Stigma Toward Consensual Non-Monogamy: Thematic Analysis and Minority Stress

Consensually non-monogamous (CNM) romantic and sexual relationships tend to be stigmatized. The present research examined this stigma across two studies. First, we qualitatively explored the specific ways that people in CNM relationships report experiencing stigma using thematic analysis and identified the following four themes: Expressions of discomfort/disapproval of CNM, Loss of resources/threatening behaviors, Character devaluation, and Relationship devaluation (Study 1; N = 372). Second, we examined the relationship between experienced stigma and psychological well-being for people in CNM relationships, using the framework of minority stress theory. We found that experienced stigma was positively associated with psychological distress and that this association was partially statistically mediated by anticipated stigma and internalized stigma (Study 2; N = 383). Overall, this research strives to achieve a better understanding of the processes and potential consequences of stigma toward CNM relationships and individuals.

Associations between multiple indicators of discrimination and allostatic load among middle-aged adults

The objective of this paper is to examine associations between multiple measures of discrimination (i.e., everyday, lifetime, and appraised burden) and components of allostatic load (AL). We drew on pooled cross-sectional data from the Biomarker Project of the Midlife in the United States study (n = 2118). Ages ranged from 25 to 84 years and included mostly Black (n = 389) and white (n = 1598) adults. Quasi-Poisson models were fit to estimate prevalence ratios for each discrimination measure and high-risk quartiles across seven physiological systems (i.e., sympathetic and parasympathetic nervous system; HPA axis; inflammation; cardiovascular; metabolic glucose; and metabolic lipids) and overall AL scores. In fully adjusted models, everyday discrimination was associated with elevated lipids (aPR: 1.07; 95% CI 1.01, 1.13). Lifetime experiences of discrimination were associated with lower sympathetic nervous system (aPR: 0.82; 95% CI: 0.69, 0.98) and greater cardiovascular risk scores (aPR: 1.17; 95% CI: 1.02, 1.34) among those reporting three or more experiences, as well as increased inflammation (aPR: 1.13; 95% CI: 1.02, 1.25; aPR: 1.28; 95% CI: 1.14, 1.43), metabolic glucose (aPR: 1.35; 95% CI: 1.19, 1.54; aPR: 1.45; 95% CI: 1.24, 1.68), and metabolic lipids (aPR: 1.13; 95% CI: 1.03, 1.24; aPR: 1.28; 95% CI: 1.15, 1.43) scores for those reporting one to two and three or more experiences. Appraised burden yielded nuanced associations with metabolic glucose and parasympathetic nervous system scores. Everyday and lifetime measures were also associated with higher overall AL, though burden of discrimination was only associated with AL among those reporting "a little" burden. While AL summary scores provide insight into the cumulative impacts of discrimination on health, there appear to be distinct physiologic pathways through which varying forms of discrimination contribute to AL and, ultimately, to poorer health. These unique pathways may be useful in identifying potential points of intervention to mitigate the impacts of discrimination on health inequities.

Examining the Reciprocity Between Perceived Discrimination and Health: A Longitudinal Perspective

This study aims to fill two interrelated knowledge gaps in the extant literature on the association between perceived discrimination and health. First, potential selection bias associated with pre-existing health conditions has rarely been rigorously tested in empirical studies. Second, whether there is a reciprocal relationship between perceived discrimination and health has been underexplored. Using longitudinal data from the Americans' Changing Lives data, waves 3 to 5 (N=1,058), we test the reciprocity between perceived discrimination and health with a formal mediation analysis technique. We also use the Heckman correction to adjust for the potential selection bias associated with attrition. Our analysis indicates that perceived discrimination is associated with poor self-rated health and depressive symptoms even when previous health conditions are considered. Furthermore, net of other confounders, there is a reciprocal relationship between perceived discrimination and depressive symptoms. However, this reciprocity does not hold for self-rated health. These findings indicate that there is a vicious circle between perceived discrimination and mental health. That is, poor mental health may lead to perceived discrimination, and heightened perceived discrimination may subsequently increase depressive symptoms. Sensitivity tests suggest that this reciprocity may vary by gender and race.

