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Farr AM, Carter JS, Webber-Ritchey K. Relationships Among the Endorsement of Superwoman Schema and Health Outcomes. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00259-4. [PMID: 39182515 DOI: 10.1016/j.jogn.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/18/2024] [Accepted: 07/28/2024] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVE To examine associations among endorsement of elements of the superwoman schema (the obligation to manifest strength and the obligation to help others) and health outcomes and to test if stress mediates the association between the obligation to manifest strength and depression in adult Black women. DESIGN Cross-sectional design. SETTING Community space in the Chicago metropolitan area. PARTICIPANTS Ninety-one adult Black women. METHODS Participants completed questionnaires to assess endorsement of superwoman schema roles, physical activity, healthy eating, weight satisfaction, depression, and stress. Height and weight were collected by research assistants. We used descriptive statistics, bivariate correlations, multiple regression models, and linear mediation analysis to analyze data. RESULTS Higher levels of obligation to suppress emotions were associated with lower physical activity, r(88) = -0.25, p < .05. Obligation to manifest strength was associated with higher levels of stress, r(79) = 0.53, p < .01, and symptoms of depression, r(71) = 0.36, p < .01. Stress mediated the relationship between the obligation to manifest strength and depression with a significant indirect effect, b = 0.37, SE = 0.10, 95% confidence interval [0.20, 0.60]. CONCLUSION Our findings offer insight into the psychological and social processes that affect Black women and may aid in the development of culturally responsive prevention and intervention programs at individual and community levels to reduce chronic diseases.
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Obeng-Nyarko CN, Ralston PA, Wickrama KKAS, Lemacks JL, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Perceived Stress and Allostatic Load Outcomes of Mid-Life and Older African American Women. HEALTH EDUCATION & BEHAVIOR 2024:10901981241263027. [PMID: 39051464 DOI: 10.1177/10901981241263027] [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: 07/27/2024]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States, with African Americans experiencing higher age-adjusted mortality compared to Whites. African American women in particular carry a high CVD burden due to more exposure to adverse personal and socioenvironmental challenges. Church-based interventions can improve health behaviors and health status of African Americans, yet few have addressed stress-related health. The purpose of this study was to determine the effectiveness of the 18-month Health for Hearts United intervention in relation to stress-related outcomes (perceived stress, allostatic load) of mid-life and older African American women (≥45 years of age; n = 152 overall sample, n = 65 clinical subsample). The results of the repeated measures analysis of variance (ANOVA) analyses showed overall significant decreases in perceived stress and allostatic load for both treatment and comparison groups over the measurement occasions (baseline and 18 months) with educational level remaining as a significant correlate over time. There was no significant interaction between treatment and time, yet there were trends in improvements for the treatment group compared to the comparison group. The findings demonstrate the potential of church-based interventions in reducing both self-reported stress and allostatic load in African American women, and highlight the need for further investigation of educational level and other possible factors influencing stress management in these settings.
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Henry CJ, Song MK. Use of the Strong Black Woman Construct in Research: An Integrative Review. ANS Adv Nurs Sci 2024; 47:E110-E120. [PMID: 37192599 DOI: 10.1097/ans.0000000000000501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This was an integrative review of the literature on research using the strong Black woman (SBW) construct. We searched for data-based articles that mentioned SBW and examined topical areas of investigation, health outcomes and other constructs associated with SBW, and methods used to assess SBW. We found 47 articles. SBW was used to study coping with trauma (n = 11) or perceived offense (n = 10), or engaging in health-seeking behaviors (n = 10). Eighteen studies suggested that SBW was linked to several major health conditions (eg, hypertension, obesity, heart disease) and depressive and anxiety symptoms. SBW was positively correlated with undesirable coping behaviors (eg, self-silencing, maladaptive perfectionism) and negatively associated with self-compassion and help-seeking. The most common method of assessing SBW was using a structured questionnaire (n = 21). Longitudinal studies to examine the impact of SBW belief on Black women's coping with hardship were lacking.
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Affiliation(s)
- Carrie J Henry
- Author Affiliations: Capstone College of Nursing, The University of Alabama, Tuscaloosa (Dr Henry); and Center for Nursing Excellence in Palliative Care, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Song)
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Prouty H, Rose LE, Hussaini H, Sy JRT, Sanders SM. Psychological distress and alcohol use disorder in college students of color: Social support's moderating properties. J Ethn Subst Abuse 2024:1-17. [PMID: 38884615 DOI: 10.1080/15332640.2024.2367243] [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: 06/18/2024]
Abstract
Alcohol use is prevalent among college students. Research has found that psychological distress in the form of depression, anxiety, or loneliness has been consistently associated with greater alcohol use. Because Students of Color (SoC) disproportionately experience greater psychological distress than White students, it is critical to determine buffers against psychological distress and subsequent alcohol use consequences. Previous literature found that social support can protect against the effects of psychological distress and weaken its link with alcohol use. This study aimed to determine the moderating effect of social support in the relation between psychological distress and alcohol use among SoC. College Students of Color from across the U.S. (n = 211, Mage = 27.51, SD = 9.63) were recruited via Prolific to answer an online survey through Qualtrics. Linear regression analyses showed that psychological distress variables (i.e., depression, anxiety, and loneliness) were positively associated with alcohol use. However, moderation analysis did not find any form of social support to moderate the relation between psychological distress variables and alcohol use. Future research needs to identify other protective factors against alcohol use to support SoC in their academic journey.
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Parks AK, Hayman LL. Unveiling the Strong Black Woman Schema-Evolution and Impact: A Systematic Review. Clin Nurs Res 2024; 33:395-404. [PMID: 38439544 DOI: 10.1177/10547738241234425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
The Strong Black Woman (SBW) schema is described as a statue of unrelenting strength, resilience, and self-sufficiency, serving as a shield of protection and cultural adaptation to suppress and control manifestations of racial and gender oppression. Stemming from superwoman syndrome, a conceptual model exploring the multifactorial roles women hold and their impact, the SBW extends beyond gender roles to the sociopolitical context of the Black woman's lived experience. Endorsement of the SBW posits risk for health disparities including stress, anxiety, depression, and obesity. This review was conducted to explore the SBW schema and experiences of Black women who endorse it, to delineate how Black women describe themselves in relation to the SBW persona, and to inform further inquiry, nursing practice, and clinical approaches to improving health outcomes of this population. A systematic review of qualitative studies was conducted with a literature search from CINAHL, APA PsycINFO, MEDLINE, PubMed, and SocINDEX databases yielding seven relevant papers for this analysis. Studies using the superwoman schema and the SBW schema with participants who identified as Black women were included in the review. Consistent with the SBW phenomenon, many participants described examples and consequences of being an SBW. While most women identified with SBW, not all endorsed the persona entirely, challenging its ideal and reinforcing positive self-care. Themes include (a) Strength by nature, not choice, (b) Suppressed emotion, (c) Success over everything, and (d) Prioritizing others over self. Additional emerging themes are also included. Black women increasingly recognize the negative impacts of the SBW schema, pinpointing how their internal feelings manifest in their external world. The conceptual framework itself is an anomaly, incongruently impacting both the mental and physical health of Black women, further contributing to the long-term health and sociopolitical disparities that Black women experience. Simply acknowledging and understanding these experiences by healthcare practitioners are not enough to prevent or eliminate the risks involved with the endorsement of the SBW schema but rather intentionally addressing these as a contributing social determinant of health that predisposes them to long-term chronic conditions.
