The emotional impact of baseless discrediting of knowledge: An empirical investigation of epistemic injustice

According to theoretical work on epistemic injustice, baseless discrediting of the knowledge of people with marginalized social identities is a central driver of prejudice and discrimination. Discrediting of knowledge may sometimes be subtle, but it is pernicious, inducing chronic stress and coping strategies such as emotional avoidance. In this research, we sought to deepen the understanding of epistemic injustice's impact by examining emotional responses to being discredited and assessing if marginalized social group membership predicts these responses. We conducted a novel series of three experiments (Total N = 1690) in which participants (1) shared their factual knowledge about how a game worked or their personal feelings about the game; (2) received discrediting feedback (invalidating remarks), validating feedback (affirming remarks), or insulting feedback (general negative social evaluation); and then (3) reported their affect. In all three studies, on average, affective responses to discrediting feedback were less negative than to insulting feedback, and more negative than to validating feedback. Participants who shared their knowledge reported more negative affect after discrediting feedback than participants who shared their feelings. There were consistent individual differences, including a twice-replicated finding of reduced negative affect after receiving discrediting and insulting feedback for Black men compared to White men and women and Black women. Black men's race-based traumatic symptom scores predicted their affective responses to discrediting and insulting feedback, suggesting that experience with discrimination contributed to the emotional processing of a key aspect of epistemic injustice: remarks conveying baseless discrediting of knowledge.

Understanding the relationship between perceived discrimination, allostatic load, and all-cause mortality in US older adults: A mediation analysis

OBJECTIVE

To understand the relationship between perceived discrimination, allostatic load, and all-cause mortality; and to determine whether allostatic load is a mediator in the relationship between perceived discrimination and all-cause mortality among an older adult US population.

METHODS

Data from the Health and Retirement Study (2006-2012) was analyzed. Cox proportional hazard models were used to investigate the relationship between all-cause mortality and perceived discrimination, and all-cause mortality and allostatic load. Linear regression models were used to investigate the relationship between perceived discrimination and allostatic load. A mediation model with perceived discrimination and allostatic loads as independent variables was used to determine the association with all-cause mortality.

RESULTS

There were 5062 adults over the age of 50 included in the analysis. The relationship between perceived discrimination and allostatic load was statistically significant (b:0.14, [95%CI 0.10,0.19]; p < 0.001). The relationship between perceived discrimination and all-cause mortality was statistically significant (HR: 1.12, [95%CI 1.03,1.22]; p = 0.01). The relationship between allostatic load and all-cause mortality was statistically significant (HR: 1.11, [95%CI 1.08,1.13]; p < 0.001). The mediation model resulted in a decrease in hazard ratio and loss of statistical significance for perceived discrimination (HR: 1.09, [95%CI 0.98,1.21]; p = 0.13) when allostatic load (HR: 1.17, [95%CI 1.10,1.24]; p < 0.001) was added to the Cox regression model, indicating full mediation.

CONCLUSIONS

Allostatic load fully mediates the relationship between perceived discrimination and all-cause mortality. Understanding the role of allostatic load in this relationship provides an additional implication for screening and indications for tighter control of the modifiable components of allostatic load by healthcare providers, especially among individuals who experience discrimination.

Working Harder than Others to Prove Yourself: High-Effort Coping as a Buffer between Teacher-Perpetrated Racial Discrimination and Mental Health among Black American Adolescents

High-effort coping (feeling like one must work harder than others to succeed due to anticipated discrimination) is an understudied concept in adolescence. The current study examined among Black American adolescents surveyed in eighth and 11^th grade (N = 630, 49% female) how high-effort coping moderated the relations between teacher-perpetrated racial discrimination and psychological distress across time, and whether the buffering role of high-effort coping varied by adolescent gender and socioeconomic status. Experiencing racial discrimination from teachers in eighth grade was positively related with depressive symptoms, anger, and suicidal ideation in 11^th grade. High-effort coping buffered against teacher discrimination for suicidal ideation among low socioeconomic status youth, as well as for anger among high socioeconomic status youth. Findings underscore the harmful influence of racial discrimination on Black American adolescents' mental health, as well as suggest that among certain subpopulations, high-effort coping may be one psychologically protective resource through which Black American youth retain positive feelings that are undermined by racial discrimination, and thus promote mental well-being.

Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress-coping model among African American women

Racial discrimination has been linked to allostatic load (i.e., cumulative biological stress) among African American women. However, limited attention has been given to psychosocial processes involved in the stress response-critical for understanding biological pathways to health-in studies examining racial discrimination as a social determinant of health. We examined whether the superwoman schema (SWS), a multidimensional culture-specific framework characterizing psychosocial responses to stress among African American women, modifies the association between racial discrimination and allostatic load. We used purposive sampling to recruit a community sample of African American women ages 30-50 from five San Francisco Bay Area counties (n = 208). Path analysis was used to test for interactions while accounting for the covariance among SWS subscales using both linear and quadratic models. Significant interactions were observed between racial discrimination and four of the five SWS subscales. Feeling obligated to present an image of strength and an obligation to suppress emotions were each protective whereas feeling an intense motivation to succeed and feeling an obligation to help others exacerbated the independent health risk associated with experiencing racial discrimination. Our findings affirm the need to consider individual variability in coping and potentially other psychosocial processes involved in the stress response process, and offer several insights that may help elucidate the mechanisms by which racial discrimination gets "under the skin."

Racial discrimination, John Henryism coping, and behavioral health conditions among predominantly poor, urban African Americans: Implications for community-level opioid problems and mental health services

The current study examined the relationship between John Henryism Active Coping (JHAC), experiences of racial discrimination, and behavioral health outcomes in a community sample of 319 Black adults. Assessments included primary health care screenings as well as self-reported survey questions to assess JHAC, experiences of discrimination, and self-reported behavioral health. Logistic regression models, adjusted for control variables, found a significant relationship between JHAC and having an opioid problem (odds ratio [OR] = 0.95, p = 0.003) and needing mental health services (OR = 0.95, p < 0.001), such that higher levels of coping were associated with lower odds of reporting an opioid problem and needing mental health services. Notably, racial discrimination was not significantly independently associated with behavioral health. Implications for interventions and community programming are discussed.

High-Effort Coping and Cardiovascular Disease among Women: A Systematic Review of the John Henryism Hypothesis

African-American women living in the United States experience higher cardiovascular disease risk (CVD) mortality compared to White women. Unique mechanisms, including prolonged high-effort coping in the face of discriminatory stressors might contribute to these racial disparities. The John Henryism hypothesis is a conceptual framework used to explain poor health outcomes observed among individuals with low resources who repeatedly utilize active coping to overcome barriers. The aims of our study were to summarize the literature related to John Henryism and CVD-related factors with a particular focus on women and to identify gaps for areas of future inquiry. We searched MEDLINE, EMBASE, Scopus, and CINAHL to identify literature that used the John Henryism Active Coping scale. Reviewers independently reviewed eligible full-text study articles and conducted data extraction. We qualitatively summarized the literature related to John Henryism and cardiovascular disease (CVD)-related health behaviors (e.g., smoking or physical activity) and risk factors (e.g., hypertension) with a focus on study populations inclusive of women. Our review included 21 studies that used the John Henryism Active Coping scale, of which 10 explicitly reported on the interaction between John Henryism and socioeconomic status (SES) and CVD-related factors. With respect to the original hypothesis, three studies reported results in line with the hypothesis, four were null, and three reported findings in opposition to the hypothesis. The remaining studies included in the review examined the main effects of John Henryism, with similarly mixed results. The literature related to the interaction between John Henryism and SES on CVD-related factors among women is mixed. Additional studies of John Henryism that incorporate biological measures, varied indicators of resources, and larger study populations may illuminate the relationship between coping and deleterious health outcomes among women.

Linking Racial-Ethnic Socialization to Culture and Race-Specific Coping Among African American College Students

In addition to the use of coping strategies generally shared by all Americans, research has shown that African Americans tend to make use of culture and race-specific coping styles that distinguish them from other racial/ethnic group populations. These coping styles are important for the negotiation of multiple types of stressors. Little has been written on the antecedents of culture and race-specific coping (i.e., Africultural coping and John Henryism). This exploratory online investigation sought to determine if childhood racial-ethnic socialization (i.e., a cultural practice and protective factor) experiences predicted present self-reported culture and race-specific coping among a group of African American college students ( N = 191). Results indicated that past racial socialization messages encouraging participants to engage in positive cross-racial interactions (i.e., cross-racial relationship messages) were positively predictive of spiritual-centered and collective coping. Racial socialization messages that prescribed how participants should cope with racism were negatively associated with prolonged, active high-effort coping (i.e., John Henryism). Ethnic socialization messages emphasizing participation in African American cultural activities (i.e., African American heritage messages) positively predicted spiritual-centered, collective, and ritual-centered coping. Finally, ethnic socialization messages encouraging participants to have respect for authority figures, retain close relationships with family members, and maintain a collectivistic orientation (i.e., African American cultural values messages) were negatively predictive of John Henryism. Taken together, childhood racial-ethnic socialization experiences are an important resource for coping during college.

