Disparities and protective factors in pandemic-related mental health outcomes: a Louisiana-based study.

Introduction: The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors. Methods: A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black and White adults. The exposure was overall pandemic impact, measured using the Epidemic-Pandemic Impacts Inventory, and the outcome was general well-being (GWB), measured with the General Well-Being Schedule. Potential protective factors included social support, resilience, and social cohesion. Linear regression models were constructed to examine the association between pandemic impact and GWB, with each protective factor added as an effect modifier. These relationships were further assessed for differences by race. Results: Pandemic stressors can be grouped into social, health, work, finance, and family-related impacts. Black persons displayed higher levels of pandemic impact as well as lower levels of social support, resilience, and social cohesion (p < 0.0001), highlighting existing racial disparities, though Black respondents and White respondents exhibited no differences in general-well being. Social support, resilience, and social cohesion were identified as protective factors for both groups (p < 0.0001, respectively), but these protective effects deteriorated as pandemic impacts increased. The addition of a pandemic impact by race interaction term was also significant in each model (p = 0.0020, p < 0.0001, and p = 0.0095, respectively) and showed that the protective effects of social support and resilience deteriorated more rapidly for Black persons than White persons, while the protective effects of social cohesion deteriorated more rapidly for White persons than Black persons. Discussion: This study emphasizes the importance of psychosocial resources in buffering the mental health impact of pandemics. It also suggests greater vulnerability for marginalized communities lacking access to crucial support systems. Findings underscore the need for targeted interventions that bolster access to social support, promote resilience, and strengthen social cohesion, particularly within minority groups. Additionally, policymakers should consider proactive measures to assist in recovery and mitigate the disproportionate impact of future crises on vulnerable populations.

Racial/ethnic differences in risk of suicidal ideation and suicide attempts in a nationally representative sample of U.S. adolescents.

BACKGROUND: Suicidal ideation (SI) and suicide attempts (SA) are risk factors for suicide which peak during adolescence; however, evidence focused on differences in SI and SA risk among racial/ethnic minority youth is limited despite increasing suicide rates among several racial/ethnic minority groups. METHODS: We analyzed a representative sample of adolescents aged 12-17 with prior depressive symptoms (n = 32,617) from the cross-sectional National Surveys on Drug Use and Health (2008-2019). Survey-weighted adjusted logistic regressions estimated the association of race/ethnicity with self-reported lifetime SI and SA, controlling for sociodemographics, lifetime substance use, lifetime major depressive episode, and self-rated health. RESULTS: Compared to white adolescents, Black and Hispanic adolescents had a 2.5 % (p = 0.04) and 4.2 % (p < 0.001) lower likelihood of reporting SI. However, among participants reporting SI, Black and Hispanic adolescents had a 3.2 % (p = 0.03) and 3.1 % (p = 0.03) higher likelihood of reporting SA than white adolescents. Multiracial adolescents were 5.9 % (p = 0.03) more likely to report SA than white adolescents. LIMITATIONS: Although racial/ethnic minority groups are less likely to self-report mental health symptoms, we could only assess SI/SA among adolescents self-reporting prior depressive symptoms, and we could only assess SA among adolescents self-reporting SI due to survey methods. CONCLUSIONS: Variation in the racial/ethnic distribution of suicidality supports theories conceptualizing separate pathways for SI and SA. This underscores the need for greater attention to racial/ethnic differences in suicide-related research, surveillance, and prevention efforts, including ensuring that mental health risk assessments directly evaluate SA in addition to SI in order to better identify high-risk racial/ethnic minority youth.

Ethno-racial differences in depressive symptom endorsement: Evaluation of brief forms of the Geriatric Depression Scale in older adults.