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Floyd James K, Chen K, Hindra SS, Gray S, Robinson MN, Tobin CST, Choi K, Saint Arnault D. Racism-related stress and mental health among black women living in Los Angeles County, California: A comparison of postpartum mood and anxiety disorder screening scales. Arch Womens Ment Health 2024:10.1007/s00737-024-01458-w. [PMID: 38561564 DOI: 10.1007/s00737-024-01458-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. METHODS Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. RESULTS The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R2 = 0.58, p = < 0.001) compared to the EPDS-3 (R2 = 0.46, p = < 0.001) or the PHQ-15 (R2 = 0.14, p = 0.035). CONCLUSIONS Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health.
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Affiliation(s)
- Kortney Floyd James
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Keren Chen
- David Geffen School of Medicine, Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sasha S Hindra
- University of California Irvine, Sue & Bill Gross School of Nursing, Irvine, CA, USA
| | | | - Milllicent N Robinson
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney S Thomas Tobin
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Sciences), University of California Los Angeles, Los Angeles, CA, USA
| | - Kristen Choi
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
- Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA, USA
| | - Denise Saint Arnault
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, USA
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Henry CJ, Kelly U, Dunlop AL, Paul S, Chandler RD, Christiansen-Lindquist L, Song MK. Relationships Between Strong Black Woman Belief, Coping Behaviors, Perceived Social Support, and Psychological Distress Symptoms for Black Mothers After Stillbirth. J Midwifery Womens Health 2024; 69:249-257. [PMID: 37903721 DOI: 10.1111/jmwh.13576] [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] [Revised: 08/18/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION Psychological distress symptoms (symptoms of depression, anxiety, and posttraumatic stress) are common following stillbirth. Black women who experience stillbirth are less likely to seek support than White women, consistent with the strong Black woman (SBW) construct, which expects Black women to tolerate stress and trauma gracefully, without seeking help. METHODS In this cross-sectional study we sought to determine the relative contributions of SBW belief, perceived lack of social support, and culturally relevant coping behaviors to psychological distress symptoms in Black women bereaved by stillbirth. We partnered with a stillbirth support organization to recruit a sample of 91 Black women bereaved by stillbirth in the 3 years prior to study participation. The online study survey measured SBW belief, culturally relevant coping behaviors, perceived social support, and psychological distress symptoms along with sociodemographics, pregnancy history, and stillbirth characteristics. We used stepwise selection in multiple linear regression to determine the relative contributions of SBW belief, perceived social support, and coping behaviors to measures of psychological distress symptoms in our sample. RESULTS Higher SBW belief, lower perceived social support, and higher collective coping (coping behaviors involving other people) were associated with increases in all 3 measures of psychological distress symptoms, controlling for age and other traumatic events. DISCUSSION Further understanding of the influence of SBW belief on Black women's psychological distress following stillbirth may assist with the development of culturally appropriate interventions to mitigate psychological distress symptoms in this group.
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Affiliation(s)
- Carrie J Henry
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sudeshna Paul
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | | | | | - Mi-Kyung Song
- Center for Nursing Excellence in Palliative Care, Nell Hodgson, Woodruff School of Nursing, Emory University, Atlanta, Georgia
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Burton WM, Ezemenaka C, Jaiswal J, Guyotte KW, Sanders AM. Coping among Black college women: A transformative study of gendered racism. Res Nurs Health 2024; 47:27-38. [PMID: 37970705 DOI: 10.1002/nur.22352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/25/2023] [Accepted: 11/04/2023] [Indexed: 11/17/2023]
Abstract
Black women in the United States are placed at higher risk for mental health challenges, including distress and depression, due to structural inequities. Black college women enrolled in predominantly White institutions may be particularly exposed to stressors related to gendered racism, but there is limited knowledge about this population's coping strategies. A cross-sectional survey and focus group were utilized to understand and disrupt participants' experiences of gendered racism. In phase one, a survey assessing coping strategies and mental health outcomes was conducted with 168 Black women enrolled at a predominantly White institution in the southeastern United States. Logistic regression results indicated that several coping strategies including behavioral disengagement, self-blame, self-distraction, denial, and positive reframing were significantly associated with depression and psychological distress, all p < 0.05. Phase two included a single focus group with a subset of the sample from phase one. The focus group findings supplemented the survey results, suggesting education (more accurately consciousness-raising) as a foundational theme that seemed to create space for humor and social support as coping subthemes and created a transformative space where participants spoke openly about gendered racism. Findings from this study highlight the societal underpinnings that shape Black college women's experiences of gendered racism. College settings should endeavor to provide formal and informal support for Black women to minimize the harms related to gendered racism.
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Affiliation(s)
- Wanda M Burton
- Capstone College of Nursing, University of Alabama, Tuscaloosa, Alabama, USA
| | - Christina Ezemenaka
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jessica Jaiswal
- Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kelly W Guyotte
- Department of Educational Studies, University of Alabama, Tuscaloosa, Alabama, USA
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James SE, Riggan KA, Halyard M, Kelly M, Cobran E, Allyse MA. The "Strong Black Woman" Paradox: Insights from a Cohort of Black Breast and Ovarian Cancer Patients and Family Members. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01905-x. [PMID: 38191790 PMCID: PMC11288339 DOI: 10.1007/s40615-023-01905-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND The strong Black woman (SBW) stereotype can be seen as a positive view of Black women and even a standard to uphold. SBW internalization is a coping mechanism for dealing with racism and sexism. However, multiple recent studies have indicated that Black women in the modern era experience the paradox of SBW internalization having negative generational health effects. We interviewed Black women with a personal or relation diagnosis of breast or ovarian cancer to understand their views and experiences, including how the perception of the SBW stereotype influenced their care. METHODS Qualitative semi-structured interviews were conducted via telephone or video conference and transcribed verbatim. Transcripts were qualitatively analyzed for iterative themes related to cancer care and psychosocial support. RESULTS Sixty-one Black women completed an interview. Responses in multiple transcripts expressed experiences and sentiments consistent with the SBW stereotype, including the importance of maintaining the appearance of strength during their cancer journey. This resulted in some patients declining assistance during their cancer journeys. Participants shared a hope that there would be more willingness to show vulnerability so that future generations of cancer patients receive adequate support. Key aspects of the SBW stereotype were also cited as potential contributors to ongoing racial disparities in breast and ovarian cancer outcomes. CONCLUSION(S) Participants described a paradox of the SBW stereotype that is ultimately detrimental to health and wellbeing. Healthcare professionals and cancer researchers should be aware of this phenomenon to address cancer care more appropriately in Black women.
