Association Between Stress and Social Support Among Young Adult Pacific Islander Smokers

Recent studies have found high levels of stress among Americans, particularly amongst young adults and ethnic minority groups. The purpose of this secondary data analysis was to explore the association between stress and social support among a sample of 276 young adult smokers of Pacific Islander ancestry, specifically Samoans and Tongans with an average age of 25.3 years. Previous research had documented the protective role of social support on stress, and thus it is hypothesized that young adult Pacific Islander smokers who perceived higher levels of social support will have less perceived stress. Social support was assessed using a 12-item scale which measured participant's perceived social support from family, friends, and significant others. Perceived stress was measured using a 10-item scale with 2 subscales - self efficacy and helplessness. Standardized parameter estimates from structural equation modeling indicated a statistically significant inverse relationship between perceived social support from family and perceived stress related to helplessness. More specifically, young adult Samoans and Tongans who report higher levels of social support from family do not feel as much stress stemming from being helpless. The results highlight the importance of family social support on stress management among this population. Most importantly, these findings add to the limited research around mental health within Pacific Islander (Samoan and Tongan) communities in the US.

'We're not gonna have a big quit if loose ones are around': urban, African American smokers' beliefs concerning single cigarette use reduction

Single cigarette use (i.e. loosies, loose ones, singles) poses risks for smoking continuation among urban, African American smokers. There is, however, limited research to inform health education interventions addressing this behavior. We conducted 25 in-depth interviews with urban, African American users (ages 20-58 years) from Baltimore, MD and the District of Columbia in June and July 2018 to assess their beliefs about reducing single cigarette use. Interviews were guided by the Health Belief Model and its constructs of perceived benefits, perceived barriers, perceived susceptibility, perceived severity and self-efficacy. We analyzed qualitative data using framework analysis. Perceived benefits of reducing single cigarette use involved the avoidance of health risks, including concerns about buying fake cigarettes and exposure to unknown personal hygiene practices from sellers. Perceived barriers were the convenience of buying singles due to their availability, accessibility and low cost. Participants shared they were willing to use cognitive behavioral strategies to reduce their purchasing and use of singles. This study provides insights on potential intervention targets related to beliefs towards reducing single cigarette use. These findings can inform enforcement policies and health education interventions targeting single cigarette use among urban, African American smokers who use singles.

Social Support Effects on Neural Stress and Alcohol Reward Responses

Social support (SS), or having people to depend on during times of stress, may offer an emotional and neurological buffer to problem drinking. Specifically, SS may modulate reward and stress-related brain responses to mitigate perceptions of alcohol reward and stress. There is limited evidence, however, on this topic and specifically on brain networks that may modulate SS effects on stress and alcohol reward. Here we present a review of the current literature on this topic as well as data from a large community sample of 115 social drinkers. Findings from a novel fMRI task viewing alcohol cue, stress, and neutral images, in separate blocks, while providing ratings on subjective feelings of alcohol craving, stress, and arousal are included. Lower SS significantly predicted greater alcohol craving during alcohol cue and stress conditions, higher baseline levels of stress, and greater arousal in the alcohol cue, relative to neutral condition. Remarkably, individuals with low SS showed greater reward activation (ventral medial prefrontal cortex (VmPFC) and ventral striatum) during alcohol cue exposure, while those with high SS showed no such activation (p < 0.001, family wise error corrected at 0.05). Furthermore, individuals with lower SS showed greater stress circuit (VmPFC, dorsal striatum, and periaqueductal gray) activation not observed in the high SS groups. Both groups showed increased amygdala activation under stress condition. The findings support the notion that SS is a powerful modulator of stress response and reward motivation. High SS buffers neural and subjective stress responses, while low SS potentiates greater reward seeking with higher alcohol craving and greater brain activation during alcohol cue exposure. Previous research and current results suggest the need to further explore the role of SS in those at risk of developing alcohol use disorder and assess novel prevention strategies to boost SS in at-risk drinkers.

Psychosocial Mediators Between Intimate Partner Violence and Alcohol Abuse in Low-Income African American Women

Intimate partner violence (IPV) exposure can increase alcohol use. Although African Americans use less alcohol compared with European Americans, African American women experience disparate rates of IPV, potentially intensifying their alcohol abuse. We used data from 171 African American women to test if IPV was related to alcohol abuse and if psychosocial factors-loneliness, embarrassment, fear of harm, hope, social support, childcare needs, and finances-mediated this link. IPV and alcohol abuse were related, and several factors were related to either IPV or alcohol abuse. Social support was related to both, and it mediated the IPV-alcohol abuse link, explaining women's alcohol abuse relating to IPV.

“I Had To Be Strong”

Although strength is often embraced as a vital aspect of African American womanhood, African American women’s endorsement of the strong Black woman race-gender schema has received empirical attention because of its association with harmful health outcomes. Thus, there is limited knowledge regarding how African American women simultaneously experience its liabilities (e.g., harmful health outcomes) and benefits (e.g., increased self-efficacy). Qualitative thematic analysis was used to analyze data from 13 African American women who discussed the competing messages experienced when internalizing the strong Black woman race-gender schema. Three tensions were identified: (a) be psychologically durable yet do not engage in behaviors that preserve psychological durability, (b) be equal yet be oppressed, and (c) be feminine yet reject traditional feminine norms. These tensions highlighted that the schema simultaneously produced advantageous outcomes with respect to self-efficacy yet unfavorable implications for self-care. Each tension is discussed with respect to its perceived advantages and disadvantages.