Anticipated and Experienced Ethnic/Racial Discrimination and Sleep: A Longitudinal Study

The transition to college is a stressful experience. For members of underrepresented minority groups, the usual stresses are frequently accompanied by ethnicity-based stressors, including discrimination. This longitudinal study extends prior work on discrimination by examining the prospective associations between anticipated and experienced ethnic/racial discrimination and sleep, a ubiquitous and basic biological need critical for optimal functioning. In a sample of 274 low-income/first-generation Latinx students, results from a cross-lagged panel model revealed that both the anticipation and experience of discrimination at the beginning of college uniquely predicted worsening sleep quality over the second half of freshmen year, controlling for relevant covariates. There was also some evidence for bidirectionality, with poor sleepers experiencing more discrimination. These findings add to the literature linking discrimination and sleep, both of which play large roles in mental, physical, social, and academic outcomes.

Weight discrimination, anticipated weight stigma, and disordered eating

Weight discrimination is a well-established risk factor for disordered eating cognitions and behaviors. However, little is known about what may account for this association. Recent research suggests that anticipated weight stigma may explain the relationship between weight discrimination and non-eating disorder related health outcomes; the present study seeks to replicate this premise and extend it to the disordered eating realm. In a non-clinical sample of adults in the United States (N = 297) we test the hypothesis that weight discrimination has an indirect association with eating disorder symptomatology through anticipated stigma. At a single timepoint, participants recruited from the online data collection platform SocialSci completed self-report, online surveys of weight discrimination in day-to-day life, anticipated weight stigma, eating disorder symptoms, and demographic information. As hypothesized, weight discrimination was indirectly associated with greater disordered eating symptoms via its association with anticipated weight stigma. This pattern of results held when controlling for gender, body mass index, and self-perceived weight status. These findings suggest that anticipated stigma is relevant in the association between weight discrimination and greater disordered eating. This premise deserves additional attention using methodological approaches that can facilitate stronger causal claims. We discuss the potential for this line of research to inform clinical interventions.

Identifying Moderators in the Link Between Workplace Discrimination and Health/Well-Being

The stress that arises from workplace discrimination can have a large impact on an employee's work attitude, their work and life satisfaction, and oftentimes whether or not they stay in a job. Workplace discrimination can also have a considerable influence on employees' short- and long-term health. However, less is known about the factors that might mitigate or exacerbate the effects of discrimination on health. The current study focused not only on the links between workplace discrimination and health, and but also on the effects of potential moderators of the discrimination-health link (i.e., perceived control, Big Five personality traits, optimism, and coworker/supervisor support). People with high neuroticism, high extraversion and high agreeableness were more negatively affected by workplace discrimination than those low on neuroticism, extraversion, and agreeableness. Perceived control was found to be a protective factor, such that those high in perceived control had fewer chronic illnesses in the context of high levels of workplace discrimination.

Longitudinal associations between self-reported experiences of discrimination and depressive symptoms in young women and men post- myocardial infarction

Objectives

Research suggests that following a myocardial infarction (MI), women under the age of 60 have more elevated depressive symptoms and adverse outcomes than similarly aged men. Identifying risk factors that contribute to gender differences in depressive symptoms among this group may be critical to the development of psychosocial interventions. Experiences of discrimination may be an important correlate of depressive symptoms in this group; however, studies of this relationship have largely been cross-sectional and focused on healthy populations. This study examines longitudinal associations among gender, discrimination, and depressive symptoms in a young post-MI cohort.

Methods

Participants were 313 adults from the Myocardial Infarction and Mental Stress Ischemia Study 2 of young (≤60 yrs) post-MI patients. At baseline and 6 month follow-up, depressive symptoms were measured with the Beck Depression Inventory-II and discrimination was assessed with the 10-item version Everyday Discrimination scale. Linear regression models were used to assess the longitudinal association between reports of discrimination and depressive symptoms adjusted for sociodemographic characteristics, psychosocial factors and health status indicators and tested for gender differences.

