'My partner will think I'm weak or overthinking my pain': how being superwoman inhibits Black women's sexual pain disclosure to their partners.

Black women experience persistent sexual pain that may often last longer than White women. Despite the value of sexual communication to alleviate sexual pain concerns, many women do not disclose sexual pain to their partners. Limited research explores barriers to disclosing sexual pain to partners among Black women. This study seeks to fill this gap. Relying on an integration of Sexual Script theory and Superwoman Schema, the study explored the barriers that premenopausal, cisgender Black women from the Southern USA perceived when disclosing sexual pain to their primary partners. We identified five common themes from women's open-ended responses to an online survey: (a) distressing emotions associated with disclosure; (b) limited knowledge and communication skills; (c) protecting partner's feelings and ego; (d) invading privacy; and (e) taking sole responsibility for managing sexual pain. Findings suggest a combination of intrapsychic, interpersonal and cultural factors influence Black women's perceived ability to have direct and open dyadic communication about sexual pain with their partners. Implications for Black women's sexual health and relationship outcomes are discussed.

"Anger, embarrassment, less than a woman": the emotional impact of Black women's sexual pain.

Limited research has examined the emotions Black women report when thinking about sexual pain. To fill this gap in the literature, we explored the types of emotions that emerged when N = 126 premenopausal Black women thought about pain during sex. Open-ended responses to the following research question were analyzed: "What feelings emerge when you think about sexual pain?" Structural tabular thematic analysis was used to find commonalities in participants' responses. Findings indicated five families, or categories, of emotions: self-judgment, anger/disgust, sadness, anxiety, and emotions felt somatically. Additionally, women's reports were predominantly within the feeling state and cognitive appraisal components of emotion. Implications for health providers and therapists are discussed.

Religion, Psychiatric Symptoms, and Gender Role Conflict Among Incarcerated Black Men.

Extant literature is mixed on the role of religiosity as a protective factor for mental health concerns and the effectiveness of faith-based prison programs on a reduction in recidivism. Religiosity and psychiatric symptoms are associated with gender role conflict, yet little is known about these relationships among Black incarcerated men. Undergirded by gender role conflict theory, this study aimed to investigate the relationship between religiosity, 30-day psychiatric symptoms, and three measures of gender role conflict: emotional restrictiveness, work-family conflict, and affectionate behavior towards men. In a sample of 206 Black men nearing community re-entry, our results indicated strong religious beliefs and psychiatric symptoms were associated with less emotional restrictiveness. Religious influence and psychiatric symptoms were positively associated with perceived work-family conflict. Further, strong religious beliefs moderated the association between psychiatric symptoms and work-family conflict. Implications for faith-based prison support programs as mechanisms for reducing recidivism among Black men are discussed.

Pursuing Pleasure Despite Pain: A Mixed-Methods Investigation of Black Women's Responses to Sexual Pain and Coping.

The current mixed-methods study is the first to explore Black women's (N = 153) cognitive (e.g., worry about being perceived as sexually unresponsive) and emotional (e.g., sadness) responses to sexual pain based on age and relationship status, and coping strategies. Findings indicated significant differences in younger and single Black women's cognitive and emotional responses to sexual pain compared to older and coupled Black women. Qualitative responses revealed Black women engage in several proactive coping strategies to mitigate their sexual pain, including non-penetrative activities, foreplay, tools for increasing arousal, making physical adjustments, and intimacy and sexual communication. Implications for sexual health providers are discussed.

Superwoman Schema: a context for understanding psychological distress among middle-class African American women who perceive racial microaggressions.

