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The present study investigated developmental pathways that can contribute to chronic disease among rural African Americans. With a sample of 342 African American youth (59% female) from the southeastern United States followed for nearly two decades (2001-2019), we examined the prospective association between family poverty during adolescence (ages 11-18) and insulin resistance (IR) in young adulthood (ages 25-29) as well as underlying biological and psychosocial mechanisms. Results indicated family poverty during adolescence forecast higher levels of IR in young adulthood, with accelerated immune cell aging at age 20 partially mediating this association. Serial mediational models confirmed the hypothesized pathway linking family poverty, perceived life chances, cellular aging, and IR. Findings provide empirical support for theorized developmental precursors of chronic disease., (© 2022 The Authors. Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

Importance: Some Black adolescents who frequently experience racial discrimination develop mental health problems. Protective caregiving may buffer adolescents from the negative mental health outcomes associated with experiencing racial discrimination., Objective: To examine if participation in programs that enhance protective caregiving will attenuate the positive association between Black adolescents' encounters with discrimination and subsequent increases in mental health problems., Design, Setting, and Participants: This secondary analysis used data from 2 randomized clinical trials testing family-centered prevention programs: the Strong African American Families-Teen (SAAF-T) program and the Adults in the Making (AIM) program. The programs were implemented in community locations convenient for participants in 12 rural Georgia counties. For the SAAF-T trial, Black adolescents and their primary caregivers were recruited from 2007 to 2008. In the AIM trial Black adolescents and their primary caregivers were recruited from 2006 to 2007. Data for this study were analyzed from June to August 2020., Exposures: Adolescents provided data at baseline on the frequency of their encounters with racial discrimination. Treatment group participants in each trial took part in a family-centered prevention program designed to prevent substance use and mental health problems. SAAF-T is a 5-session, 10-hour psychosocial intervention for families with a Black adolescent aged 14 to 16 years. AIM is a 6-session, 12-hour psychosocial intervention for families with a Black youth who is a high school senior., Main Outcomes and Measures: The primary outcomes were mental health problems, including conduct problems and depression or anxiety symptoms., Results: The SAAF-T study included 502 Black adolescents (mean [SD] age, 16.0 [0.6] years; 281 [56.0%] girls), including 252 randomized to the intervention and 250 randomized to the control, and the AIM trial included 367 Black adolescents (mean [SD] age, 17.7 [0.8] years; 217 [59.1%] girls and women), including 187 randomized to the intervention and 180 randomized to the control. Adolescents assigned to the SAAF-T intervention group who frequently experienced discrimination at baseline evinced fewer subsequent increases in conduct problems (incident risk ratio, 0.530 [95% CI, 0.340 to 0.783]). Adolescents assigned to the AIM intervention group who frequently experienced discrimination at baseline evinced fewer subsequent increases in conduct problems (mean difference, -0.361 [95% CI, -0.577 to -0.144]) and fewer subsequent increases in depression or anxiety symptoms (mean difference, -0.220 [95% CI -0.402 to -0.038]). Moderated mediation analyses suggested that enhanced protective caregiving was partially responsible for all observed interaction effects (indirect effect: SAAF-T conduct problems, -0.063 [95% CI, -0.127 to -0.001]; AIM conduct problems, -0.048 [95% CI, -0.095 to -0.001]; AIM depression or anxious symptoms, -0.036 [95% CI, -0.074 to 0])., Conclusions and Relevance: This secondary analysis of 2 randomized clinical trials found that participation in family-centered preventive interventions attenuated the association between frequent exposure to discriminatory behaviors and subsequent mental health problems. Notably, all but 1 of the treatment and moderated-mediation findings were reproduced across the SAAF-T and AIM trials., Trial Registrations: ClinicalTrials.gov Identifiers: SAAF-T, NCT04501471; AIM, NCT04510116.

