Race differences in age-trends of autonomic nervous system functioning

Identity affirmation is associated with adaptive cardiovascular flexibility in response to stress among sexual and gender minority people of color

BACKGROUND

Research with sexual and gender minority (e.g., lesbian, gay, bisexual, queer, asexual, trans, non-binary) people of Color (SGM-PoC) has largely focused on risk and negative health outcomes. The existing strengths-based mental health research suggests that identity affirmation may be associated with psychological resilience and good mental health among SGM-PoC, but little is known about predictors of physiological resilience and biomarkers of physical health in this population. Adaptive cardiovascular flexibility is an indicator of physiological resilience and physical health in that it enables the body to mobilize resources to adapt to challenges. This study explored the association between identity affirmation and physiological resilience, observed through cardiovascular flexibility in response to stress among SGM-PoC.

METHODS

Participants were 95 SGM-PoC of varying ethnoracial backgrounds, sexual orientations, and gender identities, residing in Canada. Participants completed questionnaires on sociodemographic and psychosocial variables, including a measure of identity affirmation, the Queer People of Color Identity Affirmation Scale (QPIAS). In a laboratory setting, we induced stress using the Trier Social Stress Test and measured heart rate variability (HRV) over time using wearable electrocardiogram devices.

RESULTS

Results from multilevel modeling analyses revealed that high QPIAS scores were associated with adaptive cardiovascular flexibility, as evidenced by reduced HRV during stress exposure, followed by HRV increase during recovery. As QPIAS scores increased, the shape of HRV trajectory increasingly reflected our predicted pattern of adaptive cardiovascular flexibility. Meanwhile, low QPIAS scores were not associated with this pattern and appeared to predict a more flatlined HRV activity during the experiment.

CONCLUSIONS

Findings indicate that Queer People of Color identity affirmation may be related to physiological resilience, observed through a more adaptive cardiovascular profile when responding to stress. Identity affirmation may thus be a protective factor for SGM-PoC, pointing to the critical importance of affirming resources and strengths-based health research.

Perceived control and reactivity to acute stressors: Variations by age, race and facets of control

Greater perceived control is associated with better health and well-being outcomes, possibly through more adaptive stress processes. Yet little research has examined whether facets of perceived control (personal mastery and perceived constraints) predict psychological and physiological stress reactivity. The present study evaluated the associations of personal mastery and perceived constraints with changes in subjective stress and cortisol in response to acute laboratory stressors, with age and race as potential moderators. In the Midlife in the United States Refresher Study (N = 633 adults aged 25-75), participants completed a baseline perceived control measure and were subsequently recruited to participate in the laboratory stress protocol. The protocol consisted of completing two mental stress tasks (mental arithmetic and Stroop) as well as providing saliva samples and subjective stress ratings. Race moderated the association between perceived constraints and subjective stress reactivity, such that higher constraints predicted greater subjective stress responses in White participants, but no association was observed in Black participants. Higher personal mastery and perceived constraints each predicted greater increases in cortisol in response to the stress tasks (AUC_i ) among younger but not older adults. These findings suggest that older adults were buffered against the association between facets of control and cortisol stress reactivity. Discussion on potential racial differences in the link between constraints and stress reactivity are elaborated further, as well as considerations for future work to distinguish between facets of control and examine age and racial differences.

Feasibility of using ecological momentary assessment and continuous heart rate monitoring to measure stress reactivity in natural settings