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Affiliation(s)
- Sarah E James
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA.
- Coalition of Blacks Against Breast Cancer, Phoenix, AZ, USA.
| | - Kirsten A Riggan
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA
| | - Michele Halyard
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA
- Coalition of Blacks Against Breast Cancer, Phoenix, AZ, USA
| | - Marion Kelly
- Coalition of Blacks Against Breast Cancer, Phoenix, AZ, USA
- Department of Community Engagement, Mayo Clinic, Scottsdale, AZ, USA
| | - Ewan Cobran
- Department of Quantitative Health Science, Mayo Clinic, Scottsdale, AZ, USA
| | - Megan A Allyse
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA
- Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, MN, USA
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Erving CL, McKinnon II, Van Dyke ME, Murden R, Udaipuria S, Vaccarino V, Moore RH, Booker B, Lewis TT. Superwoman Schema and self-rated health in black women: Is socioeconomic status a moderator? Soc Sci Med 2024; 340:116445. [PMID: 38043442 PMCID: PMC10959495 DOI: 10.1016/j.socscimed.2023.116445] [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: 11/02/2022] [Revised: 10/12/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The Superwoman Schema (SWS) construct elucidates Black women's socialization to be strong, suppress their emotions, resist vulnerability, succeed despite limited resources, and help others at their own expense. Drawing from intersectionality and social psychological research on self-schemas, this study examined the extent to which SWS was associated with Black women's self-rated health. We also investigated whether socioeconomic status (SES) moderated the association between SWS, its five dimensions, and self-rated health. METHODS Data were from the Mechanisms Underlying Stress and Emotions (MUSE) in African-American Women's Health Study, a cohort of African American self-identified women. SWS was assessed using Giscombé's 35-item Superwoman Schema Scale. Socioeconomic status was measured by household income and educational attainment. Ordered logistic regression models were used and statistical interactions were run to test for moderation (N = 408). RESULTS First, SWS dimension "obligation to help others" was associated with worse self-rated health (p < .05). Second, household income, but not education, moderated the association between SWS and self-rated health (p < .05): SWS overall was associated with worse self-rated health among higher income women but better self-rated health among lower income women. Third, income moderated the association between SWS dimension "obligation to present an image of strength" and self-rated health (p < .05): presenting strength was associated with better self-rated health for lower income women only. Fourth, moderation results revealed that SWS dimension "obligation to help others" was inversely associated with self-rated health particularly among higher income women. CONCLUSIONS Findings speak to the complex interplay between SES and SWS dimensions as they relate to Black women's perceived health.
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Affiliation(s)
- Christy L Erving
- The University of Texas at Austin, College of Liberal Arts, Department of Sociology, Population Research Center, USA.
| | - Izraelle I McKinnon
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Miriam E Van Dyke
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Raphiel Murden
- Emory University, Rollins School of Public Health, Biostatistics and Bioinformatics Department, USA
| | - Shivika Udaipuria
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Viola Vaccarino
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Reneé H Moore
- Drexel University, Dornsife School of Public Health, Department of Epidemiology and Biostatistics, USA
| | - Bianca Booker
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Tené T Lewis
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
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Modde Epstein C, Rice MJ, French JA, Kupzyk KA, Houfek JF. Social Support Buffers the Effects of Prenatal Depressed Mood: A Mixed-Methods Study. J Am Psychiatr Nurses Assoc 2024; 30:95-107. [PMID: 35081823 DOI: 10.1177/10783903211073793] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Women use various coping strategies to deal with stress and depression. These strategies are shaped by social contexts over the life course and may attenuate and/or exacerbate the physiologic effects of depression. AIMS: The purpose of this study was to determine whether coping strategies (active, disengaged, or social support coping) moderate depression-related diurnal cortisol dysregulation and to explore how social context influences women's use of coping. METHODS: This was a mixed-methods study of pregnant women (N = 65) during mid-pregnancy. Cortisol was measured in saliva collected during the waking hours of the day. Participants completed the Edinburgh Depression Scale and the Brief COPE. A subset of the sample participated in semistructured qualitative interviews (n = 20). RESULTS: Social support coping, but not active or disengaged coping, moderated end-of-day cortisol levels. Among depressed women, higher use of social support was associated with lower and more dynamic (i.e., less flat) diurnal cortisol rhythms. The qualitative findings revealed how complex social dynamics related to financial insecurity, lack of mutuality, and social identity affected women's use of and access to social support. CONCLUSION: These findings support theories of the stress-buffering effects of social support. Future research is needed to examine how social determinants affect access to social support, and how early life social experiences condition women's adaptive formation of social support coping strategies over the life course. Clinically, these findings underscore the value of relationship-centered nursing care for depressed women.
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Affiliation(s)
- Crystal Modde Epstein
- Crystal Modde Epstein, PhD, RN, PMHNP-BC, University of Nebraska Medical Center, Omaha, NE, USA; University of North Carolina Greensboro, NC, USA
| | - Michael J Rice
- Michael J. Rice, PhD, APRN-NP, FAAN, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jeffrey A French
- Jeffrey A. French, PhD, University of Nebraska at Omaha, NE, USA
| | - Kevin A Kupzyk
- Kevin A. Kupzyk, PhD, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julia F Houfek
- Julia F. Houfek, PhD, APRN-CNS, University of Nebraska Medical Center, Omaha, NE, USA
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Subhan BA, Johnson VE. The Strong Black Woman Archetype and Therapeutic Outcomes: Examining Relationships Among Women with Childhood Sexual Abuse Histories. J Racial Ethn Health Disparities 2023; 10:2957-2969. [PMID: 36469287 DOI: 10.1007/s40615-022-01472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
The Strong Black Woman archetype (SBWA) describes a cultural pattern where Black women are expected to and present as physically and mentally strong, regardless of past and ongoing stressors. The SBWA has served the historical purpose of aiding survival for Black women throughout years of racial and gender oppression. However, the practice has also been associated with adverse mental health and with behaviors, such as self-silencing, that could impede therapeutic process. The purpose of this empirical study was to investigate the relationships between adherence to the SBWA and therapeutic outcomes (i.e., satisfaction with therapy, satisfaction with therapist, perceptions of one's global improvement in therapy) among Black women with childhood sexual abuse histories-a subpopulation at increased need for mental health treatment and who may be susceptible to high levels of adherence to the SBWA. Black adult female participants (N = 103) completed an online survey including a demographic questionnaire, an assessment of SBWA endorsement, and treatment outcomes from their current or most recent therapy experience. Three hierarchical linear regressions were conducted with SBWA as the independent variable and (i) satisfaction with therapist, (ii) satisfaction with therapy, and (iii) global improvement as the dependent variables. Consistent with our hypotheses, we found that SBWA inversely predicted satisfaction with therapy and the therapist. While the relationship between SBWA and global improvement was statistically significant, the finding was not practically significant. Still, our study findings suggest that higher levels of SBWA predict less favorable therapy outcomes. Future research directions and clinical implications are discussed.
