Patterns of Mood and Personality Factors and Associations With STI/HIV-Related Drug and Sex Risk Among African American Male Inmates.

BACKGROUND: Research on the association between antisocial personality disorder (ASPD) with comorbid mental disorders and sexually transmitted infection (STI)/HIV risk among inmates is scant despite the high prevalence of psychopathology and of STI/HIV in this population. METHODS: We used baseline data from Project DISRUPT, a cohort study conducted among incarcerated African American men (n = 207), to measure associations between ASPD and STI/HIV risk. We also conducted latent class analyses (LCAs) to identify subgroups defined by ASPD with comorbid stress, depression, and borderline personality disorder symptoms and measured associations between latent class membership and STI/HIV risk. RESULTS: Approximately 15% had ASPD and 39% reported depression. Controlling for sociodemographics, stress, and depression, ASPD was independently associated with illicit [AOR = 3.23, 95% confidence interval (CI): 1.18-8.87] and injection drug use (AOR: 5.49, 95% CI: 1.23-24.42) but not with sexual risk. LCAs suggested that those at high risk of ASPD were likely to experience co-morbid mental disorders. ASPD comorbid with these disorders was linked to drug and sex risk. CONCLUSIONS: STI/HIV prevention for inmates should incorporate diagnosis and treatment of ASPD and comorbid disorders, and interventions to address ASPD-related factors (e.g., impulsivity) that drive STI/HIV risk.

Differential effects of self-reported lifetime marijuana use on interleukin-1 alpha and tumor necrosis factor in African American adults.

It is unknown how lifetime marijuana use affects different proinflammatory cytokines. The purpose of the current study is to explore potential differential effects of lifetime marijuana use on interleukin-1 alpha (IL-1α) and tumor necrosis factor (TNF) in a community based sample. Participants included 168 African American adults (51 % female, median age = 47 years). Upon study entry, blood was drawn and the participants completed questions regarding illicit drug use history whose answers were used to create three groups: lifetime non-drug users (n = 77), lifetime marijuana only users (n = 46) and lifetime marijuana and other drug users (n = 45). In the presence of demographic and physiological covariates, non-drug users were approximately two times more likely (AOR 2.73, CI 1.18, 6.31; p = .03) to have higher TNF levels than marijuana only users. Drug use was not associated with IL-1α. The influence of marijuana may be selective in nature, potentially localizing around innate immunity and the induction of cellular death.

Association between interleukin-6 and neurocognitive performance as a function of self-reported lifetime marijuana use in a community based sample of African American adults.

The purpose of the current study was to determine if self-reported lifetime marijuana use moderates the relationship between interleukin-6 (IL-6) and neurocognitive performance. Participants included 161 African American adults (50.3% women), with a mean age of 45.24 (SD=11.34). Serum was drawn upon entry into the study and participants completed a demographic questionnaire, which included drug use history, and a battery of neuropsychological tests. Using multiple regression analyses and adjusting for demographic covariates, the interaction term comprised of IL-6 and self-reported lifetime marijuana use was significantly associated with poorer performance on the Written (ß=-.116; SE=.059; p=.049) and Oral trials (ß=-.143; SE=.062; p=.022) of the Symbol Digit Modalities Test, as well as the Trail Making Test trial A (ß=.157; SE=.071; p=.028). Current findings support previous literature, which presents the inverse relationship between IL-6 and neurocognitive dysfunction. The potential protective properties of marijuana use in African Americans, who are at increased risk for inflammatory diseases, are discussed.

Younger versus older African Americans: patterns and prevalence of recent illicit drug use.

OBJECTIVES: The current study examined recent substance use among younger and older African Americans and factors associated with recent use. METHODS: The current study used a subset of African American men and women (N = 260) from the NEURO-HIV Epidemiological Study (Mage = 42, SD = 9.27; 59% female). Self-report of past 6 month substance use was evaluated for 21 different substances by routes of administration (ROA). RESULTS: Older adults were 1.9 times (AOR = 1.92, 95% CI = 1.13-3.26) more likely to have used crack in the past 6 months and half as likely to have used marijuana (AOR = .44, 95% CI = .25-.77). There were no significant differences for heroin use. DISCUSSION: Substance use at midlife may have significant implications for adverse social and health outcomes among African Americans. Findings support the need to better understand the developmental pathways of drug use and dependence among African Americans.

Differences in internalizing symptoms between those with and without Cannabis Use Disorder among HBCU undergraduate students.

