1
|
Brown J, Hirsch JA, Tabb LP, Judd SE, Bennett A, Rundle A, Lovasi GS. A Segmented Regression Analysis of Household Income and Recurrent Falls Among Adults in a National Cohort Study. Am J Epidemiol 2024; 193:516-526. [PMID: 37939143 DOI: 10.1093/aje/kwad211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/22/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
Falls can have life-altering consequences for older adults, including extended recovery periods and compromised independence. Higher household income may mitigate the risk of falls by providing financial resources for mobility tools, remediation of environmental hazards, and needed supports, or it may buffer the impact of an initial fall on subsequent risk through improved assistance and care. Household income has not had a consistently observed association with falls in older adults; however, a segmented association may exist such that associations are attenuated above a certain income threshold. In this study, we utilized segmented negative binomial regression analysis to examine the association between household income and recurrent falls among 2,302 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study recruited between 2003 and 2007. Income-fall association segments separated by changes in slope were considered. Model results indicated a 2-segment association between household income and recurrent falls in the past year. In the range below the breakpoint, household income was negatively associated with the rate of recurrent falls across all age groups examined; in a higher income range (from $20,000-$49,999 to ≥$150,000), the association was attenuated (weaker negative trend) or reversed (positive trend). These findings point to potential benefits of ensuring that incomes for lower-income adults exceed the threshold needed to confer a reduced risk of recurrent falls.
Collapse
|
2
|
Torquati J, Lombardi C, Chazan Cohen R, Matthews A, Brophy-Herb H. Mindfulness, coping, and disruptions as predictors of college student distress at the beginning of the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-12. [PMID: 38015160 DOI: 10.1080/07448481.2023.2277184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023]
Abstract
Objective: This research examined how stressors experienced by college students within the first month of the COVID-19 pandemic were associated with their reports of psychological distress, mindfulness, and coping strategies. Participants: Students attending 11 universities in the U.S. (N = 464, M age = 20.72, SD = 3.90, 91% female, 61% White, and 77% non-Hispanic) in early childhood education, child development, and family science classes participated.Methods: Students completed an online survey about pandemic-related disruptions, depressive symptoms, mindfulness, coping, and demographics.Results: Students whose families had more financial difficulties reported more disruptions. Depression and avoidant coping were positively correlated with distress, while mindfulness was inversely correlated with distress and depression. Disruptions, family financial status, depressive symptoms, mindfulness, and avoidant coping significantly predicted distress, controlling for university site and student sex, age, race, and ethnicity in multiple regression analyses. Avoidant coping significantly moderated (amplified) the effect of disruptions on distress. Conclusions: College student well-being can be supported through Campus programming that includes mindfulness practices and alternatives to avoidant strategies for coping with stress.
Collapse
Affiliation(s)
- Julia Torquati
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Nebraska, USA
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Rachel Chazan Cohen
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Ann Matthews
- Department of Social Work, Nebraska Wesleyan University, Lincoln, Nebraska, USA
| | - Holly Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
3
|
Shen W, Hannum E. Context-relevant risk and protective factors for children in rural communities: Long-term implications for adulthood educational and mental health outcomes. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:724-744. [PMID: 36734961 PMCID: PMC9898632 DOI: 10.1002/jcop.22909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 06/01/2022] [Accepted: 06/05/2022] [Indexed: 06/17/2023]
Abstract
Globally, rural children are more likely than others to experience barriers to opportunity. We propose context-relevant family risk and protective factors for children in rural villages in one of China's poorest provinces and analyze long-term implications for educational and mental health outcomes in early adulthood. Four proposed risk factors-low parental education, insufficient income, parental migration, and parental ill-health-show statistically significant detrimental implications for educational attainment. Low parental education stands out, with negative estimated effects on all outcomes. Insufficient income predicts higher scores for depression but not self-esteem. Parental migration and parental ill health have no significant relationships with mental health outcomes. Proposed protective factors- parental warmth, doing things together, and household credit limit-have positive estimated effects on educational attainment, but not on most mental health outcomes. Few interactions between protective and risk factors exist, and patterns are generally similar for girls and boys.