Objective: The skin-deep resilience pattern suggests that, for low-socioeconomic-status African American youths, the ability to maintain high self-control and to persist with efforts to succeed may act as a double-edged sword, facilitating academic success and adjustment while undermining physical health. We extend research by following a sample of rural African Americans, asking whether the skin-deep resilience pattern, evident during adolescence, persists into adulthood by increasing susceptibility to metabolic syndrome (MetS) and insulin resistance (IR)., Methods: The sample included 368 11-year-old African Americans, their parents, and their teachers. Parents provided data on family poverty across ages 11-18 years. Teachers provided data on youths' planful self-control across ages 11-13 years. At age 27 years, participants completed questionnaires about educational attainment and psychological adjustment and provided a fasting blood sample from which MetS and IR were assessed., Results: Regardless of years spent living in poverty, planful self-control during childhood was associated with college graduation (p < .001) and with low levels of depressive symptoms (p = .016) and antisocial behavior (p = .028). For participants exhibiting high levels of self-control, however, living more years in poverty across adolescence was associated with a greater number of MetS components that met clinical cutoff criteria (p = .018) and greater IR (p = .016) during adulthood., Conclusions: The skin-deep resilience pattern persists into adulthood, particularly among those who spent more of their adolescence living in poverty, and increases vulnerability to MetS and IR while it also promotes college graduation and positive psychological adjustment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objective: Children with low self-control who grow up in poverty are at elevated risk for living in poverty when they are adults. The purpose of this study was to further understanding of the intergenerational continuity of poverty by (a) examining the likelihood that children with low levels of self-control at age 11 earn less employment income and are more likely to live in poverty 14 years later, at age 25; and (b) determining, via a preventive intervention, whether enhancing supportive parenting during childhood will ameliorate these associations., Methods: Parents and their 11-year-old children from 381 families participated in the Strong African American Families (SAAF) program or a control condition. Teachers assessed children's self-control at 11 years; parents reported their use of supportive parenting when children were 11 and 13 years; emerging adults provided data on cognitive and emotional self-control at 19, 20, and 21 years; and young adults indicated their employment income at 25 years., Results: Significant two-way interactions were detected between children's self-control and prevention condition for employment income (b = -183.18, 95% CI [-363.82, -2.53], p < .05) and poverty status (b = 0.257, 95% CI [0.018, 0.497], p < .05). Low self-control at age 11 forecast less employment income and a greater likelihood of living in poverty among children in the control condition, but not among low self-control SAAF participants. Mediated moderation analyses confirmed that enhanced supportive parenting accounted for SAAF's effects on employment income (indirect effect = 63.057, 95% BCA [19.385, 124.748]) and poverty status (indirect effect = -0.071, 95% BCA [-0.165, -0.016])., Conclusions: This study is unique in using a randomized controlled trial to show that preventive interventions designed to enhance parenting and strengthen families can buffer the long-term economic consequences of low self-control., (© 2019 Association for Child and Adolescent Mental Health.)

Purpose: The current study was designed to investigate the unique, long-term effects of family routines during adolescence on multiple developmental domains in young adulthood for rural African-Americans., Methods: Prospective data were collected annually for 6 years from 504 rural African-American youth and their parents, beginning when the youth were 16 years of age., Results: Results indicated that youth whose primary caregivers reported more family routines during adolescence (e.g., regularly eating together as a family, consistent bedtime) reported less alcohol use, greater emotional self-regulation, lower epinephrine levels, and higher rates of college/university enrollment in young adulthood. These effects were evident for all outcomes controlling for socioeconomic risk, sex, and available baseline (age 16 years) measures; for a subset of outcomes, the effects of family routines persisted even after taking into account levels of supportive parenting, harsh parenting, and household chaos., Conclusions: Findings substantiate the benefits of consistent, predictable family environments for healthy development and suggest that family routines constitute an important, yet understudied, factor for adolescents' long-term development., (Copyright © 2018. Published by Elsevier Inc.)

Objective: Lifestyle variables such as drug use and excessive weight gain contribute to adult morbidity and mortality. This study was designed to determine whether participation in a preventive intervention designed to enhance supportive parenting can reduce drug use and body mass index (BMI) in young Black adults from disadvantaged neighborhoods., Method: This study was conducted in the rural southeastern United States. Black parents and their 11-year-old children (517 families) were assigned randomly to the Strong African American Families (SAAF) prevention trial or a control condition. Data assessing neighborhood socioeconomic status and supportive parenting were obtained when the youths were ages 11 and 16. When youths were ages 19-21 and 25, drug use and BMI were measured., Results: As hypothesized, significant three-way interactions were detected among neighborhood disadvantage, prevention condition, and gender for BMI (B = 3.341, p = .009, 95% CI [0.832, 5.849]) and substance use (B = -0.169, p = .049, 95% CI [-0.337, -0.001]). Living in a disadvantaged neighborhood during adolescence was associated with increased drug use among young men in the control group (simple-slope = 0.215, p < .003) but not among those in the SAAF condition (simple-slope = 0.030, p = .650). Neighborhood disadvantage was associated with elevated BMI among young women in the control group (simple-slope = 3.343, p < .001), but not in the SAAF condition (simple-slope = 0.204, p = .820)., Conclusions: The results suggest that participation during childhood in a preventive intervention to enhance supportive parenting can ameliorate the effects of life in a disadvantaged neighborhood on men's drug use and women's BMI across ages 19-25 years. These findings suggest a possible role for parenting enhancement programs in narrowing health disparities., (© 2018 Association for Child and Adolescent Mental Health.)

