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Past research supports the role of negative posttraumatic cognitions (NPCs) in the development and maintenance of posttraumatic stress disorder (PTSD). The relationship between NPCs and PTSD may be uniquely impacted by racial status and experiences of military sexual trauma (MST), both of which may have a unique impact on one's understanding of self, others, and the world. We explored racial differences in the association between NPCs and PTSD symptom clusters in a sample of veterans endorsing MST (N = 139; 74.8% White, 25.2% Black). A path model was created and analyzed both with the full sample and separately by racial group. In the full sample, NPCs about the self and world were significantly associated with intrusion, negative alterations in cognitions and mood (NACM), and arousal, but not avoidance. Self-blame was not a significant predictor of negative alterations in cognition in mood. This model was consistent in the White veteran model, whereas only negative cognitions about the self were associated with NACM in the Black veteran path model. NPCs about the self and world appear important to non-avoidance PTSD symptomatology related to MST and thus should be targeted in treatment. For Black veterans endorsing distress related to NACM symptoms, negative beliefs about the self should be specifically considered for intervention. [ABSTRACT FROM AUTHOR]

Background: Anxiety, depression, and reduced quality of life (QOL) are common problems for hospice family caregivers, but it is unknown if disparities in these experiences exist among Black and White caregivers. Objectives: To compare anxiety, depression, QOL, caregiver burden, and perceptions of caregiver-centered hospice team communication between Black and White hospice family caregivers. Design: Secondary analysis of baseline data from two randomized clinical trials. Setting/Subjects: Seven hundred twenty-two Black and White hospice family caregivers ages 18+ from Midwestern and Northeastern United States. Measurements: Measures included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Caregiver Quality-of-Life Index–Revised (CQLI-R), Zarit Burden Interview (ZBI-7), and Caregiver-Centered Communication Questionnaire (CCCQ). Results: Black and White caregivers differed across demographic and socioeconomic variables. Nearly one-third of hospice family caregivers reported moderate-to-severe anxiety (32.1%) and moderate-to-severe depressive symptoms (32.0%). White caregivers reported lower QOL than Black caregivers (p = 0.04), specifically in emotional (p = 0.02) and social (p = 0.0005) domains. In multiple regression analyses controlling for caregiver and patient factors, we found no racial differences in depression, anxiety, QOL, caregiver burden, or perceptions of caregiver-centered hospice communication. Conclusions: Despite demographic and socioeconomic differences, Black and White hospice family caregivers experience similarly high levels of anxiety, depression, burden, and perceptions of hospice communication. Interventions to support hospice family caregivers across racial groups and research that identifies factors that mediate social determinants of health in this population are needed. The development and validation of culture-concordant mental health screening tools in racially diverse populations is recommended. Trial registration: ClinicalTrials.gov NCT02929108 and ClinicalTrials.gov NCT01444027. [ABSTRACT FROM AUTHOR]

Sexual violence is a severe and rampant issue plaguing college campuses. However, the lack of research pertaining to underrepresented students calls into question the generalizability of university education and prevention efforts. Consequently, there is a gap in the literature regarding African American men's understanding of sexual violence. This study seeks to address this gap by examining African American university men's conceptualization of sexual violence from their own racial and cultural perspectives. Ninety-minute semi-structured interviews were conducted with eight male African American students attending predominantly White institutions. Data were analyzed by three coders using an interpretative phenomenological approach and intersectional framework. Data were then presented to an auditor and the coders revised the themes based on the auditor's feedback. Four themes emerged from this analysis: aggressive and violent stereotypes of Black men, othering of male survivors, racial considerations when responding to survivors, and awareness of racial injustices. These results provide evidence supporting the need for culturally grounded sexual violence education and prevention efforts to effectively reach African American men on university campuses. For example, universities may consider having African American confidential advocates and a committee of racially diverse members to run reported instances of sexual violence to reduce bias. In addition, universities may benefit from partnering with Black fraternities to empower men to be allies for social change against rape culture within their communities. For clinical work, such efforts could include incorporating explicit discussions of the impact of gendered racism on Black male survivors into session. Also, clinicians could aim to combat the internalization of the gender racist stereotypes with clients. [ABSTRACT FROM AUTHOR]