Collapse
Affiliation(s)
- Wensong Shen
- Department of Sociology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Emily Hannum
- Department of Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
4
|
Workplace violence and interpersonal deviance among Pakistani nurses: role of sense of coherence. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04094-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
5
|
Long AS, DeFresse JD, Bickett AK, Price DE. Factorial Validity and Invariance of an Adolescent Depression Symptom Screening Tool. J Athl Train 2021; 57:592-598. [PMID: 34902860 DOI: 10.4085/1062-6050-343-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Depression is among the most common mental health disorder in youth, results in significant impairment, and is associated with a higher risk of suicide. Screening is essential but assessment tools may not be appropriate across races or do not account for the complex interrelatedness of various demographics including gender, socio-economic status and race. OBJECTIVES (1) To determine the factor structure of the Patient Health Questionnaire-Adolescent (PHQ-A) for measuring depression in a group of adolescent athletes; and (2) to determine measurement invariance between Blacks and Whites on the PHQ-A. DESIGN Retrospective cohort design. SETTING Data obtained from a secure database collected at a free, comprehensive, mass pre-participation physical exam (PPE) event hosted by a large health care system. PARTICIPANTS Participants included 683 high school athletes (Black n=416; White n=267). Independent variables included somatic and affective factors contributing to the construct of depression measured by the PHQ-A and participant race (Black and White). MAIN OUTCOME MEASURES (1) Factors upon which the construct of depression is measured and (2) measurement invariance between Blacks and Whites. RESULTS A two-factor model, including affective and somatic components, was specified and exhibited an adequate fit to the data (CFI> .90). All items exhibited moderate to high squared multiple correlation values (R2 = .10-.65), suggesting that these items resonated relatively well with participants. The two-factor model demonstrated noninvariance Black and White participants (RMSEA = .06-.08). CONCLUSIONS Overall, the structure of the PHQ-A is supported by a two-factor model in adolescent athletes, measuring both affective and somatic symptoms of depression. A two factor PHQ-A structure is not fully invariant for the adolescents sampled across participant groups, implying that the model functions differently between Blacks and Whites sampled.
Collapse
Affiliation(s)
- Ashley S Long
- Research Consultant, Atrium Health, Department of Family Medicine Charlotte, NC, USA,
| | - J D DeFresse
- Assistant Professor, University of North Carolina-Chapel Hill, Center for the Study of Retired Athletes Chapel Hill, NC, USA,
| | - Allison K Bickett
- Director of Behavioral Health Education, Atrium Health, Department of Family Medicine Charlotte, NC, USA,
| | - David E Price
- Program Director, Primary Care Sports Medicine Fellowship, Professor of Family Medicine, Atrium Health, Department of Family Medicine Charlotte, NC, USA,
| |
Collapse
|
6
|
Atkins R, Johnson S, Pontes MCF, Stellmacher T, Gadaleta D, Lewis H, Qosja A, Finkelstein D, Williams W. Socio-Demographic and Coping Correlates and Predictors of Depressive Symptoms Among Low-Income and Ethnic Minority Mothers At-Risk. Clin Nurs Res 2021; 31:100-114. [PMID: 34328019 DOI: 10.1177/10547738211029685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study identified coping and sociodemographic correlates and predictors of depressive symptoms in mothers at risk for clinical depression. A descriptive, cross-sectional design was employed. A convenience sample of 88 low-income or ethnic-minority mothers aged 21 to 45 completed a depression scale, demographic data sheet, and responded to an open-ended question. Content analysis, descriptive, and inferential statistics was used for data analysis. Exactly 42.5% of mothers reported high depressive symptoms (>16). Lower income levels (r = .342, p = .01) and head-of-household status (r = .220, p = .04) were significantly associated with higher depressive symptoms. Those who used social support coping had lower depressive symptoms than those who did not (t = 2.50, p = .014). Those using emotion-focused coping only had higher depressive symptoms than those using a mix of coping strategies (t = 2.60, p = .011). Healthcare providers can employ vigilant depression screening and encourage utilization of a mix of problem and emotion-focused coping strategies to reduce depressive symptoms and prevent clinical depression.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Wanda Williams
- Rutgers the State University of New Jersey School of Nursing-Camden, USA
| |
Collapse
|
7
|
Kneebone II, Fife-Schaw C, Lam LT, das Nair R. The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis. F1000Res 2021; 9:1038. [PMID: 33564395 PMCID: PMC7851711 DOI: 10.12688/f1000research.25129.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation. This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS.