Introduction: The transition to adulthood can be stressful for minority adolescents, and many may cope through unhealthy behaviors, including substance use and obesity-related behaviors. This study tested substance use and obesity trajectories over time in African American youth, longitudinal associations of trajectories with mental and physical health in adulthood, and whether self-control and sex predict trajectories., Methods: Two longitudinal studies of 516 and 992 African American adolescents. In Study 1, substance use and obesity trajectories were assessed from ages 19 to 25 years. At age 25 years, internalizing and externalizing problems, metabolic syndrome, and inflammatory biomarkers were measured. In Study 2, substance use and obesity trajectories were assessed from ages 17 to 29 years. Depression, delinquency, diabetes, blood pressure, and inflammatory biomarkers were measured at age 29 years. Data analyses were conducted in 2017., Results: Across both studies, the majority of African American adolescents evinced poor health behavior trajectories (latent class growth analyses), with 23%-27% showing increasing substance use over time, 18%-27% showing increasing obesity over time, and 9%-11% showing increases in both. ANCOVAs for trajectory analyses revealed that males were more likely to evince increasing substance use, with females more likely to show increasing obesity. Substance use trajectories were associated with poorer mental health in adulthood; obesity trajectories with poorer physical health in adulthood. Those with good health behavior trajectories had higher self-control in early adolescence., Conclusions: The transition to adulthood is a vulnerable period for many African Americans. Given the commonalities of substance use and obesity in their rewarding/stress-relieving properties, similar prevention efforts may help stem the rise of both in these youth., (Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Aims: To inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood and (b) examining associations between trajectory class membership and multi-level assessments of risk factors., Design: A prospective study spanning 9 years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress and psychosocial risk factors., Setting: Rural communities in the southeastern United States., Participants: African American youth (n = 518)., Measurements: Participants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors., Findings: Latent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all Ps < 0.05). A composite of selected risk factors discriminated class membership (all Ps < 0.05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19 years., Conclusions: Rural African American youth's cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress differentiate class membership prognostically. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood., (© 2018 Society for the Study of Addiction.)

From a sample of African American families living in the rural South, this study tested the hypothesis that growing up in poverty is associated with heightened biological stress levels in youth that, in turn, forecast elevations in drug use in young adulthood. Supportive parenting during adolescence was hypothesized to protect youth's biological stress levels from rising in the context of poverty. African American youth and their primary caregivers from 385 families participated in a 14-year prospective study that began when youth were 11 years of age. Data were collected from 2001 to 2016. All families lived in impoverished communities in the rural South. Linear regression models and conditional indirect effect analyses were executed in 2016 to test the study hypotheses. High number of years living in poverty across adolescence was associated with high catecholamine levels, but only among those youth who received low levels of supportive parenting. Youth catecholamine levels at age 19 forecast an increase in substance use from age 19 to age 25. Conditional indirect effects confirmed a developmental cascade linking family poverty, youth catecholamine levels, and increases in substance use for youth who did not receive high levels of supportive parenting. Current results suggest that, for some African American youth, substance use vulnerability may develop "under the skin" from stress-related biological weathering years before elevated drug use. Receipt of supportive parenting, however, can protect rural African American youth from biological weathering and its subsequent effects on increases in substance use during adulthood., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: The aim of the study was to test the novel hypothesis that, among black Americans who used John Henryism coping, those from low socioeconomic status backgrounds would be more likely to develop metabolic syndrome than those from higher socioeconomic backgrounds., Methods: This is an ancillary analysis of Strong African American Families Healthy Adult Program, a longitudinal cohort of 391 black youths and their caregivers. From ages 11 to 18 years, family socioeconomic status was assessed. At age 25 years, John Henryism was assessed, blood samples were drawn, and measurements were taken of blood pressure and waist circumference. Metabolic syndrome status was based on International Diabetes Federation guidelines., Results: A significant interaction emerged between family socioeconomic disadvantage and John Henryism coping in predicting metabolic syndrome diagnosis (odds ratio = 1.047, 95% confidence interval = 1.004-1.091). Participants who were high in John Henryism coping were more likely to display metabolic syndrome if they were from disadvantaged backgrounds (predicted prevalence of 26.7%) than if they were from more privileged backgrounds (predicted prevalence of 9.6%)., Conclusions: These patterns illustrate for the first time that John Henryism coping can undermine cardiometabolic health among black youths from disadvantaged backgrounds.

