Emotion Regulation, Coping Strategies, and Hazardous Drinking Among Family Caregivers of People With Alzheimer's Disease and Related Dementias.

PURPOSE: The current study investigated hazardous drinking and alcohol use disorders among 453 family caregivers of individuals living with Alzheimer's disease and related dementias (ADRD). METHOD: We examined the prevalence of hazardous drinking and its relationship with emotion regulation and coping strategies (problem-solving, social support, and avoidance) using data from the first wave of a longitudinal study on daily ADRD caregiving experiences. A binary logistic regression model was performed to predict the relationship between potential risk factors and hazardous drinking. RESULTS: Findings revealed that 18.1% of ADRD caregivers screened positive for hazardous drinking based on the Alcohol Use Disorders Identification Test-Consumption. Caregivers experiencing greater difficulties in emotion regulation and greater reliance on avoidance as a coping strategy were at higher risk of screening positive for hazardous drinking. CONCLUSION: These findings stress the importance of targeted interventions to improve emotion regulation and reduce avoidance coping in ADRD caregivers, ultimately enhancing their well-being. [Research in Gerontological Nursing, 17(2), 81-90.].

Vicarious experiences of major discrimination, anxiety symptoms, and mental health care utilization among Black Adults.

BACKGROUND: The adverse mental health consequences of discrimination among Black adults, such as anxiety symptoms, are well documented. Prior research establishes anxiety as a risk factor for suboptimal health outcomes among Black adults. Most discrimination and mental health studies, however, have focused on the effects of personal experiences of discrimination. Moreover, of the studies that examine the mental health effects of vicarious exposure to discrimination, few investigate this relationship from a stress and coping perspective beyond the life stages of childhood and adolescence. Thus, the purpose of this study was to assess the effects of vicarious and personal experiences of discrimination on the subjective well-being of Black adults, while observing the potentially moderating effects of utilizing mental health care. METHODS: A subsample of Black adults (N = 627) between the ages of 22-69 years old were drawn from the Nashville Stress and Health Study and analyzed to assess within-group variation. Multivariate linear regression was employed to examine the association between vicarious experiences of major discrimination and self-reported anxiety symptoms. Additionally, we evaluated the moderating effects of lifetime utilization of mental health services on the relationship between discrimination and symptoms of anxiety. RESULTS: Findings revealed that vicarious experiences of major discrimination and personal experiences of everyday discrimination were both associated with higher levels of anxiety symptoms among the participants. Additionally, lifetime utilization of mental health care moderated the effects of vicarious and personal experiences of discrimination. CONCLUSIONS: The secondhand consequences of discrimination must be considered while assessing the racism-related stress experience. Results from this investigation suggest that mental health treatment should be included in programs targeted to reduce the negative effects of discrimination among Black adults. Additionally, culturally-specific strategies should be considered for addressing racism-related adversity.

How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes.

Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes-information that can be used to shape interventions.

Coordination of the cortisol and testosterone responses: A dual axis approach to understanding the response to social status threats.

For many people, competitions, status challenges, and being evaluated by others result in increases in cortisol as well as testosterone. It is argued that physiological processes work in a coordinated fashion when facing social evaluative-competitive situations. Such a coordinated response may be part of an evolved system, monitoring and responding to threats to one's social status. In two studies, using within-person multi-level analyses, we tested the hypothesis that adult men, pre/early pubertal boys, and pre/early pubertal girls show a coordinated response in cortisol and testosterone (i.e., coupling of cortisol and testosterone responses) during a social evaluative situation. In Study 1, 85 men delivered speeches and performed difficult arithmetic tasks in front of critical evaluators, prepared for a competition, and provided multiple saliva samples throughout the procedure for cortisol and testosterone assays. In Study 2, 79 boys and 74 girls underwent similar procedures as in Study 1. Within-person analyses suggested that cortisol and testosterone responses were indeed positively associated for all three groups (men, boys, and girls). That is, on average a participant's cortisol and testosterone levels tended to rise and fall together throughout the procedure, suggesting that cortisol and testosterone show coordinated activation and deactivation (coupling) during social status threats. Furthermore, men with higher anxiety during the stressor tasks (Study 1; coded by raters from video recordings) and both boys and girls with higher parent reported trait negative affectivity (Study 2) had stronger coupling. Men (Study 1) higher in self-reported trait dominance and verbal dominance (coded by raters from video recordings during the stressor), and lower in basal testosterone had weaker coupling. A coordinated hormone response may have important adaptive functions when dealing with status threats; cortisol can mobilize energy resources and testosterone can facilitate performance. These findings have implications for developing a dual axis understanding of physiological responses during social threats and competition and their function.