Collapse
Affiliation(s)
- Ian I Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Chris Fife-Schaw
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Lawrence T Lam
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.,Vice President (Academic), Tung Wah College, Hong Kong, Homantin, SAR, Hong Kong
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Lenton, Nottingham, Nottinghamshire, NG7 2RD, UK
| |
Collapse
|
8
|
Goodwill JR, Taylor RJ, Watkins DC. Everyday Discrimination, Depressive Symptoms, and Suicide Ideation Among African American Men. Arch Suicide Res 2021; 25:74-93. [PMID: 31597538 DOI: 10.1080/13811118.2019.1660287] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Suicide has remained a leading cause of death among African American males, yet empirical investigations that focus on the experiences of this group are limited. Therefore, we aim to interrogate the impact of everyday discrimination as a risk factor for depressive symptoms and suicide ideation among African American men. Data were drawn from the African American male subsample of the National Survey of American Life (n = 1,271). Path analysis and tests for indirect effects were used to examine relationships between everyday discrimination, depressive symptoms, and suicide ideation. Three sources of everyday discrimination were examined (any everyday discrimination, race-based everyday discrimination, and other everyday discrimination). Study findings revealed that race-based everyday discrimination was the only type of discrimination that was significantly associated with both increased rates of depressive symptoms and suicide ideation. Further, the indirect effect from race-based everyday discrimination to suicide ideation via depressive symptoms was also statistically significant. Thus, the impact of daily encounters with discrimination extends beyond depressive symptoms and is related to higher rates of suicide ideation. Moreover, experiences with discrimination do not have to be overt to be harmful toward African American men's mental health. Culturally relevant suicide prevention interventions are needed to account for the role of discrimination in the lives of African American men.
Collapse
|
9
|
Adams LB, Farrell M, Mall S, Mahlalela N, Berkman L. Dimensionality and differential item endorsement of depressive symptoms among aging Black populations in South Africa: Findings from the HAALSI study. J Affect Disord 2020; 277:850-856. [PMID: 33065826 PMCID: PMC7575820 DOI: 10.1016/j.jad.2020.08.073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/10/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Center for Epidemiologic Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its construct validity has not been adequately assessed in sub-Saharan Africa. This study validates the CES-D among an aging Shangaan-speaking and predominantly Black African sample in rural South Africa, with a special emphasis on gender differences. METHODS An 8-item CES-D scale was administered in Shangaan to 5059 respondents, aged 40+ years, residing in Agincourt, South Africa. We used Cronbach's alpha and exploratory and confirmatory factor analysis to examine and confirm dimensionality of the CES-D scale. Differential endorsement of CES-D items by gender were assessed using the Mantel-Haenszel (MH) odds ratio test. RESULTS Reliability of the CES-D scale differed by gender with women reporting higher internal consistency on items than men. A two-factor solution was retained and confirmed representing two latent factors: (1) Negative Affect (six items) and (2) Diminished Positive Affect (two items). MH results showed that men exhibited significantly higher odds of putting an effort in everything that they did (OR: 1.33, 95% CI: 1.15-1.54) and lower odds of feeling depressed (OR: 0.71, 95% CI: 0.56-0.89) and having restless sleep (OR: 0.67, 95% CI:0.58-0.77) than women. LIMITATIONS Analyses were limited to a dichotomous, short form of the CES-D, a self-reported population-based measure. CONCLUSION Aging Black Africans differ in endorsing affective and somatic items on the CES-D scale by gender, which may lead to skewed population-level estimates of depression in key subpopulations. These findings highlight the importance of continued research disentangling cross-cultural and gendered nuances of depression measurements.
Collapse
Affiliation(s)
- Leslie B. Adams
- Harvard Center for Population and Development Studies,
Harvard University, Cambridge, MA, USA,Department of Mental Health, Johns Hopkins Bloomberg School
of Public Health, Baltimore, MD
| | - Meagan Farrell
- Department of Mental Health, Johns Hopkins Bloomberg School
of Public Health, Baltimore, MD
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of
Public Health, Faculty of Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
| | - Nomsa Mahlalela
- MRC/Wits Rural Public Health and Health Transitions
Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa Berkman
- Harvard Center for Population and Development Studies,
Harvard University, Cambridge, MA, USA
| |
Collapse
|
10
|
Adams LB, Gottfredson N, Lightfoot AF, Corbie-Smith G, Golin C, Powell W. Factor Analysis of the CES-D 12 among a Community Sample of Black Men. Am J Mens Health 2020; 13:1557988319834105. [PMID: 30894043 PMCID: PMC6440056 DOI: 10.1177/1557988319834105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used measures for assessing depression in population-based research. Little is known about the varying range of symptomatology expressed by Black men, who report higher chronicity and disability of their depressive symptoms compared to men of other racial and ethnic backgrounds. This study assessed the dimensional structure of the CES-D 12-item scale using exploratory and confirmatory factor analysis in a community-based sample of Black men (n = 683). Two latent factors emerged from the scale that best fit the data: interpersonal negative affect (INA) and diminished positive affect (DPA). The item “I felt like everything I did was an effort” was removed from the final measure, resulting in an 11-item scale. The total score for the revised CES-D-11 displayed acceptable internal consistency on both latent factors (Cronbach’s α = 0.83 [INA] and 0.73 [DPA]) and model fit (χ2 = 165.58, TLI = 0.967, CFI = 0.974, RMSEA = 0.065). Results differ from CES-D factor analyses in other demographic groups, including studies with other male subpopulations, such that depressed mood and interpersonal problems factors are merged as a unidimensional construct. Findings suggest that the “effort” item from the CES-D 12 should be interpreted with caution among Black men. Future studies should continue to disentangle the divergent pathways in which Black men express depressed mood.
