RESUMO
BACKGROUND: Ethnic socialisation plays a vital role in the development of ethnic minority adolescents. However, the generalizability of research findings beyond the context of immigrant societies in the United States remains unclear. METHODS: Utilising a person-centred approach, this study analysed a sample of 2,600 ethnic minority adolescents in China (55.8% female, Mage = 14.93 ± 1.82) to explore ethnic socialisation patterns, and their correlations with depression. RESULTS: Latent profile analysis revealed four distinct ethnic socialisation profiles: low-frequency, moderate-frequency, high-frequency and proactive integration orientation. Adolescents with the high-frequency profile displayed the highest levels of depression, followed by those with the moderate-frequency profile, whereas adolescents with the low-frequency and proactive integration orientation profiles showed a lower risk of depression. CONCLUSIONS: Within the sociocultural context of China, ethnic minority families' ethnic socialisation practices demonstrate unique characteristics. Various ethnic socialisation messages are integrated in diverse patterns to exert influence on adolescents.
Assuntos
Depressão , Humanos , China/etnologia , Adolescente , Feminino , Masculino , Depressão/etnologia , Minorias Étnicas e Raciais/estatística & dados numéricos , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Etnicidade/psicologiaRESUMO
BACKGROUND: Depression is present in all societies and affects members of all racial and ethnic groups. However, attitudes about depression differ across groups and have been shown to impact help-seeking behaviors, preferences for treatments, and compliance with treatments. METHODS: Taking a cross-cultural approach, this project used a case vignette of depression to examine race/ethnic group differences in attitudes about depression and its treatment among young adults in the U.S. RESULTS: Data analyses revealed significant racial/ethnic group differences in attitudes as well as the treatments/strategies participants reported they would use. Gender x race/ethnicity interactions revealed that White and Multiracial/ethnic men were more likely to believe the vignette character should find a partner to help with symptoms, while White and Multiracial/ethnic women did not endorse those strategies. Hispanic men and women did not show a gender difference in that strategy, but gender differences were observed in other strategies. In a rare comparison, majority-minority Multiracial/ethnic participants (i.e., White selected as one of their races/ethnicities) rated identified helpers and treatments similarly to White participants and significantly higher than multiple-minority Multiracial participants (i.e., White not selected as one of their races/ethnicities). CONCLUSIONS: Findings supported previous research that indicates different U.S. racial/ethnic group ideas of depression and its treatment are potentially linked with cultural values, and we suggest that investigating these more fine-grained group differences can help to inform treating professionals as well as public health messages.
Assuntos
Depressão , Hispânico ou Latino , População Branca , Humanos , Masculino , Feminino , Adulto , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Adulto Jovem , Depressão/psicologia , Depressão/etnologia , Depressão/terapia , População Branca/psicologia , População Branca/estatística & dados numéricos , Estados Unidos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Comparação Transcultural , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Adolescente , Fatores SexuaisRESUMO
Background: The immigration enforcement system has significant effects on the health of immigrants, their families, and society. Exposure to the immigration enforcement system is linked to adverse mental health outcomes, which may have been exacerbated by sustained immigration enforcement activities during the COVID-19 pandemic. Objectives: This study was conducted to investigate the association between exposure to immigration enforcement and the mental health of undocumented young adults in California during the COVID-19 pandemic. Methods: Data are from the COVID-19 BRAVE (Building Community Raising All Immigrant Voices for Health Equity) Study, a community-engaged cross-sectional survey of the impacts of the COVID-19 pandemic on undocumented immigrants in California. A total of 366 undocumented immigrants between 18 and 39 years of age completed the online survey, which was conducted between September 2020 and February 2021. Multivariable logistic regression models were fit to examine the association between immigration enforcement exposure and depression. Results: Almost all participants (91.4%) disclosed exposure to the immigration enforcement system, with most reporting an average of 3.52 (SD=2.06) experiences. Multivariate analyses revealed that an increase in the immigration enforcement exposure score was significantly associated with higher odds of depression (adjusted odds ratio [aOR]=1.24; 95% confidence interval [CI]: 1.10, 1.40), and women were 92% more likely to report depression than were men (aOR=1.92; 95% CI: 1.12, 3.31). Those who reported deportation fears were significantly more likely to be depressed (aOR=1.24; 95% CI: 1.10, 1.40). Conclusions: Researchers should consider the mental health implications of a punitive immigration enforcement system, and policymakers should examine the impacts of immigration policies on local communities.