BACKGROUND: Depression among older adults is a pressing public health concern, necessitating accurate assessment tools. The Geriatric Depression Scale (GDS) offers a brief and efficient means of screening depressive symptoms, yet its performance across ethno-racial groups remains understudied. This study aimed to compare the ability of various brief forms of the GDS to detect depressive symptoms and to assess potential ethno-racial differences in symptom endorsement among White, Black/African-American, and American Indian/Alaska Native older adults. METHODS: Data were obtained from the Wisconsin Alzheimer's Disease Research Center (ADRC) clinical cohort, comprising 555 cognitively healthy individuals at risk for dementia. We used participants' baseline data for this cross-sectional analysis. Depressive symptoms were assessed using multiple brief forms of the GDS, derived from a systematic review and meta-analysis. We examined internal consistency and correlations with global Clinical Dementia Rating (CDR) scores. We conducted Kruskal-Wallis tests and post hoc pairwise comparisons to assess ethno-racial group differences in symptom endorsement. RESULTS: Descriptive statistics revealed a predominance of female and White participants, with notable representation from Black and American Indian/Alaska Native groups. All GDS versions demonstrated moderate to high internal consistency. Significant positive correlations were observed between GDS scores and global CDR scores. Ethno-racial group differences in depressive symptom endorsement were evident, with Black participants consistently reporting higher levels of symptoms across most GDS versions. However, American Indian/Alaska Native participants endorsed significantly fewer symptoms than Black participants in one GDS version. CONCLUSION: The study highlights the importance of considering ethno-racial differences in depressive symptomatology when assessing older adults. While the GDS demonstrates overall reliability, variations in symptom endorsement across different ethno-racial groups underscore the need for culturally sensitive assessment tools and interventions. Future research should further explore these group differences and develop tailored approaches to depression screening and treatment in diverse older adult populations.

Remembering the good and bad and the self and others in a culturally modulated self-memory system.

Wang and Conway (2006, Autobiographical memory, self, and culture. In L.-G. Nilsson, & N. Ohta (Eds.), Memory and society: Psychological perspectives (pp. 9-27). Psychology Press) posit that remembering takes place in a culturally modulated self-memory system in which working self-goals are shaped by society and, in turn, influence the encoding and construction of memories in a culturally canonical fashion. The current research examined the self-goal of competence, which manifests through self-enhancement versus self-improvement motivations, in influencing remembering in different cultural contexts. We conducted two cross-cultural studies to examine memories for personal successes and failures (Study 1) and autobiographical and vicarious experiences (Study 2) in connection with individuals' positive self-views. European Americans recalled a greater number of success than failure memories (Study 1) and US participants recalled a greater number of autobiographical than vicarious memories (Study 2), which was further associated with positive self-views at the individual level. In contrast, Asian (Study 1) and Chinese participants (Study 2) recalled even-handedly the different types of memories, and the memory retrieval was unrelated to individuals' self-views. We discuss the findings in light of the different manifestations of the competence goal in shaping memory in the culturally modulated self-memory system.

Microaggression and discrimination exposure on young adult anxiety, depression, and sleep.

BACKGROUND: Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups. METHODS: Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure. RESULTS: Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (ORMicro = 1.42, ORDiscrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (ORDepress = 1.24, ORSleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents. LIMITATIONS: Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences. CONCLUSIONS: The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.

Cultural values, parenting, and child adjustment in the United States.

We examined whether cultural values, conformity and parenting behaviours were related to child adjustment in middle childhood in the United States. White, Black and Latino mothers (n = 273), fathers (n = 182) and their children (n = 272) reported on parental individualism and collectivism, conformity values, parental warmth, monitoring, family obligation expectations, and child internalising and externalising behaviours. Mean differences, bivariate correlations and multiple regression analyses were performed on variables of interest. Collectivism in mothers and fathers was associated with family obligation expectations and parental warmth. Fathers with higher conformity values had higher expectations of children's family obligations. Child internalising and externalising behaviours were greater when Latino families subscribed to individualistic values. These results are discussed in the context of cultural values, protective and promotive factors of behaviour, and race/ethnicity in the United States.

The misperception of organizational racial progress toward diversity, equity, and inclusion.

Despite a checkered racial history, people in the United States generally believe the nation has made steady, incremental progress toward achieving racial equality. In this article, we investigate whether this U.S. racial progress narrative will extend to how the workforce views the effectiveness of organizational efforts surrounding diversity, equity, and inclusion. Across three studies (N = 1,776), we test whether Black and White U.S. workers overestimate organizational racial progress in executive representation. We also examine whether these misperceptions, surrounding organizational progress, drive misunderstandings regarding the relative ineffectiveness of common organizational diversity policies. Overall, we find evidence that U.S. workers largely overestimate organizational racial progress, believe that organizational progress will naturally improve over time, and that these misperceptions of organizational racial progress may drive beliefs in the effectiveness of diversity, equity, and inclusion policies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Racial/Ethnic Differences in Relationships Between Pregnancy Intentions and Maternal Outcomes.