Collapse
Affiliation(s)
- Leslie B Adams
- 1 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,2 Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Nisha Gottfredson
- 1 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexandra F Lightfoot
- 1 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Giselle Corbie-Smith
- 3 Department of Social Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,4 Center for Health Equity Research, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carol Golin
- 1 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,5 Department of General Medicine and Epidemiology, Department of Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wizdom Powell
- 1 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,6 Health Disparities Institute, University of Connecticut, Hartford, CT, USA
| |
Collapse
|
11
|
Shen W. A tangled web: The reciprocal relationship between depression and educational outcomes in China. SOCIAL SCIENCE RESEARCH 2020; 85:102353. [PMID: 31789192 PMCID: PMC6901113 DOI: 10.1016/j.ssresearch.2019.102353] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 05/05/2023]
Abstract
Research on depression and education usually focuses on a unidirectional relationship. This paper proposes a reciprocal relationship, simultaneously estimating the effects of depression on education and of education on depression. China, which has the world's largest education system, is used as a case study. This paper applies structural equation modeling to three datasets: the China Family Panel Studies, the China Education Panel Survey, and the Gansu Survey of Children and Families. Analyses reveal a reciprocal and negative relationship between depression and educational outcomes. Specifically, early depression reduces later educational achievement, and higher educational achievement also lowers the level of subsequent depression by resulting in less peers' unfriendliness, less pressure from parents' expectations, and less teachers' criticism. More time spent on studies is not associated with higher educational achievement but significantly increases the level of depression. Children from lower SES families bear more pressure and spend more time on studies, which does not correspond to higher educational achievement but rather to higher levels of depression. In the long term, prior depression lowers educational attainment and, after controlling for prior depression, lower educational attainment is also associated with higher levels of subsequent depression. This paper shows that the lower achievers, not the high achievers, bear the major psychological burden of the education system's quest to produce high achievement. This situation reinforces these students' educational disadvantage.
Collapse
Affiliation(s)
- Wensong Shen
- Department of Sociology, University of Pennsylvania, 3718 Locust Walk, McNeil Building, Ste. 353, Philadelphia, PA, 19104, USA.
| |
Collapse
|
12
|
Assari S, Bazargan M. Being Married Increases Life Expectancy of White but Not Black Americans. J Family Reprod Health 2019; 13:132-140. [PMID: 32201487 PMCID: PMC7072027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objective: The positive effect of high socioeconomic position (SEP) on health is well established. According Minorities' Diminished Returns (MDRs) theory, however, the SEP-health link is smaller for Blacks compared to Whites. Using a 25-year follow up data of a national sample, this study tested racial differences in the effects of marital status on life expectancy among American adults. Materials and methods: The data of Americans' Changing Lives (ACL, 1986 - 2011) were used. The ACL is a nationally representative longitudinal cohort study followed 3,361 White or Blacks adults from 1986 to 2011. The predictor of interest was marital status in 1986. Confounders included demographic factors (age and gender), SEP (education and employment), health behaviors (drinking, smoking, and physical activity), and health status (depressive symptoms, chronic disease, and self-rated health) all measured at baseline. Race was the moderator variable. All-cause mortality was the main dependent variable (outcome). Cox proportional hazard modeling was applied for data analysis. Results: In the overall sample, individuals who were married at baseline had a lower risk of mortality during the 25 years of follow up. Race altered the effect of marital status on life expectancy, indicating smaller protective effect for Blacks relative to Whites. Race -specific Cox regression models showed an association between marital status and life expectancy for White but not Black Americans. Conclusion: In line with the MDRs theory, the health gain that follows marital status is diminished for Black Americans compared to White Americans. Only equalizing SEP across racial groups may not be adequate for eliminating racial/ethnic health inequalities. Policies should go beyond SEP and reduce societal and structural barriers that disproportionately hinder Blacks from translating their SEP indicators to desirable health outcomes.