Assuntos
COVID-19 , Depressão , Imigrantes Indocumentados , Humanos , Masculino , Feminino , COVID-19/epidemiologia , COVID-19/psicologia , California/epidemiologia , Adulto , Adulto Jovem , Estudos Transversais , Depressão/epidemiologia , Depressão/etnologia , Adolescente , Imigrantes Indocumentados/psicologia , Imigrantes Indocumentados/estatística & dados numéricos , Emigração e Imigração/legislação & jurisprudência , Violência/estatística & dados numéricos , Violência/etnologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Perceived discrimination in health care settings can have adverse consequences on mental health in minority groups. However, the association between perceived discrimination and mental health is prone to unmeasured confounding. The study aims to quantitatively evaluate the influence of unmeasured confounding in this association, using g-estimation. METHODS: In a predominantly African American cohort, we applied g-estimation to estimate the association between perceived discrimination and mental health, adjusted and unadjusted for measured confounders. Mental health was measured using clinical diagnoses of anxiety, depression and bipolar disorder. Perceived discrimination was measured as the number of patient-reported discrimination events in health care settings. Measured confounders included demographic, socioeconomic, residential and health characteristics. The influence of confounding was denoted as α1 from g-estimation. We compared α1 for measured and unmeasured confounding. RESULTS: Strong associations between perceived discrimination in health care settings and mental health outcomes were observed. For anxiety, the odds ratio (95% confidence interval) unadjusted and adjusted for measured confounders were 1.30 (1.21, 1.39) and 1.26 (1.17, 1.36), respectively. The α1 for measured confounding was -0.066. Unmeasured confounding with α1=0.200, which was over three times that of measured confounding, corresponds to an odds ratio of 1.12 (1.01, 1.24). Similar results were observed for other mental health outcomes. CONCLUSION: Compared with measured confounding, unmeasured that was three times measured confounding was not enough to explain away the association between perceived discrimination and mental health, suggesting that this association is robust to unmeasured confounding. This study provides a novel framework to quantitatively evaluate unmeasured confounding.
Assuntos
Negro ou Afro-Americano , Fatores de Confusão Epidemiológicos , Saúde Mental , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtorno Bipolar/psicologia , Transtorno Bipolar/etnologia , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Estudos de Coortes , Depressão/epidemiologia , Depressão/psicologia , Depressão/etnologia , Transtornos Mentais/epidemiologia , Racismo/psicologia , Racismo/estatística & dados numéricos , Discriminação PercebidaRESUMO
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.
Assuntos
Agressão , Ansiedade , Depressão , Humanos , Masculino , Feminino , Adulto Jovem , Depressão/psicologia , Depressão/etnologia , Depressão/epidemiologia , Ansiedade/psicologia , Ansiedade/etnologia , Ansiedade/epidemiologia , Agressão/psicologia , Adulto , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etnologia , Transtornos do Sono-Vigília/psicologia , Adolescente , Estados Unidos/epidemiologia , Hispânico ou Latino/estatística & dados numéricos , Hispânico ou Latino/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricosRESUMO
Digital health technologies may offer an alternate approach to augmenting the established mental health care delivery systems for migrants and promoting their mental well-being. This review aims to provide a broad examination of literature, to determine the impact of technology-based interventions on outcomes of immigrants and refugees experiencing mental health symptoms associated with pre-and postmigration stress (depression, anxiety, psychological stress, PTSD). We searched five electronic databases (PubMed, Embase, PsycINFO, Web of Science, and the ACM digital library). We included studies that looked at the effectiveness of any technologybased intervention (internet or phone-based, telepsychiatry, telemedicine, digital technology, videoconferencing, or tele video). We limited our search to articles written in English and published up until January 2202. Two reviewers independently extracted article data and evaluated the quality of studies using the Cochrane risk-of-bias criteria and ROBINS-I risk of bias evaluation tool. We found scant evidence that the use of digital interventions, such as mobile-based therapies, video conferencing, and digital platforms, is associated with a statistically significant reduction in depressive and anxious symptoms among immigrants and refugees. In the included trials, no evidence of a substantial decrease in PTSD symptoms was found following the use of a self-help mobile app. Our systematic review revealed intriguing but limited evidence that digital psychological therapies can reduce depression in immigrants and refugees. Future study with a randomized experimental design is required to examine the effectiveness of digital treatments in lowering the impacts of mental health outcomes among immigrants.