Results

The mean age was 51.2, 49.6% were women, and 69.5% were African-American. Although the discrimination-by-gender interaction was marginally significant (p=.09) in the fully adjusted model, findings suggest that the association between changes in reports of discrimination and depressive symptoms over time may be more pronounced for women (β=.61, standard error=.15, p<.001) than men (β=.27, standard error=.13, p=.033).

Conclusion

Our findings suggest that discrimination is a risk factor for depressive symptoms in young post-MI populations over time.

Social integration, perceived discrimination, and self-esteem in mid- and later life: intersections with age and neuroticism

OBJECTIVES

Social relations can influence well-being throughout the life course. Integration in one's community may serve as a source of social support whereas negative interactions such as day-to-day discrimination can be psychosocial stressors, particularly for neurotic persons. Yet social connectedness may vary in importance across the age range. Individuals trim their social networks in later life to optimize emotional well-being, but older adults may also be at heightened risk of social isolation. This study examines the impacts of social integration and perceived discrimination on self-esteem, and whether such impacts differ according to individuals' age and/or neuroticism.

METHOD

Random effects models analyzed 2,982 observations from 1,882 individuals who participated in at least one of the two most recent waves of the National Survey of Midlife Development in the United States (2004-2014).

RESULTS

Self-esteem displayed a minor cubic trajectory across the age range, including declines after age 70. Social integration, perceived discrimination, and neuroticism were all significantly associated with self-esteem, in the expected directions. Self-esteem trajectories varied according to the level of social integration, such that low social integration exacerbated later life declines in self-esteem. The influence of social integration on self-esteem was also stronger at higher levels of neuroticism. Perceived discrimination's influence on self-esteem did not vary by participants' age or neuroticism.

DISCUSSION

Social ties are influential for well-being across the life course, but may take on added importance in later life. Oldest-old and neurotic adults are at particular risk of experiencing low self-esteem if they lack integration with their community.

Coding the Everyday Discrimination Scale: implications for exposure assessment and associations with hypertension and depression among a cross section of mid-life African American women

BACKGROUND

Studies suggest that racial discrimination impacts health via biological dysregulation due to continual adaptation to chronic psychosocial stress. Therefore, quantifying chronicity is critical for operationalising the relevant aetiological exposure and hence maximising internal validity. Using one of the most common discrimination scales in the epidemiological literature, we develop a novel approach for more accurately assessing chronicity and compare it with conventional approaches to determine whether coding influences differential exposure classification and associations with hypertension and depression among African American women.

METHODS

Data are from a socioeconomically diverse cross section of 208 mid-life African American women in Northern California (data collection: 2012-2013). Racial discrimination was assessed using the Everyday Discrimination Scale (α=0.95), and was coded using two conventional approaches: (1) situation-based coding: number of different situations ever experienced; (2) frequency-based coding: sum of Likert scale responses ranging from 'never' to 'almost everyday'; and (3) a new chronicity-based coding approach: sum of responses, weighted to capture annual chronicity (eg, 'a few times a month'=3×12=36×/year). Outcomes are hypertension and depressive symptomatology (10-item Center for Epidemiologic Studies-Depression Scale).

FINDINGS

Exposure classification differed by coding approach, by up to 41%. There was a positive association between racial discrimination and hypertension prevalence for chronicity coding only (prevalence ratio=1.61, 95% CI 1.03 to 2.49). For depressive symptoms, a dose-response relationship of similar magnitude was observed for all three coding approaches.

CONCLUSION

Scale coding is an important methodological consideration for valid exposure assessment in epidemiological research. Coding can impact exposure classification and associations with important indicators of African American women's mental and physical health.

Does getting stigma under the skin make it thinner? Emotion regulation as a stress-contingent mediator of stigma and mental health

Emotion regulation deficits may link stigma to poor mental health, yet existing studies rely on self-reported stigma and do not consider contextual factors. In the present research, we examined associations among cultural stigma (i.e., objective devaluation of others' status), emotion regulation deficits, and poor mental health. In Study 1, we created an index of cultural stigma by asking members of the general public and stigma experts to indicate desired social distance towards 93 stigmatized attributes. In Study 2, emotion regulation deficits mediated the association between cultural stigma and adverse mental health outcomes, including depressive symptoms and alcohol use problems, among individuals endorsing diverse stigmatized identities. The indirect effect of cultural stigma, via emotion regulation, on these outcomes was stronger among those reporting more life stress. These findings highlight the adverse impact of cultural stigma on mental health and its role in potentiating stigmatized individuals' susceptibility to general life stress.

