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Webb EK, Stevens JS, Ely TD, Lebois LAM, van Rooij SJH, Bruce SE, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Murty VP, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Pearson C, Peak DA, Domeier RM, Rathlev NK, O’Neil BJ, Sergot P, Sanchez LD, Joormann J, Pizzagalli DA, Harte SE, Kessler RC, Koenen KC, Ressler KJ, McLean SA, Harnett NG. Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma. JAMA Psychiatry 2024:2821946. [PMID: 39083325 PMCID: PMC11292566 DOI: 10.1001/jamapsychiatry.2024.2148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/15/2024] [Indexed: 08/03/2024]
Abstract
Importance Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD). Objective To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward. Design, Setting, and Participants As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023. Exposures Residential greenspace within a 100-m buffer of each participant's home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC). Main Outcome and Measures PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income). Results In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald z test = -3.92; P < .001), nonremitting moderate (Wald z test = -2.24; P = .03), or slow recovery (Wald z test = -2.27; P = .02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n = 288; t277 = 2.83; adjusted P value = 0.02); however, reward reactivity did not differ by PTSD trajectory. Conclusions and Relevance In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.
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Affiliation(s)
- E. Kate Webb
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Timothy D. Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Lauren A. M. Lebois
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts
| | - Sanne J H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri-St Louis, St Louis
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Francesca L. Beaudoin
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Department of Emergency Medicine, Brown University, Providence, Rhode Island
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Thomas C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta
| | - Sarah D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Laura T. Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
- The Many Brains Project, Belmont, Massachusetts
| | - Kenneth A. Bollen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Scott L. Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Brittany E. Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus
- Ohio State University College of Nursing, Columbus
| | - Robert A. Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Vishnu P. Murty
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jose L. Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia
| | - Elizabeth M. Datner
- Department of Emergency Medicine, Jefferson Einstein Hospital, Jefferson Health, Philadelphia, Pennsylvania
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St John Hospital, Detroit, Michigan
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston
| | - Robert M. Domeier
- Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, Michigan
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield
| | - Brian J. O’Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, Michigan
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas
| | - Leon D. Sanchez
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts
| | - Samuel A. McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
| | - Nathaniel G. Harnett
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts
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Norbury A, Seeley SH, Perez-Rodriguez MM, Feder A. Functional neuroimaging of resilience to trauma: convergent evidence and challenges for future research. Psychol Med 2023; 53:3293-3305. [PMID: 37264949 PMCID: PMC11350638 DOI: 10.1017/s0033291723001162] [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] [Indexed: 06/03/2023]
Abstract
Resilience is broadly defined as the ability to adapt successfully following stressful life events. Here, we review functional MRI studies that investigated key psychological factors that have been consistently linked to resilience to severe adversity and trauma exposure. These domains include emotion regulation (including cognitive reappraisal), reward responsivity, and cognitive control. Further, we briefly review functional imaging evidence related to emerging areas of study that may potentially facilitate resilience: namely social cognition, active coping, and successful fear extinction. Finally, we also touch upon ongoing issues in neuroimaging study design that will need to be addressed to enable us to harness insight from such studies to improve treatments for - or, ideally, guard against the development of - debilitating post-traumatic stress syndromes.
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Affiliation(s)
- Agnes Norbury
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Queen Square Institute of Neurology and Mental Health Neuroscience Department, Applied Computational Psychiatry Lab, Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
| | - Saren H. Seeley
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Springfield S, Qin F, Hedlin H, Eaton CB, Rosal MC, Taylor H, Staudinger UM, Stefanick ML. Modifiable Resources and Resilience in Racially and Ethnically Diverse Older Women: Implications for Health Outcomes and Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7089. [PMID: 35742334 PMCID: PMC9223074 DOI: 10.3390/ijerph19127089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 12/10/2022]
Abstract
Introduction: Resilience-which we define as the "ability to bounce back from stress"-can foster successful aging among older, racially and ethnically diverse women. This study investigated the association between psychological resilience in the Women's Health Initiative Extension Study (WHI-ES) and three constructs defined by Staudinger's 2015 model of resilience and aging: (1) perceived stress, (2) non-psychological resources, and (3) psychological resources. We further examined whether the relationship between resilience and key resources differed by race/ethnicity. Methods: We conducted a secondary analysis on 77,395 women aged 62+ (4475 Black or African American; 69,448 non-Hispanic White; 1891 Hispanic/Latina; and 1581 Asian or Pacific Islanders) who enrolled in the WHI-ES, which was conducted in the United States. Participants completed a short version of the Brief Resilience Scale one-time in 2011. Guided by Staudinger's model, we used linear regression analysis to examine the relationships between resilience and resources, adjusting for age, race/ethnicity, and stressful life events. To identify the most significant associations, we applied elastic net regularization to our linear regression models. Findings: On average, women who reported higher resilience were younger, had fewer stressful life events, and reported access to more resources. Black or African American women reported the highest resilience, followed by Hispanic/Latina, non-Hispanic White, and Asian or Pacific Islander women. The most important resilience-related resources were psychological, including control of beliefs, energy, personal growth, mild-to-no forgetfulness, and experiencing a sense of purpose. Race/ethnicity significantly modified the relationship between resilience and energy (overall interaction p = 0.0017). Conclusion: Increasing resilience among older women may require culturally informed stress reduction techniques and resource-building strategies, including empowerment to control the important things in life and exercises to boost energy levels.