OBJECTIVE: To determine the differences in internalizing symptoms between those who met criteria for Cannabis Use Disorder (CUD) and those who did not in young adults attending a Historically Black College or University (HBCU). PARTICIPANTS: The sample included 619 undergraduate students, with 110 (18%) who met criteria for CUD. METHODS: Participants completed an online survey, which included demographic, anxious and depressive symptomatology, and substance use assessment. RESULTS: Those who met CUD criteria reported more depressive symptoms (M = 22.83 ± 10.74) and anxiety symptoms (M = 45.70 ± 12.82) than their non-CUD counterparts (M = 19.17 ± 10.58; M = 40.57 ± 14.11, respectively). CONCLUSION: Differences between those who met criteria for CUD and those who did not are consistent with previous literature and may aid in characterizing internalizing behaviors in HBCU students with CUD. Future research should examine the subgroups that may cycle through withdrawal symptoms, despite not having severe CUD. This subgroup may be at higher risk for psychopathology than their severe counterparts.

Cannabis use disorder severity and sleep quality among undergraduates attending a Historically Black University.

Nearly one third of Americans experience poor sleep, which is associated with numerous deleterious health outcomes. Poor sleep may be exacerbated when an individual attends college, as they experience drastic shifts in lifestyle and sleep patterns. Previous research suggests cannabis has therapeutic potential for sleep disorders but may also impair sleep quality long-term. However, no study has examined the differences in sleep quality within individuals who meet criteria for Cannabis Use Disorder (CUD). The purpose of the current study was to determine differences in sleep quality among undergraduate students who met criteria for mild CUD (n = 18), moderate CUD (n = 22), severe CUD (n = 16) and students who did not meet criteria for CUD (n = 244). Participants included 300 predominantly Black/African American undergraduate students (79% female), aged between 18 and 25 years. Each participant completed an online survey that included measures assessing sleep quality and CUD criteria. Employing analysis of covariance, the moderate CUD subgroup (M = 9.00, SD = 3.32) reported poorer sleep quality than individuals who did not meet criteria for CUD (M = 6.93, SD = 3.03). Interestingly, the severe CUD subgroup (M = 6.75, SD = 2.52) reported similar sleep quality to individuals who did not meet criteria for CUD (M = 6.93, SD = 3.03). Individuals meeting criteria for mild and moderate CUD reported the poorest sleep quality among the groups, suggesting a differentiation within CUD severity. Future research should assess withdrawal and cannabis use frequency among individuals who meet criteria for CUD to further elucidate disturbances in sleep quality among those with CUD.

Recreational cannabis use is associated with poorer sleep outcomes in young adult African Americans.

INTRODUCTION: The present study sought to determine the relationship between self-reported cannabis use dosage in grams per day with (1) objective sleep outcomes: sleep efficiency (SE), sleep onset latency SOL and number of night-time awakenings (NWAK) (2) if objective and subjective sleep measures, using the PSQI, differed between cannabis users and non-cannabis users. METHODS: Our sample included 178 participants, aged 18-35 years. We collected demographic information, cannabis use in dosage per day and frequency of use, depressive symptoms through the CESD, and subjective sleep reports using the PSQI. After the survey assessment, we monitored sleep using the Phillips Actiwatch Spectrum watch for a minimum of 5 nights. RESULTS: The amount of cannabis consumed per day was inversely related to SOL and SE, and positively related to NWAK. After controlling for covariates, regression models were statistically significant for predicting SOL (ß = -0.369, p <.001), SE (ß = -0.232, p <.05) and NWAK, (ß = -0.318, p <.001), indicating cannabis dosage per day is the strongest predictor for the sleep parameters. Subjective sleep measures did not differ from cannabis users versus non-cannabis users. CONCLUSION: Recreational cannabis use is beneficial for SOL but may be detrimental to SE as those who reported increased cannabis use also had more NWAK. Cannabis may be useful for sleep onset, results suggest that increased use does not aid in sleep maintenance.

Assessing the validity of the Self-Report Webexec Questionnaire: Self-report vs performance neurocognitive inferences.

The Webexec is a self-reported neuropsychological measure, which previous research suggests is associated with personality and executive functions. Though the Webexec could be useful for brief neuropsychological assessment, there is limited literature examining its validity. The current study's purpose was to determine Webexec's validity and association with mood symptomatology in two Historically Black College or University (HBCU) undergraduate student samples. Study 1 employed a neurocognitive battery for convergent validity testing, while the second study utilized psychological measures to determine the Webexec's association with mood-based symptomatology. Study 1 included 149 participants, with a mean age of 20.08 (SD = 1.75) years. Participants completed a demographic questionnaire, the Webexec, and a neuropsychological battery. The neuropsychological battery measured verbal fluency, visual scanning, and working memory. The Webexec was positively associated with working memory (r = 0.18, p = 0.03), but no other neuropsychological measures. Study 2 utilized an online survey with 799 HBCU participants. Results suggest Webexec was associated with depressive symptomatology (r = 0.41, p = 0.01), anxiety symptomatology (r = 0.39, p = 0.01), and impulsivity (r = 0.21, p = 0.01). Taken together, results from both studies suggest the Webexec is not consistently associated with performance measures of executive function and maybe more consistent with self-reported psychological symptoms.