Recent reports have highlighted disparities in representation of Black men within research, calling for more work to be done with this group. The authors take up this call by exploring whether adherence to masculine norms influences mental health outcomes among young Black men. The sample included survey responses from 18- to 30-year-old Black men (N  =   273) enrolled at five colleges and universities in the midwestern United States. Two theoretically relevant subscales from the Conformity to Masculine Norms Inventory (that is, self-reliance and emotional control) were used to measure adherence to masculine norms, and depressive symptoms were measured using the Patient Health Questionnaire. Confirmatory factor analysis results indicate that the model fit the data well. Furthermore, self-reliance was associated with higher rates of depressive symptoms (β =.358, p <.001), but emotional control was not (β =.137, p =.099). Study findings suggest that depression treatment interventions should be tailored to incorporate aspects of masculinity that are most salient to young Black men. In addition, social work researchers, clinicians, and service providers are uniquely positioned to contribute to the promotion of mental wellness among this underserved population and should be prepared to attend to young Black men's mental health needs. [ABSTRACT FROM AUTHOR]

The prevalence of community-based violence (CBV) exposure among black American male emerging adults ages 18 to 25 with a history of involvement with the criminal justice system is a major public health concern. Although exposure (whether as victim or witness) to CBV is linked with negative outcomes, empirical research examining black men's negative emotional responses to seeing videos of real-life incidents of CBV on social media is scant. To address these identified concerns and make recommendations for future research, the present study examines the relationship between seeing videos of CBV on social media and three types of negative emotional responses (that is, feeling sad, angry, and fearful) prior to incarceration among a sample of 101 black men detained in a midwestern jail. Social media use and seeing videos of CBV on social media were moderately high for study participants. Seeing a video involving police violence was significantly associated with an increase in the odds of feeling sad, angry, and fearful. Social media research is an emerging area that has the potential to advance our understanding of the impact of seeing social media videos of police violence on the well-being of black men and factors that mediate or moderate this relationship. [ABSTRACT FROM AUTHOR]

Background: Midlife black women are at a high risk for cardiovascular disease and experience higher morbidity and mortality rates. Chronic life stress contributes to the existent cardiovascular-related disparities for midlife black women. Objectives: The purpose of this qualitative study was to describe stress reduction strategies relevant to midlife black women, identify barriers, and generate ideas for the development of a stress reduction wellness intervention for midlife black women. Methods: A community advisory board consisting of 11 midlife black women from the Midwest was established and charged with exploring life stress and stress-related issues for women like themselves. The community advisory board was led through a series of focus group discussions using open-ended questions focused on stress reduction strategies used by midlife black women, what kept them from incorporating stress reduction strategies into their daily routines, and what would be helpful in a stress reduction routine. Discussions were audiotaped, transcribed, coded, and analyzed using content analysis. Results: Stress reduction strategies identified included exercise, faith and prayer, self-care, sisterhood, volunteerism, and mindfulness. Barriers to adopting stress reduction behaviors included time, finances, physical limitations, health status, health insurance, and guilt. Suggested modes of delivery for an intervention included informative lectures and coaching, demonstration, team sessions, social media, and continued access. Conclusions: Findings from this study were consistent with those from a preliminary study focused on midlife black women from the West Coast. Recommendations will inform development of a stress reduction wellness intervention for midlife black women. [ABSTRACT FROM AUTHOR]

The purpose of this research was to determine the extent to which women of African ancestry manifested power in their relationships regarding sexual activities and to examine the influence that specific variables had on their sexual partnerships. A sample (N = 200) of midlife women aged 40–65, who lived in the Midwest participated in this research. The Sexual Relationship Power Scale was used to examine these relationships. Face-to-face interviews occurred in community settings. Multiple regression equations were used to examine the potential impact of specific variables on sexual functioning. Results of the analysis revealed that variables such as mental quality of life, decision-making, and health promotion were positively associated with sexual relationships. Conversely, depression and life stress scores were negatively linked to sexual relationships. Knowledge gained from this research could be used to explore the phenomena of power as expressed in the daily lives of women of African descent. The research can also be discussed from the perspective of a "Black tax," that has burdened Black women for centuries and is manifested through years of discrimination, bias, and the lack of equity in most domains of American institutions. [ABSTRACT FROM AUTHOR]