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Affiliation(s)
- Bibi Aneesa Subhan
- John Jay College of Criminal Justice, City University of New York, 524 West 59Th Street, 10.65.19 NB, New York, NY, 10019, USA.
| | - Veronica Elaine Johnson
- John Jay College of Criminal Justice, City University of New York, 524 West 59Th Street, 10.65.19 NB, New York, NY, 10019, USA
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C Harrington C, Dean-Witt C, Z Cacchione P. Female caregivers' contextual complexities and familial power structures within Alzheimer's care. J Women Aging 2023; 35:446-464. [PMID: 36288108 DOI: 10.1080/08952841.2022.2130655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/29/2022] [Accepted: 09/22/2022] [Indexed: 10/31/2022]
Abstract
In 2021, 11.3 million unpaid caregivers of persons with Alzheimer's disease/Alzheimer's disease and related dementias (AD/ADRD) provided 16 billion hours of unpaid caregiving worth $271.6 billion. This study aimed to fully capture the contextual complexities of the caregiving role acquisition articulated by female family caregivers of those with AD/ADRD, emphasizing assigned meaning to one's lived experience with a critical focus on how family power structures influence caregiving practices. Recorded open structured interview transcripts (N = 30) from two qualitative studies with the same two opening questions resulted in a corpus of 481 pages of pooled textual data. The data were analyzed using Utrecht's descriptive and interpretive thematic analysis approach. The interpretive thematic analysis uncovered the theme of intervening to protect and its subthemes of financial exploitation, mistreatment, and endangerment. Based on the evolving analysis, we reanalyzed the data using critical discourse analysis (CDA), drawing from Foucault and feminist CDA to explore the complex but subtle nuances of gender, power, and ideologies. CDA uncovered the theme of compulsory altruism. Ambiguity about violating personhood delayed responses to potentially dangerous behavior and actual harm. Using interpretive thematic and critical discourse analysis, we discovered a deeper understanding of female caregivers' contextual complexities, their journey to becoming a caregiver of a family member with AD/ADRD, and the power structures that relegated caregiving to female family members. This research identified a substantial policy gap in supporting female family caregivers who provide the majority of care to persons with AD/ADRD risking their health and financial security.
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Affiliation(s)
| | - Cheryl Dean-Witt
- University of Louisville School of Nursing, Louisville, Kentucky, USA
| | - Pamela Z Cacchione
- Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Denyse T, Martin KJ, Kim JHJ, Pageot YK, Owoyemi P, DeLuz KD, Stanton AL. "No Complaining, No Crying": A Qualitative Study of the Strong Black Woman Schema in the Breast Cancer Context. Ann Behav Med 2023; 57:733-742. [PMID: 37318273 PMCID: PMC10441856 DOI: 10.1093/abm/kaad029] [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] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Black women have the highest mortality from breast cancer compared with other racial/ethnic groups. Black women with breast cancer also evidence compromised quality of life in some domains. Culturally relevant aspects of their experience are understudied. PURPOSE The goal of this qualitative study was to examine the relevance of the Strong Black Woman schema in the cancer context. METHODS Three Gatherings (i.e., culturally curated focus groups) were conducted with Black women who had been diagnosed with breast cancer and recruited from cancer-related listservs and events. A five-person team conducted reflexive thematic analysis of Gathering transcripts. RESULTS The 37 participants ranged in age (30 to 94 years) and in diagnosis duration (2 months to 29 years). Reflexive thematic analysis yielded six themes that characterized the women's experience: historical legacy of the Strong Black Woman, navigating intersecting Strong Black Woman identities, everyday challenges encountered on the battlefield by Strong Black Women, Strong Black Woman in action during the breast cancer journey, the complexities of seeking and accepting support, and the liberated Strong Black Woman. The schema's negative consequences included the oncologic team and others expecting the participants to be strong and not to need support. Expectations to suppress emotions and continue caring for others to the neglect of the self also were evident. Positive consequences included engaging in self-advocacy in the oncologic context and redefining strength to include expressing emotions and accepting help. CONCLUSIONS The Strong Black Woman schema is highly relevant in the breast cancer context and could be addressed in culturally centered interventions.
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Affiliation(s)
| | - Kimberly J Martin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jacqueline H J Kim
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yrvane K Pageot
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Praise Owoyemi
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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15
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Ramos MD, Spearman J, Heath J, Lee D, Adewuyi M. Navigating the Complexities of Dementia Care: The Lived Experiences of Black American Family Caregivers. J Gerontol Nurs 2023; 49:19-26. [PMID: 37256757 DOI: 10.3928/00989134-20230512-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Black American individuals have a higher rate of Alzheimer's disease and related dementias (ADRD) diagnoses compared to other racial/ethnic groups, and their family caregiver population is expected to increase rapidly over the next 2 decades. The current study aimed to explore Black American women's experiences caring for family members with ADRD. An interpretative phenomenology approach was used to gain a deeper understanding of the caregiving experiences of Black American women. Participants in the study were all Black American married women aged 63 to 81 years (mean = 71.3 years, SD = 6.6 years). Key themes that emerged from the study included: (a) Family Care Obligation, (b) Caregiving Journey, (c) Prioritizing Health Concerns, (d) Coping Behaviors, and (e) Support Needs and Challenges. Family caregivers require ongoing support, education, and guidance. Implications for nursing practice include focusing on family assessments, increased education and awareness, and collaboration with interdisciplinary teams to provide the best resources. [Journal of Gerontological Nursing, 49(6), 19-26.].
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16
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Crooks N, Barrie R, Singer R, Donenberg G. The Role of the Strong Black Woman in Black Female Sexual Development. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1389-1402. [PMID: 36652135 DOI: 10.1007/s10508-023-02529-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
Black girls and women are disproportionately impacted by sexual health disparities, including an increased risk of HIV and sexually transmitted infections (STI). Early sexual development among Black females heightens their risk of HIV/STI. Utilizing the Becoming a Sexual Black Woman (SBW) framework, this study sought to understand how early sexual development and stereotype messages may underpin HIV/STI risk, building on and furthering the discussion of the consequences of the SBW schema. To better understand this phenomenon, we conducted a secondary thematic data analysis from two previously completed grounded theory studies with Black girls and women ranging in age from 11 to 62 (N = 40). Findings revealed that Black women have been socialized to be strong and independent and yet are highly vulnerable to HIV/STI. This clash between Black girl's and women's ideals of strength and heightened vulnerability to HIV/STI presents a paradox that may help explain disparities in HIV/STI risk. Four themes emerged among both Black girls and women: complex construction of the SBW schema, burden and consequences of strength, pressure to be strong, and being strong and sexual. Findings also highlight how becoming both a strong and sexual Black woman occurs over the life course and is inherent to Black female sexual development. We discuss the implications of these findings for parents, healthcare providers, educators, and researchers with the aim to improve sexual health outcomes for Black females across the life course.