Collapse
Affiliation(s)
- Shervin Assari
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, CA, United States
| | - Mohsen Bazargan
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, CA, United States,Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| |
Collapse
|
13
|
Assari S, Javanbakht A, Saqib M, Helmi H, Bazargan M, Smith JA. Neuroticism polygenic risk score predicts 20-year burden of depressive symptoms for Whites but not Blacks. JOURNAL OF MEDICAL RESEARCH AND INNOVATION 2019; 4:e000183. [PMID: 32133428 PMCID: PMC7055662 DOI: 10.32892/jmri.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Black-White differences are reported in social, psychological, behavioral, medical, and biological correlates of depression. This study was conducted to compare Black and White older adults for the association between neuroticism polygenic risk score (N-PRS) and chronicity of depressive symptoms over 20 years. METHODS Data came from the Health and Retirement Study (HRS), 1990 - 2012, a nationally representative sample of Americans above age 50. Current analysis followed 9,249 individuals (7,924 Whites and 1,325 Blacks) for up to 22 years. Depressive symptoms were measured every two years between 1992 and 2012 using the 8-item Center for Epidemiological Studies-Depression Scale (CES-D-8). The independent variable was N-PRS. The dependent variable was average depressive symptoms between 1992 and 2012. Linear regression was used for data analysis. RESULTS In the pooled sample, higher N-PRS was associated with higher average depressive symptoms over the 20-year follow up period [b=0.01, 95%CI=0.00 to 0.04], net of all covariates. We also found an interaction between race and N-PRS [b=-0.02, 95%CI=-0.03 to 0.00], suggesting a stronger effect of N-PRS on 20-year average depressive symptoms for Whites than Blacks. Based on our race-specific linear regression models, higher N-PRS was associated with higher depressive symptoms from 1992 to 2012 for Whites [b=0.01, 95%CI=0.01 to 0.02] but not Blacks [b=0.00, 95%CI=-0.02 to 0.02]. CONCLUSION Black and White older adults may differ in the salience of the existing N-PRS for depressive symptoms, which better reflects the burden of depression for Whites than Blacks. This may be because the existing PRSs are derived from mostly or exclusively White samples, limiting their applicability in other race groups. Racial variation in psychosocial, clinical, and biological correlates of depression needs further research.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Arash Javanbakht
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
| | - Mohammed Saqib
- Department of Health Behavior and Health Education, School of Public health, University of Michigan, Ann Arbor, MI, USA
| | - Hamid Helmi
- Department of Internal Medicine, Wayne State University, Detroit, MI, USA
- School of Medicine, University of Chicago, IL, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Jennifer A Smith
- Department of Epidemiology, School of Public health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
14
|
Getnet B, Alem A. Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in Eritrean refugees living in Ethiopia. BMJ Open 2019; 9:e026129. [PMID: 31064806 PMCID: PMC6528005 DOI: 10.1136/bmjopen-2018-026129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Depression is among the top mental health problems with a major contribution to the global burden of disease. This study aimed at identifying the latent factor structure and construct validity of the Center for Epidemiologic Studies Depression (CES-D) Scale. PARTICIPANTS AND SETTING A cross-sectional survey of 562 adults aged 18 years and above who were randomly selected from the Eritrean refugee community living in the Mai-Aini refugee camp, Ethiopia. MEASURES The CES-D Scale, Primary Care PTSD (PC-PTSD) screener, premigration and postmigration living difficulties checklist, Oslo Social Support Scale (OSS-3), Sense of Coherence Scale (SoC-13), Coping Style Scale and fast alcohol screening test (FAST) were administered concurrently. Confirmatory factor analysis was employed to test prespecified factor structures of CES-D. RESULT First-order two factors with second-order common factor structure of CES-D (correlated error terms) yielded the best fit to the data (Comparative Fit Index =0.975; root mean square error of approximation=0.040 [90% CI 0.032 to 0.047]). The 16 items defining depressive affect were internally consistent (Cronbach's α=0.932) and internal consistency of the 4 items defining positive affect was relatively weak (Cronbach's α=0.703). These two latent factors have a weaker standardised covariance estimate of 33% (24% for women and 40% for men), demonstrating evidence of discriminant validity. CES-D is significantly associated with measures of adversities, specifically, premigration living difficulties (r=0.545, p<0.001) and postmigration living difficulties (r=0.47, p<0.001), PC-PTSD (r=0.538, p<0.001), FAST (r=0.197, p<0.001) and emotion-oriented coping (r=0.096, p˂0.05) providing evidence of its convergent validity. It also demonstrated inverse association with measures of resilience factors, specifically, SoC-13 (r=-0.597, p<0.001) and OSS-3 (r=-0.319, p<0.001). The two correlated factors model of CES-D demonstrated configural, metric, scalar, error variance and structural covariance invariances (p>0.05) for both men and women. CONCLUSIONS Unlike previous findings among Eritreans living in USA, second-order two factors structure of CES-D best fitted the data for Eritrean refugees living in Ethiopia; this implies that it is important to address culture for the assessment and intervention of depression.