Informed by the Network-Episode Model, 26 African-American men with serious mental illness and 26 members of their kinship networks completed in-depth qualitative interviews about their experiences with the mental health care system to better understand racial differences in mental health care. The aim was to better understand communication among kin networks, clients, and treatment agencies with a focus on the opportunities for kinship involvement. Although kin were involved in clients' everyday lives, they were largely excluded from the community mental health agency (CMHA) and treatment decisions. In addition to incorporating family resources, enhanced efforts by CMHAs to collaborate with kin may increase knowledge about mental illness and mental health care in the African-American community, removing an impediment to service access and client retention. [ABSTRACT FROM AUTHOR]

Racial and ethnic diversity among health professionals has been shown to promote better access to and improved health care quality for underserved populations. Diversity is considered particularly important to better meet the health needs of an increasingly diverse population, though many barriers remain. For example, in postsecondary education, typically the diversity focus has been on student recruitment and retention issues, such as cost, academic preparedness, unwelcoming campus climates, and lack of social and emotional support. However, too little attention has been directed toward understanding existing barriers to professional development, advancement, and interracial collegiality in settings where many African Americans will likely find themselves employed. In this study, we sought to improve our understanding of how race shapes the meanings of relationships Black faculty and professional staff have with their colleagues at predominantly White institutions (PWIs) of higher education. Sixteen in-depth interviews were conducted with male and female full-time faculty and professional staff employed at 10 PWIs across the East Coast, Midwest, and West Coast regions of the United States between October 2014 and June 2015. Among the several findings, two are key: (a) Race is not experienced as a unitary construct and further shapes intercollegial experiences as multileveled clashes of encounters to influence academic and professional development of African American/Black faculty and professional staff. (b) White colleagues do not understand the scope of what it means for African Americans/Blacks to coexist within the PWI context and the larger experiential social/racial/cultural context (i.e., the functional salience of race). This article discusses three specific target areas that speak to strategic organizational solutions and organizational development and change issues to improve diversity in PWI settings, with particular implications for those serving in or allying with health care professions (e.g., historically Black colleges and universities). [ABSTRACT FROM AUTHOR]

The Young Black Men, Masculinities, and Mental Health (YBMen) project is a Facebook-based intervention that provides mental health education and social support to young Black men. The YBMen project was created to better understand and address the pressures and needs of young Black men, particularly with regard to issues related to their conceptualization of masculinity and mental health. Black men from a 2-year liberal arts college in the Midwest (United States) enrolled in the YBMen pilot project. The purpose of this study is to report what participants in the YBMen pilot project liked and disliked about the intervention, along with their suggestions for improvement. Qualitative results from the 8 Black men who actively participated in the YBMen Facebook intervention and completed the postintervention interview are reported. A systematic analysis identified 9 subthemes that described participants' reactions to different components and characteristics of the Facebook intervention. Results indicated that opportunities for relationship building and connectivity, coupled with engaging popular culture references used in the intervention encouraged young Black men to actively participate in the YBMen Facebook intervention. The YBMen project has potential to improve the health and well-being of young Black men by providing nontraditional resources that are easily accessible, culturally sensitive, and gender-specific. Implications of the YBMen project as an effective Internet-based program that promotes mental health and increases social support among young Black men are discussed. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

In a midwestern city of the USA, the authors implemented the Leaving Homelessness Intervention Research Project-and its eight subprojects-to further understand homelessness as experienced by older minority women, develop intervention strategies to facilitate the movement of the participants out of homelessness, and illuminate the women's recovery process. After reviewing the social issue of homelessness among older African American women in the USA, and offering a framework on recovery and qualitative themes of recovery among participants involved in the Telling My Story subproject, the authors present a four-factor model of recovery-focused practice. The model reflects two recovery paradigms: one that is responsive to the negative consequences people experience as a result of their exposure to extreme situations, such as homelessness, and a proactive one in which assistance is designed to help people in recovery advance their own self-development and move forward their process of individuation. [ABSTRACT FROM AUTHOR]