Unplanned or unwanted pregnancies and births are linked to adverse maternal outcomes, but the extent to which such relationships hold for all racial/ethnic groups remains unknown. In this paper, I use large-scale data to estimate unadjusted and inverse propensity weighted associations between a five-level measure of pregnancy intention and six indicators of maternal well-being among separate samples of white, Black, and Hispanic mothers. I find substantial racial/ethnic variation. White and Hispanic mothers who reported that their pregnancies were mistimed, unwanted, or that they were unsure how they felt were significantly more likely to experience adverse outcomes than same-race/ethnicity mothers who reported that their pregnancy was intended, but the pattern was much more tenuous for Black mothers. After adjusting for potential confounding variables, relationships between pregnancy intentions and adverse outcomes remain substantial only for white and Hispanic mothers.

Interactive effects of participant and stimulus race on cognitive performance in youth: Insights from the ABCD study.

An extensive literature shows that race information can impact cognitive performance. Two key findings include an attentional bias to Black racial cues in U.S. samples and diminished recognition of other-race faces compared to same-race faces in predominantly White adult samples. Yet face stimuli are increasingly used in psychological research often unrelated to race (Conley et al., 2018) or without consideration for how race information may influence cognitive performance, especially among developmental participants from different racial groups. In the current study we used open-access data from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study® 4.0.1 release to test for developmentally similar other- and same-race effects of Black and White face stimuli on attention, working memory, and recognition memory in 9- and 10-year-old Black and White children (n=5,659) living in the U.S. Black and White children showed better performance when attending to Black versus White faces. We also show an advantage in recognition memory of same-race compared to other-race faces in White children that did not generalize to Black children. Together the findings highlight how race information, even when irrelevant to an experiment, may indirectly lead to misinterpretation of group differences in cognitive performance in children of different racial backgrounds.

Racial/Ethnic Disparities in HRQoL and Associated Risk Factors in Colorectal Cancer Survivors: With a Focus on Social Determinants of Health (SDOH).

PURPOSE: This study aimed to understand how health-related quality of life (HRQoL) differs by race/ethnicity in colorectal (CRC) survivors. We aimed to 1) examine racial/ethnic disparities in HRQoL, and 2) explore the roles of social determinants of health (SDOH) risk factors for HRQoL differ by racial/ethnic groups. METHODS: In 2,492 adult CRC survivors using Behavioral Risk Factor Surveillance System (BRFSS) survey data (from 2014 to 2021, excluding 2015 due to the absence of CRC data), we used the Centers for Disease Control and Prevention (CDC) HRQoL measure, categorized into "better" and "poor." Multivariate logistic regressions with prevalence risk (PR) were employed for our primary analyses. RESULTS: Compared with non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB) (PR = 0.61, p = .045) and Hispanics (PR = 0.32, p < .001) reported worse HRQoL in adjusted models. In adjusted models, unemployed/retired and low-income levels were common risk factors for worse HRQoL across all comparison groups (NHW, NHB, non-Hispanic other races, and Hispanics). Other SDOH associated with worse HRQoL include divorced/widowed/never married marital status (non-Hispanic other races and Hispanics), living in rural areas (NHW and NHB), and low education levels (NHB and Hispanics). Marital status, education, and employment status significantly interacted with race/ethnicity, with the strongest interaction between Hispanics and education (PR = 2.45, p = .045) in adjusted models. CONCLUSION: These findings highlight the need for culturally tailored interventions targeting modifiable factors (e.g., social and financial supports, health literacy), specifically for socially vulnerable CRC survivors, to address the disparities in HRQoL among different racial/ethnic groups.

Psychotic white men and bipolar black women? Racialized and gendered implications of mental health terminology.

This study investigates the intersection of race, gender, and criminality in the language surrounding mental health and illness. Applying computational methods of word embeddings to full text data from major American newspapers between 2000 and 2023, I show that the landscape of mental health is broadly racialized as black, challenging the notion of mental illness as a predominantly white phenomenon. Cultural ideas about mental illness are gendered such that women are medicalized and men are criminalized, yet certain terms blur the boundary between illness and criminality. I highlight how stereotypes embedded in mental health language perpetuate stigma around men's mental health and justify social control with notable implications for black men. I conclude with recommendations for the mental health movement by advocating for more inclusive discussions around men's mental health and revised person-centric language.

Measurement of adolescent psychological wellbeing: A test of factor structure and measurement invariance.