The way people respond to stressful situations (i.e., stress reactivity) varies widely. Researchers typically measure stress reactivity in controlled studies, but this is limited because laboratory stressors cannot capture the variety, severity, or duration of stressors that individuals face in their daily lives. The present study examined the feasibility of using ecological momentary assessment (EMA) and a wireless electrocardiography (ECG) patch to develop an understanding of stress reactivity in natural settings. Thirty-five adult women completed EMA surveys about stressors they were exposed to while wearing a wireless ECG monitor for 7 consecutive days. Daily stressors were measured using seven questions adapted from the Daily Inventory of Stressful Events and a stressor interval was defined as the presence of at least one stressor during the EMA survey prompt. Participants wore the Cardea SOLO wireless ECG monitor (Cardiac Insight Inc., Bellevue, WA) to continuously track their heart rate. Participant-specific differences in 5-minute heart rate variability (HRV) between intervals when participants did and did not report stressors were calculated and displayed in a heat map. Survey response rate was satisfactory (72.0%, n = 588) and nearly all participants (33 out of 35) reported both stressor and non-stressor intervals. Each participant reported at least one stressor on approximately 35% of completed surveys while wearing the ECG patch. Mean wear time (6.6 days) and the duration of analyzable data with an ECG monitor were close to the 7-day study period. While many participants had lower HRV during stressor versus non-stressor intervals, the magnitude and direction of these differences varied widely. In summary, we found that a 7-day sampling scheme combining ecological momentary assessment (EMA) with HRV measured using continuous ECG monitoring was feasible and effective in capturing a variety of daily stressors and measuring autonomic stress reactivity.

Chronic stress, autonomic dysregulation and prospective drug use among African American emerging adults

OBJECTIVE

Chronic stress is associated with increased vulnerability to drug use and may contribute to drug-related health disparities in the African American community. The underlying physiological mechanisms by which chronic stress confers this increased risk remain unclear. The present study aimed to characterize the impact of chronic and race-related stress exposure on regulatory mechanisms of the autonomic nervous system (ANS) in response to acute stress, to examine John Henryism as potential moderator of this relationship, and to investigate the association between ANS reactivity and subsequent drug use among a sample of African American emerging adults (18-25 years old) in the Southern United States (U.S.).

METHOD

Participants (N = 276) completed self-report measures of chronic and race-related stress and John Henryism and underwent a laboratory-based stressor. ANS reactivity was assessed via heart rate variability (HRV) and skin conductance levels (SCL). At 90-day follow-up, retrospective reports of drug use were provided.

RESULTS

Race-related stress was associated with greater SCL reactivity. John Henryism moderated the relationship between chronic stress exposure and HRV reactivity. SCL reactivity was associated with higher rates of alcohol and marijuana use at 90-day follow-up. HRV reactivity was associated with tobacco use at 90-day follow-up.

CONCLUSIONS

Chronic stress exposure and active coping may interact to affect regulatory mechanisms of the ANS. ANS (dys)regulation may be an important endophenotype for increasing drug use vulnerability among African American emerging adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cardiorespiratory Functioning in Youth with Persistent Post-Concussion Symptoms: A Pilot Study

Dysregulation of the autonomic nervous system (ANS) may play an important role in the development and maintenance of persistent post-concussive symptoms (PPCS). Post-injury breathing dysfunction, which is influenced by the ANS, has not been well-studied in youth. This study evaluated cardiorespiratory functioning at baseline in youth patients with PPCS and examined the relationship of cardiorespiratory variables with neurobehavioral outcomes. Participants were between the ages of 13-25 in two groups: (1) Patients with PPCS (concussion within the past 2-16 months; n = 13) and (2) non-injured controls (n = 12). Capnometry was used to obtain end-tidal CO2 (EtCO2), oxygen saturation (SaO2), respiration rate (RR), and pulse rate (PR) at seated rest. PPCS participants exhibited a reduced mean value of EtCO2 in exhaled breath (M = 36.3 mmHg, SD = 2.86 mmHg) and an altered inter-correlation between EtCO2 and RR compared to controls. Neurobehavioral outcomes including depression, severity of self-reported concussion symptoms, cognitive catastrophizing, and psychomotor processing speed were correlated with cardiorespiratory variables when the groups were combined. Overall, results from this study suggest that breathing dynamics may be altered in youth with PPCS and that cardiorespiratory outcomes could be related to a dimension of neurobehavioral outcomes associated with poorer recovery from concussion.