Objective: Current racial mental health disparities among African American women have been attributed to chronic experiences of race-related stressors. Increased exposure to racism in predominately White spaces may increase reliance on culturally normative coping mechanisms. The objective of this study was to investigate the relationship between psychological distress, perceived racial microaggressions, and an obligation to show strength/suppress emotions among educated, middle-class African American women.Design: A sample of 243 African American women aged 19-72 years (M = 39.49 years) participated in an online study. Participants completed self-report measures of psychological distress (PHQ-8 and GAD-7), racial microaggressions (IMABI), and modified items from the Stereotypical Roles for Black Women (SRBWS) to assess an obligation to show strength/suppress emotions. Factor analyses were conducted to assess the reliability of the obligation to show strength/suppress emotions subscale in our sample. Descriptive statistics, multiple linear regression, and mediation analyses were also conducted to examine variable associations.Results: Statistical analyses revealed educated, middle-class African American women who endorse an obligation to show strength/suppress emotions with perceived racial microaggressions experienced increased psychological distress.Conclusion: Obligation to show strength/suppress emotion may increase risk for psychological distress among African American women who perceive racial microaggressions. Future research and clinical implications are discussed.

"White people stress me out all the time": Black students define racial trauma.

OBJECTIVE: Using a constructivist-interpretivist paradigm and a Black feminist qualitative framework, this study investigated how Black students at a predominantly White university in the southeast defined racial trauma. METHOD: A purposive sample of 26 participants (10 men and 16 women, aged 18-27) participated in a semistructured interview about their definitions of race-based stress and racial trauma. Data analysis consisted of a six-phase inductive, latent thematic analysis. Researcher reflexivity, interviews, observations, and research memos contributed to trustworthiness. RESULTS: Participants' understandings of race-based stress and racial trauma-informed two composite definitions of racial trauma. Participants conceptualized racial trauma and race-based stress as related and identified three salient components of racial trauma: (a) "Sticking with": temporal component, (b) "Suffering severely": intensity component, and (c) "Repeating regularly": frequency component. CONCLUSIONS: The findings of this study contribute to the existing literature by providing an academic and community definition of racial trauma grounded in the voices of Black collegians. These definitions of racial trauma may be used to inform future research, clinical services, and outreach. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"Why Would I Talk To Them About Sex?": Exploring Patient-Provider Communication Among Black Women Experiencing Sexual Pain.

Ineffective patient-provider communication poses a potential health risk to Black women if medical providers are not addressing their needs or concerns. Additionally, less than half of OBGYNs report asking their patients about sexual difficulties, which limits women's opportunities to disclose their experiences of sexual pain. The purpose of this qualitative study is to explore Black women's experiences of patient-provider communication about sexual pain (reoccurring unwanted genital pain). Specifically, we aimed to describe the pathway from sexual pain disclosure to treatment among N = 25 premenopausal Black women living in the southern United States who were experiencing sexual pain. Using constructivist grounded theory, open-ended responses to six interview questions related to healthcare experiences, treatment, and patient-provider communication were qualitatively analyzed and categorized to form a conceptual framework of patient-provider communication about sexual pain. Five key categories emerged related to Black women's experiences with their medical providers regarding sexual pain: (1) provider preferences, (2) healthcare experiences, (3) reasons for non-disclosure, (4) provider responses to sexual pain, and (5) treatment for sexual pain. Useful strategies to improve patient-provider communication are presented for both patients and providers.

Polysubstance use among frequent marijuana users: an examination of John Henryism Active Coping, psychiatric symptoms, and family social support among African American incarcerated men.

Incarcerated African American men who use marijuana are vulnerable to polysubstance use, which is associated with greater risk for negative health and psychosocial outcomes than marijuana use alone. It is imperative to understand risk and protective factors for polysubstance use among this vulnerable population to inform the development of culturally tailored substance use interventions. The current study examined the association between John Henryism Active Coping (JHAC), family social support, psychiatric symptoms, and polysubstance use among African American incarcerated men who frequently use marijuana. Results indicated that higher John Henryism Active Coping (JHAC) is associated with decreased likelihood of engaging in polysubstance use, while psychiatric symptoms are associated with increased likelihood of polysubstance use. Incorporating elements of JHAC into concurrent mental health and substance use treatment may reduce risk for overdose and reincarceration among African American incarcerated men upon release into the community.

Balancing the sexology scales: a content analysis of Black women's sexuality research.