Gains in holistic approaches to adult mental health have been associated with increasing interest in understanding psychological wellbeing (PWB) among adolescents. Empirical examination of measurement models for PWB in adolescence is lacking. Thus, the current study examined PWB in a longitudinal, diverse sample of 433 adolescents (non-Latinx Black: 37.6%; non-Latinx White: 25.9%; Latinx: 36.5%; Male adolescents: 50.1%). A one-factor, correlated six-factor and hierarchical models were examined across racial/ethnic (White, Black, and Hispanic) and gender (female, male) identities, after which the best fitting model was selected to undergo invariance testing. A one-factor structure was superior, and exhibited strict invariance across racial/ethnic and gender identities at each wave of the study, as well as longitudinal invariance within the entire sample.

The Mediating Effects of Education and Occupational Complexity Between Race and Longitudinal Change in Late Life Cognition in ACTIVE.

This study examined educational and occupational inequality as two aspects of social determinants of health that might mediate the longitudinal relationship between racialization and late life cognitive level and change. Participants were 2371 individuals racialized as Black and White from the ACTIVE study who provided occupational data. Data were analyzed from baseline and five assessments over 10-years using structural equation modeling. Black/White race served as the predictor, occupational complexity (OC) and years of education as mediators, and cognitive (memory, reasoning, and speed of processing) intercept, linear slope, and quadratic slope as the dependent variables. Black/White race showed significant indirect associations through education and OC on level of performance in cognition, linear change in reasoning and memory, and quadratic change in reasoning. Education and OC accounted for 11-16% of the association between race and cognitive level and represent modifiable social determinants of health that are associated with disparities in cognitive aging.

Racial differences in physical activity engagement, barriers, and enjoyment during weight loss.

OBJECTIVE: Aiming to identify potential intervention targets to achieve more equitable outcomes from behavioral weight loss (BWL) programs, the current study examined whether Black and White individuals experienced similar increases in physical activity (PA) engagement, perceived PA barriers, and PA enjoyment during an 18-month BWL program. METHOD: Adults (N = 290) enrolled in an 18-month BWL program from 2014 to 2016 completed accelerometer-based measurements of moderate-to-vigorous PA and self-reported measures of PA barriers and enjoyment at months 0, 6, 12, and 18. RESULTS: Black participants had significantly fewer minutes of PA than White participants at baseline, 6, 12, and 18 months. Black participants reported fewer barriers to PA than White participants at 0 and 6 months but not at 12 or 18 months. They also reported higher PA enjoyment than White participants at 0 and 6 months but not at 12 or 18 months. Furthermore, whereas White participants had a significant reduction in PA barriers and an increase in PA behavior overtime, Black participants did not. There was no interaction between race and time on PA enjoyment. CONCLUSIONS: Traditional BWL interventions may be ineffective for promoting PA among Black participants and may not appropriately address the unique PA barriers that Black participants experience. An improved understanding of differences in PA behaviors during BWL among Black and White individuals could help delineate why Black participants do not appear to benefit as much as White participants from traditional BWL programs and inform intervention strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Why did peri-pandemic suicide death rates decrease among non-Hispanic white people while increasing among most people of color?

INTRODUCTION: While suicides in the United States decreased during the COVID-19 pandemic, statistically significant decreases have been limited to White people throughout a large portion of 2020. METHODS: This paper outlines possible explanations for racial/ethnic differences in suicidality in the early pandemic phases. RESULTS: We propose both distal (i.e., tele-mental health usage, internet and technology access, employment protections, and economic security) and proximal (cultural beliefs, coping strategies, clustering, pulling together, and embracing life) factors that may have helped build and foster community and mental wellness. However, this paper argues these factors did not extend, or did not extend as much, to many communities of color. CONCLUSIONS: We argue that these disparities are due to the myriad effects of discrimination and systemic racism, encapsulated broadly by the minority stress theory, and provide suggestions for relief and research.

Reevaluating the "deaths of despair" narrative: Racial/ethnic heterogeneity in the trend of psychological distress-related death.