Clinical and neurohormonal characteristics in African Americans with neurogenic orthostatic hypotension

PURPOSE

Neurogenic orthostatic hypotension (nOH) is the hallmark of neurodegenerative forms of autonomic failure, including pure autonomic failure, multiple system atrophy, and Parkinson's disease. Studies have shown autonomic physiological differences in Africans Americans (AA) such as lower heart rate variability, enhanced blood pressure reactivity, and blunted sympathetic neural response compared to non-Hispanic whites. However, the clinical characteristics and neurohormonal profile of autonomic failure in AA is unknown.

METHODS

A total of 65 patients with nOH participated in this study (9 AA and 56 non-Hispanic whites). Both groups were of similar age and comorbidity status, and they underwent standardized autonomic testing and assessment of neurohormonal levels and renin activity and aldosterone in supine and upright positions.

RESULTS

There were no significant differences in baseline autonomic clinical characteristics between non-Hispanic whites and AA with nOH. Non-Hispanic whites demonstrated a significant increase in upright renin activity compared to AA (295 ± 88% vs. 13 ± 13%, respectively). AA showed a blunted increase in aldosterone compared to non-Hispanic whites (188 ± 27% vs. 59 ± 38%, respectively). These results indicated persistent suppression of the renin-angiotensin system in AA, particularly during upright posture.

CONCLUSION

Our findings demonstrate that AA with nOH have similar clinical characteristics and hemodynamic autonomic profiles, but lower upright renin activity and aldosterone levels, compared to non-Hispanic whites. Renin suppression persists in AA with severe autonomic failure and can potentially contribute to postural changes and supine hypertension.

Inflammation, depression, and anxiety disorder: A population-based study examining the association between Interleukin-6 and the experiencing of depressive and anxiety symptoms

The uncovering of a positive association between inflammatory cytokine levels - Interkleukin-6 (IL-6) in particular - and the experiencing of depressive and anxiety symptoms is one of the most promising and enthusiastically-discussed finding in recent years. Despite considerable ambiguity in the directionality and underpinnings of this association, anti-inflammatory drugs are already being tested on mental health patients who present no physical symptoms of inflammation, risking potential adverse side effects. Researchers have thus urgently called for more rigorous empirical elucidations of this association. Based on a large, longitudinal, nationally representative sample of middle-aged adults in the United States (N = 1255), IL-6 was observed to be significantly associated with one's present experiencing of depressive and anxiety symptoms. However, IL-6 was predictive of only prospective depressive (not anxiety) symptoms measured six years later, and only when baseline number of symptoms was not accounted for. Further, evidence for IL-6's postulated role as being either a biological cause itself (augmenting HPA stress reactivity) or a biological consequence of a psychological cause (psychological stress) for depression and anxiety was not found. These findings underscore the imperativeness of more rigorous studies to be conducted in this area, and caution practitioners against the premature consideration of IL-6 levels in clinical practice.

Stress and Depressive Symptoms Among Demographically Diverse American Pregnant Women

Pregnancy is a sensitive period of life where mental health is of utmost importance to the mother's and child's well-being peripartum and beyond. To better prevent and treat common mental health conditions such as depressive symptoms and perceived stress (defined in this study to encompass psychological and physiological (heart rate variability (HRV)) dimensions), it is crucial to examine and report differences in mental health outcomes among demographically diverse pregnant women. Therefore, the purpose of this secondary analysis (N = 79) was to determine if there are differences in mental health outcomes between pregnant women who differ across demographic factors, as well as to determine if demographic factors predict mental health outcomes when controlling for other demographic variables. Findings indicate that there were significant differences in depressive symptoms and perceived stress by all demographic factors except age. Marital status and total household income were the only significant predictors of depressive symptoms and perceived stress, respectively, when all other factors were controlled. There were no significant differences or correlations between demographic variables and HRV. Pregnant women may be predisposed to adverse mental health outcomes, illustrating the need for more refined interventions that are sensitive to pre-existing factors.