Background: Some of the country's highest rates of morbidity and mortality from cardiovascular disease are found in lower-income black communities in the rural Southeast. Research suggests these disparities originate in the early decades of life, and partly reflect the influence of broader socioeconomic forces acting on behavioral and biological processes that accelerate cardiovascular disease progression. However, this hypothesis has not been tested explicitly. Here, we examine metabolic syndrome (MetS) in rural black young adults as a function of their family's economic conditions before and after the Great Recession., Methods and Results: In an ongoing prospective study, we followed 328 black youth from rural Georgia, who were 16 to 17 years old when the Great Recession began. When youth were 25, we assessed MetS prevalence using the International Diabetes Federation's guidelines. The sample's overall MetS prevalence was 18.6%, but rates varied depending on family economic trajectory from before to after the Great Recession. MetS prevalence was lowest (10.4%) among youth whose families maintained stable low-income conditions across the Recession. It was intermediate (21.8%) among downwardly mobile youth (ie, those whose families were lower income before the Recession, but slipped into poverty). The highest MetS rates (27.5%) were among youth whose families began the Recession in poverty, and sank into more meager conditions afterwards. The same patterns were observed with 3 alternative MetS definitions., Conclusions: These patterns suggest that broader economic forces shape cardiometabolic risk in young blacks, and may exacerbate disparities already present in this community., (© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Objectives: This study was designed to test the hypothesis that African American preadolescents who participated in a family-centered parenting intervention at age 11 would show lower levels of cotinine, a biomarker for recent smoking, at age 20 than would similar participants in the control condition. The study was also designed to test the hypothesis that prevention-induced increases in supportive parenting would account for any prevention effects that emerged., Methods: African American parents and their 11-year-old children in the rural southern United States were assigned randomly to the Strong African American Families program or to a control condition. Parents provided self-reported data on supportive parenting when the youth were 11 and 16 years of age. When the youth were 20 years of age, blood was drawn from which cotinine was assayed., Results: Intervention program participants (M = 0.672, SD = 0.048) displayed significantly lower cotinine levels at age 20 years than did control participants (M = 0.824, SD = 0.059), P = .046. Mediation analyses confirmed that increases in supportive parenting accounted for intervention effects on smoking., Conclusions: We have demonstrated in this study that a randomized trial of a prevention program designed to enhance supportive parenting reduced cotinine levels among young African American adults. The developmentally appropriate family-centered intervention buffered the risk of smoking 9 years after program participation., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2017 by the American Academy of Pediatrics.)

Individuals exposed to adverse childhood experiences (ACEs) are vulnerable to various health problems later in life. This study was designed to determine whether participation in an efficacious program to enhance supportive parenting would ameliorate the association between ACEs and prediabetes status at age 25. Rural African American parents and their 11-year-old children (N=390) participated in the Strong African American Families (SAAF) program or a control condition. Each youth at age 25 provided a total ACEs score and a blood sample from which overnight fasting glucose was assayed. Logistic regression equations were used to test the hypotheses. The logistic regression analyses revealed a significant interaction between total ACEs and random assignment to SAAF or control, OR=0.56, 95% CI [0.36, 0.88]. Follow-up analyses indicated that, for participants in the control condition, a 1-point increase in ACEs was associated with a 37.3% increase in risk of having prediabetes. ACEs were not associated with the likelihood of having prediabetes among participants in the SAAF condition. Control participants with high total ACEs scores were 3.54 times more likely to have prediabetes than were SAAF participants with similar scores. This study indicated that participation at age 11 in a randomized controlled trial designed to enhance supportive parenting ameliorated the association of ACEs with prediabetes at age 25. If substantiated, these findings may provide a strategy for preventing negative health consequences of ACEs., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Importance: This study was designed to determine whether a preventive intervention focused on enhancing supportive parenting could ameliorate the association between exposure to poverty and brain development in low socioeconomic status African American individuals from the rural South., Objective: To determine whether participation in an efficacious prevention program designed to enhance supportive parenting for rural African American children will ameliorate the association between living in poverty and reduced hippocampal and amygdalar volumes in adulthood., Design, Setting, and Participants: In the rural southeastern United States, African American parents and their 11-year-old children were assigned randomly to the Strong African American Families randomized prevention trial or to a control condition. Parents provided data used to calculate income-to-needs ratios when children were aged 11 to 13 years and 16 to 18 years. When the participants were aged 25 years, hippocampal and amygdalar volumes were measured using magnetic resonance imaging., Exposures: Household poverty was measured by income-to-needs ratios., Main Outcomes and Measures: Young adults' whole hippocampal, dentate gyrus, and CA3 hippocampal subfields as well as amygdalar volumes were assessed using magnetic resonance imaging., Results: Of the 667 participants in the Strong African American Families randomized prevention trial, 119 right-handed African American individuals aged 25 years living in rural areas were recruited. Years lived in poverty across ages 11 to 18 years forecasted diminished left dentate gyrus (simple slope, -14.20; standard error, 5.22; P = .008) and CA3 (simple slope, -6.42; standard error, 2.42; P = .009) hippocampal subfields and left amygdalar (simple slope, -34.62; standard error, 12.74; P = .008) volumes among young adults in the control condition (mean [SD] time, 2.04 [1.88] years) but not among those who participated in the Strong African American Families program (mean [SD] time, 2.61 [1.77] years)., Conclusions and Relevance: In this study, we described how participation in a randomized clinical trial designed to enhance supportive parenting ameliorated the association of years lived in poverty with left dentate gyrus and CA3 hippocampal subfields and left amygdalar volumes. These findings are consistent with a possible role for supportive parenting and suggest a strategy for narrowing social disparities.