Assuntos
Emigrantes e Imigrantes , Refugiados , Telemedicina , Humanos , Refugiados/psicologia , Emigrantes e Imigrantes/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/etnologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Depressão/terapia , Depressão/psicologia , Depressão/etnologia , Comunicação por Videoconferência , Ansiedade/terapia , Ansiedade/psicologia , Ansiedade/etnologia , Estresse Psicológico/terapia , Estresse Psicológico/psicologiaRESUMO
Parents' socialization beliefs have implications for the psychological adjustment of their children through their parenting behaviors; however, such pathways have rarely been established among Chinese American families. The present study examined how Chinese American parents' goals for their children to take on bicultural values and behaviors (i.e., bicultural socialization beliefs) influenced their child's level of depressive symptoms in emerging adulthood through their parenting behaviors and the level of parent-child alienation. Data came from Waves 2 (adolescence) and 3 (emerging adulthood) of a longitudinal study of 444 Chinese American families. Mothers' reports of their bicultural socialization beliefs positively predicted adolescents' reports of mothers' autonomy-supporting behaviors and interdependence-focused shaming behaviors. In addition, there was a significant and negative indirect effect of mothers' bicultural socialization beliefs on emerging adult depressive symptoms through adolescents' reports of mothers' autonomy-supporting behaviors and emerging adults' reports of alienation to their parents. In contrast, there was a significant and positive indirect effect from fathers' reports of their bicultural socialization beliefs to emerging adult depressive symptoms, through emerging adults' reports of alienation only. Findings contribute to our understanding of bicultural processes in Chinese American families and establish that parents' beliefs have significant implications for the psychological adjustment of Chinese American youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Assuntos
Asiático , Depressão , Relações Pais-Filho , Poder Familiar , Socialização , Humanos , Feminino , Masculino , Depressão/etnologia , Depressão/psicologia , Asiático/psicologia , Adolescente , Estudos Longitudinais , Relações Pais-Filho/etnologia , Poder Familiar/psicologia , Poder Familiar/etnologia , Adulto Jovem , Pais/psicologia , AdultoRESUMO
BACKGROUND: Black patients meeting indications for implantable cardioverter-defibrillators (ICDs) have lower rates of implantation compared with White patients. There is little understanding of how mental health impacts the decision-making process among Black patients considering ICDs. Our objective was to assess the association between depressive symptoms and ICD implantation among Black patients with heart failure. METHODS AND RESULTS: This is a secondary analysis of the VIVID (Videos to Address Racial Disparities in ICD Therapy via Innovative Designs) randomized trial, which enrolled self-identified Black individuals with chronic systolic heart failure. Depressive symptoms were assessed by the Patient Health Questionnaire-2 and the Mental Component Summary of the 12-Item Short-Form Health Survey. Decisional conflict was measured by an adapted Decisional Conflict Scale (DCS). ANCOVA was used to assess differences in Decisional Conflict Scale scores. Multivariable logistic regression was used to examine the association between depressive symptoms and ICD implantation. Among 306 participants, 60 (19.6%) reported depressed mood, and 142 (46.4%) reported anhedonia. Participants with the lowest Mental Component Summary of the 12-Item Short-Form Health Survey scores (poorer mental health and higher likelihood of depression) had greater decisional conflict regarding ICD implantation compared with those with the highest Mental Component Summary of the 12-Item Short-Form Health Survey scores (adjusted mean difference in Decisional Conflict Scale score, 3.2 [95% CI, 0.5-5.9]). By 90-day follow-up, 202 (66.0%) participants underwent ICD implantation. There was no association between either the Patient Health Questionnaire-2 score or the Mental Component Summary of the 12-Item Short-Form Health Survey score and ICD implantation. CONCLUSIONS: Depressed mood and anhedonia were prevalent among ambulatory Black patients with chronic systolic heart failure considering ICD implantation. The presence of depressive symptoms did not impact the likelihood of ICD implantation in this population.