Impact of Racial Discrimination and Hostility on Adrenergic Receptor Responsiveness in African American Adults

OBJECTIVE

Racial discrimination is increasingly recognized as a contributor to increased cardiovascular disease (CVD) risk among African Americans. Previous research has shown significant overlap between racial discrimination and hostility, an established predictor of CVD risk including alterations in adrenergic receptor functioning. The present study examined the associations of racial discrimination and hostility with adrenergic receptor responsiveness.

METHODS

In a sample (N = 57) of young to middle-aged African American adults (51% female) with normal and mildly elevated blood pressure, a standardized isoproterenol sensitivity test (CD25) was used to evaluate β-AR responsiveness, whereas the dose of phenylephrine required to increase mean arterial pressure by 25 mm Hg (PD25) was used to assess α1-AR responsiveness. Racial discrimination was measured using the Perceived Racism Scale and hostility was assessed using the Cook-Medley Hostility Scale.

RESULTS

In hierarchical regression models, greater racial discrimination, but not hostility, emerged as a significant predictor of decreased β-adrenergic receptor responsiveness (β = .38, p = .004). However, moderation analysis revealed that the association between racial discrimination and blunted β-adrenergic receptor responsiveness was strongest among those with higher hostility (β = .49, 95% confidence interval = .17-.82, p = .004). In addition, hostility, but not racial discrimination, significantly predicted α1-AR responsiveness.

CONCLUSIONS

These findings suggest racial discrimination was associated with blunted β-adrenergic receptor responsiveness, providing further evidence of the potential contribution of racial discrimination to increased CVD risk among African Americans. The adverse effects of discrimination on cardiovascular health may be enhanced in individuals with higher levels of hostility.

Microaggressions

The microaggression concept has recently galvanized public discussion and spread to numerous college campuses and businesses. I argue that the microaggression research program (MRP) rests on five core premises, namely, that microaggressions (1) are operationalized with sufficient clarity and consensus to afford rigorous scientific investigation; (2) are interpreted negatively by most or all minority group members; (3) reflect implicitly prejudicial and implicitly aggressive motives; (4) can be validly assessed using only respondents’ subjective reports; and (5) exert an adverse impact on recipients’ mental health. A review of the literature reveals negligible support for all five suppositions. More broadly, the MRP has been marked by an absence of connectivity to key domains of psychological science, including psychometrics, social cognition, cognitive-behavioral therapy, behavior genetics, and personality, health, and industrial-organizational psychology. Although the MRP has been fruitful in drawing the field’s attention to subtle forms of prejudice, it is far too underdeveloped on the conceptual and methodological fronts to warrant real-world application. I conclude with 18 suggestions for advancing the scientific status of the MRP, recommend abandonment of the term “microaggression,” and call for a moratorium on microaggression training programs and publicly distributed microaggression lists pending research to address the MRP’s scientific limitations.

A Psychometric Review of Measures Assessing Discrimination Against Sexual Minorities

Discrimination against sexual minorities is widespread and has deleterious consequences on victims' psychological and physical wellbeing. However, a review of the psychometric properties of instruments measuring lesbian, gay, and bisexual (LGB) discrimination has not been conducted. The results of this review, which involved evaluating 162 articles, reveal that most have suboptimal psychometric properties. Specifically, myriad scales possess questionable content validity as (1) items are not created in collaboration with sexual minorities; (2) measures possess a small number of items and, thus, may not sufficiently represent the domain of interest; and (3) scales are "adapted" from measures designed to examine race- and gender-based discrimination. Additional limitations include (1) summed scores are computed, often in the absence of scale score reliability metrics; (2) summed scores operate from the questionable assumption that diverse forms of discrimination are necessarily interrelated; (3) the dimensionality of instruments presumed to consist of subscales is seldom tested; (4) tests of criterion-related validity are routinely omitted; and (5) formal tests of measures' construct validity are seldom provided, necessitating that one infer validity based on the results obtained. The absence of "gold standard" measures, the attendant difficulty in formulating a coherent picture of this body of research, and suggestions for psychometric improvements are noted.