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Affiliation(s)
- Sparkle Springfield
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL 60153, USA
| | - Feifei Qin
- Department of Medicine, Stanford Center for Biomedical Informatics Research, Quantitative Sciences Unit, Stanford University, Palo Alto, CA 94304, USA; (F.Q.); (H.H.)
| | - Haley Hedlin
- Department of Medicine, Stanford Center for Biomedical Informatics Research, Quantitative Sciences Unit, Stanford University, Palo Alto, CA 94304, USA; (F.Q.); (H.H.)
| | - Charles B. Eaton
- Department of Epidemiology, Brown University School of Public Health and Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02912, USA;
| | - Milagros C. Rosal
- Department of Population and Quantitative Health Sciences, Medical School, University of Massachusetts, Worcester, MA 01605, USA;
| | - Herman Taylor
- Cardiovascular Research Institute Research, Morehouse School of Medicine, Morehouse College, Atlanta, GA 30310, USA;
| | | | - Marcia L. Stefanick
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Palo Alto, CA 94305, USA;
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Beatty Moody DL, Waldstein SR, Leibel DK, Hoggard LS, Gee GC, Ashe JJ, Brondolo E, Al-Najjar E, Evans MK, Zonderman AB. Race and other sociodemographic categories are differentially linked to multiple dimensions of interpersonal-level discrimination: Implications for intersectional, health research. PLoS One 2021; 16:e0251174. [PMID: 34010303 PMCID: PMC8133471 DOI: 10.1371/journal.pone.0251174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/21/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives To examine whether intersections of race with other key sociodemographic categories contribute to variations in multiple dimensions of race- and non-race-related, interpersonal-level discrimination and burden in urban-dwelling African Americans and Whites. Methods Data from 2,958 participants aged 30–64 in the population-based Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to estimate up to four-way interactions of race, age, gender, and poverty status with reports of racial and everyday discrimination, discrimination across multiple social statuses, and related lifetime discrimination burden in multiple regression models. Results We observed that: 1) African Americans experienced all forms of discrimination more frequently than Whites, but this finding was qualified by interactions of race with age, gender, and/or poverty status; 2) older African Americans, particularly African American men, and African American men living in poverty reported the greatest lifetime discrimination burden; 3) older African Americans reported greater racial discrimination and greater frequency of multiple social status-based discrimination than younger African Americans; 4) African American men reported greater racial and everyday discrimination and a greater frequency of social status discrimination than African American women; and, 5) White women reported greater frequency of discrimination than White men. All p’s < .05. Conclusions Within African Americans, older, male individuals with lower SES experienced greater racial, lifetime, and multiple social status-based discrimination, but this pattern was not observed in Whites. Among Whites, women reported greater frequency of discrimination across multiple social statuses and other factors (i.e., gender, income, appearance, and health status) than men. Efforts to reduce discrimination-related health disparities should concurrently assess dimensions of interpersonal-level discrimination across multiple sociodemographic categories, while simultaneously considering the broader socioecological context shaping these factors.