Subjective social status and stress responsivity in late adolescence

Subjective social status (SSS) reflects one's perception of one's standing within society. SSS has been linked with health outcomes, over and above socioeconomic status, and is thought to influence health in part by shaping stress responsivity. To test this, the present study examined the links between SSS and psychological, hypothalamic-pituitary-adrenal (HPA) axis, and cardiovascular responsivity in a sample of 87 ethnically diverse late adolescents (Mage = 18.39 years). Participants rated their family's SSS while either in high school (n = 50) or 1 year afterward (n = 37). Participants completed the Trier Social Stress Task (TSST) and reported their fear during baseline and after task completion, provided six saliva samples throughout the task, and had their heart rate monitored continuously throughout the task. Multilevel models, with time points nested within participants, were conducted to assess reactivity and recovery for each outcome. Results indicated that lower SSS was associated with greater fear reactivity and faster rates of HPA axis reactivity and recovery to baseline. Regarding cardiovascular responses, no differences were observed with respect to heart rate. Lower SSS predicted increased respiratory sinus arrhythmia during the stress task only among participants who rated their SSS while in high school; no association was observed for those who rated SSS after high school. Results suggest that perceptions of one's family's standing in society can shape responses to stress and potentially broader health.HighlightsSubjective social status (SSS) was linked with differences in stress responsivity. Specifically, lower SSS was associated with greater increases in fear following an acute stressor and faster rates of cortisol reactivity and recovery. Adolescents with lower SSS in high school showed less cardiovascular reactivity and recovery with respect to respiratory sinus arrhythmia, a marker of parasympathetic nervous system activity.

The Autonomic Nervous System and Hypertension: Ethnic Differences and Psychosocial Factors

PURPOSE OF THE REVIEW

In the present paper, we overview emerging research examining the autonomic nervous system (ANS), especially the parasympathetic nervous system as indexed by heart rate variability (HRV), and the impact of psychosocial factors on hypertension-related disease in African Americans.

RECENT FINDINGS

A growing corpus of studies has shown that (1) usual patterns of compensatory sympathetic-parasympathetic regulation differ between African Americans and European Americans; (2) despite their enhanced cardiovascular disease risk profile, African Americans tend to exhibit higher HRV relative to European Americans; and (3) racial discrimination and other forms of psychosocial stress are associated with diminished HRV among African Americans. Significant disparities in hypertension-related disease exist such that African Americans have greater risk. The underlying factors associated with this increased risk are, to date, not fully understood. The present review provides evidence for a unique pattern of ANS regulation in African Americans and shows that psychosocial factors such as racial discrimination may contribute to this paradoxical situation.

Active coping moderates associations among race-related stress, rumination, and depressive symptoms in emerging adult African American women

Cross-sectional and longitudinal research has shown that race-related stress is associated with increased depressive symptoms among racial/ethnic minorities. Rumination has long been considered a maladaptive self-regulatory response to race-related stress, and growing evidence suggests that it may be an important link in the relation between race-related stress and depression. More adaptive forms of self-regulation, such as active coping, may counteract the negative impact of rumination. We examined the influence of rumination on the relation between race-related stress and depressive symptoms in a sample (N = 69) of young adult (mean age = 20 ± 1.5 years) African American women. We also considered the possible moderating effects of John Henryism, a form of persistent and determined goal striving, and vagally mediated heart rate variability, a purported biomarker of coping. Anticipatory race-related stress was indirectly associated with depressive symptoms through rumination: estimate = 0.07, 95% confidence interval [0.01, 0.16]. Both John Henryism and vagally mediated heart rate variability moderated the relationship between race-related stress and rumination; however, only John Henryism reliably influenced the indirect association between race-related stress and depression through rumination. We discuss these findings in the context of growing research examining the interplay between cultural and biological factors in the risk for poorer mental health.