Despite the significant scientific advancement in deciphering the "deaths of despair" narrative, most relevant studies have focused on drug-, alcohol-, and suicide-related (DAS) deaths. This study directly investigated despair as a determinant of death and the temporal variation and racial heterogeneity among individuals. We used psychological distress (PD) as a proxy for despair and drew data from the US National Health Interview Survey-Linked Mortality Files 1997 to 2014, CDC (Centers for Disease Control and Prevention) Multiple Cause of Death database 1997 to 2014, CDC bridged-race population files 1997 to 2014, Current Population Survey 1997 to 1999, and the American Community Survey 2000 to 2014. We used Cox proportional hazards models to estimate mortality hazard ratios of PD and compared age-standardized PD- and DAS-related mortality rates by race/ethnicity and over time. We found that while Whites had a lower prevalence of PD than Blacks and Hispanics throughout the whole period, they underwent distinctive increases in PD-related death and have had a higher PD-related mortality rate than Blacks and Hispanics since the early 2000s. This was predominantly due to Whites' relatively high and increasing vulnerability to PD less the prevalence of PD. Furthermore, PD induced a more pervasive mortality consequence than DAS combined for Whites and Blacks. In addition, PD- and DAS-related deaths displayed a concordant trend among Whites but divergent patterns for Blacks and Hispanics. These findings suggest that 1) DAS-related deaths underestimated the mortality consequence of despair for Whites and Blacks but overestimated it for Hispanics; and 2) despair partially contributed to the DAS trend among Whites but probably not for Blacks and Hispanics.

Perceptions of Falling Behind "Most White People": Within-Group Status Comparisons Predict Fewer Positive Emotions and Worse Health Over Time Among White (but Not Black) Americans.

Despite the persistence of anti-Black racism, White Americans report feeling worse off than Black Americans. We suggest that some White Americans may report low well-being despite high group-level status because of perceptions that they are falling behind their in-group. Using census-based quota sampling, we measured status comparisons and health among Black (N = 452, Wave 1) and White (N = 439, Wave 1) American adults over a period of 6 to 7 weeks. We found that Black and White Americans tended to make status comparisons within their own racial groups and that most Black participants felt better off than their racial group, whereas most White participants felt worse off than their racial group. Moreover, we found that White Americans' perceptions of falling behind "most White people" predicted fewer positive emotions at a subsequent time, which predicted worse sleep quality and depressive symptoms in the future. Subjective within-group status did not have the same consequences among Black participants.

Parental Cognitions, Treatment Engagement, and Child Outcomes of ADHD Behavioral Treatment among Asian American Families.

Asian American (AA) families remain critically underrepresented in clinical trials for ADHD interventions. Little is known about AA families' engagement in and outcomes of behavioral treatment (BT). Comparing AA families to other minoritized (OM) families and White families, this study examined parental cognitions, treatment engagement, and child outcomes of BT for ADHD inattentive type (ADHD-I). Path analyses were conducted utilizing data from a randomized controlled trial of BT for ADHD-I (N = 199 children, ages 7-11). Racial/ethnic differences in pretreatment parental self-competence and treatment expectations were examined for AA (n = 29) compared to OM (n = 35) and White (n = 135) parents. Two additional path models were conducted to examine the relations among race/ethnicity, pretreatment parental cognitions, treatment engagement, and posttreatment child outcomes. Direct effects of race/ethnicity and parental cognitions on posttreatment child outcomes as well as their indirect effects via treatment engagement were estimated. At pretreatment, AA parents endorsed lower parental self-competence and treatment expectations compared to OM and White parents. At posttreatment, AA parents reported fewer improvements in ADHD symptoms than White parents and lower global psychosocial improvement than OM parents. For all parents, treatment expectations positively predicted parent- and observer-rated treatment engagement, which in turn predicted child global psychosocial improvement. Path analyses indicated that the relationship between treatment expectations and posttreatment child global improvement was fully mediated by treatment engagement. These findings suggest that treatment expectations impede AA parents' engagement and success in BT. Implications for cultural adaptations of BT to improve AA families' treatment experience are discussed.

Negotiating cancer alone: A qualitative study exploring care experiences of racially and ethnically diverse women diagnosed with breast cancer during COVID-19.

COVID-19 has critically impacted cancer care services including reduced screenings, diagnoses, and surgeries; particularly among Black and Latina/x women who already suffer worse outcomes. This qualitative study explored the care experiences of a diverse sample of breast cancer survivors (N = 21; 7 Black, 4 Hispanic, 10 White) undergoing treatment during the pandemic via online semi-structured interviews. Grounded theory analysis yielded the core category "negotiating cancer alone," that included: (1) psychological distress, negotiating the cancer trajectory in isolation; (2) provider/healthcare system diagnostic and treatment delays; (3) heightened anxiety about treatment delays causing cancer progression; (4) supportive care limitations; and (5) disparate experiences of cancer care disruptions. Black and Latina/x women described greater delays in care, financial challenges, treatment complications, and insurance limitations than White women. The study identifies cancer patients' pandemic-related psychological, healthcare system, and health equity challenges and suggests recommendations to support their increased psychological needs during oncologic care disruptions.