Correlates of Problem Drinking and Drug Use in Black Sexual Assault Victims

Few studies have examined factors related to problem drinking and drug use in Black sexual assault victims. Given that sexual assault and histories of trauma are associated with substance abuse in victims, research is needed to determine what factors may be related to these outcomes for Black survivors. Furthermore, child sexual abuse (CSA) is a risk factor for substance abuse, but no studies have examined correlates of substance abuse outcomes separately according to CSA history. This study examines a large diverse sample of Black sexual assault victims (N = 495) to determine the associations of demographics, trauma history, assault characteristics, and postassault psychosocial factors with problem drinking and drug use using multivariate regressions. Traumatic life events, using substances to cope and self-blame, were associated with greater problem drinking and drug use. Implications for practitioners and policymakers are discussed.

The impact of neighborhood quality, perceived stress, and social support on depressive symptoms during pregnancy in African American women

Living in a lower-quality neighborhood is associated with higher levels of depressive symptoms in the general population as well as among pregnant and postpartum women. However, little is known of the important pathways by which this association occurs. We proposed a model in which perceived stress and social support mediated the effects of neighborhood quality on depressive symptoms during pregnancy (measured by the 20-item Center for Epidemiologic Studies-Depression, CES-D, scale) in a sample of 1383 African American women from the Detroit metropolitan area interviewed during their delivery hospitalization. Using structural equation modeling (SEM), we built a latent variable of neighborhood quality using 4 measures (neighborhood disorder, neighborhood safety/danger, walking environment, overall rating). We then tested two SEM mediation models. We found that lower neighborhood quality was associated with higher prevalence of depressive symptoms during pregnancy (standardized total effect = .16, p = .011). We found that perceived stress partially mediated the neighborhood quality association with depressive symptoms. Although the association of social support with depressive symptoms was negligible, social support mediated associations of neighborhood quality with perceived stress [standardized path coefficient = .38 (.02), p = .009]. Our results point to the need for public health, health care, as well as non-health related interventions (e.g. crime prevention programs) to decrease overall exposure to stressors, as well as stress levels of women living in poor quality neighborhoods. Interventions that increase the levels of social support of women during pregnancy are also needed for their potential to decrease stress and ultimately improve mental health at this important time in the life course.

Family Functioning and Stress in African American Families

Having social support substantially reduces the effects of stressful experiences. Family relationships are central components of social support for African Americans. In a community-based sample of African Americans ( n = 255), the relationship between family functioning and stress was examined, as well as possible mediators of this relationship, independent of demographic variables. Using multiple regression analysis, close and flexible family relationships were linked to lower perceived stress levels. The association of family functioning and stress operated through the internal processes of anxiety, depression, daily hassles, and higher hardiness and explained more than half of the variance in stress levels. These findings also remained above and beyond the known stressor of discrimination and the known stress reducer of spirituality. These findings suggest that expanding traditional stress management programs to include strategies for bolstering family functioning could have significant benefits.

Does Social Support Buffer the Effect of Financial Strain on the Trajectory of Smoking in Older Japanese? A 19-Year Longitudinal Study

OBJECTIVES

Although there is extensive research on the stress-buffering effects of social support on health, there is little understanding of this effect on health behaviors such as smoking, particularly during old age. This study aimed to estimate the effect of financial strain and the stress-buffering effect of social support, on the trajectory of smoking over an extended period of time among older Japanese.

METHOD

Data came from a national sample of more than 4,800 adults, aged 60 and older in Japan, with up to 7 repeated observations between 1987 and 2006 (16,669 observations). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in smoking.

RESULTS

Higher financial strain at baseline was associated with greater amount of smoking, and a slower rate of decline, after adjusting for sociodemographic attributes. Greater instrumental support partially offset the deleterious effect of financial strain on the rate of decline in smoking.

DISCUSSION

Our findings add a dynamic dimension to understanding the relationship among financial strain, social support, and smoking in old age. This knowledge is significant when designing health policies and interventions regarding health behaviors in late life.

Race of Interviewer Effect on Disclosures of Suicidal Low-Income African American Women

Few studies have investigated the impact of interviewer race on the results gleaned through psychological assessment. African American and European American clinical evaluators conducted face-to-face interviews with 161 low-income African American women seeking services at an inner-city hospital following a suicide attempt. Participants were administered measures related to various current life stressors, including the Survey for Recent Life Events, which assesses various forms of daily hassles, and the Index of Spouse Abuse, which taps both physical and nonphysical intimate partner violence (IPV). Multivariate analyses of variance revealed a significant difference on the participants’ reports of daily hassles and IPV to African Americanand European American evaluators. With regard to overall life stress, African American women reported higher levels of total life stress, time pressure stress, social acceptability stress, and social victimization to African American than in European American–led interviews. They also endorsed higher levels of both physical and nonphysical IPV to interviewers of the same race as themselves as compared with interviewers from a different racial background. There were no group differences in terms of work stress, sociocultural differences, and finances. The findings underscore the saliency of interviewer race as a source of nonrandom measurement error capable of influencing statistical results. Implications of ignoring race of interviewer effects in analysis are explored and suggestions are offered in terms of culturally responsive assessment processes.