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Affiliation(s)
- Danielle L. Beatty Moody
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
- * E-mail:
| | - Shari R. Waldstein
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland, United States of America
| | - Daniel K. Leibel
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
| | - Lori S. Hoggard
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Gilbert C. Gee
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Jason J. Ashe
- Department of Human Services Psychology, University of Maryland, Baltimore, Maryland, United States of America
| | - Elizabeth Brondolo
- Department of Psychology, St. John’s University, Queens, New York, New York, United States of America
| | - Elias Al-Najjar
- Department of Mathematics and Statistics, University of Maryland, Baltimore County, Baltimore, Maryland, United States of America
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
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Casten R, Rovner B, Chang AM, Hollander JE, Kelley M, Leiby B, Nightingale G, Pizzi L, White N, Rising K. A randomized clinical trial of a collaborative home-based diabetes intervention to reduce emergency department visits and hospitalizations in black individuals with diabetes. Contemp Clin Trials 2020; 95:106069. [PMID: 32561466 DOI: 10.1016/j.cct.2020.106069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 01/22/2023]
Abstract
The prevalence of diabetes mellitus (DM) in black individuals (blacks) is twice that of white individuals (whites), and blacks are more likely to have worse glycemic control, less optimal medication regimens, and higher levels of mistrust in the medical system. These three factors account for higher rates of acute medical care use in blacks with DM. To address this disparity, we developed DM I-TEAM (Diabetes Interprofessional Team to Enhance Adherence to Medical Care), a home-based multidisciplinary behavioral intervention that integrates care from a community health worker (CHW), the participant's primary care physician (PCP), a DM nurse educator, and a clinical pharmacist. Treatment is delivered during 9 sessions over 1 year, and includes diabetes education and goal setting, telehealth visits with participants' PCP and a DM nurse educator, and comprehensive medication reviews by a pharmacist. We describe the rationale and methods for a randomized controlled trial to test the efficacy of DM I-TEAM to reduce emergency department (ED) visits and hospitalizations. We are enrolling 200 blacks with DM during an ED visit. Participants are randomized to DM I-TEAM or Usual Medical Care (UMC). Follow-up assessments are conducted at 6 and 12 months. The primary outcome is the number of ED visits and hospitalizations over 12 months, and is measured by participant self-report and medical record review. Secondary outcomes include hemoglobin A1c (HbA1c), number of potentially inappropriate medications (PIMs), and trust in health care.
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Affiliation(s)
- Robin Casten
- Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College at Thomas, Jefferson University, United States of America.
| | - Barry Rovner
- Departments of Neurology, Psychiatry, and Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, United States of America
| | - Anna Marie Chang
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, United States of America
| | - Judd E Hollander
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, United States of America
| | - Megan Kelley
- Department of Neurology, Sidney Kimmel Medical College at Thomas Jefferson University, United States of America
| | - Benjamin Leiby
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College at Thomas Jefferson University, United States of America
| | - Ginah Nightingale
- Jefferson College of Pharmacy at Thomas Jefferson University, United States of America
| | - Laura Pizzi
- Center for Health Outcomes, Policy, and Economics, Ernest Mario School of Pharmacy, Rutgers University, United States of America
| | - Neva White
- Center for Urban Health, Thomas Jefferson University Hospital, United States of America
| | - Kristin Rising
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, United States of America
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Brownlow BN, Sosoo EE, Long RN, Hoggard LS, Burford TI, Hill LK. Sex Differences in the Impact of Racial Discrimination on Mental Health Among Black Americans. Curr Psychiatry Rep 2019; 21:112. [PMID: 31686220 DOI: 10.1007/s11920-019-1098-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Greater racial discrimination is associated with poorer mental health among Black Americans; yet, there remains an incomplete understanding of sex differences in exposure to racial discrimination, and further, of how sex differences in coping with racial discrimination may heighten or diminish risk for poorer mental health. RECENT FINDINGS Black men may experience greater exposure to both structural and communal forms of racial discrimination, whereas Black women may face both a wider range of potential sources, as well as encounter greater variability in the subjective experience of racial discrimination. For both Black women and men, racial discrimination may be similarly associated with maladaptive coping strategies (i.e., emotional eating, rumination) that also are linked to poorer mental health; however, emerging findings suggest that mindfulness may partially buffer these deleterious effects. Overall, the recent literature reveals mixed findings with respect to sex differences in the experience and negative mental health impact of racial discrimination. Despite this heterogeneity, evidence documents sex differences in the settings, type, and qualitative experience of racial discrimination among Black Americans. Additionally, growing evidence indicating that racial discrimination is associated with physiological markers of stress reactivity and psychopathology risk further bolsters its characterization as a unique form of chronic stress among Black Americans and other minority groups in the USA.
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Affiliation(s)
- Briana N Brownlow
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Effua E Sosoo
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Risa N Long
- Department of Family Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lori S Hoggard
- Department of Psychology, Rutgers-The State University of New Jersey, New Brunswick, NJ, USA
| | - Tanisha I Burford
- Department of Psychology, North Carolina Central University, Durham, NC, USA
| | - LaBarron K Hill
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
- Center for Biobehavioral Health Disparities Research, Duke University-Social Science Research Institute, Durham, NC, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
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Abstract
African Americans (AAs) have a higher risk for cardiovascular disease (CVD) which is not fully explained by traditional CVD risk factors such as smoking, obesity, hypertension, and diabetes. Evidence demonstrates that chronic stress, low subjective status, and lack of social support play important roles in increasing the risk for CVD, particularly in minority women. Increasing evidence demonstrates that resilience may ameliorate the effect of social stressors on the development of CVD. However, little is known about the social context that may influence resilience in AA women. Therefore, the purpose of this exploratory study was to examine the predictors of resilience in AA women at risk for CVD. A cross-sectional sample of AA women (N = 104) participated in the study. Participants completed measures of resilience, subjective social status, social support, and general stress. Findings revealed that participants had low levels of resilience as measured by the Connor-Davidson Resilience Scale (mean = 50.3 ± 11.4) compared to norms. Results of the multiple linear regression analysis demonstrated that both subjective social status in relation to others in the USA (p = 0.021) and perceived social support (p < 0.001) predicted greater level of resilience. The model, controlling for age, marital status, income, level of education, and general stress, accounted for a significant proportion of variance (F[8,75] = 6.6, p < .001), explaining 41.7% of the variation in resilience. Results suggest that subjective social status and social support contribute to perceived resilience in AA women. Additional research is needed to assess the association of subjective social status and social support in longitudinal studies.
