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Colorism has been propagated across the globe, and skin tone discrimination may partly explain social stratification and health disparities within the Black American population. Using data from a large probability sample of Black American adults (National Survey of American Life; 2001-2003), we examined the relations between perceived colorism and psychiatric disorders. In multivariable logistic regression models, in-group colorism was associated with greater odds of having any lifetime psychiatric disorder (aOR: 1.20; 95% CI: 1.08-1.32; p = 0.00); however, out-group colorism was not significantly associated, net of sociodemographic characteristics and in-group colorism (aOR: 1.08; 95% CI: 0.99-1.18; p = 0.08). When looking at specific disorders, in-group colorism was significantly associated with greater odds of alcohol use disorder, substance use disorder, anxiety disorder, and eating disorder, but was not associated with post-traumatic stress disorder or mood disorder. Out-group colorism was not significantly associated with any psychiatric disorder except anxiety disorder. Our findings show that colorism predicts psychiatric disorders, though more research is needed to understand why the effects of in-group and out-group colorism are related to certain psychiatric disorders but not others.

Background Research documents the adverse health effects of systemic inflammation. Overall, older Black Americans tend to have higher inflammation than older non-Hispanic White adults. Given that inflammation is related to a range of chronic health problems that disproportionately affect Blacks compared to Whites, this racial disparity in inflammation may contribute to racial disparities in particular chronic health problems. Thus, a better understanding of its determinants in the older Black population is of critical importance. This analysis examined the association between neighborhood characteristics and inflammation in a national sample of older non-Hispanic Black Americans. An additional aim of this study was to determine whether hopelessness and pessimism moderate the association between neighborhood characteristics and inflammation. Methods A sample of older non-Hispanic Black Americans aged 60+ were drawn from the Health and Retirement Study (N = 1004). Neighborhood characteristics included neighborhood physical disadvantage and neighborhood social cohesion. Inflammation was assessed by C-reactive protein. Results The analyses indicated that neighborhood physical disadvantage and social cohesion were not associated with C-reactive protein. Hopelessness and pessimism moderated the association between neighborhood physical disadvantage and C-reactive protein. Conclusions Knowledge regarding the role of hopelessness and pessimism as moderator in the neighborhood–inflammation association can inform cognitive-behavioral interventions targeted at changes in cognition patterns.

Background Compared to Whites, African Americans have elevated risk for earlier onset fatal and nonfatal chronic conditions and accelerated aging. Despite these persistent race disparities, the causes remain poorly understood. The purpose of this study was to define a biopsychosocial risk typology that might explain accelerated aging in African Americans. Methods Analyses were based on the African American and White subsample of the Health and Retirement Study (N = 8269). Latent class analysis was used to identify risk types. Chronic health conditions, salivary telomere length (STL), emotional support from family, negative interaction with family, early life adversities, and discrimination were used as class indicators. Latent class multinomial logistic regression was used to identify racial and demographic differences in risk type membership. Results Three distinct risk types were identified: high risk, health risk, and psychosocial risk. African Americans were more likely than Whites to be assigned to the high-risk type characterized by chronic health conditions, shorter STL, strained social relationships and high psychosocial stress. African Americans were less likely than Whites to be assigned to the health risk type characterized by chronic health conditions, shorter STL, optimal social relationships, and low psychosocial stress. Conclusions The biopsychosocial risk typology accounted for population heterogeneity, identified high-risk profiles, and modifiable factors within risk types that can inform current clinical interventions. The risk types also revealed different patterns of risk and resilience factors and shed light on the interplay between telomere length, stress exposure, chronic disease, and accelerated aging in African Americans.

Objectives To test a culturally tailored intervention to improve Alzheimer's disease (AD) literacy among African Americans. Design A 3-arm randomized comparative effectiveness trial. Setting Community sites in Los Angeles, CA. Participants 193 African American community-dwelling adults, ages 45 to 95 years old. Intervention All groups attended BrainWorks Live, a culturally tailored, 60-minute talk show and received standard printed educational materials on AD. From there: a) the BrainWorks Live group received no further contact until the post-test; b) one intervention group received a 1-month, culturally tailored, unidirectional, daily text-message program; and c) a second intervention group received daily text messages based on the printed educational materials that the general public would receive. AD literacy was measured at baseline and one month post intervention. Measurements Alzheimer's disease literacy and demographic and health covariates. Results At one month, participants who received culturally tailored text messages had the highest increase in AD literacy levels, followed by those in the BrainWorks Live arm. Participants who received general text messages had a lower overall increase in AD literacy levels compared to the other arms, but had higher mean AD literacy levels than the BrainWorks Live arm. There was a significantly greater increase in AD literacy levels among participants who received culturally tailored text messages compared with those who attended BrainWorks Live only. There were no other statistically significant differences between arms. Conclusions AD literacy among African Americans can be improved after only one month through culturally competent, economically feasible educational formats.