Neuroticism Predicts Acculturative Stress in Mexican American College Students

Neuroticism is a risk factor for mood and anxiety disorders and a strong predictor of subjective stress in non-Hispanics. This study examined neuroticism as a predictor of subjective acculturative stress in 122 Mexican American college students. Neuroticism was measured using the Revised Neuroticism Extroversion Openness Personality Inventory (NEO-PI-R), and acculturative stress was measured using the Hispanic Stress Inventory (HSI). Results of hierarchical regression analyses showed that overall neuroticism and the facets of depression, vulnerability, and anger and/or hostility significantly predicted acculturative stress. The association between neuroticism and greater subjective psychosocial stress can now be extended to acculturative stress for a subgroup of Mexican Americans. Findings support and extend previous work from the authors' laboratory suggesting that neuroticism modulates the relationship between exposure to culturally specific stress and risk for certain mood and anxiety disorders.

Perceived discrimination as a stressor for close relationships: identifying psychological and physiological pathways

Approaching the inverse association between perceived discrimination and close relationship functioning from a stress and coping framework, we propose and test a novel model incorporating psychological (emotion dysregulation) and physiological (chronic inflammation) pathways. Analyses of data from a sample of African American participants (N = 592) enrolled in the Midlife in the United States (MIDUS) study revealed support for the proposed model. Specifically, results from structural equation modeling analyses showed that perceived discrimination was indirectly associated with increased emotion dysregulation (venting and denial) through stressor appraisals and directly associated with increased inflammation (interluekin-6, e-selectin and c-reactive protein). Furthermore, relationship strain with family, friends and spouses was associated with greater levels of emotion dysregulation and chronic inflammation. Overall, the proposed model fit the data well and provides support for new avenues of research on the social, psychological and physiological correlates of perceived discrimination and close relationship functioning. To conclude, evidence for the proposed biopsychosocial model is summarized and directions for future research on these topics are discussed.

Associations between self-reported discrimination and diurnal cortisol rhythms among young adults: The moderating role of racial-ethnic minority status

Discrimination is theorized to set in motion a neuroendocrine response, which includes cortisol secretion from the hypothalamic-pituitary-adrenal axis. Repeated exposure to perceived discrimination is thought to contribute to alterations in diurnal cortisol rhythms and to have implications for health. Discrimination may have particularly strong effects on racial/ethnic minority individuals, based on histories of past exposure and/or greater perceived implications of discriminatory events. Utilizing an ethnically and racially diverse sample of young adults (N=140; Mage=22.8 years) and a multiple-day naturalistic cortisol protocol, the present study examined associations between self-reported discrimination and diurnal cortisol rhythms, and whether this relation was moderated by racial/ethnic minority status. Results revealed that self-reported discrimination predicted flatter diurnal cortisol slopes for racial/ethnic minority individuals only. These findings align with theory suggesting that discrimination experiences are important among racial/ethnic minorities.

Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities

Understanding how stigmatized identities contribute to increased rates of depression and anxiety is critical to stigma reduction and mental health treatment. There has been little research testing multiple aspects of stigmatized identities simultaneously. In the current study, we collected data from a diverse, urban, adult community sample of people with a concealed stigmatized identity (CSI). We targeted 5 specific CSIs--mental illness, substance abuse, experience of domestic violence, experience of sexual assault, and experience of childhood abuse--that have been shown to put people at risk for increased psychological distress. We collected measures of the anticipation of being devalued by others if the identity became known (anticipated stigma), the level of defining oneself by the stigmatized identity (centrality), the frequency of thinking about the identity (salience), the extent of agreement with negative stereotypes about the identity (internalized stigma), and extent to which other people currently know about the identity (outness). Results showed that greater anticipated stigma, greater identity salience, and lower levels of outness each uniquely and significantly predicted variance in increased psychological distress (a composite of depression and anxiety). In examining communalities and differences across the five identities, we found that mean levels of the stigma variables differed across the identities, with people with substance abuse and mental illness reporting greater anticipated and internalized stigma. However, the prediction pattern of the variables for psychological distress was similar across the substance abuse, mental illness, domestic violence, and childhood abuse identities (but not sexual assault). Understanding which components of stigmatized identities predict distress can lead to more effective treatment for people experiencing psychological distress.