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Affiliation(s)
- Natasha Crooks
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue, Room 816, Chicago, IL, 60612, USA.
| | - Rabiatu Barrie
- School of Public Health, Department of Family Science, University of Maryland, College Park, MD, USA
| | - Randi Singer
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue, Room 816, Chicago, IL, 60612, USA
| | - Geri Donenberg
- Department of Medicine, Center for Dissemination and Implementation Science, University of Illinois Chicago, Chicago, IL, USA
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17
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Kroshus E, Hawrilenko M, Tandon PS, Browning A, Steiner MK, Christakis DA. Structural Inequities in Self-compassion and Parental Burnout. Mindfulness (N Y) 2023; 14:1192-1203. [PMID: 37304655 PMCID: PMC10113733 DOI: 10.1007/s12671-023-02104-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 06/13/2023]
Abstract
Objectives When parenting-related stressors and coping resources are chronically imbalanced, there is risk of parental burnout, and consequent negative impact on parent and child wellbeing. The objective of this study was to determine the relations between structural and social determinants of health inequities, self-compassion (a theoretically indicated coping practice), and parental burnout during the COVID-19 pandemic. Method Participants were parents (n = 2324) with at least one child aged 4-17 in the household recruited from NORC's AmeriSpeak Panel (a probability-based panel providing coverage of 97% of the US household population). Parents completed an online or telephone questionnaire in English or Spanish in December 2020. Structural equation modeling was used to test a system of relations between income, race and ethnicity, parental burnout, and parent and child mental health. Indirect effects and moderation by self-compassion were also tested. Results On average, parents experienced symptoms of burnout several days per week. Symptoms were the most frequent among parents with the least income, as well as female-identified and Asian parents. More self-compassion was associated with less parental burnout, and fewer parent and child mental health difficulties. Black and Hispanic parents were more self-compassionate compared to white parents, helping to explain similar levels of parental burnout and relatively better mental health outcomes, despite comparatively more stressors. Conclusions Self-compassion is a potentially promising target for interventions aiming to address parental burnout; however, such efforts must not detract from critical structural changes to reduce parenting stressors, particularly those impacting parents experiencing systemic racism and other forms of socioeconomic disadvantage. Preregistration This study is not preregistered. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-023-02104-9.
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Affiliation(s)
- Emily Kroshus
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101 USA
- Department of Pediatrics, University of Washington, Seattle, USA
| | - Matt Hawrilenko
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Pooja S. Tandon
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101 USA
- Department of Pediatrics, University of Washington, Seattle, USA
| | - Anne Browning
- School of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Mary Kathleen Steiner
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101 USA
| | - Dimitri A. Christakis
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101 USA
- Department of Pediatrics, University of Washington, Seattle, USA
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18
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Silas MJ, Seward DX. Black women's help‐seeking and self‐care strategies: A phenomenological exploration. JOURNAL OF COUNSELING AND DEVELOPMENT 2023. [DOI: 10.1002/jcad.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Melany J. Silas
- Department of Health Services State University of New York at Monroe Community College Rochester New York USA
| | - Derek X. Seward
- Department of Counseling and Human Services Syracuse University Syracuse New York USA
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19
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Pahl K, Williams SZ, Capasso A, Lewis CF, Lekas HM. A longitudinal pathway from ethnic-racial discrimination to sexual risk behaviors among Black women and Latinas: Ethnic-racial identity exploration as a protective factor. Soc Sci Med 2023; 316:115061. [PMID: 35637046 DOI: 10.1016/j.socscimed.2022.115061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Black women and Latinas in their thirties continue to be at risk for HIV transmission via heterosexual intercourse. METHODS Informed by the Theory of Gender and Power, this study investigated a longitudinal path model linking experiences of ethnic-racial discrimination in late adolescence to sexual risk behaviors in adulthood among 492 Black women and Latinas. We also tested whether ethnic-racial identity exploration served as a resilience asset protecting women against the psychological impact of ethnic-racial discrimination. Survey data from female participants in the Harlem Longitudinal Development Study, which has followed a cohort of New York City Black and Latinx youth since 1990, were analyzed. Data for this analysis were collected at four time points when participants were on average 19, 24, 29, and 32 years of age. Structural equation modeling was used to examine a hypothesized pathway from earlier ethnic-racial discrimination to later sexual risk behaviors and the protective role of ethnic-racial identity exploration. RESULTS Results confirmed that ethnic-racial discrimination in late adolescence was linked with sexual risk behaviors in the early thirties via increased levels of affective distress in emerging adulthood, experiences of victimization in young adulthood, and substance use in the early thirties among women low in ethnic-racial identity exploration. We also found that ethnic-racial identity served as a resilience asset, as the association between discrimination in late adolescence and affective distress in emerging adulthood was not significant among women with higher levels of ethnic-racial identity exploration. CONCLUSIONS The results provide important preliminary evidence that ethnic-racial identity exploration may serve as a resilience asset among Black women and Latinas confronting racial discrimination. Further, we suggest that ethnic-racial identity exploration may constitute an important facet of critical consciousness.
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Affiliation(s)
- Kerstin Pahl
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Sharifa Z Williams
- Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Ariadna Capasso
- NYU School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - Crystal Fuller Lewis
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Helen Maria Lekas
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
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20
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Hearne BN. Psychological distress across intersections of race/ethnicity, gender, and marital status during the COVID-19 pandemic. ETHNICITY & HEALTH 2022; 27:1932-1951. [PMID: 34431730 DOI: 10.1080/13557858.2021.1969537] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Analyze how psychological distress in the U.S. population during the COVID-19 pandemic differed across race/ethnicity, gender, and marital status. DESIGN Cross-sectional data collected March 19-24, 2020, as a part of the American Trends Panel (ATP) were used for this study (N=9,976). Weighted descriptive statistics were estimated. Next, generalized linear models were used to assess differences in psychological distress by race/ethnicity, gender, and marital status. Multivariate Ordinary Least Squares (OLS) regression analyses were estimated to assess patterns of psychological distress across race/ethnicity-gender net of COVID-19 pandemic variables and control variables. Lastly, OLS regression models were used to assess psychological distress by marital status. Wald tests were completed to compare distress across race/ethnicity-gender. RESULTS Adjusting for COVID-19 stressors and control variables, White women frequently reported higher distress compared to the other groups. Hispanic men reported lower distress symptoms than White men and Hispanic women. The cohabiting and married had lower distress symptoms compared to the never married. In the analyses by marital status, race/ethnicity-gender differences were present among the never married, married, and marital disruption groups such that White women reported higher distress than other groups. Black married women reported greater distress symptoms compared to married White and Hispanic men. CONCLUSIONS The findings of this study show that White women were especially vulnerable to psychological distress at the beginning of the COVID-19 pandemic. Further, despite marriage being a health-promoting status, it is only among the married that Black women reported greater distress than other groups. Married Black women and White women generally need psychological health resources as they are perhaps overtaxed in meeting the demands of family, such as teaching school-age children in the home or caring for elders during the pandemic.