John Henryism Active Coping as a Cultural Correlate of Substance Abuse Treatment Participation Among African American Women

The rates of illicit drug use among African American women are increasing, yet African American women are least likely to participate in treatment for substance use disorders when compared to women of other racial groups. The current study examined family history of substance use, perceived family support, and John Henryism Active Coping (JHAC) as correlates to seeking treatment for substance abuse. The underlying theoretical frame of JHAC (James et al., 1983) suggests that despite limited resources and psychosocial stressors, African Americans believe that hard work and self-determination are necessary to cope with adversities. The current study is a secondary data analyses of 206 drug-using African American women (N=104 urban community women with no criminal justice involvement and N=102 women living in the community on supervised probation) from urban cities in a southern state. It was expected that African American women with a family history of substance abuse, higher levels of perceived family support, and more active coping skills would be more likely to have participated in substance abuse treatment. Step-wise logistic regression results reveal that women on probation, had children, and had a family history of substance abuse were significantly more likely to report participating in substance abuse treatment. Perceived family support and active coping were significant negative correlates of participating in treatment. Implication of results suggests coping with psychosocial stressors using a self-determined and persistent coping strategy may be problematic for drug-using women with limited resources.

A qualitative study assessing cardiovascular risk factors: the accumulative stressors influencing societal integration of teenage African immigrants

Background

This study examines the nature of disparities in cardiovascular risk by exploring chronic stressors and other cardiovascular risk factors on youth of African descent who are integrating into an industrialized society.

Methods

Qualitative data on cardiovascular risk and acclimation to the dominant society were collected from three groups of key informants: (1) community leaders; (2) youth; and (3) a community advisory group.

Results

Youth of Ethiopian descent engaged in the same western diets, computerized social networking, and habits in smoking and alcohol use as did youth from the dominant society. However, informants of Ethiopian descent encountered and witnessed racism, institutional discrimination and evidence of devaluing Ethiopian culture, influencing youths’ ability to integrate into the society.

Conclusion

Immigrant youth of Ethiopian descent face an accumulation of conflicting social support, psychosocial factors, and stressors, including: living in low-income, high-crime areas; encountering pervasive discrimination; acclimating to a new and industrialized culture; and navigating within an often unhospitable society. Contributing to these factors are changes in health behaviors such as adding processed foods and sugary drinks to the diet, increasing heavy alcohol use and substituting screen use for physical activity. The accumulative impact of these factors contributes to the marginalization of youth of Ethiopian descent in the dominant society and perpetuates a cycle of increasing cardiovascular risk.

Perceived social support, coping styles, and Chinese immigrants' cardiovascular responses to stress

BACKGROUND

Social support and coping strategies are important determinants of health, especially for those in the immigrant community adjusting to a new environment.

PURPOSE

This study assessed the buffering effects of perceived social support and different coping styles on cardiovascular reactivity to stress among Chinese immigrants in the New York City Chinatown area.

METHOD

Participants (N = 50, 76% women, and 22-84 years old) completed questionnaires assessing their perceived social support and coping strategy preferences. They were then asked to recall a stress-provoking event related to their immigration experience in a semi-structured interview format.

RESULTS

Hierarchical multiple regression analyses confirmed the interaction effect between perceived social support and problem-focused, emotion-focused, or reappraisal coping on heart rate reactivity. Additionally, Chinese immigrants who upheld more Chinese values were highly correlated with stronger perceived availability of social support and were more likely to incorporate the use of problem-focused and reappraisal coping styles.

CONCLUSION

Findings suggest that high level of social support and the use of reappraisal coping strategies were associated with attenuated cardiovascular responses to stress.

Stress and coping in African American Women with chronic heart disease: a cultural cognitive coping model

This article examines the role of stress in relation to heart disease self-care among African American women. Women described a unique stress-coping model: Stress was a cause and contributor to "bad heart" and associated with "not worrying." Family history of heart disease was used as an experiential reference scale to evaluate the severity of women's heart health. Stress attributions were associated with coping practices to manage the effect of illness through emotion-focused coping and with the physiological worsening of their condition. This model highlights opportunities to reframe stress-coping activities into culturally based heart-healthy practices for African American women.