Reducing Psychological Stress in Peripartum Women With Heart Rate Variability Biofeedback: A Systematic Review

Peripartum women are exposed to a variety of stressors that have adverse health consequences for the maternal-child dyad (e.g., impaired bonding). To combat these adverse health consequences, heart rate variability biofeedback (HRVBF) may be implemented by holistic nurses to aid peripartum women experiencing a high level of stress. A systematic review was completed using the guidelines established in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. To be included in the review, studies had to meet the following criteria: (a) published scientific articles, (b) studies published in English, (c) experimental, quasi-experimental, or case reports, (d) use of HRVBF as the main treatment, (e) use of psychological stress as a dependent variable, and (f) studies published until December 2017. The major findings of this review can be described as follows: (a) HRVBF and psychological stress in peripartum women are related concepts, (b) peripartum women who completed HRVBF report a reduction in stress compared with participants who did not receive HRVBF, and (c) there is currently no information on the effectiveness of HRVBF on psychological stress in the first and early second trimester of pregnancy. Overall, this systematic review of the literature provides objective evidence that HRVBF may be a potential beneficial adjuvant treatment for stress management in peripartum women.

The association of birth weight and infant growth with childhood autonomic nervous system activity and its mediating effects on energy-balance-related behaviours-the ABCD study

BACKGROUND

The purpose of this study was to examine the association of birth weight and infant growth with childhood autonomic nervous system (ANS) activity and to assess whether ANS activity mediates the associations of birth weight and infant growth with energy-balance-related behaviours, including energy intake, satiety response, physical activity and screen time.

METHODS

In 2089 children, we prospectively collected birth weight, infant growth defined as conditional weight and height gain between birth and 12 months and-at 5 years-indices of cardiac ANS activity and parent-reported energy-balance-related behaviours. A mediation analysis was conducted, based on MacKinnon's multivariate extension of the product-of-coefficients strategy.

RESULTS

Birth weight and infant height gain were inversely associated with sympathetic, but not parasympathetic, activity at age 5. Infant weight gain was not associated with childhood ANS activity. Infant weight gain was predictive of increased childhood screen time and infant height gain of diminished childhood energy intake, but sympathetic activity did not mediate these associations.

CONCLUSIONS

Low-birth-weight children have higher sympathetic activity, which is considered a risk factor for cardiovascular disease. Height gain in infancy seems to be beneficial for childhood sympathetic activity. However, sympathetic activity was no mediator of the associations of infant growth with childhood energy-balance-related behaviours. As individual differences in ANS activity predict increased risk of cardiovascular disease, these differences may offer insight into the early-life origins of chronic diseases and provide further basis for public health strategies to optimize birth weight and infant growth.

Racial Disparities in Blood Pressure Trajectories of Preterm Children: The Role of Family and Neighborhood Socioeconomic Status

Racial disparities in cardiovascular disease mortality in the United States remain substantial. However, the childhood roots of these disparities are not well understood. In the current study, we examined racial differences in blood pressure trajectories across early childhood in a sample of African-American and European-American low-birth-weight preterm infants. Family and neighborhood socioeconomic status (SES), measured at baseline, were also examined as explanations for subsequent group disparities. Analyses focused on 407 African-American and 264 European-American children who participated in the Infant Health and Development Program, a US longitudinal study of preterm children born in 1985. Blood pressure was assessed on 6 occasions between the ages of 24 and 78 months, in 1987-1992. Across this age range, the average rate of change in both systolic and diastolic blood pressure was greater among African-American children than among European-American children. Neighborhood SES explained 29% and 24% of the racial difference in the average rate of change in systolic and diastolic blood pressure, respectively, whereas family SES did not account for group differences. The findings show that racial differences in blood pressure among preterm children emerge in early childhood and that neighborhood SES accounts for a portion of racial disparities.

Linking Daily Stress Processes and Laboratory-Based Heart Rate Variability in a National Sample of Midlife and Older Adults

OBJECTIVE

This study evaluates the associations between people's trait-like patterns of stress in daily life (stressor frequency, perceived stressor severity, affective reactivity to stressors, and negative affect) and laboratory-assessed heart rate variability (HRV).