CHRNA5 and CHRNA3 variants and level of neuroticism in young adult Mexican American men and women

A lifetime history of alcohol dependence has been associated with elevations in neuroticism in Mexican American young adults. The identification of genetic markers associated with neuroticism and their influence on the development of alcohol use disorders (AUD) may contribute to our understanding of the relationship between personality traits and the increased risk of AUD in Mexican Americans. The purpose of this study was to investigate associations between neuroticism and 13 single nucleotide polymorphisms (SNPs) in the nicotinic acetylcholine (nAChR) α5-subunit (CHRNA5) and α3-subunit (CHRNA3) genes in young adult Mexican American men and women. Participants were 465 young adult Mexican American men and women who are literate in English and are residing legally in San Diego County. Each participant gave a blood sample and completed a structured diagnostic interview. Neuroticism was assessed using the Maudsley Personality Inventory. The minor alleles of four CHRNA5 polymorphisms (rs588765, rs601079, rs680244 and rs555018) and three CHRNA3 polymorphisms (rs578776, rs6495307 and rs3743078) showed associations with neuroticism. Several of these SNPs also displayed nominal associations with DSM-IV alcohol and nicotine dependence, but tests of mediation suggested that these relations could be partially explained by the presence of co-occurring neuroticism. These findings suggest that genetic variations in nicotinic receptor genes may influence the development of neuroticism, which in turn is involved in the development of AUDs and nicotine dependence in Mexican American young adults.

The relationship between perceived discrimination and psychotherapeutic and illicit drug misuse in Chicago, IL, USA

Based on several stress-coping frameworks, recent studies have suggested that perceived experiences of discrimination, a psychosocial stressor, may be associated with various risky health behaviors. The 2001 Chicago Community Adult Health Study (n = 3,101), a face-to-face representative probability sample of adults in Chicago, IL, USA, was used to examine the relationship among lifetime everyday discrimination, major discrimination, and the use of illicit and psychotherapeutic drugs for nonmedical reasons. We used negative binomial logistic and multinomial regression analyses controlling for potential confounders. Approximately 17 % of the respondents reported using one or more illicit drugs and/or misusing one or more psychotherapeutic drug. Adjusting for socio-demographic characteristics, other stressors and various personality-related characteristics, results from negative binomial regression suggest that respondents who experienced moderate to high levels of everyday discrimination misused on average 1.5 different kinds of drugs more than respondents that experienced relatively low levels of everyday discrimination (p < 0.05). Similarly, an increase in one lifetime major discrimination event was associated with an increase of misusing 1.3 different drugs on average regardless of experiences of everyday discrimination (p < 0.001). When examining the types of drugs misused, results from multinomial logistic regression suggest that everyday discrimination was only associated with illicit drug use alone; however, lifetime major discrimination was associated with increased odds of using any illicit and both illicit/psychotherapeutic drugs. Mental health and substance use clinical providers should be aware of these potential relationships and consider addressing the harmful effects of perceived discrimination, in all patients not only among racial/ethnic minority patients.

Interpersonal discrimination and depressive symptomatology: examination of several personality-related characteristics as potential confounders in a racial/ethnic heterogeneous adult sample

BACKGROUND

Research suggests that reports of interpersonal discrimination result in poor mental health. Because personality characteristics may either confound or mediate the link between these reports and mental health, there is a need to disentangle its role in order to better understand the nature of discrimination-mental health association. We examined whether hostility, anger repression and expression, pessimism, optimism, and self-esteem served as confounders in the association between perceived interpersonal discrimination and CESD-based depressive symptoms in a race/ethnic heterogeneous probability-based sample of community-dwelling adults.