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Affiliation(s)
- Brittany N Hearne
- Department of Sociology and Criminology, University of Arkansas, Fayetteville, USA
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21
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Abstract
OBJECTIVE This discussion paper describes the intricacies of the strong Black woman (SBW) construct and how understanding this construct is significant and relevant within nursing. METHOD This article is a discussion piece that provides a succinct conceptual and historical overview of the SBW construct. It then describes the impacts of this construct before presenting implications as they relate to nursing practice, education, policy, and research. RESULTS The SBW construct is exclusively and routinely applied to Black women. Typically, the SBW construct encompasses five components, which center on independence, caring, and strength. These five components include the obligation to (1) always maintain and present an image of strength, (2) suppress emotion, (3) be self-reliant, (4) succeed despite all odds, and (5) always place the needs [especially comfort] of others above those of oneself. Moreover, the SBW construct posits Black women as possessing superhuman capabilities. The nature of this construct is complex, with some Black women using it as a survival mechanism, and others finding empowerment through this image. Nevertheless, recent research has revealed the harms associated with this image including detriment to physical, mental, and spiritual well-being, with the implications extending to Black families and communities. CONCLUSION Understanding this topic is essential in providing support to all Black women in health care and within the Black community-including patients, nurses, faculty, staff, and students. Recognizing the implications of the SBW construct is essential toward ensuring that our care, practices, and policies are not only supportive but also antiracist.
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Affiliation(s)
- Keisha Jefferies
- Keisha Jefferies, MN, RN, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
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22
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Platt LF, Fanning SC. The Strong Black Woman Concept: Associated Demographic Characteristics and Perceived Stress Among Black Women. JOURNAL OF BLACK PSYCHOLOGY 2022. [DOI: 10.1177/00957984221096211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Being a “Strong Black Woman” (SBW) is a frequent cultural demand for Black Women. The physical and emotional disadvantages of this persistent racial gender role expectation are notable. The purpose of the current exploratory study was to (1) confirm a link between endorsement of the SBW schema and self-reported perceived stress and (2) investigate the potential demographic features that predict the level of endorsement of the SBW schema. A community sample of n = 185 Black women completed an online survey containing the Giscombé Superwoman Schema Questionnaire ( Woods-Giscombé et al., 2019 ), the Perceived Stress Scale-10 ( Cohen & Williamson, 1988 ), and a demographic questionnaire. The results indicated that more endorsement of SBW ideals uniquely predicted greater perceived stress. Also, only the demographic variables of age and number of children were predictors of SBW endorsement. Endorsement of SBW expectations did not vary across the other demographic variables indicating the SBW schema was prominent for most participants in the sample.
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Affiliation(s)
- Lisa F. Platt
- Department of Counseling and Learning Sciences, West Virginia University, Morgantown, WV, USA
| | - Sandy C. Fanning
- Department of Counseling and Learning Sciences, West Virginia University, Morgantown, WV, USA
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23
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Knighton JS, Dogan J, Crowell C, Stevens-Watkins D. Superwoman Schema: a context for understanding psychological distress among middle-class African American women who perceive racial microaggressions. ETHNICITY & HEALTH 2022; 27:946-962. [PMID: 32931323 PMCID: PMC7956919 DOI: 10.1080/13557858.2020.1818695] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 08/30/2020] [Indexed: 05/29/2023]
Abstract
Objective: Current racial mental health disparities among African American women have been attributed to chronic experiences of race-related stressors. Increased exposure to racism in predominately White spaces may increase reliance on culturally normative coping mechanisms. The objective of this study was to investigate the relationship between psychological distress, perceived racial microaggressions, and an obligation to show strength/suppress emotions among educated, middle-class African American women.Design: A sample of 243 African American women aged 19-72 years (M = 39.49 years) participated in an online study. Participants completed self-report measures of psychological distress (PHQ-8 and GAD-7), racial microaggressions (IMABI), and modified items from the Stereotypical Roles for Black Women (SRBWS) to assess an obligation to show strength/suppress emotions. Factor analyses were conducted to assess the reliability of the obligation to show strength/suppress emotions subscale in our sample. Descriptive statistics, multiple linear regression, and mediation analyses were also conducted to examine variable associations.Results: Statistical analyses revealed educated, middle-class African American women who endorse an obligation to show strength/suppress emotions with perceived racial microaggressions experienced increased psychological distress.Conclusion: Obligation to show strength/suppress emotion may increase risk for psychological distress among African American women who perceive racial microaggressions. Future research and clinical implications are discussed.
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Affiliation(s)
- Joi-Sheree’ Knighton
- Michigan Department of Health and Human Services (MDHHS), Center for Forensic Psychiatry
| | - Jardin Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, 36 Dickey Hall, Lexington, Kentucky 40506
| | - Candice Crowell
- Department of Educational, School, and Counseling Psychology, University of Kentucky, 36 Dickey Hall, Lexington, Kentucky 40506
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, 36 Dickey Hall, Lexington, Kentucky 40506
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24
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Leath S, Jones MK, Butler-Barnes S. An examination of ACEs, the internalization of the Superwoman Schema, and mental health outcomes among Black adult women. J Trauma Dissociation 2022; 23:307-323. [PMID: 34622746 DOI: 10.1080/15299732.2021.1989113] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite the growing literature on the mental health implications of adverse childhood events (ACEs), little empirical evidence considers the role of sociocultural scripts in Black women's experiences of trauma and mental health. Emerging scholarship suggests that gendered racial stereotypes, such as the Superwoman Schema, might worsen the impact of ACEs on the mental health outcomes of Black women in the U.S. To address this gap, we sought to examine relationships among Black women's exposure to ACEs, endorsement of the Superwoman Schema, and mental health outcomes. The current sample included 447 Black women (20-35 years old) who completed measures of adverse childhood events, Superwoman Schema endorsement, and mental health (stress, anxiety, and depression). ACEs and endorsement of the Superwoman Schema were associated with higher stress, anxiety, and depressive symptomology. Additionally, Black women who experienced more ACEs and felt a stronger obligation to present an image of strength indicated more stress. Black women who experienced more ACEs and had a stronger determination to succeed reported higher anxiety. These results offer further evidence of the role of the Superwoman Schema on Black women's mental health. The authors discuss future research directions and clinical implications regarding the interconnections among sociocultural scripts of Black womanhood and trauma experiences.