METHODS

Data were collected from 909 participants aged 35 to 85 years in the Midlife in the United States Study. Participants reported negative affect and minor stressful events during telephone interviews on 8 consecutive evenings. On a separate occasion, HRV was measured from electrocardiograph recordings taken at rest during a laboratory-based psychophysiology protocol. Regression models were used to evaluate the associations between daily stress processes and three log-transformed HRV indices: standard deviation of R-R intervals (SDRR), root mean square of successive differences (RMSSD), and high-frequency power (high-frequency HRV [HF-HRV]). Analyses were adjusted for demographics, body mass index, comorbid conditions, medications, physical activity, and smoking.

RESULTS

Stressor frequency was unrelated to HRV (r values ranging from -0.04 to -0.01, p values >.20). However, people with greater perceived stressor severity had lower resting SDRR (fully adjusted B [standard error {SE}] = -0.05 [0.02]), RMSSD (-0.08 [0.03]), and HF-HRV (-0.16 [0.07]). Individuals with more pronounced affective reactivity to stressors also had lower levels of all three HRV indices (SDRR: B [SE] = -0.28 [0.14]; RMSSD: -0.44 [0.19]; HF-HRV: -0.96 [0.37]). Furthermore, aggregated daily negative affect was linked to reduced RMSSD (B [SE] = -0.16 [0.08]) and HF-HRV (-0.35 [0.15]).

CONCLUSIONS

In a national sample, individual differences in daily negative affect and responses to daily stressors were more strongly related to cardiovascular autonomic regulation than the frequency of such stressors.

Resting respiratory sinus arrhythmia is related to longer hospitalization in mood-disordered repetitive suicide attempters

OBJECTIVES

Our aims were (1) to measure respiratory sinus arrhythmia (RSA), a high-frequency spectrum component of heart rate variability (HRV) in mood-disordered suicide attempters and (2) to investigate the relationship of RSA to symptoms and length of hospitalization.

METHODS

Forty-nine female repetitive-suicide attempters with depressive disorder or bipolar disorder were recruited in a general hospital setting. Manic or psychotic patients were excluded. Resting RSA values were calculated from electrocardiogram data, and severity of clinical presentation shortly after admission and length of hospital stay were assessed.

RESULTS

RSA was positively associated with a higher Beck Scale for Suicidal Ideation score (r = 0.33 P = 0.019). Stepwise multiple regression analysis showed a significant correlation between RSA and hospitalization length after adjusting other variables (beta coefficient = 3.00; P = 0.030). Patients with a higher resting RSA had more prolonged hospitalizations (hospitalization beyond 30 days) after controlling for other variables (odds ratio = 5.08, P = 0.017).

CONCLUSIONS

Interaction between the environment and the autonomic nervous system is complex. Further and more comprehensive research is needed.

Perceived discrimination and markers of cardiovascular risk among low-income African American youth

OBJECTIVES

Our study examines the relationship between perceived discrimination and levels of C-reactive protein and blood pressure in low-income youth ages 10-15 years old.

METHODS

Data were collected from 10 to 15 year old focal children and their mothers. Face-to-face interviews were implemented to collect data on stressors including experiences of everyday discrimination from youth. High sensitivity CRP in dried blood spot samples and diastolic and systolic blood pressure were also collected at the time of the interview.

RESULTS

Perceived discrimination among youth was significantly associated with higher levels of CRP, systolic, and diastolic blood pressure. CRP, systolic, and diastolic blood pressure remained significant after controlling for age-adjusted BMI, waist circumference, and other factors.

CONCLUSIONS

Discrimination is a salient risk factor for inflammation and cardiovascular health. Early life course inflammation and cardiovascular reactivity are important candidate pathways through which the repeated exposure to discrimination for minority group members contributes to racial and economic health inequities in adulthood.

The Association Between Relationship Quality and Physical Health Across Racial and Ethnic Groups

The association between relationship quality and physical health is well established. We examined whether this association was similar across different races and ethnicities. Relationship quality and health were assessed in three national samples from the United States: the National Survey of American Life, the National Latino and Asian American Study, and the National Comorbidity Survey Replication ( N = 9,020). Relationship quality was positively correlated with overall health across races and ethnicities; however, the association between relationship quality and specific health problems was inconsistent. Finally, there were no reliable differences between racial or ethnic groups in the magnitude of the relationship quality and physical health association.