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Resilience attenuates the association between neurocognitive functioning and everyday functioning in individuals aging with HIV in the Deep South. Int J Geriatr Psychiatry 2019. [DOI: https:/doi.10.1002/gps.4988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Fazeli PL, Moore RC, Vance DE. Resilience attenuates the association between neurocognitive functioning and everyday functioning in individuals aging with HIV in the Deep South. Int J Geriatr Psychiatry 2019; 34:72-78. [PMID: 30230608 PMCID: PMC6298797 DOI: 10.1002/gps.4988] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/06/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Adults aging with HIV are at risk for poorer neurocognitive and daily functioning. Identifying factors to protect such outcomes is a significant research priority. The aim of this study was to explore the role of resilience in cognitive and everyday functioning in a largely African American and low socioeconomic status sample of adults and older adults with HIV in the Deep South. METHODS/DESIGN In this cross-sectional study 100 HIV+ middle-aged and older adults (range 40-73; 61% aged 50+) completed a comprehensive neurocognitive battery along with self-reported measures of resilience and everyday functioning. RESULTS Higher resilience was associated with better global neurocognitive functioning (rho = 0.31, P < 0.01), as well as better functioning in all domains (verbal fluency, executive functioning, speed of information processing, learning, working memory) except recall and motor skills. Resilience was also significantly associated with instrumental activities of daily living (IADL) dependence, with lower resilience observed in those with IADL dependence compared with those who were IADL independent (P < 0.01). In a multiple regression adjusting for data-driven covariates (verbal IQ, income, depression), and global neurocognitive impairment, resilience was the only significant (P = 0.02) correlate of IADL dependence. A follow-up mediation showed that the direct relationship between neurocognitive functioning and IADL declines was fully attenuated after accounting for shared variance with resilience. CONCLUSIONS Resilience is associated with better cognitive and functional outcomes in people aging with HIV. While further work is needed to understand these associations over time, results suggest interventions to build resilience may promote successful aging in this vulnerable population.
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Affiliation(s)
- Pariya L. Fazeli
- Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - Raeanne C. Moore
- Department of Psychiatry, University of California, San Diego, CA
- VA San Diego Healthcare System, San Diego, CA
| | - David E. Vance
- Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL
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10
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The development of the cortisol response to dyadic stressors in Black and White infants. Dev Psychopathol 2018; 30:1995-2008. [PMID: 30328402 DOI: 10.1017/s0954579418001232] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Acute reactivity of the stress hormone cortisol is reflective of early adversity and stress exposure, with some studies finding that the impact of adversity on the stress response differs by race. The objectives of the current study were to characterize cortisol reactivity to two dyadically based stress paradigms across the first year of life, to examine cortisol reactivity within Black and White infants, and to assess the impact of correlates of racial inequity including socioeconomic status, experiences of discrimination, and urban life stressors, as well as the buffering by racial socialization on cortisol patterns. Salivary cortisol reactivity was assessed at 4 months of age during the Still Face paradigm (N = 207) and at 12 months of age across the Strange Situation procedure (N = 129). Infants demonstrated the steepest recovery after the Still Face paradigm and steepest reactivity to the Strange Situation procedure. Race differences in cortisol were not present at 4 months but emerged at 12 months of age, with Black infants having higher cortisol. Experiences of discrimination contributed to cortisol differences within Black infants, suggesting that racial discrimination is already "under the skin" by 1 year of age. These findings suggest that race-related differences in hypothalamic-pituitary-adrenal reactivity are present in infancy, and that the first year of life is a crucial time period during which interventions and prevention efforts for maternal-infant dyads are most likely able to shape hypothalamic-pituitary-adrenal reactivity thereby mitigating health disparities early across the life course.