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Affiliation(s)
- Seanna Leath
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Martinque K Jones
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Sheretta Butler-Barnes
- Brown School of Social Work, Washington University in St. Louis, St Louis, Missouri, USA
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25
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Relationship between parental history of dementia, motor-cognitive and executive function performance in African American women. J Neurol Sci 2022; 439:120305. [DOI: 10.1016/j.jns.2022.120305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/19/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
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26
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Cousin L, Johnson-Mallard V, Booker SQ. "Be Strong My Sista'": Sentiments of Strength From Black Women With Chronic Pain Living in the Deep South. ANS Adv Nurs Sci 2022; 45:127-142. [PMID: 35234672 PMCID: PMC9064901 DOI: 10.1097/ans.0000000000000416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The experience of chronic pain is influenced by gender, race, and age but is understudied in older Black women. Society and family alike expect Black older women to display superhuman strength and unwavering resilience. This qualitative study examined the narratives of 9 rural- and urban-dwelling Black older women to identify the ways in which they displayed strength while living with chronic osteoarthritis pain. Their "herstories" parallel the 5 characteristics of the Superwoman Schema/Strong Black Woman. Two additional characterizations emerged: spiritual submission for strength and code switching to suffering Black woman; these may be unique to Black Americans with pain.
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Affiliation(s)
- Lakeshia Cousin
- College of Nursing, University of Florida, Gainesville, FL 32610
| | | | - Staja Q. Booker
- College of Nursing, University of Florida, Gainesville, FL 32610
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL 32610
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27
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Anyiwo N, Stanton AG, Avery LR, Bernard DL, Abrams JA, Golden A. Becoming Strong: Sociocultural Experiences, Mental Health, & Black Girls' Strong Black Woman Schema Endorsement. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:89-98. [PMID: 34958150 PMCID: PMC9077465 DOI: 10.1111/jora.12707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study examines the precedents and consequences of Black girls' Strong Black Woman schema (SBW) endorsement. Hierarchical regression analyses revealed that, among Black girls (N= 308), racial discrimination experiences and racial barrier socialization messages were positively associated with SBW endorsement. However, there was no significant interaction between racial discrimination and racial barrier messages in predicting SBW endorsement. Our analyses also revealed that SBW was not directly associated with internalizing symptoms (e.g., anxiety and depression symptoms). Furthermore, there was no significant interaction between racial discrimination and SBW endorsement in predicting internalizing symptoms. Findings provide evidence of and clarity on how sociocultural experiences shape SBW development and highlight a need to better understand how SBW endorsement functions in the mental health of Black girls.
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28
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Loyd AB, Kürüm E, Crooks N, Maya A, Emerson E, Donenberg GR. Investigating Longitudinal Associations Between Racial Microaggressions, Coping, Racial/Ethnic Identity, and Mental Health in Black Girls and Women. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:69-88. [PMID: 34951078 DOI: 10.1111/jora.12710] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Racial microaggressions pose significant risk to health and well-being among Black adolescents and adults. Yet, protective factors (i.e., coping, racial/ethnic identity) can moderate the impact of racial microaggressions over time. Unfortunately, few studies have evaluated the role of these protective factors longitudinally or specifically among Black girls and women. In the current study, we focused on the experiences of Black girls and women and investigated the longitudinal links between racial microaggressions and mental health symptoms over 1 year. We then explored the role of two key protective factors as moderators-coping with racial discrimination and racial/ethnic identity-for mental health. Participants included 199 Black adolescent girls (Mage = 16.02) and 199 Black women (Mage = 42.82) who completed measures on two types of racial microaggressions, three types of coping strategies, racial/ethnic identity, and mental health symptomology. Girls and women completed measures at three time points over 1 year. Results indicated both types of microaggressions predicted increased mental health symptoms in Black women. Among Black girls, assumptions of criminality predicted increased externalizing symptoms only when protective factors were included in the model. Analysis of the protective factors indicated a potential direct benefit rather than a moderating role of coping with racial discrimination through positive thinking for mental health in both Black girls and women. Evidence suggests that coping may have had a direct rather than an indirect effect on Black girls' mental health over time. We conclude with future directions for research and considerations for practice.
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29
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Castelin S, White G. “I’m a Strong Independent Black Woman”: The Strong Black Woman Schema and Mental Health in College-Aged Black Women. PSYCHOLOGY OF WOMEN QUARTERLY 2022. [DOI: 10.1177/03616843211067501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Strong Black Woman Schema (SBWS) is a cultural expectation for Black women to unfailingly display signs of strength and caretaker qualities, while suppressing their emotions. Although this schema is a purported source of strength for Black women, quantitative explorations of its psychological impact have been limited. In the present study, we examined associations between endorsement of the SBWS and several indicators of mental health and resilience in Black women. We analyzed responses from 212 college-aged, Black women assessing psychological distress, suicidal behaviors, resilience, and SBWS endorsement. Findings indicated that endorsement of the SBWS was positively related to both psychological distress and self-reported suicidal behaviors. In addition, the SBWS’ link to suicidal behaviors was mediated by psychological distress. Lastly, results from moderated mediation analysis supported a buffering effect of resilience. That is, when resilience was high, the association between psychological distress and suicidal behaviors, as well as the conditional indirect effects of the SBWS, was lessened. Implications of these findings suggest that prevalent endorsement of SBWS within Black communities may be harmful to Black women’s mental health. We call for additional research and provide recommendations on how the media, mental health professionals, and community leaders can mitigate its negative effects.