Objectives: This study was designed to determine whether black adolescents from disadvantaged backgrounds who have an unrelenting determination to succeed would, as adults, show "skin-deep resilience" by faring well in psychosocial domains but also show a heightened chance of having a chronic disease, specifically type 2 diabetes., Methods: Secondary data analyses were executed with the use of waves 1 and 4 of the US Longitudinal Study of Adolescent to Adult Health (Add Health). At wave 1, when participants were age 16, data were obtained on a behavioral style termed "striving." Striving includes high aspirations, unwavering persistence, investment in education, and avoidance of activities that sidetrack success. At wave 4, when participants were age 29, college graduation, personal income, symptoms of depression, and type 2 diabetes status were assessed., Results: Black and non-Hispanic white youth who displayed striving during adolescence evinced, at age 29, a higher likelihood of college graduation, greater personal income, and fewer symptoms of depression than did nonstrivers. Among black participants, the findings were consistent with the "skin-deep resilience" pattern for type 2 diabetes. High-striving black adolescents in the most disadvantaged families had a greater likelihood of developing type 2 diabetes during adulthood than did similar high-striving black adolescents living in more privileged families. The skin-deep resilience pattern did not emerge among non-Hispanic white participants., Conclusions: This study is the first to show that an unrelenting determination to succeed among black adolescents from disadvantaged backgrounds forecasts an elevated risk of developing type 2 diabetes during adulthood., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2016 by the American Academy of Pediatrics.)

For the past quarter century, scientists at the Center for Family Research at the University of Georgia have conducted research designed to promote understanding of normative developmental trajectories among low socioeconomic status African American children, youths, and young adults. In this paper, we describe a recent expansion of this research program using longitudinal, epidemiological studies and randomized prevention trials to test hypotheses about the origins of disease among rural African American youths. The contributions of economic hardship, downward mobility, neighborhood poverty, and racial discrimination to allostatic load and epigenetic aging are illustrated. The health benefits of supportive family relationships in protecting youths from these challenges are also illustrated. A cautionary set of studies is presented showing that some psychosocially resilient youths demonstrate high allostatic loads and accelerated epigenetic aging, suggesting that, for some, "resilience is just skin deep." Finally, we end on an optimistic note by demonstrating that family-centered prevention programs can have health benefits by reducing inflammation, helping to preserve telomere length, and inhibiting epigenetic aging.

This study investigated the influences of neighborhood factors (residential stability and neighborhood disadvantage) and variants of the serotonin transporter linked polymorphic region (5-HTTLPR) genotype on the development of substance use among African American children aged 10-24 years. To accomplish this, a harmonized data set of five longitudinal studies was created via pooling overlapping age cohorts to establish a database with 2,689 children and 12,474 data points to span ages 10-24 years. A description of steps used in the development of the harmonized data set is provided, including how issues such as the measurement equivalence of constructs were addressed. A sequence of multilevel models was specified to evaluate Gene × Environment effects on growth of substance use across time. Findings indicated that residential instability was associated with higher levels and a steeper gradient of growth in substance use across time. The inclusion of the 5-HTTLPR genotype provided greater precision to the relationships in that higher residential instability, in conjunction with the risk variant of 5-HTTLPR (i.e., the short allele), was associated with the highest level and steepest gradient of growth in substance use across ages 10-24 years. The findings demonstrated how the creation of a harmonized data set increased statistical power to test Gene × Environment interactions for an under studied sample.

This study tested the hypothesis that supportive family environments during adolescence buffer exposure to racial discrimination, reducing its impact on biological weathering and its manifestation in cellular aging. Perceived racial discrimination, support in the family environment, and confounder variables were assessed for 3 consecutive years across adolescence in two independent cohorts of African American youth from rural Georgia. DNA was extracted from peripheral blood mononuclear cells collected during young adulthood. Patterns of methylation were used to index the epigenetic ages of these cells and the extent to which they differed from participants' chronological ages. Among youth in supportive family environments, exposure to higher levels of racial discrimination did not forecast greater epigenetic aging. Among youth in less supportive family environments, exposure to higher levels of racial discrimination did forecast greater epigenetic aging. The associations emerged independently of confounder variables, and the results were replicated across the two cohorts., (© The Author(s) 2016.)