Objectives: An emerging body of literature shows that allergies and infections are associated with psychiatric disorders, though there is little research to confirm these associations among Black A...

The current study examined the prevalence of lifetime family violence among older women (N = 525) and the influence of family violence on depression using data from a national survey in South Korea. The major findings were that 49.3 % of respondents had been victimized from lifetime family violence, the prevalence of childhood maltreatment was 37.1 % and intimate partner violence was 23.4 %. Approximately, 55 % of participants had clinical depression, which was significantly associated with reported experiences of family violence. The findings suggest that family violence and depression are common social problems and that individualized intervention for older women in South Korea is needed.

African American men in the US experience disparities across multiple health outcomes. A common mechanism underlying premature declines in health may be accelerated biological aging, as reflected by leukocyte telomere length (LTL). Racial discrimination, a qualitatively unique source of social stress reported by African American men, in tandem with poor mental health, may negatively impact LTL in this population. The current study examined cross-sectional associations between LTL, self-reported racial discrimination, and symptoms of depression and anxiety among 92 African American men 30-50 years of age. LTL was measured in kilobase pairs using quantitative polymerase chain reaction assay. Controlling for sociodemographic factors, greater anxiety symptoms were associated with shorter LTL (b=-0.029, standard error [SE]=0.014; p

Objective: This study examined the role of stress in the association among physical activity, obesity, and depression among women. The extent to which physical activity moderated these relationship...

Background This brief report examines the association between marital and relationship status and 12-month and lifetime prevalence of major depressive disorder (MDD) among African Americans. Previous work has found that adults with major depressive disorder are less likely to be married or in a cohabiting relationship. This report extends previous research by investigating whether unmarried, non-cohabiting African Americans with depression are also less likely to be involved in a romantic relationship. Methods Data are from the African American sub-sample ( n =3570) of the National Survey of American Life (NSAL; 2001–2003). The DSM-IV World Mental Health Composite International Diagnostic Interview was used to assess 12-month and lifetime MDD. Weighted logistic regression was used. Results The findings indicate that for both 12-month and lifetime major depressive disorder, African Americans who are depressed are not only less likely to be married; they are also significantly less likely to be involved in a romantic relationship. This is particularly the case for 12-month depression. Limitations Due to limitations in the number of cohabiting respondents, currently married and cohabiting respondents were combined into a single category. Conclusion The findings of this brief report highlight the importance of changes in marital and relationship circumstances of the U.S. population for research and practice on depression and other psychiatric disorders. Our study provides evidence for a more nuanced approach in which examining marital and romantic relationship status together promotes a better understanding of the impact of major depression on romantic unions.

Purpose To examine associations between racial discrimination, mood disorders, and cardiovascular disease (CVD) among Black Americans. Methods Weighted logistic regression analyses were performed on a nationally representative sample of Black Americans (n = 5022) in the National Survey of American Life (NSAL; 2001–2003). Racial discrimination and CVD were assessed via self-report. Mood disorder was measured with the World Health Organization Composite International Diagnostic Interview. Results Model-adjusted risk ratios (RRs) revealed that participants with a history of mood disorder had greater risk of CVD (RR, 1.28; 95% confidence interval (CI), 1.12–1.45). This relationship was found specifically among those younger than 50 years of age (RR, 1.56; 95% CI, 1.27–1.91). There was a significant interaction between racial discrimination and mood disorder in predicting CVD in the total (F = 2.86, 3 df, p = .047) and younger sample (F = 2.98, 3 df, p = .047). Participants with a history of mood disorder who reported high levels of racial discrimination had the greatest risk of CVD. Conclusions The association between racial discrimination and CVD is moderated by history of mood disorder. Future studies may examine pathways through which racial discrimination and mood disorders impact CVD risk among Black Americans.