Assuntos
Negro ou Afro-Americano , Morte Súbita Cardíaca , Desfibriladores Implantáveis , Depressão , Humanos , Desfibriladores Implantáveis/psicologia , Masculino , Feminino , Morte Súbita Cardíaca/prevenção & controle , Morte Súbita Cardíaca/epidemiologia , Pessoa de Meia-Idade , Depressão/psicologia , Depressão/etnologia , Negro ou Afro-Americano/psicologia , Idoso , Insuficiência Cardíaca Sistólica/terapia , Insuficiência Cardíaca Sistólica/psicologia , Insuficiência Cardíaca Sistólica/etnologia , Fatores de Risco , Saúde Mental , Medição de RiscoRESUMO
BACKGROUND: Access to evidence-based interventions is urgently required, especially for individuals of minoritized identities who experience unique barriers to mental health care. Digital mental health interventions have the potential to increase accessibility. Previous pilot studies testing HabitWorks, a smartphone app providing an interpretation bias intervention, have found strong engagement and adherence for HabitWorks; however, previous trials' samples consisted of predominantly non-Hispanic, White individuals. OBJECTIVE: This study conducted an open trial of HabitWorks in a community sample of adults who identified as Black, Hispanic or Latinx, or both. This study aims to test safety, acceptability, and engagement with the HabitWorks app for Black and Latinx adults. METHODS: Black, Hispanic or Latinx adults (mean age 32.83, SD 11.06 y; 22/31, 71% women) who endorsed symptoms of anxiety or depression were asked to complete interpretation modification exercises via HabitWorks 3 times per week for 1 month. Interpretation bias and anxiety and depression symptoms were assessed at baseline and posttreatment assessments. Participants completed qualitative interviews to assess overall perceptions of HabitWorks. RESULTS: Of the 31 participants that downloaded the app, 27 (87%) used HabitWorks all 4 weeks. On average, participants completed 15.74 (SD 7.43) exercises out of the 12 prescribed, demonstrating high engagement. Acceptability ratings met all a priori benchmarks except for relevancy. Qualitative interviews also demonstrated high acceptability and few negative experiences. Significant improvements were found in interpretation style (t30=2.29; P<.001), with a large effect size (Cohen d=1.53); anxiety symptoms (t30=2.29; P=.03), with a small effect size (Cohen d=0.41); and depression symptoms (t30=3.065; P=.005), with a medium effect size (Cohen d=0.55). CONCLUSIONS: This study adds to the literature evaluating digital mental health interventions in Black and Latinx adults. Preliminary results further support a future controlled trial testing the effectiveness of HabitWorks as an intervention.
Assuntos
Negro ou Afro-Americano , Hispânico ou Latino , Aplicativos Móveis , Aceitação pelo Paciente de Cuidados de Saúde , Smartphone , Humanos , Feminino , Adulto , Masculino , Hispânico ou Latino/psicologia , Negro ou Afro-Americano/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Depressão/terapia , Depressão/etnologia , Depressão/psicologia , Adulto Jovem , Ansiedade/terapia , Ansiedade/psicologia , Ansiedade/etnologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Child neglect is prevalent in western rural China, yet there is limited research among ethnic minority communities. The Salar, a Turkic-Muslim ethnic minority residing primarily in western China, also face this specific problem. The group is deeply influenced by ethnicity, Islam and Chinese Confucianism, which in turn makes women vulnerable to child marriage and IPV. These victimizations, coupled with various life stressors, further complicate the challenges of providing adequate care for their children. OBJECTIVE: This study hypothesizes a relationship between child neglect and maternal child marriage, IPV victimization, and depression symptoms. PARTICIPANTS AND SETTING: 201 married Salar women from five villages in Xunhua Salar Autonomous County, China, were randomly selected to participate in the study. METHOD: A probability proportional to size (PPS) sampling approach was used to collect a random representative multi-stage cluster sample in 2022. Random effects Poisson regression models were used to test the hypotheses. RESULTS: The participants reported a 65.6 % rate of child neglect and a 30.8 % rate of IPV in the past year. 37.6 % experienced child marriage. Results revealed significant associations between child neglect and child marriage, IPV, and depression symptoms. A two-way interaction between IPV and depression symptoms was strongly positively associated with child neglect. CONCLUSIONS: This research indicates that Salar Muslim mothers who have experienced child marriage, adulthood victimization, and depression are at a higher risk of neglecting their children. The findings represent a valuable initial step toward researching and addressing the protection needs of women and children from Muslim ethnic minorities in China.