Existing research adopting a sex positive and intersectional framework for investigating Black women's sexualities is scarce. We conducted a 46-year (1972-2018) content analysis of sexualities research focussed on Black women. It sought to examine which sexualities topics were published most; whether the publications aligned with sex-positive, neutral or negative discourse; what methodologies were used; and differences in how various identities were investigated among Black women. Using human coding, we applied an integrative approach to the content analysis. Results found 245 articles meeting criteria. Approximately one-third of articles within the analysis focussed on the topic of sexually transmitted infections (STIs), HIV and sexual risk behaviours among Black women. Only 6.5% of articles utilised a sex-positive discourse. Quantitative articles were the most published methodology, and publications disproportionately overlooked Black women's intersectional identities. Implications for future research and practice are discussed.

Incarcerated Black Men's Restrictive Emotionality: The Influence of Parental Closeness and Childhood Abuse.

Black men are often socialized to limit their emotional expression, which can lead to negative relationships and emotional health outcomes. Yet, little is known about how childhood experiences influence their emotional restrictiveness in adulthood. This study examined the relationship between parental closeness, childhood abuse, and restricted emotionality among 183 Black incarcerated men nearing release. Findings conclude men who reported having a closer relationship with their parents had lower emotional restrictiveness than men who did not. Men who reported childhood sexual abuse by two people reported more restricted emotionality than their non-abused counterparts. Implications for programming, intervention and prevention strategies are discussed. PUBLIC SIGNIFICANCE STATEMENT: The present study suggests childhood abuse, specifically sexual abuse by multiple individuals, is an important risk factor for restrictive emotionality among Black incarcerated men. Additionally, this study highlights the importance of close supportive relationships, particularly with parents, as factors to consider for prevention and intervention approaches, and correctional strategies to foster emotional wellness for this population.

"Don't Feel Like You Have to Do This All on Your Own": Exploring Perceived Partner Support of Breastfeeding Among Black Women in Kentucky.

BACKGROUND: Few researchers have explored partner breastfeeding support among Black women, who report low breastfeeding rates compared to women of other cultural groups. Ways to encourage partner support of Black women's breastfeeding can be understood from an Afrocentric perspective. RESEARCH AIM: To explore perceptions of partner support among Black mothers to develop a culturally relevant framework of partner breastfeeding support. METHODS: Secondary data analyses of qualitative data from a larger prospective, cross-sectional mixed methods study were utilized. Participants from Kentucky (N = 14), aged 23-71, who breastfed for at least 6 months, were recruited to participate in individual interviews. Professionally transcribed interviews were analyzed using Braun and Clarke's (2006) thematic analysis. RESULTS: By integrating the Breastfeeding Coparenting Framework and Optimal Conceptual Theory, we identified four culturally affirming partner support themes that participants believed impacted their breastfeeding experiences: (a) doing research, (b) offering care, (c) verbalizing praise, and (d) achieving teamwork, and three culturally incongruent partner support barrier themes: (e) withdrawing commitment, (f) politicking bodies, and (g) stripping agency. CONCLUSION: Participants who breastfed for at least 6 months largely attributed their breastfeeding success to the support received from their partners. Our findings offer a culturally relevant framework of partner breastfeeding support that can facilitate intervention efforts with participants and their partners to increase breastfeeding rates among this population.

Experiencing Burnout: John Henryism, Gender Role Conflict, and Anxiety Among Incarcerated Black Men.

At the intersection of race and gender, Black men encounter conflicting and often stress-inducing gender norms. Research suggests Black men may utilize John Henryism Active Coping (JHAC), a culturally-relevant strategy to manage stress. However, little is known about how incarcerated Black men cope with gender role conflict (GRC) and resulting psychological distress. To better understand stressors and coping strategies among Black male prisoners, the current study examined the relationships between GRC, anxiety, and JHAC among N = 193 incarcerated Black men nearing community reentry. Hierarchical linear regression results showed length of incarceration, GRC, and anxiety were all negatively associated with JHAC. Full-time employment prior to incarceration was positively associated with JHAC. Moderation analyses indicated anxiety increased the strength of the negative association between GRC and JHAC. Implications highlight incarcerated Black men may benefit from interventions that encourage active coping strategies to manage gender-related stress and anxiety.