Objectives To examine the demographic correlates of lifetime and 12-month prevalence of major depressive disorder (MDD) among older African Americans, Black Caribbeans, and non-Hispanic Whites. Methods Data are from adults aged 55 years and older (n = 1439) recruited to the National Survey of American Life (NSAL; 2001–2003). The Diagnostic and Statistical Manual Version IV World Mental Health Composite International Diagnostic Interview was used to assess the 12-month and lifetime MDD. Weighted logistic regression was used to model demographic correlates of MDD. Results The population prevalence of lifetime and 12-month MDD were 11.2% and 4.1%, respectively. Bivariate analyses revealed that younger respondents and those with greater disability had a higher prevalence of both lifetime and 12-month MDD compared with those who were older and who had lower disability. Multivariable logistic regressions controlling for demographic characteristics revealed that non-Hispanic Whites had the greatest odds of lifetime MDD (OR = 2.27, 95% CI = 1.32, 3.93). Women had significantly greater odds of lifetime MDD compared with men (OR = 2.49, 95% CI = 1.14, 5.41); there were no gender differences in 12-month MDD. Other significant predictors of MDD were marital status and region of residence. Conclusions The distribution, correlates, and nature of associations with MDD vary as a function of whether we examined lifetime vs. 12-month MDD. Future work should account for within group differences among older adults with depression. Understanding MDD correlates and the nature of intergroup diversity can inform the identification of particularly vulnerable subgroups as well as appropriate treatment approaches. Copyright © 2011 John Wiley & Sons, Ltd.

Objectives The purpose of this study is to estimate lifetime prevalence of seven psychiatric affective disorders for older non-Hispanic White people, African Americans, Caribbean Black people, Latinos, and Asian Americans and examine demographic, socioeconomic, and immigration correlates of those disorders. Design Data are taken from the older sub-sample of the Collaborative Psychiatric Epidemiology Surveys. Selected measures of lifetime DSM-IV psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder, major depressive disorder, and dysthymia). Setting Community epidemiologic survey. Participants Nationally representative sample of adults 55 years and older (n = 3046). Measurements Disorders were assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview. Results Major depressive disorder and social phobia were the two most prevalent disorders among the seven psychiatric conditions. Overall, non-Hispanic White people and Latinos consistently had higher prevalence rates of disorders, African Americans had lower prevalence of major depression and dysthymia, and Asian Americans were typically less likely to report affective disorders than those of their counterparts. There is variation across groups in the association of demographic, socioeconomic, and immigration variables with disorders. Conclusions This study furthers our understanding of the racial and ethnic differences in the prevalence of DSM-IV disorders among older adults and the correlates of those disorders. It highlights the importance of examining both between-group and within-group differences in disorders and the complexity of the mechanisms associated with differences across groups. Findings from this study underscore the need for future research that more clearly delineates subgroup differences and similarities. Copyright © 2011 John Wiley & Sons, Ltd.

Few studies have examined the association between social support, negative interaction, and major depressive disorder among representative samples of racial and ethnic minority groups. This study investigates the relationship between emotional support and negative interaction with family members on lifetime major depressive disorder among African Americans and Caribbean Blacks.Cross-sectional epidemiologic data from the National Survey of American Life and multivariable logistic regression analyses were used to predict lifetime history of major depressive disorder and to examine the effect of perceived emotional support and negative interaction on major depressive disorder among 3,570 African Americans and 1,621 Caribbean Blacks aged 18 and older.Multivariate analyses found that perceived emotional support was associated with lower odds of MDD for African Americans and Caribbean Blacks. Negative interaction with family was associated with greater odds of MDD for African Americans and Caribbean Blacks. Emotional support moderated the impact of negative interaction on MDD for Caribbean Blacks, but not for African Americans.This is the first study to investigate the relationships between emotional support, negative interaction with family members and depressive disorder among African Americans and Caribbean Blacks. Negative interaction was a risk factor for depression and emotional support was a protective factor.