Collapse
Affiliation(s)
- Berhanie Getnet
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychology, University of Gondar, Gondar, Ethiopia
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Consultant Psychiatrist, Amanuel Hospital, Addis Ababa, Ethiopia
| |
Collapse
|
15
|
Assari S. Educational Attainment Better Protects African American Women than African American Men Against Depressive Symptoms and Psychological Distress. Brain Sci 2018; 8:E182. [PMID: 30274391 PMCID: PMC6210325 DOI: 10.3390/brainsci8100182] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Recent research has shown smaller health effects of socioeconomic status (SES) indicators such as education attainment for African Americans as compared to whites. However, less is known about diminished returns based on gender within African Americans. AIM To test whether among African American men are at a relative disadvantage compared to women in terms of having improved mental health as a result of their education attainment. This study thus explored gender differences in the association between education attainment and mental health, using a representative sample of American adults. METHODS The National Survey of American Life (NSAL; 2003) recruited 3570 African American adults (2299 females and 1271 males). The dependent variables were depressive symptoms and psychological distress. The independent variable was education attainment. Race was the focal moderator. Age, employment status, and marital status were covariates. Linear regressions were used for data analysis. RESULTS In the pooled sample that included both male and female African American adults, high education attainment was associated with lower depressive symptoms and psychological distress, net of covariates. Significant interactions were found between gender and education attainment with effects on depressive symptoms and psychological distress, suggesting stronger protective effects of high education attainment against depressive symptoms and psychological distress for female as compared to male African Americans. CONCLUSION A smaller gain in mental health with respect to educational attainment for male African American males as compared to African American females is in line with studies showing high risk of depression in African American men of high-socioeconomic status. High-SES African American men need screening for depression and psychological distress.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
16
|
Assari S, Moghani Lankarani M. Depressive Symptoms and Self-Esteem in White and Black Older Adults in the United States. Brain Sci 2018; 8:E105. [PMID: 29891800 PMCID: PMC6024986 DOI: 10.3390/brainsci8060105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 05/24/2018] [Accepted: 06/09/2018] [Indexed: 01/03/2023] Open
Abstract
Background. Poor self-esteem is a core element of depression. According to recent research, some racial groups may vary in the magnitude of the link between depression and poor self-esteem. Using a national sample, we compared Black and White older Americans for the effect of baseline depressive symptoms on decline in self-esteem over time. Methods. This longitudinal study used data from the Religion, Aging, and Health Survey, 2001⁻2004. The study followed 1493 older adults (734 Black and 759 White) 65 years or older for three years. Baseline depressive symptoms (CES-D), measured in 2001, was the independent variable. Self-esteem, measured at the end of the follow up, was the dependent variable. Covariates included baseline demographic characteristics (age and gender), socioeconomic factors (education, income, and marital status), health (self-rated health), and baseline self-esteem. Race/ethnicity was the moderator. Linear multi-variable regression models were used for data analyses. Results. In the pooled sample, higher depressive symptoms at baseline were predictive of a larger decline in self-esteem over time, net of covariates. We found a significant interaction between race/ethnicity and baseline depressive symptoms on self-esteem decline, suggesting a weaker effect for Blacks compared to Whites. In race/ethnicity-specific models, high depressive symptoms at baseline was predictive of a decline in self-esteem for Whites but not Blacks. Conclusion. Depressive symptoms may be a more salient contributor to self-esteem decline for White than Black older adults. This finding has implications for psychotherapy and cognitive behavioral therapy of depression of racially diverse populations.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2700, USA.
| | | |
Collapse
|
17
|
Alexandrowicz RW, Jahn R, Wancata J. Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models. PLoS One 2018; 13:e0197908. [PMID: 29799866 PMCID: PMC5969764 DOI: 10.1371/journal.pone.0197908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/10/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one. Methods The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional model reflecting the subscale structure suggested by [1], and a four-dimensional model with the background variables gender and age were applied. Results While the one-dimensional model showed relatively good fit, the four-dimensional model fitted much better. EAP reliability indices were generally satisfying and the latent correlations varied between 0.31 and 0.88. In the analysis involving background variables, we found a limited effect of the participants’ gender. DIF effects were found unveiling some peculiarities. The two-items subscale Interpersonal Difficulties showed severe weaknesses and the Positive Affect subscale with the reversed item wordings also showed unexpected results. Conclusions While a one-dimensional over-all score might still contain helpful information, the differentiation according to the latent dimension is strongly preferable. Altogether, the CES-D can be recommended as a screening instrument, however, some modifications seem indicated.