Assuntos
Depressão , Islamismo , Casamento , Humanos , Feminino , Adulto , China/epidemiologia , China/etnologia , Depressão/epidemiologia , Depressão/etnologia , Criança , Casamento/psicologia , Pessoa de Meia-Idade , Vítimas de Crime/psicologia , Vítimas de Crime/estatística & dados numéricos , Mães/psicologia , Mães/estatística & dados numéricos , Adulto Jovem , Adolescente , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/etnologiaRESUMO
OBJECTIVE: To assess associations of ACEs with depression and anxiety, with special emphasis on potential racial and ethnic disparities. METHOD: Data were from the National Survey of Children's Health (NSCH), 2021-2022, a large, cross-sectional, nationally representative, population-based study of United States children aged 0-17. The associations of cumulative ACEs with depression and anxiety among 104,205 children and adolescents were assessed via multivariable logistic regression, including adjustment for age, sex, race, household income, and parental educational attainment. RESULTS: ACEs were associated with depression and anxiety in a linear, dose-dependent manner. After adjustment for covariates, compared to no ACE exposures, participants with exposures to one, two, and three ACEs exhibited significantly higher odds of depression (fully-adjusted ORs and 95 % CIs = 2.18 [2.03, 2.35], 4.95 [4.55, 5.39], and 11.39 [10.18, 12.75], respectively). For anxiety, compared to no ACEs exposures, participants with exposure to one, two, and three ACEs had significantly higher odds of anxiety (fully-adjusted ORs and 95 % CIs = 1.90 [1.81, 2.00], 3.66 [3.44, 3.90], and 6.91 [6.30, 7.58], respectively). Notably, stratified analyses indicated potential effect modification by race, wherein the associations of ACEs with depression and anxiety were strongest in Black and White participants. CONCLUSION: ACEs were robustly associated with depression and anxiety in a national sample of U.S. children and adolescents, with differential impacts of ACES on mental health observed across racial and ethnic groups. These findings underscore the need for urgent government and healthcare interventions and policies to ameliorate ACEs' health effects, especially among disproportionately impacted minority groups.
Assuntos
Experiências Adversas da Infância , Ansiedade , Depressão , Humanos , Experiências Adversas da Infância/estatística & dados numéricos , Criança , Estados Unidos/epidemiologia , Feminino , Masculino , Adolescente , Estudos Transversais , Depressão/etnologia , Depressão/epidemiologia , Ansiedade/etnologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Pré-Escolar , Disparidades nos Níveis de Saúde , Etnicidade/estatística & dados numéricos , Etnicidade/psicologia , Lactente , Recém-Nascido , Saúde Mental/estatística & dados numéricos , Saúde Mental/etnologia , Inquéritos EpidemiológicosRESUMO
Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.
Assuntos
Indígena Americano ou Nativo do Alasca , Apoio Social , Ideação Suicida , Prevenção do Suicídio , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indígena Americano ou Nativo do Alasca/psicologia , Estudos Transversais , Depressão/psicologia , Depressão/etnologia , Fatores de Proteção , Suicídio/psicologia , Suicídio/etnologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/etnologiaRESUMO
Background Black individuals with chronic musculoskeletal (MSK) pain tend to experience worse pain and opioid use-related outcomes, including other substance co-use, compared with non-Hispanic White individuals. Co-using cannabis with opioids could instigate a cascade of pain-related vulnerabilities and poor outcomes. Here, we test associations between cannabis/opioid co-use and pain-related outcomes among Black individuals with chronic MSK pain. Methods Black adults with chronic MSK pain who use opioids (N=401; 51.62% female, Mage=35.90, SD=11.03) completed online measures of pain intensity/interference, emotional distress, opioid dependence, and risky use of other substances. Results Compared with opioid use alone, opioid and cannabis co-use was associated with elevated anxiety and depression symptoms, opioid dependence, and risky substance use, but not pain. Conclusions Black individuals with chronic MSK pain who co-use opioids and cannabis warrant targeted interventions that address their needs. Tailored interventions could help address disparities in pain-related outcomes and opioid morbidity and mortality rates.