METHODS

We employed a series of ordinary least squares regression analyses to examine the potential confounding effect of hostility, anger repression and expression, pessimism, optimism, and self-esteem between interpersonal discrimination and depressive symptoms.

RESULTS

Hostility, anger repression, pessimism and self-esteem were significant as possible confounders of the relationship between interpersonal discrimination and depressive symptoms, together accounting for approximately 38% of the total association (beta: 0.1892, p < 0.001). However, interpersonal discrimination remained a positive predictor of depressive symptoms (beta: 0.1176, p < 0.001).

CONCLUSION

As one of the first empirical attempts to examine the potential confounding role of personality characteristics in the association between reports of interpersonal discrimination and mental health, our results suggest that personality-related characteristics may serve as potential confounders. Nevertheless, our results also suggest that, net of these characteristics, reports of interpersonal discrimination are associated with poor mental health.

Putting stigma in context: Do perceptions of group stigma interact with personally experienced discrimination to predict mental health?

Research has linked experiences of personal discrimination with negative mental health consequences, but less is known about the role of group stigma (perceived stigma against one’s group as a whole). The theoretical literature has offered mixed predictions. The present study examined the independent and interactive effects of group stigma and personal discrimination on depressive symptoms and suicidal ideation in a sample of gay and bisexual men ( N = 986). Experiences of personal discrimination predicted depressive symptoms and suicidal ideation regardless of group stigma. However, group stigma was associated with depressive symptoms contextually—only when level of perceived personal discrimination was low. Personal discrimination may be a relatively more powerful force in the lives of stigmatized group members that overwhelms the influence of group stigma in harming mental health.

Perceived discrimination and DSM-IV-based alcohol and illicit drug use disorders

OBJECTIVES

We examined the relationship between everyday and major discrimination and alcohol and drug use disorders in a nationally representative sample of African Americans and Black Caribbeans.

METHODS

With data from the National Survey of American Life Study, we employed multivariable logistic regression analyses--while controlling for potential confounders--to examine the relationship between everyday and major discrimination and substance use disorders on the basis of Diagnostic and Statistical Manual of Mental Disorders criteria.

RESULTS

Every 1 unit increase in the everyday discrimination scale positively predicted alcohol (odds ratio [OR] = 1.02; P < .01) and drug use (OR = 1.02; P < .05) disorders. Similarly, each additional major discrimination event positively predicted alcohol (OR = 1.10; P < .05) and drug use (OR = 1.15; P < .01) disorders.

CONCLUSIONS

To our knowledge, this study is the first to examine problematic usage patterns rather than infrequent use of alcohol and drugs in a national sample of African American and Black Caribbean adults and the first to examine this particular relationship in a national sample of Black Caribbeans.

Neuroticism, acculturation and the cortisol awakening response in Mexican American adults

Neuroticism is associated with greater susceptibility to the adverse effects of stress and greater exposure to the stressors associated with acculturation in U.S. born Mexican Americans. Neuroticism and acculturation have been associated with injury to crucial stress response systems and are known risk factors for certain mood and anxiety disorders. The purpose of the current study was to examine the effects of neuroticism, and acculturation on the cortisol awakening response (CAR) in healthy Mexican-American adults. Salivary cortisol samples were collected at awakening and 30, 45, and 60 min thereafter, on two consecutive weekdays from 59 healthy Mexican American adult males (26) and females (33), ages 18 to 38 years. Participants were assessed for level of neuroticism and acculturation. Data were analyzed using a mixed effects regression model with repeated measures at four time points. Results showed a significant Neuroticism×Acculturation×Time interaction. The CAR was virtually eliminated in highly acculturated Mexican Americans with greater Anglo orientation and high neuroticism compared with less acculturated Mexican Americans with greater Mexican orientation and lower neuroticism. Findings suggest that some Mexican Americans with high levels of neuroticism may be particularly susceptible to certain challenges and stressors associated with acculturation leading over time to the development of allostatic load, desensitization of the Hypothalamic CRF system and attenuation of the CAR.