Social Health Care Determinants of Breastfeeding Black Women: A Multigenerational Study.

Background: Black women encounter many challenges to breastfeeding, including inequitable access to support and resources and medical racism. However, limited research investigates how Black women across generations interface with health care systems to initiate or continue breastfeeding and what factors facilitate or hinder their breastfeeding experiences. Objective: Using the social determinants of health (SDoH) theoretical framework, this study qualitatively explored how a multigenerational sample of Black mothers' interactions with health care systems facilitated or hindered their breastfeeding initiation and continuation. There were three areas of interest: (1) access and quality, (2) professional and personal support, and (3) literacy and resources. Materials and Methods: Four age cohorts and three breastfeeding length cohorts of Black mothers in Kentucky completed semi-structured interviews on their breastfeeding experiences. Responses to research questions (e.g., "What was your experience during the birthing process and how did it impact your decision to breastfeed?") informed by the SDoH were analyzed using thematic analysis. Results: Four themes emerged on how experiences within health care systems influence Black women's breastfeeding initiation and continuation: (1) health care access, (2) health care quality/bias, (3) health care-related support, and (4) health care resource use. Conclusions: Interpersonal and systemic barriers in health care related to access, quality, support, and resources hindered Black mother's breastfeeding across generations. Mothers across each age and breastfeeding cohorts emphasized a need for culturally tailored pro-breastfeeding health care systems to meet their breastfeeding needs.

Cultural race-related stress and cannabis use among incarcerated African American men.

OBJECTIVE: Research suggests African American men use cannabis to cope with racial discrimination. This conjecture may also be true for incarcerated African American men, who report high rates of cannabis use prior to and after incarceration. However, no studies to date have examined the association between race-related stress and chronic cannabis use among incarcerated African American men. As this population encounters pervasive negative cultural stereotypes and devaluation from larger society, cultural race-related stress may predict cannabis use among this population. Therefore, the purpose of this brief report was to examine the relationship between cultural race-related stress and years of regular cannabis use among a sample of incarcerated African American men. METHOD: Study staff completed interviews with N = 177 African American men nearing release from four prisons in Kentucky. The interviews focused on mental health, drug use, and HIV risk behaviors. Participants provided their demographics (e.g., age, years of education, and length of incarceration), self-reported their years of regular cannabis use (3 times or more per week), and completed the Brief Index of Race-Related Stress (IRRS-B; Utsey, Measurement & Evaluation in Counseling & Development, 1999, 32, 149). RESULTS: Multivariate regression analyses demonstrated cultural race-related stress was significant and positively associated with the number of years of regular cannabis use (p = .003) among this population. CONCLUSIONS: This finding has implications for culturally tailored substance abuse treatment, specifically for cannabis use, with African American men upon their community re-entry from prison. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sleep time differs among people who co-use cocaine and cannabis compared to people who only use cocaine.

OBJECTIVE: People who use cocaine experience numerous sleep problems and often use cannabis to mitigate these problems. However, co-using cocaine and cannabis may result in worse sleep outcomes when compared to using cocaine only. The current study examined group differences in subjective sleep outcomes among people who use cocaine and people who co-use cocaine and cannabis. METHODS: Participants were 82 individuals with cocaine use disorder who were enrolled in a randomized clinical trial for cocaine treatment. Sleep outcomes, assessed at baseline prior to treatment, were measured with the Saint Mary's Hospital Sleep Questionnaire and included total sleep time, perceived sleep quality, difficulty falling asleep, and daytime alertness. Analysis of covariance and Kruskal-Wallis tests were used to compare sleep outcomes between participants with urine samples that tested positive for both cocaine and cannabis at baseline, those who tested positive for cocaine only, and those who tested negative for all drugs. RESULTS: Total reported sleep time was highest among those with a drug negative urine, followed by those with a cocaine positive urine and those who tested positive for cocaine and cannabis. There were no differences in perceived sleep quality, difficulty falling asleep, or daytime alertness between groups. CONCLUSIONS: People who co-use cocaine and cannabis may report reduced sleep time relative to those who only use cocaine. Co-use of cannabis may exacerbate sleep difficulties in people who use cocaine by decreasing total sleep time, although it is important to note that the groups each reported similar sleep quality. Implications for treatment and directions for future research are discussed.