Ethnic differences in resting heart rate variability: a systematic review and meta-analysis

BACKGROUND

Ethnic disparities in cardiovascular morbidity and mortality are widely documented in the literature. Recently, research has shown that decreased parasympathetic cardiac modulation is associated with the established and emerging risk factors for cardiovascular disease (CVD) and stroke. In consideration of the disproportionate CVD risk and disease profile of African Americans (AAs), it is plausible that decreased cardiac parasympathetic functioning may partially explain these disparities. In the present systematic review and meta-analysis, we assess the available evidence for a reliable ethnic difference in tonic vagally mediated heart rate variability (HRV), an indicator of parasympathetic cardiac modulation.

METHODS

A systematic literature search was conducted yielding studies comparing tonic HRV in AAs and European Americans. Adjusted standardized effect sizes (Hedges g) were calculated using a mixed-effects model, with restricted maximum likelihood estimation for 17 studies containing appropriate measures of vagally mediated HRV.

RESULTS

Meta-analysis results suggest that AAs have greater HRV than do European Americans (Hedges g = 0.93, 95% confidence interval = 0.25-1.62), even after consideration of several covariates including health status, medication use, and subgroup stratification by sex and age.

CONCLUSIONS

These findings suggest that decreased vagally mediated HRV is not likely to account for the persistent health disparities experienced by AAs with respect to CVD risk and burden. These disparities underscore the need for continued research addressing socioethnic cardiovascular differences and the biobehavioral mechanisms involved.

Racial disparities in the health benefits of educational attainment: a study of inflammatory trajectories among African American and white adults

OBJECTIVE

The current study examined the prospective effects of educational attainment on proinflammatory physiology among African American and white adults.

METHODS

Participants were 1192 African Americans and 1487 whites who participated in Year 5 (mean [standard deviation] age = 30 [3.5] years), and Year 20 (mean [standard deviation] age = 45 [3.5]) of an ongoing longitudinal study. Initial analyses focused on age-related changes in fibrinogen across racial groups, and parallel analyses for C-reactive protein and interleukin-6 assessed at Year 20. Models then estimated the effects of educational attainment on changes in inflammation for African Americans and whites before and after controlling for four blocks of covariates: a) early life adversity, b) health and health behaviors at baseline, c) employment and financial measures at baseline and follow-up, and d) psychosocial stresses in adulthood.

RESULTS

African Americans had larger increases in fibrinogen over time than whites (B = 24.93, standard error = 3.24, p < .001), and 37% of this difference was explained after including all covariates. Effects of educational attainment were weaker for African Americans than for whites (B = 10.11, standard error = 3.29, p = .002), and only 8% of this difference was explained by covariates. Analyses for C-reactive protein and interleukin-6 yielded consistent results.

CONCLUSIONS

The effects of educational attainment on inflammation levels were stronger for white than for African American participants. Why African Americans do not show the same health benefits with educational attainment is an important question for health disparities research.

A roadmap for the integration of culture into developmental psychopathology

In this paper, I propose a roadmap for the integration of culture in developmental psychopathology. This integration is pressing because culture continues to be somewhat disconnected from theory, research, training, and interventions in developmental psychopathology, thus limiting our understanding of the epigenesis of mental health. I argue that in order to successfully integrate culture into developmental psychopathology, it is crucial to (a) study cultural development, (b) consider both individual-level and social-level cultural processes, (c) examine the interplay between culture and biology, and (d) promote improved and direct cultural assessment. I provide evidence in support of each of these guidelines, present alternative conceptual frameworks, and suggest new lines of research. Hopefully, that these directions will contribute to the emerging field of cultural development and psychopathology, which focuses on the elucidation of the cultural processes that initiate, maintain, or derail trajectories of normal and abnormal behavior.