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The role of bicultural adaptation, familism, and family conflict in Mexican American adolescents' cortisol reactivity. Dev Psychopathol 2018; 30:1571-1587. [PMID: 30295207 DOI: 10.1017/s0954579418001116] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Scarce research has examined stress responsivity among Latino youths, and no studies have focused on the role of acculturation in shaping cortisol stress response in this population. This study assessed Mexican American adolescents' Mexican and Anglo cultural orientations and examined prospective associations between their patterns of bicultural orientation and hypothalamic-pituitary-adrenal cortisol reactivity to an adapted Trier Social Stress Test. The sample included 264 youths from a longitudinal birth cohort study who completed the Trier Social Stress Test and provided saliva samples at age 14. The youths completed assessments of cultural orientation at age 12, and family conflict and familism at age 14. Analyses testing the interactive effects of Anglo and Mexican orientation showed significant associations with cortisol responsivity, including the reactivity slope, peak levels, and recovery, but these associations were not mediated by family conflict nor familism values. Findings revealed that bicultural youth (high on both Anglo and Mexican orientations) showed an expected pattern of high cortisol responsivity, which may be adaptive in the context of a strong acute stressor, whereas individuals endorsing only high levels of Anglo orientation had a blunted cortisol response. Findings are discussed in relation to research on biculturalism and the trade-offs and potential recalibration of a contextually responsive hypothalamic-pituitary-adrenal axis for acculturating adolescents.
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12
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Moving beyond the individual: Community-level prejudice and health. Soc Sci Med 2017; 183:169-172. [DOI: 10.1016/j.socscimed.2017.04.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 01/01/2023]
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13
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Abstract
OBJECTIVE A social action theory of chronic stress proposes that agonistic striving (seeking to influence or control others) impairs cardiovascular health by magnifying the impact of high adversity-induced cortisol levels on blood pressure. We tested three predictions of social action theory: (1) the social action theory taxonomy of regulatory strivings characterizes young adults from high-adversity neighborhoods; (2) high cortisol levels predict high blood pressure more reliably in the subgroup with the agonistic striving profile than in subgroups with other profiles; (3) the association of higher cortisol and higher blood pressure with agonistic striving is not explained by negative affect (depressive symptoms/dysphoria, anger, hostility). METHODS Participants were young adults (N = 198, mean [SD] age = 32 [3.4] years); 71% female; 65% black) from disadvantaged urban neighborhoods. Motive profiles (including agonistic strivings) were assessed using the Social Competence Interview. Cortisol levels were derived from saliva samples; blood pressure level was obtained during two days of ambulatory monitoring. Psychological measures of negative affect were assessed using questionnaires. RESULTS The predicted taxonomy of regulatory strivings was replicated in this sample; the interaction between cortisol and motive profile was significant (F(2, 91) = 6.72, p = .002); analyses of simple effects disclosed that higher cortisol levels predicted higher ambulatory blood pressure only in individuals who exhibited agonistic striving. Depressive symptoms/dysphoria, trait anger, and hostility were not correlated with agonistic striving, cortisol, or blood pressure. CONCLUSIONS Agonistic striving may represent a distinctive (and novel) social-cognitive mechanism of toxic stress and cardiovascular risk.
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14
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Mortality Among Black Men in the USA. J Racial Ethn Health Disparities 2017; 5:50-61. [PMID: 28236289 DOI: 10.1007/s40615-017-0341-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 02/07/2023]
Abstract
IMPORTANCE Black men have the lowest life expectancy of all major ethnic-sex populations in the USA, yet no recent studies have comprehensively examined black male mortality. OBJECTIVE The purpose of this study was to analyze recent mortality trends for black men, including black to white (B to W) disparities. DESIGN The study design was national mortality surveillance for 2000 to 2014. SETTING The setting was the USA. POPULATION All black non-Hispanic males aged ≥15 years old in the USA, including institutionalized persons, were included. EXPOSURE The 15 leading causes of death were analyzed. MAIN OUTCOMES AND MEASURES Linear regression of log-transformed annual age-adjusted death rates was used to calculate average annual percent change (AAPC) in mortality. Black to white (B to W) disparity rate ratios (RR) and 95% confidence intervals (CI) were compared for 2000 and 2014. The most recent available social and economic profile data were obtained from the U.S. Census of Population. RESULTS The top five causes of death for black men in 2014, with percentage of total deaths, were (1) heart disease (24.8%), (2) cancer (23.0%), (3) unintentional injuries (5.8%), (4) stroke (5.1%), and (5) homicide (4.3%). Significant mortality declines for 12 of the 15 leading causes occurred through 2014, with the strongest decline for HIV/AIDS (AAPC -8.0, 95% CI -8.8 to -7.1). Only Alzheimer's disease, ranked #15, significantly increased (AAPC +2.5, 95% CI +1.4 to +3.7). Significant black disadvantage persisted for 10 of the 15 leading causes in 2014, including homicide (RR = 10.43, 95% CI 9.98 to 10.89), HIV/AIDS (RR = 8.01, 95% CI 7.50 to 8.54), diabetes (RR = 1.88, 95% CI 1.82 to 1.93), and stroke (RR = 1.61, 95% CI 1.57 to 1.65). The B to W disparity did not improve for heart disease (RR 1.24 in 2000 vs. RR 1.23 in 2014), but did improve for cancer (RR 1.39 in 2000 vs. 1.20 in 2014). Death rates were significantly lower in black men for five causes, including unintentional injuries (RR = 0.83, 95% CI 0.80 to 0.84), chronic lower respiratory diseases (RR = 0.75, 95% CI 0.73 to 0.78), and suicide (RR = 0.37, 95% CI 0.35 to 0.39). CONCLUSIONS AND RELEVANCE Total mortality significantly declined for black men from 2000 to 2014, and the overall B to W disparity narrowed to RR = 1.21 (95% CI 1.20 to 1.23) in 2014. However, significant black disadvantages relative to white men persisted for 10 leading causes of death.