Personal mastery predicts pain, stress, fatigue, and blood pressure in adults with rheumatoid arthritis

Among individuals with rheumatoid arthritis (RA), stress-associated disease flare can severely impact well-being. Psychological factors such as personal mastery may buffer an individual from the negative effects of those flares. We tested the hypothesis that a high sense of personal mastery would prospectively predict stress reactivity. Measures of pain,perceived stress, fatigue, and mean arterial pressure (MAP) were collected before, during, and after two interpersonal stressors conducted on 73 individuals with RA. Factor analysis of the personal mastery scale yielded two independent factors: a 5-item "fatalism" component and a 2-item "control" component. Individuals with high fatalism scores reported overall greater joint pain at baseline and those scoring high on control exhibited lower MAP, and reported less stress and fatigue at baseline. After controlling for baseline differences, those high in control exhibited greater MAP increase during stress, and less drop in pain when compared to those low in control. These results suggest that individuals high in control may be more susceptible to the effects of acute stress; however, the overall beneficial aspects of high control outweigh the acute negative effects. Personal mastery may play a role in the experience of pain, stress, and fatigue for people with RA.

Perceived racism and vascular reactivity in black college women: moderating effects of seeking social support

This quasi-experimental study explored the association of perceived racism and seeking social support to vascular reactivity in a college sample of 110 Black women. Perceived racism and seeking social support were assessed via self-report, and vascular reactivity was measured before and during a standardized speaking task. Hierarchical regression analyses indicated that perceived racism was positively related to changes in systolic blood pressure. These analyses also indicated that seeking social support moderated the relationship between perceived racism and systolic blood pressure changes. This interaction effect persisted after controlling for several potential confounders. Follow-up regression analyses showed that perceived racism was positively associated with reactivity among participants who were low in seeking social support. A significant relationship was not observed between perceived racism and systolic blood pressure changes among participants who were high in seeking social support. Perceived racism and seeking social support were not significantly associated with changes in diastolic blood pressure. These findings highlight the importance of examining psychosocial factors that may mitigate the hypothesized relationship between perceived racism and reactivity.

Self-reported racism and social support predict blood pressure reactivity in Blacks

This study explored the effects of perceived racism and social support (quantity and quality) on blood pressure reactivity. In a college sample of 64 Blacks (M age = 22.69 years, SD =6.60), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed before and during a standardized serial subtraction task. Perceptions of racism and the quantity and quality of social support were measured by self-report. Separate multiple regression analyses revealed that perceived racism and social support (neither quantity nor quality) were not independent predictors of SBP or DBP changes (ps >.05). These analyses did indicate that perceived racism interacted with the quantity of social support (p <.002, partial R2 =.175) and with the quality of social support (p <.0007, partial R2 =.195) to predict DBP changes. Perceived racism also interacted with the quantity of social support to predict changes in SBP (p <.02, partial R2 =.11). In general, whereas high social support was related to less marked blood pressure changes under conditions of low perceived racism, high social support was associated with exaggerated blood pressure changes under conditions of high perceived racism. These significant interaction effects persisted after statistically controlling for potential confounders. The findings highlight the importance of examining the joint contribution of real-world experiences and coping resources to blood pressure reactivity in Blacks.

Parental history of hypertension and coping responses predict blood pressure changes in black college volunteers undergoing a speaking task about perceptions of racism

OBJECTIVE

This investigation explored the relationship of coping responses and parental history of hypertension to task-induced blood pressure changes.

MATERIALS AND METHODS

The sample consisted of 215 black college student volunteers (median age = 25.95 y). During the speaking task, participants responded to standardized questions about perceptions of intra-ethnic and inter-ethnic group racism. Systolic blood pressure and diastolic blood pressure were measured via an automated blood pressure monitor. Usual ways of coping with intra-ethnic group racism were assessed with the COPE Scale, and parental history of hypertension (PHH) was self-reported by participants.

RESULTS

Findings from the final step of hierarchical general linear models indicated that the main effect of emotion-focused coping was negatively associated with diastolic blood pressure (p = 0.02) and systolic blood pressure (p = 0.002) changes. Further, these analyses revealed that PHH interacted: (1) with the coping responses of planning (p = 0.007) and denial (p = 0.002) to predict changes in systolic blood pressure and (2) with the planning coping response to predict diastolic blood pressure changes (p = 0.02). The direction of these effects indicated that among participants who were high in these coping responses, participants who also had a positive PHH had larger blood pressure changes. Regression analyses also revealed that PHH interacted with the cognitive coping response (p = 0.01) to predict changes in systolic blood pressure. The direction of this effect indicated that among participants who were low in this coping response, participants who also had a positive PHH had larger systolic blood pressure changes.

CONCLUSION

This study highlights the importance of examining the joint contribution of biological and psychosocial parameters to blood pressure reactivity in blacks.