Comparison of Cardiorespiratory Fitness in Black or African American Versus Caucasian Patients With Heart Failure.

PURPOSE: Cardiopulmonary exercise testing (CPX) is a well-established assessment with important insight into prognosis and therapeutic efficacy in patients with heart failure (HF). Prior studies have identified several clinical differences between Black or African American (B-AA) and Caucasian patients with HF. Differences in key CPX responses between these two groups require further investigation. METHODS: Using a database consisting of subjects with symptomatic HF who had undergone CPX for inclusion in various prospective randomized clinical trials, we identified 198 (n = 94 [47%] B-AA; n = 105 [53%] Caucasian) patients with a qualifying baseline CPX. Significant univariate predictors of peak oxygen uptake (V˙o2peak) were included in a multivariate linear regression model. RESULTS: When compared with Caucasian patients, B-AA were younger (mean ± SD = 54.8 ± 10.0 vs 57.9 ± 9.6 yr, P = .03), had higher C-reactive protein (CRP) (median [IQR] = 4.9 [2.3, 8.8] vs 1.9 [0.6, 5.5] mg/L, P < .0001), lower hemoglobin (13.0 ± 1.8 vs 13.8 ± 1.6 g/dL, P = .003), and lower left ventricular ejection fraction (LVEF) (40 [32, 51] vs 53 [43, 59]%, P < .00010). During CPX, B-AA patients also had lower V˙o2peak (14.6 ± 3.9 vs 17.6 ± 4.8 mL·kg-1·min-1, P < .0001). No differences were observed between B-AA and Caucasian in the minute ventilation/carbon dioxide production (V˙e/V˙co2) slope (P = .14). The difference in V˙o2peak between B-AA and Caucasian was largely attenuated after adjusting for age, body mass index, CRP, N-terminal pro-brain natriuretic peptide, hemoglobin, LVEF, and peak HR (14.1: 95% CI, 13.2-14.9 vs 15.6: 95% CI, 14.4-16.8 mL·kg-1·min-1, P = .053). CONCLUSIONS: Directly measured V˙o2peak was significantly lower in B-AA than in Caucasians with HF. This is largely explained by differences in clinical characteristics, whereas no significant differences were observed in the V˙e/V˙co2 slope.

The influence of coping with perceived racism and stress on lipid levels in African Americans.

BACKGROUND: Lipid dysregulation is a major contributor to cardiovascular disease (CVD) risk and is attributed to numerous biological, psychosocial, and behavioral risk factors. Psychological stress has been examined as a predictor of lipid dysregulation; however, the role of coping with perceived racism, a stressor unique to the African American experience, has not been addressed. The current study sought to determine the impact of behavioral coping responses to perceived racism and perceived daily stress on lipid levels in African Americans. METHODS: The sample consisted of 122 African American participants who resided in the Washington, DC, metropolitan area. Data were collected as part of an ongoing study entitled Stress and Psychoneuroimmunological Factors in Renal Health and Disease at Howard University Hospital. RESULTS: Through canonical analysis, distinct profiles of African American lipid function emerged with body mass index, age, and behavioral coping responses to perceived racism being associated with high-density lipoprotein cholesterol (HDL-C), triglycerides, and low-density lipoprotein cholesterol (LDL-C), respectively. Results from linear regression analyses showed that greater endorsement of behavioral coping responses to perceived racism items predicted higher levels of LDL (B = .24, p < .05). This relationship was not mediated by pathophysiological mechanisms associated with the stress response system such as cortisol, norepinephrine, epinephrine, and IL-6. CONCLUSION: The relationship between elevated levels of LDL and behavioral coping responses to perceived racism suggests that African Americans may be at increased risk for CVD due to the unique stress encountered by racism in our culture. Behavioral pathways used to counteract the negative effects of perceived discrimination may better explain this relationship. Further research is necessary to determine other biobehavioral and pathophysiological mechanisms that explain this relationship.