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15
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Han SD, Adeyemi O, Wilson RS, Leurgans S, Jimenez A, Oullet L, Shah R, Landay A, Bennett DA, Barnes LL. Loneliness in Older Black Adults with Human Immunodeficiency Virus Is Associated with Poorer Cognition. Gerontology 2017; 63:253-262. [PMID: 28125811 PMCID: PMC5391275 DOI: 10.1159/000455253] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 12/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The human immunodeficiency virus (HIV) is associated with cognitive impairment, and loneliness is associated with cognitive decline in old age. Older Black adults with HIV may be at particular risk of loneliness due to stigma and lack of social resources. OBJECTIVE We tested the hypotheses that (1) older Black adults with HIV would show greater loneliness than older White adults with HIV, and (2) greater loneliness among older Black adults with HIV would be associated with poorer cognitive function. METHODS A total of 370 participants (177 with HIV, 193 without HIV; mean age 58.8 years, standard deviation 6.2 years; mean education 13.4 years, standard deviation 2.9 years; 73.9% male, 68.9% Black) in a community-based cross-sectional study of the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA) completed a 5-item self-report scale used to measure emotional loneliness and a battery of cognitive measures. RESULTS Contrary to our expectations, older Black adults indicated less overall loneliness than White adults (β = -0.3893, SE = 0.1466, p = 0.0087) in models controlling for the effects of age, education, sex, global cognition, and income. However, in models with cognitive function as the outcome, an interaction between race and loneliness was observed, such that older Black adults who indicated greater loneliness showed poorer cognitive function relative to White adults (β = -0.2736, SE = 0.1138, p = 0.0174). CONCLUSION Older Black adults with HIV reported less loneliness than older White adults; however, the inverse association between loneliness and cognitive function was stronger in Black than White older adults. Additional work is needed to elucidate the mechanisms underlying this interaction.
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Affiliation(s)
- S Duke Han
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
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16
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Hill LK, Hoggard LS, Richmond AS, Gray DL, Williams DP, Thayer JF. Examining the association between perceived discrimination and heart rate variability in African Americans. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:5-14. [PMID: 28045306 PMCID: PMC5755701 DOI: 10.1037/cdp0000076] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Previous research attempting to delineate the role of discrimination in racial/ethnic disparities in hypertension has focused largely on blood pressure, which is chiefly governed by the sympathetic branch of the autonomic nervous system. Consequently, few studies have considered the role of the parasympathetic branch and particularly its regulation of the heart via the vagus nerve. METHOD In the present cross-sectional study, we employed hierarchical linear regressions to examine associations between perceived ethnic discrimination and resting heart rate variability (HRV), an important biomarker of parasympathetic cardiac modulation and overall health, in a sample (N = 103) of young, healthy African American participants (58% female, Mage = 19.94 years, SD = 2.84). RESULTS After accounting for demographic factors and health status characteristics, lifetime discrimination emerged as an inverse predictor of HRV. When subdomains of discrimination were considered, discrimination attributable to threats or actual acts of aggression was also predictive of lower HRV. CONCLUSIONS Our findings suggest that a greater lifetime burden of discrimination and discriminatory harassment and/or assault is associated with lower resting HRV in African Americans. The implications of these findings are discussed in the context of past, present and emerging research emphasizing biological linkages between discrimination and health. (PsycINFO Database Record
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Affiliation(s)
- LaBarron K Hill
- Center for the Study of Aging and Human Development, Duke University Medical Center
| | - Lori S Hoggard
- Department of Psychology, University of North Carolina at Chapel Hill
| | | | - DeLeon L Gray
- Department of Educational Psychology, North Carolina State University
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Hagiwara N, Alderson CJ, Mezuk B. Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans. Ethn Dis 2016; 26:453-60. [PMID: 27440987 DOI: 10.18865/ed.26.3.453] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Racial/ethnic minorities in the United States not only experience discrimination personally but also witness or hear about fellow in-group members experiencing discrimination (ie, group-level discrimination). The objective of our study was to examine whether the effects of group-level discrimination on mental and physical health are different from those of personal-level discrimination among Black Americans by drawing upon social psychology research of the Personal/Group Discrimination Discrepancy. DESIGN AND SETTING We conducted a secondary analysis of cross-sectional survey data from a larger study. PARTICIPANTS One hundred and twenty participants, who self-identified as Black/African Americans during the laboratory sessions (57.5% women, mean age = 48.97, standard deviation = 8.58) in the parent study, were included in our analyses. MAIN PREDICTOR