Collapse
Affiliation(s)
| | - Rebecca Jahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Johannes Wancata
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
18
|
Assari S. Depressive Symptoms Increase the Risk of Mortality for White but Not Black Older Adults. Healthcare (Basel) 2018; 6:E36. [PMID: 29690578 PMCID: PMC6026472 DOI: 10.3390/healthcare6020036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction. Long-term studies have shown that depressive symptoms predict the risk of mortality. However, it is unknown if this effect is present in shorter time intervals. In addition, recent research suggests that the salience of the negative affect on the risk of mortality is not similar across racial groups. The current study uses data from a national study of Black and White older adults to examine racial differences in the effect of baseline depressive symptoms on mortality risk over three years in the United States. Methods. This study used a longitudinal prospective design and followed 1493 older adults who were either White (n = 759) or Black (n = 734) for three years from 2001 to 2004. Depressive symptoms measured at baseline was the independent variable. Demographic factors, socio-economic characteristics (education, income, marital status), health behaviors (smoking and drinking), and health (self-rated health) measured at baseline in 2001 were covariates. The dependent variable was all-cause mortality between 2001 and 2004. Race was the moderator. Logistic regressions were used for data analysis. Results. In the pooled sample, high depressive symptoms at baseline were not associated with the three-year risk of mortality. In the pooled sample, we found a significant interaction between race and depressive symptoms on mortality, suggesting a stronger effect for Whites in comparison to Blacks. In race stratified models, depressive symptoms at baseline were predictive of mortality risk for Whites, but not Blacks. Conclusions. In the United States, Black-White differences exist in the effects of depressive symptoms on mortality risk in older adults. White older adults may be more vulnerable to the effects of depressive symptoms on mortality risk.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
19
|
Assari S, Miller RJ, Taylor RJ, Mouzon D, Keith V, Chatters LM. Discrimination Fully Mediates the Effects of Incarceration History on Depressive Symptoms and Psychological Distress Among African American Men. J Racial Ethn Health Disparities 2018; 5:243-252. [PMID: 28405962 PMCID: PMC6556396 DOI: 10.1007/s40615-017-0364-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
AIM Using a nationally representative sample of African American men, this study investigated the associations between lifetime history of incarceration, discrimination, and mental health (e.g., depressive symptoms and psychological distress). We hypothesized that discrimination would fully mediate the association between incarceration history and mental health outcomes among African American men. METHODS Using a cross-sectional design, our analysis included 1271 African American men who participated in the National Survey of American Life (NSAL), 2001-2003. Incarceration history was the main independent variable. Depressive symptoms and psychological distress were the dependent variables. Everyday discrimination was the mediator. Age, education, and income were covariates. Structural equation models (SEMs) were used for data analysis. RESULTS Among African American men, incarceration history was positively associated with perceived discrimination, depressive symptoms, and psychological distress. Everyday discrimination fully mediated the associations between incarceration history and both depressive symptoms and psychological distress. CONCLUSION Discrimination may play an important role in the mental health problems of African American men with a history of incarceration. These findings have public policy implications as well as clinical implications for mental health promotion of African American men. Policies that reduce preventable incarceration or at least reduce subsequent discrimination for those who have been incarcerated may enhance mental health of previously incarcerated African American men.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
| | | | - Robert Joseph Taylor
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Dawne Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Verna Keith
- Race and Ethnic Studies Institute, Texas A&M University, College Station, TX, USA
| | - Linda M Chatters
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
20
|
Assari S. Psychiatric Disorders Differently Correlate with Physical Self-Rated Health across Ethnic Groups. J Pers Med 2017; 7:E6. [PMID: 29137173 PMCID: PMC5748622 DOI: 10.3390/jpm7040006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 11/16/2022] Open
Abstract