In the present study, we investigated associations of macro-economic conditions - the Great Recession - with cellular epigenetic aging, allostatic load, and self-reported health, in a group that experiences significant health disparities, African Americans. A sample of 330 African American adolescents in Georgia was followed from pre-recession (2007, M age=16.6) to post-recession (2010, M age=19.3). Economic data were collected in both 2007 and 2010. Three groups were formed to represent economic trajectories across the period of the Great Recession (stable low economic hardship, downward mobility, and stable high economic hardship). At age 19, measures of cellular epigenetic aging (derived from leukocyte DNA methylation profiles, reflecting the disparity between a person's biological and chronological age), allostatic load (composite of blood pressure, C reactive protein, cortisol, epinephrine, norepinephrine, and body mass index), and adolescent self-report of health were obtained. Linear trend analyses documented significant differences across all outcomes. The more time adolescents spent under economic hardship, the higher their epigenetic aging [estimate=1.421, SE=0.466, p=.002] and allostatic load [estimate=1.151, SE=0.375, p=.002] scores, and the worse their self-report of health [estimate=4.957, SE=1.800, p=.006]. Specific group comparisons revealed that adolescents in the downward mobility group had higher levels of allostatic load than adolescents in the stable low hardship group [p<.05]. Overall, these findings suggest that the health profiles of African American youth may in part be shaped by environmental macro-economic societal conditions, and that effects on biological markers can be detected relatively early in life., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: Low-grade inflammation, measured by circulating levels of cytokines, is a pathogenic mechanism for several chronic diseases of aging. Identifying factors related to inflammation among African-American youths may yield insights into mechanisms underlying racial disparities in health. The purpose of the study was to determine whether (1) reported racial discrimination from ages 17-19 years forecasts heightened cytokine levels at the age of 22 years and (2) this association is lower for youths with positive racial identities., Methods: A longitudinal research design was used with a community sample of 160 African-Americans who were aged 17 years at the beginning of the study. Discrimination and racial identity were measured with questionnaires, and blood was drawn to measure basal cytokine levels. Ordinary least squares regression analyses were used to examine the hypotheses., Results: After controlling for socioeconomic risk, life stress, depressive symptoms, and body mass index, racial discrimination (β = .307; p < .01), racial identity (β = -.179; p < .05), and their interaction (β = -.180; p < .05) forecast cytokine levels. Youths exposed to high levels of racial discrimination evinced elevated cytokine levels 3 years later. This association was not significant for young adults with positive racial identities., Conclusions: High levels of interpersonal racial discrimination and the development of a positive racial identity operate jointly to determine low-grade inflammation levels that have been found to forecast chronic diseases of aging, such as coronary disease and stroke., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Racial discrimination is a pervasive stressor that can undermine mental health among African American youth and young adults. Several studies identify links between racial discrimination and depressive symptoms; however, this research base does not focus on male African American youth who experience significant racism-related stress during the transition to young adulthood. Moreover, few prospective studies consider significant confounding variables that affect exposure to and perception of discriminatory treatment. In response to this need, we examined the effect of exposure to racial discrimination from ages 16 to 18 on depressive symptoms among male African Americans at age 20. Racial self-concept, one's sense of positivity about one's race, was examined as a mediator and self-control as a moderator. Hypotheses were tested with 222 participants, age 16 at baseline and age 20 at the endpoint. Participants provided self-report data at five time points. Exposure to racial discrimination from ages 16 to 18 predicted depressive symptoms at age 20, net of confounding influences. Racial self-concept mediated this effect. Self-control moderated the influence of discrimination on racial self-concept. This study underscores the salience of racial discrimination in the development of depressive symptoms among African American male youth and the clinical utility of interventions targeting racial pride and self-control.

This study was designed to investigate a genetic moderation effect of dopamine receptor 4 gene (DRD4) alleles that have seven or more repeats (long alleles) on an intervention to deter drug use among rural African American adolescents in high-risk families. Adolescents (N = 291, M age = 17) were assigned randomly to the Adults in the Making (AIM) program or to a control condition and were followed for 27.5 months. Adolescents provided data on drug use and vulnerability cognitions three times after pretest. Pretest assessments of caregiver depressive symptoms, disruption in the home, and support toward the adolescent were used to construct a family risk index. Adolescents living in high-risk families who carried at least one DRD4 long allele and were assigned to the control condition evinced greater escalations in drug use than did (a) adolescents who lived in high-risk families, carried the DRD4 long allele, and were assigned to AIM, or (b) adolescents assigned to either condition who carried no DRD4 long alleles. AIM-induced reductions in vulnerability cognitions were responsible for the Family Risk × AIM × DRD4 status drug use prevention effects. These findings support differential susceptibility predictions and imply that prevention effects on genetically susceptible individuals may be underestimated.

Telomere length (TL) is an indicator of age-related changes at the cellular level associated with heightened mortality risk. The effect of nonsupportive parenting (NSP) during late adolescence and young adulthood on TL 5 years later was examined in a sample of N = 183 young adult African Americans to determine if effects of NSP on TL were mediated by substance use. Results indicated that the effect of caregiver reported NSP on diminished TL was mediated by escalation of drinking and smoking in young adulthood, even after controlling effects of socioeconomic status risk, gender, BMI, young adult stress, and intervention status. Results suggest that prevention of NSP may influence later physical health consequences by influencing substance use trajectory.