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Affiliation(s)
- Stephanie Castelin
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Grace White
- Department of Psychology, University of Central Florida, Orlando, FL, USA
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Barr AB, Simons RL, Beach SR, Simons LG. Racial discrimination and health among two generations of African American couples. Soc Sci Med 2022; 296:114768. [DOI: 10.1016/j.socscimed.2022.114768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
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Huertas-Zurriaga A, Palmieri PA, Aguayo-Gonzalez MP, Dominguez-Cancino KA, Casanovas-Cuellar C, Linden KLV, Cesario SK, Edwards JE, Leyva-Moral JM. Reproductive decision-making of Black women living with HIV: A systematic review. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221090827. [PMID: 35404192 PMCID: PMC9006353 DOI: 10.1177/17455057221090827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Black women living with HIV account for a higher proportion of new HIV diagnoses than other groups. These women experience restricted access to reproductive services and inadequate support from healthcare providers because their position in society is based on their sexual health and social identity in the context of this stigmatizing chronic disease. By recognizing the analytical relevance of intersectionality, the reproductive decision-making of Black women can be explored as a social phenomenon of society with varied positionality. OBJECTIVE The purpose of this review was to synthesize the evidence about the reproductive decision-making of Black women living with HIV in high-income countries from the beginning of the HIV epidemic to the present. METHODS This systematic review was guided by the JBI evidence synthesis recommendations. Searches were completed in seven databases from 1985 to 2021, and the review protocol was registered with PROSPERO (CRD420180919). RESULTS Of 3503 records, 22 studies were chosen for synthesis, including 19 observational and three qualitative designs. Nearly, all studies originated from the United States; the earliest was reported in 1995. Few studies provided detailed sociodemographic data or subgroup analysis focused on race or ethnicity. Influencing factors for reproductive decision-making were organized into the following seven categories: ethnicity, race, and pregnancy; religion and spirituality; attitudes and beliefs about antiretroviral therapy; supportive people; motherhood and fulfillment; reproductive planning; and health and wellness. CONCLUSION No major differences were identified in the reproductive decision-making of Black women living with HIV. Even though Black women were the largest group of women living with HIV, no studies reported a subgroup analysis, and few studies detailed sociodemographic information specific to Black women. In the future, institutional review boards should require a subgroup analysis for Black women when they are included as participants in larger studies of women living with HIV.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Àrea de Suport a la Recerca en Cures, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
| | - Patrick A Palmieri
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Perú
- College of Graduate Health Studies, A.T. Still University, Kirksville, MO, USA
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
| | - Mariela P Aguayo-Gonzalez
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- Department d’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Karen A Dominguez-Cancino
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- Escuela de Enfermería, Universidad Científica del Sur, Lima, Perú
- Escuela de Salud Pública, Universidad de Chile, Santiago de Chile, Chile
| | - Cristina Casanovas-Cuellar
- Àrea de Suport a la Recerca en Cures, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department d’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Kara L Vander Linden
- Department of Research, Saybrook University, Pasadena, CA, USA
- Glaser Center for Grounded Theory, Institute for Research and Theory Methodologies, Poway, CA, USA
| | - Sandra K Cesario
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, Houston, TX, USA
| | - Joan E Edwards
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, Houston, TX, USA
| | - Juan M Leyva-Moral
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
- Department d’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Spain
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Clarke LS, Riley HEM, Corwin EJ, Dunlop AL, Hogue CJR. The unique contribution of gendered racial stress to depressive symptoms among pregnant Black women. WOMEN'S HEALTH 2022; 18:17455057221104657. [PMID: 35900027 PMCID: PMC9340355 DOI: 10.1177/17455057221104657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Pregnant Black women are at disproportionate risk for adverse birth outcomes,
in part associated with higher prevalence of stress. Stress increases risk
of depression, a known risk factor for preterm birth. In addition, multiple
dimensions of stress, including perceived stress and stressful life events,
are associated with adverse birth outcomes, independent of their association
with prenatal depression. We use an intersectional and contextualized
measure of gendered racial stress to assess whether gendered racial stress
constitutes an additional dimension to prenatal depression, independent of
stressful life events and perceived stress. Methods: In this cross-sectional study of 428 Black women, we assessed gendered racial
stress (using the 39-item Jackson Hogue Phillips Reduced Common
Contextualized Stress Measure), perceived stress (using the Perceived Stress
Scale), and stressful life events (using a Stressful Life Event Index) as
psychosocial predictors of depressive symptoms (measured by the Edinburgh
Depression Scale). We used bivariate analyses and multivariable regression
to assess the association between the measures of stress and prenatal
depression. Results: Results revealed significant bivariate associations between participant
scores on the full Jackson Hogue Phillips Reduced Common Contextualized
Stress Measure and its 5 subscales, and the Edinburgh Depression Scale. In
multivariable models that included participant Perceived Stress Scale and/or
Stressful Life Event Index scores, the Jackson Hogue Phillips Reduced Common
Contextualized Stress Measure contributed uniquely and significantly to
Edinburgh Depression Scale score, with the burden subscale being the
strongest contributor among all variables. No sociodemographic
characteristics were found to be significant in multivariable models. Conclusion: For Black women in early pregnancy, gendered racial stress is a distinct
dimension of stress associated with increased depressive symptoms.
Intersectional stress measures may best uncover nuances within Black women’s
complex social environment.
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Affiliation(s)
- Lasha S Clarke
- Morehouse School of Medicine, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Halley EM Riley
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Anne L Dunlop
- School of Medicine, Emory University, Atlanta, GA, USA
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Avent Harris JR, Haskins N, Parker J, Lee A. Womanist Theology and Relational Cultural Theory: Counseling Religious Black Women. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.1999359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - Aiesha Lee
- College of William & Mary, Williamsburg, VA, USA
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Interrupting internalized racial oppression: A community based ACT intervention. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Chance NL. Resilient Leadership: A Phenomenological Exploration Into How Black Women in Higher Education Leadership Navigate Cultural Adversity. JOURNAL OF HUMANISTIC PSYCHOLOGY 2021. [DOI: 10.1177/00221678211003000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores adversity and the lived experiences of Black women in higher education leadership. Using phenomenology, this study specifically explores how Black women in higher education leadership navigate the adverse challenges of intersectionality, stereotype threat, and tokenism. Black women in leadership undergo adversity including limited role models, the concrete ceiling, and the intersectionality of racism, sexism, and ageism, as well as tokenism. The current findings validate that Black women in higher education leadership experience adversity. Some of the more salient codes that emerged were discrimination such as racism, sexism, ageism, and the intersection of these challenges with identity, cultural diversity and belonging, resilience, and leadership callings. Referred to as “superwomen,” Black women are resilient and strong. The results of this study reveal that Black women use adversity as fuel, thus helping them develop the necessary skills to prepare them for leadership. Their strength through adversity is driven by the resilience that has manifested as motivation factors such as family and relationships, mentorship and sponsorship, as well as the support of cultural identity and diversity. The current findings support the notion that adversity shapes Black women into leaders with an emphasis on higher education leadership.
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Graham R, Clarke V. Staying strong: Exploring experiences of managing emotional distress for African Caribbean women living in the UK. FEMINISM & PSYCHOLOGY 2021. [DOI: 10.1177/0959353520964672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The “strong Black woman” (SBW) is a Western cultural stereotype that depicts African-heritage women as strong, self-reliant, independent, yet nurturing and self-sacrificing. US research indicates that this stereotype negatively impacts the emotional wellbeing of African-heritage women, while also allowing them to survive in a racist society. UK research has documented the significance of this stereotype in relation to African Caribbean women’s experience of depression around the time of childbirth and “attachment separation and loss”. However, research is yet to explore how UK African Caribbean women make sense of and negotiate the SBW stereotype in relation to their emotional wellbeing more broadly. Using five focus groups, with a total of 18 women, this research explored how these women experienced and managed emotional distress in relation to the SBW stereotype. The importance of “being strong” consistently underpinned the participants’ narratives. However, this requirement for strength often negatively impacted their ability to cope effectively with their distress, leading them to manage it in ways that did little to alleviate it and sometimes increased it. This study offers important implications for understanding the experiences of emotional distress for UK African Caribbean women.
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Affiliation(s)
- Rachel Graham
- University of the West of England, UK
- University of the West of England, UK
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Affiliation(s)
- Dawn M. Szymanski
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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