In this study, we compared 10 ethnic groups for associations between psychiatric disorders and physical self-rated health (SRH) in the United States. Data came from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. The study included 7587 non-Latino White, 4746 African American, 1442 Mexican, 1106 other Hispanic, 656 other Asian, 600 Chinese, 577 Cuban, 520 Vietnamese, 508 Filipino, and 495 Puerto Rican individuals. The Composite International Diagnostic Interview (CIDI) was used to measure psychiatric disorders, including major depressive disorder (MDD), general anxiety disorder (GAD), social phobia, panic disorder, post-traumatic stress disorder (PTSD), alcohol abuse, and binge eating disorders. A single-item measure was used to estimate physical SRH. Demographic (age and gender) and socioeconomic (education and income) factors were also measured. Unadjusted and adjusted correlations between psychiatric disorders and physical SRH were calculated. Major ethnic variations were found in the correlation between psychiatric disorders and physical SRH; as well as the role of demographic and socioeconomic status (SES) factors in explaining these associations. non-Hispanic Whites, Cubans, and African Americans showed more correlations between psychiatric disorders and physical SRH than other ethnic groups. In non-Hispanic Whites, the associations between psychiatric disorders and physical SRH were explained by demographic factors. In African Americans, the link between psychiatric disorders and poor physical SRH were explained by SES indicators. In conclusion, although single-item physical SRH measures are traditionally assumed to reflect the physical health needs of populations, they may also indicate psychiatric disorders in some ethnic groups, such as non-Hispanic Whites, Cubans, and African Americans. Demographic and socioeconomic factors also have differential roles in explaining the link between psychiatric disorders and physical SRH. Physical SRH does not exclusively reflect physical health, and it may be more biased by mental health across some ethnic groups.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
21
|
Shallcross AJ, Spruill TM. The Protective Role of Mindfulness in the Relationship Between Perceived Discrimination and Depression. Mindfulness (N Y) 2017; 9:1100-1109. [PMID: 30128053 DOI: 10.1007/s12671-017-0845-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study examined the potential buffering role of trait mindfulness in the relationship between perceived discrimination and depressive symptoms in a community-based sample of racial and ethnic minority adults. Analyses conducted on 97 participants indicated that self-reported trait mindfulness moderated the relationship between perceived discrimination and depressive symptoms. Individuals low in mindfulness experienced elevated depressive symptoms at high levels of discrimination. However, individuals high in mindfulness reported lower depressive symptoms at high levels of discrimination. Results remained robust when controlling for potential confounding effects of age, sex, and income. Results suggest mindfulness is an important individual difference that may confer resilience for racial and ethnic minority communities who experience disproportionate levels of discrimination-related stressors and health disparities. Findings point to the potential utility of interventions that target mindfulness as a modifiable skill that can be used specifically to cope with discrimination. Socio-cultural considerations for the use of mindfulness-based approaches in racial and ethnic minority communities are discussed.
Collapse
Affiliation(s)
| | - Tanya M Spruill
- New York University, School of Medicine Department of Population Health
| |
Collapse
|
22
|
Positive and Negative Affect More Concurrent among Blacks than Whites. Behav Sci (Basel) 2017; 7:bs7030048. [PMID: 28763017 PMCID: PMC5618056 DOI: 10.3390/bs7030048] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 07/14/2017] [Accepted: 07/18/2017] [Indexed: 01/28/2023] Open
Abstract
Background: While positive and negative affect are inversely linked, people may experience and report both positive and negative emotions simultaneously. However, it is unknown if race alters the magnitude of the association between positive and negative affect. The current study compared Black and White Americans for the association between positive and negative affect. Methods: We used data from MIDUS (Midlife in the United States), a national study of Americans with an age range of 25 to 75. A total number of 7108 individuals were followed for 10 years from 1995 to 2004. Positive and negative affect was measured at baseline (1995) and follow-up (2004). Demographic (age and gender), socioeconomic (education and income) as well as health (self-rated health, chronic medical conditions, and body mass index) factors measured at baseline were covariates. A series of linear regressions were used to test the moderating effect of race on the reciprocal association between positive and negative affect at baseline and over time, net of covariates. Results: In the pooled sample, positive and negative affect showed inverse correlation at baseline and over time, net of covariates. Blacks and Whites differed in the magnitude of the association between positive and negative affect, with weaker inverse associations among Blacks compared to Whites, beyond all covariates. Conclusion: Weaker reciprocal association between positive and negative affect in Blacks compared to Whites has implications for cross-racial measurement of affect and mood, including depression. Depression screening programs should be aware that race alters the concordance between positive and negative affect domains and that Blacks endorse higher levels of positive affect compared to Whites in the presence of high negative affect.
Collapse
|