Objective: The purpose of this study was to establish, using a quasi-experimental design, whether 2 family risk factors, parental psychological dysfunction and nonsupportive parenting, during preadolescence could longitudinally predict elevated sympathetic nervous system (SNS) activity 9 years later, and to determine whether participation in an efficacious family centered prevention program could moderate these associations if they emerged., Method: Rural African American preadolescents (N = 476) were assigned randomly to the Strong African American Families (SAAF) program or to a control condition. When youths were 11 years of age (M = 11.2 years), primary caregivers provided data on their own depressive symptoms and self-esteem, and youths provided data on their receipt of nonsupportive parenting. When the youths were 20 years of age, indicators of SNS activity, the catecholamines epinephrine and norepinephrine, were assayed from their overnight urine voids., Results: Parental psychological dysfunction and nonsupportive parenting forecast elevated catecholamine levels for youths in the control condition, but not for those in the SAAF condition., Conclusions: The demonstration that a prevention program can induce reduction of catecholamine levels is important from both theoretical and public health perspectives, because it shows that the developmental progression from family risk factors to heightened sympathetic nervous system activity is not immutable., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Aims: To test hypotheses about the contributions of the catecholamines epinephrine and norepinephrine [which serve as biological markers of life stress through sympathetic nervous system (SNS) activation], delay discounting and their interaction to the prediction of drug use among young African American adults., Design: A 1-year prospective study that involved assessment of SNS activity and collection of self-report data involving delay discounting and drug use., Setting: Rural communities in the southeastern United States., Participants: A total of 456 African Americans who were 19 years of age at the beginning of the study., Measurements: At age 19, participants provided overnight urine voids that were assayed for epinephrine and norepinephrine. Participants were also assessed for hyperbolic temporal discounting functions (k) and drug use. At age 20, the participants again reported their drug use., Findings: Linear regression analyses revealed that (i) catecholamine levels at age 19 forecast increases in drug use [B = 0.087, P < 0.01, 95% confidence interval (CI) = 0.025, 0.148] and (ii) among young men, catecholamine levels interacted positively with delay discounting to forecast increases in drug use (simple slope = 0.113, P < 0.001, 95% CI = 0.074, 0.152)., Conclusions: Higher urinary catecholamine concentrations in their adulthood predict higher levels of drug use a year later among young African American men in the United States who engage in high, but not low, levels of delay discounting., (© 2014 Society for the Study of Addiction.)

Objective: This study was designed to examine the prospective relations of harsh parenting during preadolescence, anger across adolescence, and a health phenotype at late adolescence among African American youths living in the rural South. A second purpose was to determine whether, for genetic reasons, some youths will be more sensitive than others to a harsh parenting to anger to poor health pathway., Method: Participants were 368 youths (age 11.2 at the first assessment) who provided data on receipt of harsh parenting during preadolescence (ages 11 to 13), anger across adolescence (ages 16 to 18), and a health phenotype consisting of C Reactive Protein, depressive symptoms, and health problems at age 19. Youths were genotyped at the 5-HTTLPR at age 16., Results: The data analysis revealed that (a) harsher parenting was associated positively across time with anger and poor health, (b) anger across adolescence also was associated positively across time with poor health, (c) anger served as a mediator connecting harsh parenting and poor health, and (d) the harsh parenting to anger to poor health pathway was significant only for youths carrying one or two copies of a short allele at the 5-HTTLPR., Conclusions: These findings are consistent with the hypothesis that harsh parent-child interactions presage health through effects on emotion regulation, particularly anger. This mediational pathway pertained only to youths carrying a gene that confers sensitivity and reactivity to harsh family processes and the negative emotional states they occasion., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

This study was designed to examine the prospective relations of perceived racial discrimination with allostatic load (AL), along with a possible buffer of the association. A sample of 331 African Americans in the rural South provided assessments of perceived discrimination from ages 16 to 18 years. When youth were 18 years, caregivers reported parental emotional support and youth assessed peer emotional support. AL and potential confounder variables were assessed when youth were 20. Latent growth mixture modeling identified two perceived discrimination classes: high and stable, and low and increasing. Adolescents in the high and stable class evinced heightened AL even with confounder variables controlled. The racial discrimination to AL link was not significant for young adults who received high emotional support., (© 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.)

Objective: The purpose of this study was to investigate a genetic moderation effect of dopamine receptor-4 gene (DRD4) alleles that have 7 or more repeats on the efficacy of a preventive intervention to deter rural African American adolescents' substance use., Methods: Adolescents (N = 502, M age = 16 years) were assigned randomly to the Strong African American Families-Teen (SAAF-T) program or to a control condition and were followed for 22 months. Adolescents provided data on substance use, and both adolescents and their primary caregivers provided data on intervention-targeted protective parenting practices., Results: Male adolescents who carried at least one allele of DRD4 with 7 or more repeats who were assigned to the control condition evinced more substance use across 22 months than did (a) carriers of at least one allele of DRD4 with 7 or more repeats who were assigned to SAAF-T or (b) adolescents assigned to either condition who carried two alleles of DRD4 with 6 or fewer repeats. These findings were mediated by DRD4 × SAAF-T interaction effects on increases in intervention-targeted protective parenting practices, a mediated moderation effect., Conclusions: The results imply that prevention effects on health-relevant outcomes for genetically susceptible individuals, such as carriers of at least one allele of DRD4 with 7 or more repeats, may be underestimated., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