Self-Reported Lifetime Violence Exposure and Self-Compassion Associated With Satisfaction of Life in Historically Black College and University Students.

In the United States, approximately 25% of minors have witnessed a violent act, specifically physical assault. African Americans from under-served backgrounds are more likely than other racial and ethnic groups to be exposed to traumatic events. However, there is scant literature examining violence exposure, SC, and life satisfaction collectively, specifically in an African American college sample. The current study sought to determine the associations among violence exposure, SC components, and life satisfaction in an African American college sample. The current sample was comprised of 356 participants (80% female) with a mean age of 20.23 (SD = 1.70). Eighty-eight participants (25%) reported being exposed to violence in their lifetime. Employing logistic regression, we determined violence exposed individuals were less likely to report high satisfaction of life than their non-exposed counterparts (OR = 0.58, 95% CIs = 0.33, 1.00). Individuals with high level of self-kindness were approximately two times more likely to have higher satisfaction of life (OR = 2.48; CI = 1.52, 4.05) compared to their low level self-kindness counterparts and in the presence of demographic covariates. These findings may educate and increase awareness of the impacts of traumatic events. This education could lead to the implementation of interventions to build upon overall well-being in order increase life satisfaction in college students.

Differences in heart rate among recent marijuana use groups.

BACKGROUND: Marijuana use increases cardiac sympathetic activity within minutes of its use and this effect may begin to decrease as soon as one hour after marijuana use. However, the cardiovascular effects of marijuana use more than an hour after use is poorly characterized. The purpose of the current study is to compare heart rate, a marker of cardiac sympathetic activity, across recent marijuana use groups (never used: N.=63; recent use [in the past 24 hours; subacute] N.=13; in the past 7 days, but not in the past 24 hours: N.=17). Overall, the current sample included 93 African American/Black college students, with a mean age of 20.03±2.21 years. METHODS: Participants completed a demographic form, a brief battery of psychological questionnaires, and had their heart rate assessed at baseline. RESULTS: Analysis of covariance showed that heart rate was statistically significantly lower in the recent use group (62.38 bpm) compared with the non-users group (73.92 bpm). This difference persisted before and after statistically adjusting for demographic covariates. CONCLUSIONS: These results suggest that there may be a cardiovascular process that occurs when using marijuana that results in a compensatory, reduced heart rate.

Clinical features and outcomes between African American and Caucasian patients with Takotsubo Syndrome.

BACKGROUND: Takotsubo syndrome (TS) is an acute, reversible form of heart failure, often mimicking an acute coronary syndrome (ACS). Data regarding racial differences in TS are inconsistent. The aim is to assess clinical features associated with unfavorable in-hospital outcomes between African American (AA) and Caucasian (CAU) patients. METHODS: A retrospective electronic health record query identified 44 AA patients and 110 CAU patients with a diagnosis of TS. Our primary outcome was a composite of death, stroke, and cardiogenic shock during hospitalization. Variables associated with an increased risk of the primary composite outcomes were included in a logistic regression model. RESULTS: Compared to CAU patients, AA patients were a more comorbid population, and presented a higher prevalence of history of illicit drug use (27.3% vs. 13.6% P=0.044). There were no significant differences regarding in-hospital complication rates between AA and CAU patients. In the logistic regression model, infection was associated with greater risk of developing the primary outcome in AA patients (OR=7.26 [95% CI 1.22-43.17], P=0.029), whereas angina was a protective factor (OR=0.11 [95% CI 0.02-0.65], P=0.015). In CAU patients, severely depressed ejection fraction and worse peak creatinine during hospitalization increased risk of developing the primary outcome (OR=5.88 95% CI [2.01-17.17], P<0.001 and OR=1.64 [95% CI 1.15-2.58], P=0.031, respectively). Meanwhile, emotional stressors were protective (OR=0.16 [95% CI 0.03-0.88], P=0.004). CONCLUSIONS: Despite experiencing the same rate of in-hospital complications, the clinical profiles of AA patients are distinct from CAU patients admitted for TS, and clinical variables correlated with worse in-hospital outcomes also differ by race.

Inverse associations between parasympathetic activity and cognitive flexibility in African Americans: Preliminary findings.