Perceived need for drug treatment among African American male drug-using prisoners.

Since 2016, African Americans have experienced the largest increase in cocaine-related drug overdose deaths compared to other racial/ethnic groups. African American male prisoners who used drugs prior to incarceration are at an increased risk for relapse and overdose upon community re-entry. Using the Theory of Planned Behavior as a guiding framework, this study examined correlates of perceived need for treatment among 193 drug-using incarcerated African American men nearing release. Linear regression analyses revealed that the number of lifetime drug overdoses, severity of legal problems, and previous drug treatment significantly predicted a need for treatment. Further, more frequent drug use, specifically crack cocaine, in the month prior to incarceration predicted a higher perceived need for drug treatment. Implications suggest this population demonstrates a need for treatment, which may be exacerbated by re-entry stressors. Preventative measures, including culturally tailored treatment and transitional care from prison to community-based services, are necessary to reduce risk of relapse and overdose among this group.

"No One Can Make that Choice for You": Exploring Power in the Sexual Narratives of Black Collegians.

Power is enacted to oppress others, pursue wellness, or resist oppression. For Black people, societal and relational oppression influences racialized and gendered expressions of power within sexual encounters. The current study analyzed power dynamics within Black university students' first and most recent sexual encounters. Using narrative inquiry within a critical paradigm, five narrative strategies were identified within participants' interviews: 1) Offering a Peek into Powerlessness, 2) Detailing Disempowerment, 3) Privileging Stereotypical Power, 4) Reclaiming Power, and 5) Emphasizing Empowered Sex. Racialized, gendered sexual socialization among Black students is discussed. Counseling considerations to increase sexual wellness for Black people are explored.

Culturally relevant risk and protective factors for nonmedical use of prescription opioids among incarcerated African American men.

BACKGROUND: Recent studies have demonstrated that nonmedical use of prescription opioids (NMUPO) is a national phenomenon affecting a multitude of subpopulations, including incarcerated African American men. However, there has been little investigation of the correlates of NMUPO among this population. OBJECTIVE: Grounded in primary socialization theory, the current study aimed to examine the association between family bonds, family history of prescription drug misuse, and mental health symptoms on NMUPO among African American incarcerated men. METHOD: A step-wise logistic regression was conducted to determine whether family and mental health factors affected the likelihood of lifetime NMUPO. RESULTS: Prescription drug misuse among immediate family members (p < 0.001) and lifetime experience of serious anxiety (p = 0.003) were significantly associated with an increased likelihood of NMUPO. Having a close personal relationship with one's father was significantly associated with a decreased likelihood of NMUPO (p = 0.034). CONCLUSIONS/IMPORTANCE: Risk and protective factors are identified that can be incorporated into interventions aimed at reducing or preventing NMUPO among African American men. Directions for future research on NMUPO among African American incarcerated men are discussed.

Catchin' Feelings: Experiences of Intimacy During Black College Students' Sexual Encounters.

Research regarding intimacy within Black relationships is often deficiency-focused, reinforcing negative stereotypes about Black people's capacity to relate in sexual and romantic relationships. Utilizing social exchange theory and social learning theory as a combined framework, we examined intimacy-related narratives of 18 Black college students during their first and last sexual encounters. A thematic analysis constructed five themes: (a) limited knowledge of intimacy, (b) internal barriers to non-sexual intimacy, (c) external barriers to non-sexual intimacy, (d) seeking an emotional connection, and (e) experiencing intimacy. Findings suggest varying perspectives and experiences related to intimacy. Intimacy barriers and facilitators are discussed.