Although racial disparities in health have been documented both historically and in more contemporary contexts, the frameworks used to explain these patterns have varied, ranging from earlier theories regarding innate racial differences in biological vulnerability, to more recent theories focusing on the impact of social inequalities. However, despite increasing evidence for the lack of a genetic definition of race, biological explanations for the association between race and health continue in public health and medical discourse. Indeed, there is considerable debate between those adopting a “social determinants” perspective of race and health and those focusing on more individual-level psychological, behavioral, and biologic risk factors. While there are a number of scientifically plausible and evolving reasons for the association between race and health, ranging from broader social forces to factors at the cellular level, in this essay we argue for the need for more transdisciplinary approaches that specify determinants at multiple ecological levels of analysis. We posit that contrasting ways of examining race and health are not necessarily incompatible, and that more productive discussions should explicitly differentiate between determinants of individual health from those of population health; and between inquiries addressing racial patterns in health from those seeking to explain racial disparities in health. Specifically, we advance a socio-psychobiological framework, which is both historically grounded and evidence-based. This model asserts that psychological and biological factors, while playing a central role in determining individual risk for poor health, are relatively less consequential for understanding racial disparities in health at the population level. Such a framework emphasizes the etiologic role of social inequities in generating and perpetuating racial disparities in health and highlights their impact on psychological, behavioral, and biological disease processes.

This study examines the demographic correlates of depressive symptoms, serious psychological distress (SPD), and major depressive disorder (MDD; 12-month and lifetime prevalence) among a national sample of African American men. Analysis of the National Survey of American Life (NSAL) data set provides first-time substantiation of important demographic differences in depressive symptoms (measured by the Center for Epidemiological Studies Depression scale [CES-D]), SPD (measured by the K6), and 12-month and lifetime MDD among African American men. Findings illuminate the heterogeneity within the African American male population. Findings also demonstrate the need for additional research focusing on within-group differences and a comprehensive research and mental health promotion agenda that recognizes the importance of improving access to education and employment and promoting healthy coping behaviors, while acknowledging the larger social context in which African American men live.

This study examines relationships among financial strain, unfair treatment, and martial satisfaction among African Americans. Using data from the National Survey of American Life, findings indicated that social stressors that occur inside of the home (i.e., financial strain) as well as those experienced outside of the home (i.e., unfair treatment) have negative consequences for marital quality and psychological distress. Furthermore, the combination of experiencing unfair treatment and financial strain has particularly deleterious mental health consequences for married African Americans. Results also highlight the protective effect of marital satisfaction on psychological distress as well as its potential to buffer the negative effects of unfair treatment and financial strain on psychological distress. Implications for policy to improve marital quality and promote the mental health of African Americans are discussed.

This study investigated the correlates of relationship satisfaction, marriage expectations, and relationship longevity among unmarried African American and Black Caribbean (Caribbean Black) adults who are in a romantic relationship. The study used data from the National Survey of American Life, a national representative sample of African Americans and Caribbean Blacks in the United States. The findings indicated that the correlates of relationship satisfaction, expectations of marriage, and relationship longevity were different for African Americans and Black Caribbeans. For Black Caribbeans, indicators of socioeconomic status were particularly important correlates of relationship satisfaction. For African Americans, indicators of parental status were important for relationship longevity. Policy and practice implications for nonmarital unions are discussed.

Structural equation modeling was used to examine the relationships among stress, social support, negative interaction, and mental health in a sample of African American men and women between ages 18 and 54 (N = 591) from the National Comorbidity Study. The study findings indicated that social support decreased the number of depressive symptoms, did not mitigate the effects of stress, and was reduced in response to financial strain. Financial strain and traumatic events were associated with increased negative interaction with relatives and depressive symptoms. The findings verify that stressful and traumatic events have direct influences on levels of depressive symptoms and affect the quality of social interactions and suggest how social interaction processes contribute to mental health.

Obesity and depression often co-occur; however, the association between these conditions is poorly understood, especially among racial/ethnic minority groups. Using multinomial logistic regression and data from the National Survey of American Life, the relationships between race, ethnicity, and sociodemographic factors to the joint classification of body mass index categories and depression among African Americans, Caribbean Blacks, and non-Hispanic Whites were examined. Differential risk for the combination of obesity and depression by sociodemographic status was found. Being African American, female, young, married, or having low income or education increases the risk for obesity without depression. Risk factors for obesity with depression include being female, young, married and having a low income. Race was not a significant predictor of obesity with depression relative to normal weight without depression status. However, racial differences were observed among the non-depressed. Non-depressed African Americans were more likely than non-depressed Whites or Caribbean Blacks to be obese.