Previous research suggests that vagal activity and executive function (EF) are positively associated. However, existing data exploring the relationship between HRV and EF remains limited. Though Blacks may have higher HRV, they remain underrepresented in previous research examining HRV and EF. The current study aimed to determine the relationship between EF and HRV in a sample of 92 Black undergraduates (Mean age = 20.32, SD = 2.28). Participants wore an 6­lead ambulatory electrocardiographic impedance monitoring system to obtain the root mean square of interbeat interval differences (rMSSD) and Cardiac Sympathetic Index. After baseline autonomic activity assessment, participants completed the Berg Card Sorting Test. Utilizing hierarchical regression analyses, HRV was negatively associated with correct responses (Beta = -0.40, SE = 0.04, p=0.01) and categories experienced (Beta = -0.37, SE = 0.01, p=0.01), and positively associated with total errors (Beta = 0.39, SE =0.04, p=0.01). To further elucidate these findings, participants were assigned to coinhibition (n = 12), parasympathetically dominant (n = 34), sympathetically dominant (n = 35), or coactivation (n = 11) autonomic space subgroups. Participants in the sympathetically dominant subgroup completed more categories (M = 6.86, SD = 2.13) and committed fewer errors (M = 30.63, SD = 11.53) than their parasympathetic counterparts (M = 5.74, SD = 2.44; M = 43.29, SD = 18.83, respectively). This study suggests that a state of sympathetic arousal immediately prior to the administration of an EF task, may aid in better task performance.

Confirmed marijuana use and lymphocyte count in black people living with HIV.

BACKGROUND: Marijuana is a commonly used recreational substance with purported analgesic and mood enhancing properties. Many people living with HIV identify marijuana as a palliative substance. However, through its main psychoactive component, tetrahydrocannabinol (THC), is known to influence the immune system. The effects of marijuana use in people with HIV are still controversial, with very scant literature in Black adults. METHODS: The current study determined the differences in the lymphocyte count, specifically the number cluster differentiation 4 and 8 (CD4+ and CD8+), among patients who urine drug tested negative for THC (n = 70) and those who tested positive for THC (n = 25). The sample included 95 Black people living with HIV, 51% female, with a mean age of 46 ± 11 years. Participants provided a urine sample for substance use testing and a trained researcher extracted clinical data from clinical charts on the day of appointment. RESULTS: After adjusting for demographic and HIV-related covariates, THC-positive patients had significantly higher CD4+ and CD8+ counts than their THC-negative counterparts. CONCLUSION: These results extend previous HIV-related immunity findings in an underrepresented group, and suggest that THC use does not reduce immune function as measured by CD count. Further research is warranted on the overall effects of THC on immune function in HIV positive patients.

Confirmed marijuana use and lymphocyte count in black people living with HIV.

BACKGROUND: Marijuana is a commonly used recreational substance with purported analgesic and mood enhancing properties. Many people living with HIV identify marijuana as a palliative substance. However, through its main psychoactive component, tetrahydrocannabinol (THC), is known to influence the immune system. The effects of marijuana use in people with HIV are still controversial, with very scant literature in Black adults. METHODS: The current study determined the differences in the lymphocyte count, specifically the number cluster differentiation 4 and 8 (CD4+ and CD8+), among patients who urine drug tested negative for THC (n=70) and those who tested positive for THC (n=25). The sample included 95 Black people living with HIV, 51% female, with a mean age of 46±11years. Participants provided a urine sample for substance use testing and a trained researcher extracted clinical data from clinical charts on the day of appointment. RESULTS: After adjusting for demographic and HIV-related covariates, THC-positive patients had significantly higher CD4+ and CD8+ counts than their THC-negative counterparts. CONCLUSION: These results extend previous HIV-related immunity findings in an underrepresented group, and suggest that THC use does not reduce immune function as measured by CD count. Further research is warranted on the overall effects of THC on immune function in HIV positive patients.

Lifetime marijuana use and sexually transmitted infection history in a sample of Black college students.

BACKGROUND: Sexually transmitted infections (STIs) and marijuana use are more prevalent in African Americans/Blacks (Blacks) than any other ethnicity in the United States. Given the significant health care costs and deleterious health correlates of using marijuana or contracting a STI, it is imperative to examine their association, especially in the vulnerable and underrepresented group of young adult Blacks. PURPOSE: The current study examines the association between lifetime marijuana use on history of STI diagnosis in a sample of Black college students. RESULTS: Approximately 81% of the 213 participants were female, with approximately 81% also being 21years of age or younger. Alcohol (88%) led the prevalence of substances ever used, followed by marijuana (75%), and cigarettes (57%). When including demographic and substance use covariates, lifetime marijuana use (AOR=2.51; 95% CIs, 1.01, 6.21) and age (AOR=2.72; 95% CIs, 1.32, 5.64) were associated with history of STI. CONCLUSION: These findings will inform intervention and prevention methods used to reduce STI prevalence and marijuana use among Black young adults. Both epidemiological and biological foundations will be discussed.