Assuntos
Analgésicos Opioides , Negro ou Afro-Americano , Dor Crônica , Transtornos Relacionados ao Uso de Opioides , Humanos , Feminino , Dor Crônica/tratamento farmacológico , Dor Crônica/etnologia , Adulto , Masculino , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Negro ou Afro-Americano/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Transtornos Relacionados ao Uso de Opioides/etnologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Pessoa de Meia-Idade , Dor Musculoesquelética/etnologia , Dor Musculoesquelética/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Depressão/epidemiologia , Depressão/etnologiaRESUMO
To examine the association between recent experiences of discrimination and depressive symptom presentation and severity among a U.S. sample of older Black and African American adults. A cross-sectional survey of 124 Black and African American adults aged 50 and older in the United States was conducted assessing interpersonal discrimination and depressive symptoms. The Perceived Ethnic Discrimination Questionnaire assessed four forms of interpersonal discrimination. A measure of heightened vigilance to bias assessed anticipatory coping with discrimination experiences. Past-month affective and somatic symptoms of depression were assessed using the Depressive and Somatic Symptoms Scale. All forms of interpersonal racial discrimination were positively associated with greater affective symptom severity. Being avoided, devalued, and threatened or actively physically harmed were associated with greater somatic symptom severity. Vigilant coping was positively associated with affective symptom severity but not somatic symptom severity. Racial discrimination is linked to depression severity among older Black and African American and varies by symptom. This study helps inform work on processes linking discrimination with poorer psychological outcomes and will allow for more effective interventions and prevention efforts that are tailored to older minority populations.
Assuntos
Negro ou Afro-Americano , Depressão , Racismo , Humanos , Negro ou Afro-Americano/psicologia , Masculino , Feminino , Depressão/psicologia , Depressão/etnologia , Depressão/epidemiologia , Pessoa de Meia-Idade , Idoso , Racismo/psicologia , Estudos Transversais , Estados Unidos/epidemiologia , Adaptação Psicológica , Inquéritos e Questionários , Idoso de 80 Anos ou maisRESUMO
This study examines the intervention effect of a culturally tailored parent education program in reducing depressive symptoms among Latina mothers of autistic children. In this two-site randomized waitlist-control study (n = 109 mother-child dyads), a peer-to-peer mentoring (promotora) model was used to deliver an intervention that was designed to increase mothers' self-efficacy and use of evidence-based strategies. We assessed mothers' depressive symptom (CES-D) scores at three time points and used linear mixed models to determine whether their scores significantly changed from baseline to postintervention (Time 2) and at 4 months postintervention (Time 3). Results show that mothers in the intervention group reported a significant decrease in mean depressive symptom scores at Time 2 and that the effect was maintained at Time 3 with intermediate to medium effect sizes. There were no differences in results across sites. Findings suggest that Parents Taking Action, a culturally tailored intervention led by peer mentors, showed a significant effect both immediately after the intervention and 4 months postintervention in reducing depressive symptoms among Latina mothers of autistic children.
Assuntos
Depressão , Hispânico ou Latino , Mães , Humanos , Feminino , Mães/psicologia , Depressão/etnologia , Adulto , Criança , Masculino , Transtorno Autístico/etnologia , Transtorno Autístico/psicologia , Pré-Escolar , AutoeficáciaRESUMO
INTRODUCTION: Severe inequities in depression and its diagnosis and treatment among rural-dwelling, racial-minority and ethnic-minority older adults compared with their urban white counterparts result in cognitive impairment, comorbidities and increased mortality, presenting a growing public health concern as the United States (US) population ages. These inequities are often attributable to social and environmental factors, including economic insecurity, histories of trauma, gaps in transportation and safety-net services, and disparities in access to policy-making processes rooted in colonialism. This constellation of factors renders racial-minority and ethnic-minority older adults 'structurally vulnerable' to mental ill health. Fewer data exist on protective factors associated with social and environmental contexts, such as social support, community attachment and a meaningful sense of place. Scholarship on the social determinants of health widely recognises the importance of such place-based factors. However, little research has examined how they shape disparities in depression and treatment specifically, limiting the development of practical approaches addressing these factors and their effects on mental well-being for rural minority populations. METHODS AND ANALYSIS: This community-driven mixed-method study uses quantitative surveys, qualitative interviews and ecological network research with 125 rural American Indian and Latinx older adults in New Mexico and 28 professional and non-professional social supporters to elucidate how place-based vulnerabilities and protective factors shape experiences of depression among older adults. Data will serve as the foundation of a community-driven plan for a multisystem intervention focused on the place-based causes of disparities in depression. Intervention Mapping will guide the intervention development process. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the University of New Mexico Health Sciences Center Institutional Review Board. All participants will provide informed consent. Study results will be disseminated within the community of study through community meetings and presentations, as well as broadly via peer-reviewed journals, conference presentations and social media.