Depression represents a growing concern among Asian Americans. This study examined whether discrimination and family dynamics are associated with depression in this population. Weighted logistic regressions using nationally representative data on Asian American adults (N = 2095) were used to examine associations between discrimination, negative interactions with relatives, family support, and 12-month major depressive disorder (MDD). Discrimination (odds ratio [OR] = 2.13, 95% confidence interval [CI] = 1.67, 2.71) and negative interactions with relatives (OR = 1.28, 95% CI = 1.03, 1.58) were positively associated with MDD. Family support was associated with lower MDD (OR = 0.73, 95% CI = 0.59, 0.89), and buffered lower levels of discrimination. Results suggest that discrimination may have negative mental health implications, and also point to the importance of family relationships for depression among Asian Americans. Findings suggest that providers may consider stress experienced at multiple ecological levels to address Asian American mental health needs.

Both emotional support and negative interaction with family members have been linked to mental health. However, few studies have examined the associations between emotional support and negative interaction and psychiatric disorders in late life. This study investigated the relationship between emotional support and negative interaction on lifetime prevalence of mood and anxiety disorders among older African Americans.The analyses utilized the National Survey of American Life.Logistic regression and negative binomial regression analyses were used to examine the effect of emotional support and negative interaction with family members on the prevalence of lifetime DSM-IV mood and anxiety disorders.Data from 786 African Americans aged 55 years and older were used.The DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to assess mental disorders. Three dependent variables were investigated: the prevalence of lifetime mood disorders, the prevalence of lifetime anxiety.Multivariate analysis found that emotional support was not associated with any of the three dependent variables. Negative interaction was significantly and positively associated with the odds of having a lifetime mood disorder, a lifetime anxiety disorder and the number of lifetime mood and anxiety disorders.This is the first study to investigate the relationships among emotional support, negative interaction with family members and psychiatric disorders among older African Americans. Negative interaction was a risk factor for mood and anxiety disorders among older African Americans, whereas emotional support was not significant.

Studies examining associations between racial discrimination and cardiovascular health outcomes have been inconsistent, with some studies finding the highest risk of hypertension among African Americans who report no discrimination. A potential explanation of the latter is that hypertension and other cardiovascular problems are fostered by internalization and denial of racial discrimination. To explore this hypothesis, the current study examines the role of internalized negative racial group attitudes in linking experiences of racial discrimination and history of cardiovascular disease among African American men. We predicted a significant interaction between reported discrimination and internalized negative racial group attitudes in predicting cardiovascular disease. Weighted logistic regression analyses were conducted among 1216 African American men from the National Survey of American Life (NSAL; 2001– 2003). We found no main effect of racial discrimination in predicting history of cardiovascular disease. However, agreeing with negative beliefs about Blacks was positively associated with cardiovascular disease history, and also moderated the effect of racial discrimination. Reporting racial discrimination was associated with higher risk of cardiovascular disease among African American men who disagreed with negative beliefs about Blacks. However, among African American men who endorsed negative beliefs about Blacks, the risk of cardiovascular disease was greatest among those reporting no discrimination. Findings suggest that racial discrimination and the internalization of negative racial group attitudes are both risk factors for cardiovascular disease among African American men. Furthermore, the combination of internalizing negative beliefs about Blacks and the absence of reported racial discrimination appear to be associated with particularly poor cardiovascular health. Steps to address racial discrimination as well as programs aimed at developing a positive racial group identity may help to improve cardiovascular health among African American men.

This study examined demographic predictors of attitudes regarding religious coping (i.e., prayer during stressful times and look to God for support, strength and guidance) within a national sample of African American, Caribbean Blacks and non-Hispanic Whites (National Survey of American Life). The findings demonstrate significant Black-White differences in attitudes regarding religious coping with higher endorsements of religious coping among African Americans and Black Caribbeans (Caribbean Blacks). Comparisons of African Americans and Black Caribbeans revealed both similar and divergent patterns of demographic effects. For both African Americans and Black Caribbeans, women were more likely to utilize religious coping than men and married respondents were more likely than never married respondents to report utilizing prayer when dealing with a stressful situation. Further, for both groups, higher levels of education were associated with lower endorsements of the importance of prayer in dealing with stressful situations. Among African Americans only, Southerners were more likely than respondents who resided in other regions to endorse religious coping. Among Black Caribbeans, those who emigrated from Haiti were more likely than Jamaicans to utilize religious coping when dealing with a stressful episode.