MEASURES Perceived personal-level discrimination was assessed with five items that were taken from two existing measures, and group-level racial discrimination was assessed with three items. MAIN OUTCOME MEASURES Self-reported physical and mental health were assessed with a modified version of SF-8. RESULTS Perceived personal-level racial discrimination was associated with worse mental health. In contrast, perceived group-level racial discrimination was associated with better mental as well as physical health. CONCLUSIONS Perceived group-level racial discrimination may serve as one of several health protective factors even when individuals perceive personal-level racial discrimination. The present findings demonstrate the importance of examining both personal- and group-level experiences of racial discrimination as they independently relate to health outcomes for Black Americans.
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Affiliation(s)
- Nao Hagiwara
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Courtney J Alderson
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Briana Mezuk
- Division of Epidemiology, Department of Family Medicine and Population Health,Virginia Commonwealth University, Richmond, Virginia
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Waldstein SR, Moody DLB, McNeely JM, Allen AJ, Sprung MR, Shah MT, Al'Najjar E, Evans MK, Zonderman AB. Cross-sectional relations of race and poverty status to cardiovascular risk factors in the Healthy Aging in Neighborhoods of Diversity across the Lifespan (HANDLS) study. BMC Public Health 2016; 16:258. [PMID: 26975845 PMCID: PMC4791792 DOI: 10.1186/s12889-016-2945-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 03/09/2016] [Indexed: 01/30/2023] Open
Abstract
Background Examine interactive relations of race and poverty status with cardiovascular disease (CVD) risk factors in a socioeconomically diverse sample of urban-dwelling African American (AA) and White adults. Methods Participants were 2,270 AAs and Whites (57 % AA; 57 % female; ages 30–64 years) who completed the first wave of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. CVD risk factors assessed included body mass index (BMI), waist circumference (WC), total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C, LDL-C), triglycerides (TG), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (CRP), and systolic, diastolic, and pulse pressure (SBP, DBP, PP). Interactive and independent relations of race, poverty status, and sex were examined for each outcome via ordinary least squares regression adjusted for age, education, literacy, substance use, depressive symptoms, perceived health care barriers, medical co-morbidities, and medications. Results Significant interactions of race and poverty status (p’s < .05) indicated that AAs living in poverty had lower BMI and WC and higher HDL-C than non-poverty AAs, whereas Whites living in poverty had higher BMI and WC and lower HDL-C than non-poverty Whites. Main effects of race revealed that AAs had higher levels of HbA1c, SBP, and PP, and Whites had higher levels of TC, LDL-C and TG (p’s < .05). Conclusion Poverty status moderated race differences for BMI, WC, and HDL-C, conveying increased risk among Whites living in poverty, but reduced risk in their AA counterparts. Race differences for six additional risk factors withstood extensive statistical adjustments including SES indicators.
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Affiliation(s)
- Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA.
| | - Danielle L Beatty Moody
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
| | - Jessica M McNeely
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA.,Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
| | - Allyssa J Allen
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
| | - Mollie R Sprung
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA
| | - Mauli T Shah
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA.,Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
| | - Elias Al'Najjar
- Department of Mathematics and Statistics, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
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Umeh K, Mackay M, Mulhearn C. Information and Communication Technology, Well-Being, and Ethnicity. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2016; 19:165-71. [PMID: 26794148 DOI: 10.1089/cyber.2015.0328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The relationship between use of information and communication technologies (ICTs) and well-being is an increasingly debated public health issue. Currently, there is limited understanding of how the ethnic digital divide influences this association. Thus, this study assessed how ethnicity has historically moderated relations between ICT (mobile phone, computer, and TV) uptake, and several well-being indicators: (a) long-term health (chronic illness), (b) cigarette smoking, and (c) self-perceptions of personal health. Archived data from a U.K. Office for National Statistics household survey 2007-2011 (97,697 participant records) were analyzed, controlling for multiple sociodemographic confounders. Mobile phone dependence was associated with poorer health perceptions in Caucasian women, but more favorable appraisals in ethnic minority females (OR = 0.51). Furthermore, mobile phone uptake was more strongly related to increased behavioral risk (cigarette smoking) in Caucasian men compared with ethnic minority males (OR = 1.68). Ethnicity did not influence relations between ICT uptake and long-term health. Overall, ethnicity was implicated in relations between mobile phone use and well-being indicators: unfavorable associations occurred primarily in Caucasians.