Assuntos
Saúde Mental , População Rural , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Depressão/terapia , Depressão/etnologia , Minorias Étnicas e Raciais , Hispânico ou Latino/psicologia , Projetos de Pesquisa , Determinantes Sociais da Saúde , Apoio Social , Estados Unidos , Indígena Americano ou Nativo do Alasca/psicologiaRESUMO
Importance: Racial discrimination is a psychosocial stressor associated with youths' risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US. Objective: To investigate the association between racial discrimination and risk for psychopathology moderated by neuroaffective processing. Design, Setting, and Participants: This cohort study used longitudinal self-report and functional magnetic resonance imaging (fMRI) data from Black youth participants in the US from the Adolescent Brain Cognitive Development (ABCD) study. Data were analyzed from January 2023 to May 2024. Exposures: At time 1 of the current study (12 months after baseline), youths self-reported on their experiences of interpersonal racial discrimination and their feelings of marginalization. Amygdalar response was measured during an emotionally valenced task that included blocks of faces expressing either neutral or negative emotion. Main Outcomes and Measures: At 24 and 36 months after baseline, youths reported their internalizing (anxiety and depressive symptoms) and externalizing symptoms (aggression and rule-breaking symptoms). Results: A total of 1596 youths were a mean (SD) age of 10.92 (0.63) years, and 803 were female (50.3%). Families in the study had a mean annual income range of $25â¯000 to $34â¯999. Two factors were derived from factor analysis: interpersonal racial discrimination and feelings of marginalization (FoM). Using structural equation modeling in a linear regression, standardized ß coefficients were obtained. Neural response to faces expressing negative emotion within the right amygdala significantly moderated the association between FoM and changes in internalizing symptoms (ß = -0.20; 95% CI, -0.32 to -0.07; P < .001). The response to negative facial emotion within the right amygdala significantly moderated the association between FoM and changes in externalizing symptoms (ß = 0.24; 95% CI, 0.04 to 0.43; P = .02). Left amygdala response to negative emotion significantly moderated the association between FoM and changes in externalizing symptoms (ß = -0.16; 95% CI, -0.32 to -0.01; P = .04). Conclusions and Relevance: In this cohort study of Black adolescents in the US, findings suggest that amygdala function in response to emotional stimuli can both protect and intensify the affective outcomes of feeling marginalized on risk for psychopathology, informing preventive interventions aimed at reducing the adverse effects of racism on internalizing and externalizing symptoms among Black youths.
Assuntos
Tonsila do Cerebelo , Negro ou Afro-Americano , Imageamento por Ressonância Magnética , Racismo , Humanos , Feminino , Masculino , Racismo/psicologia , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Criança , Tonsila do Cerebelo/fisiopatologia , Tonsila do Cerebelo/diagnóstico por imagem , Adolescente , Estudos Longitudinais , Estados Unidos/epidemiologia , Depressão/psicologia , Depressão/etnologia , Ansiedade/psicologia , Ansiedade/etnologia , Estudos de Coortes , AutorrelatoRESUMO
OBJECTIVES: Adverse childhood experiences (ACEs) have been linked to adulthood chronic diseases, but there is little research examining the mechanisms underlying this association. We tested pathways from ACEs to adult disease mediated via risk factors of depression, smoking, and body mass index. METHOD: Prospective data from adults 18 to 74 years old from the Hispanic Community Health Study/Study of Latinos and Sociocultural Ancillary Study were used. Retrospectively reported ACEs and hypothesized mediators were measured at Visit 1 (2008-2011). Outcomes of disease prevalence were assessed at Visit 2, approximately 6 years later. The analytic sample includes 5,230 Hispanic/Latino participants with ACE data. Statistical mediation was examined using structural equation modeling on cardiometabolic and pulmonary disease prevalence and reported probit regression coefficients with 95% confidence intervals (CIs). RESULTS: We found a significant association between ACEs and the prevalence of asthma/chronic obstructive pulmonary disorder (standardized ß = .07, 95% CI [0.02, 0.12]). In the mediational model, the direct association was nonsignificant (ß = .02, 95% CI [-0.04, 0.07]) but was mediated by depressive symptoms (ß = .03, 95% CI [0.02, 0.04]). There were no associations between ACEs and the prevalence of diabetes and self-reported coronary heart disease or cerebrovascular disease. However, a small indirect effect was identified via depressive symptoms and coronary heart disease (ß = .02, 95% CI [0.01, 0.03]). CONCLUSION: In this diverse Hispanic/Latino sample, depressive symptoms were found to be a pathway linking ACEs to self-reported cardiopulmonary diseases, although the effects were of small magnitude. Future work should replicate pathways, confirm the magnitude of effects, and examine cultural moderators that may dampen expected associations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Assuntos