The impact of stressors on second generation Indian Residential School survivors

From 1863 to 1996, many Aboriginal children in Canada were forced to attend Indian Residential Schools (IRSs), where many experienced neglect, abuse, and the trauma of separation from their families and culture. The present study examined the intergenerational impact of IRS exposure on depressive symptomatology in a convenience sample of 143 First Nations adults. IRS experiences had adverse intergenerational effects in that First Nations adults who had a parent attend IRS (n = 67) reported greater depressive symptoms compared to individuals whose parents did not attend (n = 76). Parental IRS attendance moderated the relations between stressor experiences (adverse childhood experiences, adult traumas, and perceived discrimination) and depressive symptoms, such that second generation Survivors exhibited greater symptomatology. Adverse childhood experiences partially mediated the relation between parental IRS attendance and both adult trauma and perceived discrimination. Moreover, both of these adulthood stressors partially mediated the relation between adverse childhood experiences and depressive symptoms. Finally, all three stressors demonstrated a unique mediating role in the relation between parental IRS attendance and depressive symptoms. Although alternative directional paths could not be ruled out, offspring of IRS Survivors appeared at increased risk for depression, likely owing to greater sensitivity to and experiences of childhood adversity, adult traumas, and perceived discrimination.

Perceived Discrimination and Social Support

The experiences of lesbian, gay, bisexual, and transgender (LGBT) college students have been an increasing area of interest in the realm of career development in recent years. Although career theorists have posited the importance of considering context when examining career development, the specific variables related to LGBT individuals' experiences warrant further investigation. The aim of this study was to examine how the perception of discrimination and social support related to career development and college adjustment in an LGBT undergraduate student sample. Two multiple regression analyses demonstrated that perceived discrimination and social support contribute to vocational indecision and college adjustment. The implications for career counselors and other professionals working with this student group are discussed.

Acculturation, childhood trauma and the cortisol awakening response in Mexican-American adults

Exposure to chronic and traumatic stress has been associated with the dysregulation of crucial stress response systems. Acculturation has been associated with unique forms of chronic psychosocial stress. The purpose of this study was to examine the effects of exposure to early traumatic stress and acculturation on dysregulation of the cortisol awakening response (CAR) in Mexican-American adults. Salivary cortisol samples were collected at awakening and 30, 45, and 60 min thereafter, on two consecutive weekdays from 59 healthy Mexican-American adult males (26) and females (33), ages 18-38 years. Participants were assessed for level of acculturation and exposure to early trauma. Data were analyzed using a mixed effects regression model with repeated measures at four time points. Mixed effects regression results indicated a significant Early Trauma x Time interaction (p=.0029) and a significant Acculturation x Time interaction (p=.0015), after controlling for age and sex. Subsequent analyses of the interaction of Trauma x Acculturation x Time showed that more than minimal exposure to either risk factor was associated with attenuation of the awakening cortisol response (p=.0002). Higher levels of acculturation with greater Anglo-orientation were associated with attenuation of the CAR in Mexican-American adults. Both moderate and higher levels of exposure to early trauma were associated with an attenuated CAR. However, greater exposure to both risk factors was only incrementally worse than exposure to either one.

Neuroticism, Side Effects, and Health Perceptions Among HIV-Infected Individuals on Antiretroviral Medications

Side effects from antiretroviral therapy (ART) for HIV disease can deter treatment, impact quality of life, and impede medication adherence. Individual differences in neuroticism may account for variations in the experience of side effects and perceptions of health status. Cross-sectional assessments were conducted with 258 HIV-infected participants with confirmed HIV infection and current ART regimen. Structural equation modeling (SEM) was used to evaluate a model of self-reported ART side effect frequency and severity and perceived health status, as related to symptoms of neuroticism. Symptoms of neuroticism were associated with greater reports of ART side effects and poorer perceived health but unrelated to reported CD4 count and viral load. A structural model was supported in which greater symptoms of neuroticism are linked to poorer perceived health through greater side effect frequency and severity. Individual differences in symptoms of neuroticism can explain variations in side effect reporting and consequential impairments in perceived health in the context of HIV treatment. Identification and intervention with individuals high in symptoms of neuroticism may be warranted to alleviate side effect-related concerns and maximize treatment benefit.