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Affiliation(s)
- Kanayo Umeh
- 1 School of Natural Sciences and Psychology, Liverpool John Moores University , Liverpool, United Kingdom
| | - Michael Mackay
- 2 School of Computer Science, Liverpool John Moores University , Liverpool, United Kingdom
| | - Chris Mulhearn
- 3 Liverpool Business School, Liverpool John Moores University , Liverpool, United Kingdom
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20
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Adam EK, Heissel JA, Zeiders KH, Richeson JA, Ross EC, Ehrlich KB, Levy DJ, Kemeny M, Brodish AB, Malanchuk O, Peck SC, Fuller-Rowell TE, Eccles JS. Developmental histories of perceived racial discrimination and diurnal cortisol profiles in adulthood: A 20-year prospective study. Psychoneuroendocrinology 2015; 62:279-91. [PMID: 26352481 PMCID: PMC4739843 DOI: 10.1016/j.psyneuen.2015.08.018] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 07/31/2015] [Accepted: 08/21/2015] [Indexed: 01/02/2023]
Abstract
Perceived racial discrimination (PRD) has been associated with altered diurnal cortisol rhythms in past cross-sectional research. We investigate whether developmental histories of PRD, assessed prospectively, are associated with adult diurnal cortisol profiles. One-hundred and twelve (N=50 Black, N=62 White) adults from the Maryland Adolescent Development in Context Study provided saliva samples in adulthood (at approximately age 32 years) at waking, 30min after waking, and at bedtime for 7 days. Diurnal cortisol measures were calculated, including waking cortisol levels, diurnal cortisol slopes, the cortisol awakening response (CAR), and average daily cortisol (AUC). These cortisol outcomes were predicted from measures of PRD obtained over a 20-year period beginning when individuals were in 7th grade (approximately age 12). Greater average PRD measured across the 20-year period predicted flatter adult diurnal cortisol slopes for both Black and White adults, and a lower CAR. Greater average PRD also predicted lower waking cortisol for Black, but not White adults. PRD experiences in adolescence accounted for many of these effects. When adolescent and young adult PRD are entered together predicting cortisol outcomes, PRD experiences in adolescence (but not young adulthood) significantly predicted flatter diurnal cortisol slopes for both Black and White adults. Adolescent, but not young adult PRD, also significantly predicted lower waking and lower average cortisol for Black adults. Young adult PRD was, however, a stronger predictor of the CAR, predicting a marginally lower CAR for Whites, and a significantly larger CAR for Blacks. Effects were robust to controlling for covariates including health behaviors, depression, income and parent education levels. PRD experiences interacted with parent education and income to predict aspects of the diurnal cortisol rhythm. Although these results suggest PRD influences on cortisol for both Blacks and Whites, the key findings suggest that the effects are more pervasive for Blacks, affecting multiple aspects of the cortisol diurnal rhythm. In addition, adolescence is a more sensitive developmental period than adulthood for the impacts of PRD on adult stress biology.
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Affiliation(s)
- Emma K. Adam
- School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Evanston, IL 60208, United States,Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, United States,Corresponding author. (E.K. Adam)
| | - Jennifer A. Heissel
- School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Evanston, IL 60208, United States,Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, United States
| | - Katharine H. Zeiders
- Human Development and Family Science, University of Missouri Gentry Hall, Columbia, MO 64221, United States
| | - Jennifer A. Richeson
- Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, United States,Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston, IL 60208, United States
| | - Emily C. Ross
- School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Evanston, IL 60208, United States,Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, United States
| | - Katherine B. Ehrlich
- Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, United States,Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston, IL 60208, United States
| | - Dorainne J. Levy
- Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston, IL 60208, United States
| | - Margaret Kemeny
- Psychiatry, University of California at San Francisco, 3333 California Street, Laurel Heights, San Francisco, CA 94143, United States
| | - Amanda B. Brodish
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Oksana Malanchuk
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Stephen C. Peck
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Thomas E. Fuller-Rowell
- Human Development and Family Studies, Auburn University, 203 Spidle Hall, Auburn, AL 36849 United States
| | - Jacquelynne S. Eccles
- School of Education, University of California, Irvine, 2068 Education, Mail Code: 5500, Irvine, CA 92697, United States
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