Experiências Adversas da Infância , Hispânico ou Latino , Humanos , Masculino , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Feminino , Pessoa de Meia-Idade , Adulto , Experiências Adversas da Infância/estatística & dados numéricos , Idoso , Adolescente , Adulto Jovem , Estudos Prospectivos , Asma/etnologia , Asma/epidemiologia , Asma/psicologia , Depressão/etnologia , Depressão/epidemiologia , Depressão/psicologia , Prevalência , Fatores de Risco , Doença Crônica , Doença Pulmonar Obstrutiva Crônica/etnologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fumar/epidemiologia , Fumar/etnologia , Estados Unidos/epidemiologia , Índice de Massa CorporalRESUMO
Among the many social determinants linked to adolescent alcohol use and depression, racial and ethnic discrimination is a prevalent determinant among Latinx adolescents and adults that is largely overlooked in preventive interventions. This study explored the influence of perceived racial and ethnic discrimination on depressive symptoms and alcohol use intentions among Latinx adolescents. Additionally, the study explored the cross-generational effects of how mothers' perceived discrimination impacts the depressive symptoms and alcohol use of the adolescent. The study used a sample of 800 inner-city Dominican and Puerto Rican adolescent-mother dyads (adolescent mean age = 12.42 years, SD = 0.81; mother mean age = 40.55 years, SD = 8.70). Employing a five-wave panel design that followed adolescents from 8th grade to 10th grade, the study found statistically significant mediation pathways which showed that adolescents' self-reported racial and ethnic discrimination experiences were associated with increases in their immediate and long-term depressive symptoms, which in turn were associated with stronger intentions to use alcohol in the future. Further, perceived racial and ethnic discrimination experienced by Latinx mothers was associated with increases in adolescents' intentions to drink alcohol in the future, mediated by the mothers' depressive symptoms and subsequently the adolescents' depressive symptoms. As discussed, these findings have wide-ranging implications for alcohol use prevention programs targeting inner-city Latinx adolescents.
Assuntos
Depressão , Hispânico ou Latino , Racismo , Humanos , Adolescente , Hispânico ou Latino/psicologia , Feminino , Depressão/etnologia , Masculino , População Urbana , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/psicologia , Adulto , Criança , IntençãoRESUMO
BACKGROUND AND OBJECTIVES: Cognitive impairment and Alzheimer's disease and related dementias (ADRD) pose significant challenges for Indigenous populations, necessitating urgent research. Limited evidence suggests that high rates of ADRD among Indigenous peoples are associated with social determinants of health (SDOH), such as education, income, health literacy, religion, and social engagement. RESEARCH DESIGN AND METHODS: Collaborating with a Northern Plains tribe, participants were recruited 123 self-identified Indigenous women aged 40-70 through a comprehensive recruitment strategy. Employing the SDOH framework, the research assessed cognitive impairment and Alzheimer's disease knowledge (ADK), utilizing the Ascertain Dementia 8 and Alzheimer's disease knowledge scales (ADK-30). The investigation examined the relationships between selected SDOH variables and cognitive impairment status. RESULTS: More than half of the participants showed signs of cognitive impairment, which correlated with lower income and education levels. Increased knowledge about Alzheimer's disease, particularly in terms of treatment management and its life impact subscales, was associated with lower odds of cognitive impairment. Conversely, higher levels of depressive symptoms and participation in religious activities were linked to increased odds of cognitive impairment. DISCUSSION AND IMPLICATIONS: The findings underscore the importance of culturally grounded tools and SDOH frameworks tailored to Indigenous contexts in addressing ADRD disparities. Future research should integrate historical and cultural factors to advance health equity within Indigenous communities, ultimately mitigating the impact of ADRD and promoting overall well-being.