African American male youth disproportionately report involvement with multiple sexual partners, which increases their risk for sexually transmitted infections and initiation of unplanned pregnancies. Little is known about the developmental precursors of sexual partner trajectories among African American male youth. Moreover, few studies focus on the many African American youth who evince highly conventional sexual partner trajectories, i.e., youth who have only one partner or abstain from sexual activity across time. Using four waves of data from a longitudinal study, we hypothesized that an accumulation of social and economic disadvantages in early adolescence would negatively influence youths' conventional sexual partner trajectories in late adolescence. We expected these disadvantages to affect youths' receipt of protective family processes and their reports of a set of intrapersonal processes (self-regulation, hope, and low levels of anger) linked to generally conventional behavior. Hypotheses were tested with data from 315 African American male youth from 11 to 18.5 years of age and their primary caregivers. Our results supported the hypotheses. Socioeconomic disadvantages during preadolescence predicted less involvement in conventional sexual partner trajectories from ages 16 to 18.5 years. This association was mediated by protective family processes and a set of interrelated intrapersonal protective processes. Preventive interventions designed to promote protective parenting and intrapersonal processes can be expected to promote sexual behavior trajectories characterized by abstinence or relations with very few partners.

Many African American youth may develop high levels of allostatic load, a measure of physiological wear and tear on the body, by developing psychosocial competence under conditions of high risk related to socioeconomic status (SES). The current study was designed to test this hypothesis, which is based on John Henryism theory. In a representative sample of 489 African American youth living in the rural South, cumulative SES-related risks and teacher-reported competence were assessed at ages 11 to 13; depressive symptoms, externalizing behavior, and allostatic load were assessed at age 19. The data revealed that rural African American preadolescents who evinced high psychosocial competence under conditions of high cumulative SES-related risk displayed low levels of adjustment problems along with high allostatic load at age 19. These results suggest that, for many rural African Americans, resilience may indeed be only "skin deep."

The purpose of this study was to investigate interactions between exposure to supportive family environments and genetic characteristics, which were hypothesized to forecast variations in allostatic load (AL) in a representative sample of 315 rural African American youths. Data on family environments were gathered when youths were 11-13, and genetic data were collected when they were 16, years of age. Data on AL were obtained at the beginning of emerging adulthood, age 19 years. The data analyses revealed that, as predicted, emerging adults exposed to less supportive family environments across preadolescence manifested higher levels of AL when they carried the short (s) allele at the 5-HTTLPR and an allele of DRD4 with seven or more repeats. This is an E(family environment) × G(5-HTTLPR status) × G(DRD4 status) interaction. These data suggest that African American youths carrying genes that confer sensitivity who are exposed to less supportive family environments may be at greater risk for adverse physical health consequences that AL presages., (PsycINFO Database Record (c) 2013 APA, all rights reserved.)

Objectives: The present research addressed the following important question in pediatric medicine: Can participation in a new family-centered preventive intervention, the Strong African American Families-Teen (SAAF-T) program, deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents across 22 months?, Methods: Data were collected from 502 black families in rural Georgia, assigned randomly to SAAF-T or an attention control condition. The prevention condition consisted of 5 consecutive meetings at community facilities with separate, concurrent sessions for caregivers and adolescents followed by a caregiver-adolescent session in which families practiced skills they learned in the separate sessions. Adolescents self-reported conduct problem behaviors, substance use, substance use problems, and depressive symptoms at ages 16 years (pretest) and 17 years 10 months (long-term assessment)., Results: Adolescents who participated in SAAF-T evinced lower increases in conduct problem behavior, substance use, substance use problems, and depressive symptom frequencies than did adolescents in the attention control condition across the 22 months between pretest and long-term assessment., Conclusions: This is the first study to demonstrate efficacy in a prevention program designed to deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents. Because SAAF-T is a manualized, structured program, it can be easily disseminated to public health agencies, schools, churches, boys' and girls' clubs, and other community organizations.

BackgroundSupportive parenting during childhood has been associated with many positive developmental outcomes for offspring in adulthood, including fewer health-risk behaviors. Little is known about the neural mechanisms underlying these associations.MethodsThe present study followed rural African Americans (n = 91, 52% female) from late childhood (11-13 years of age) to emerging adulthood (25 years of age). Parent-child communication was assessed at 11, 12, and 13 years of age. Functional magnetic resonance imaging was used at 25 years of age to measure resting-state functional connectivity of the anterior salience network (ASN). Harmful alcohol use and emotional eating were also assessed at 25 years of age. Structural equation modeling was used to test pathways from parent-child communication at 11 to 13 years of age to harmful alcohol use and emotional eating at 25 years of age via resting-state functional connectivity of the ASN.ResultsGreater parent-child communication between 11 and 13 years of age forecast greater resting-state functional connectivity of the ASN at 25 years of age which, in turn, was associated with lower harmful alcohol use and emotional eating at 25 years of age. Significant indirect effects through the ASN were present for both outcomes.ConclusionsThese findings indicate the importance of parenting in late childhood for adaptive behaviors and suggest a pathway via higher ASN coherence. This network was implicated in both harmful alcohol use and emotional eating, corroborating evidence of overlap in brain regions for dysregulated substance use and eating behaviors and revealing divergent pathways. These findings support the value of prevention and intervention efforts targeting parenting skills in childhood toward fostering long-term, adaptive neurocognitive development.