptoms of depression predicted poorer functional recovery of White survivors; whereas somatic symptoms predicted poorer functional recovery of Black survivors. CONCLUSIONS Domains of depressive symptomatology were differentially associated with poorer functional recovery in Black and White stroke survivors. Psychosocial interventions aimed at alleviating depressive symptomatology have the potential to improve functional recovery in Black and White stroke survivors and should be addressed in planning rehabilitation post-stroke.
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Affiliation(s)
- Stephen C L Lau
- Program in Occupational Therapy, Washington University School of Medicine, 600 S. Taylor Ave 00163, St. Louis, MO, 63110, USA
| | - Bettina F Drake
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Carolyn M Baum
- Program in Occupational Therapy, Washington University School of Medicine, 600 S. Taylor Ave 00163, St. Louis, MO, 63110, USA.
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA.
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
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14
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Eche IJ, Yusufov M, Isibor DA, Wolfe J. A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes. Pediatr Blood Cancer 2021; 68:e29328. [PMID: 34523798 DOI: 10.1002/pbc.29328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/28/2021] [Accepted: 08/13/2021] [Indexed: 11/11/2022]
Abstract
Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.
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Affiliation(s)
- Ijeoma Julie Eche
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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15
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Emami AS, Bairey Merz CN, Eastwood JA, Pepine CJ, Handberg EM, Bittner V, Mehta PK, Krantz DS, Vaccarino V, Eteiba W, Cornell CE, Rutledge T. Somatic Versus Cognitive Depressive Symptoms as Predictors of Coronary Artery Disease among Women with Suspected Ischemia: The Women's Ischemia Syndrome Evaluation. HEART AND MIND 2021; 5:112-118. [PMID: 34966880 PMCID: PMC8713564 DOI: 10.4103/hm.hm_34_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Depression is an established predictor of coronary artery disease (CAD) progression and mortality. "Somatic" symptoms of depression such as fatigue and sleep impairment overlap with symptoms of CAD and independently predict CAD events. Differentiating between "somatic" and "cognitive" depressive symptoms in at-risk patients may improve our understanding of the relationship between depression and CAD. METHODS The study utilized data from the Women's Ischemia Syndrome Evaluation. Participants (N = 641; mean age = 58.0 [11.4] years) were enrolled to evaluate chest pain or suspected myocardial ischemia. They completed a battery of symptom and psychological questionnaires (including the Beck Depression Inventory [BDI]) at baseline, along with quantitative coronary angiography and other CAD diagnostic procedures. The BDI provided scores for total depression and for cognitive and somatic depressive symptom subscales. RESULTS Two hundred and fourteen (33.4%) women met criteria for obstructive CAD. Logistic regression models were used to examine relationships between depression symptoms and obstructive CAD. Neither BDI total scores (odds ratio [OR] =1.02, 95% confidence interval [CI], 0.99-1.05, P = 0.053) nor BDI cognitive scores (OR = 1.02, 95% CI, 1.00-1.04, P = 0.15) predicted CAD status. BDI somatic symptom scores, however, significantly predicted CAD status and remained statistically significant after controlling for age, race, and education (OR = 1.06, 95% CI, 1.01-1.12, P = 0.02). CONCLUSION Among women with suspected myocardial ischemia, somatic but not cognitive depressive symptoms predicted an increased risk of obstructive CAD determined by coronary angiography. Consistent with prior reports, these results suggest a focus on somatic rather than cognitive depressive symptoms could offer additional diagnostic information.
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Affiliation(s)
- Ashley S. Emami
- Psychology Service, VA San Diego Healthcare System, San Diego, California
| | - C. Noel Bairey Merz
- Barbra Streisand Women’s Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California
| | | | - Carl J. Pepine
- Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida
| | - Eileen M. Handberg
- Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida
| | - Vera Bittner
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Puja K. Mehta
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - David S. Krantz
- Department of Medical and Clinical Psychology Uniformed Services University, Bethesda, Maryland
| | - Viola Vaccarino
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Wafia Eteiba
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Carol E. Cornell
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Thomas Rutledge
- Psychology Service, VA San Diego Healthcare System, San Diego, California
- Department of Psychiatry, University of California, San Diego, California
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