This study examined the association between perceived family economic stress, quality of father-son relationships, and depressive symptoms among African American adolescent fathers. Data were collected during pregnancy from 65 African American adolescents who were first-time fathers, ages 14-19. Results from multiple regression analyses indicated that higher paternal relationship satisfaction was associated with fewer depressive symptoms among adolescent fathers. Additionally, depressive symptoms were higher among adolescent fathers who reported experiencing higher levels of conflict with their fathers. Further, paternal conflict moderated the effect of perceived family economic stress on depressive symptoms. That is, among adolescent fathers experiencing low levels of conflict with their fathers, high perceived family economic stress was associated with more depressive symptoms. Study findings suggest that the risk for depressive symptoms is highest among adolescent fathers experiencing low family economic stress and highly conflictual relations with their fathers. These results highlight the complexities of paternal relationships and perceived economic stressors on depressive symptoms during pregnancy for African American adolescent fathers. The importance of expanding research on influential familial relationships and economic stressors on adolescent African American fathers is discussed. [ABSTRACT FROM AUTHOR]

A majority of detained adolescents experience mental health and substance use problems. Limited research has examined the interaction between the race/ethnicity of an individual youth and county-level racial heterogeneity on adolescent mental health outcomes. Participants were identified through a statewide mental health screening project that took place in detention centers across 11 different counties in a Midwestern state during January 1, 2008, to May 10, 2010. A total of 23,831 detained youth (ages 11-18 years), identified as non-Hispanic White (46.6%), Black (43.5%), or Hispanic (9.8%), completed a mental health screener that assessed problems in alcohol/drug use, depression-anxiety, anger-irritability, trauma, somatic complaints, and suicide ideation. Census data were gathered to determine the racial heterogeneity of each county and other county-level variables. Hierarchical linear regression analyses were used to test the independent and interactive effects of youth race/ethnicity and county-level variables (including racial heterogeneity of the county) on adolescent mental health. Independent of other community characteristics, as county-level racial heterogeneity increased, mental health problems among detained youth decreased. In future research on the development and persistence of mental health problems in detained youth, both community and individual-level factors should be considered. [ABSTRACT FROM AUTHOR]

To determine whether African American women expecting their first infant carry a disproportionate burden of posttraumatic stress disorder morbidity, we conducted a comparative analysis of cross-sectional data from the initial psychiatric interview in a prospective cohort study of posttraumatic stress disorder effects on childbearing outcomes. Participants were recruited from maternity clinics in three health systems in the Midwestern USA. Eligibility criteria were being 18 years or older, able to speak English, expecting a first infant, and less than 28 weeks gestation. Telephone interview data was collected from 1,581 women prior to 28 weeks gestation; four declined to answer racial identity items ( n = 1,577), 709 women self-identified as African American, 868 women did not. Measures included the Life Stressor Checklist, the National Women's Study Posttraumatic Stress Disorder Module, the Composite International Diagnostic Interview, and the Centers for Disease Control's Perinatal Risk Assessment Monitoring System survey. The 709 African American pregnant women had more trauma exposure, posttraumatic stress disorder symptoms and diagnosis, comorbidity and pregnancy substance use, and had less mental health treatment than 868 non-African Americans. Lifetime prevalence was 24.0% versus 17.1%, respectively (OR = 1.5, p = 0.001). Current prevalence was 13.4% versus 3.5% (OR = 4.3, p < 0.001). Current prevalence of posttraumatic stress disorder (PTSD) was four times higher among African American women. Their risk for PTSD did not differ by sociodemographic status, but was explained by greater trauma exposure. Traumatic stress may be an additional, addressable stress factor in birth outcome disparities. [ABSTRACT FROM AUTHOR]

The authors examined ecological risk factors associated with teen pregnancy with a sample of 1,190 court-involved female juvenile offenders between 11 and 18 years of age. Data were obtained from five Midwestern juvenile county courts using a recently developed youth risk assessment instrument called the global risk assessment device (GRAD). In line with past research on teen pregnancy, the authors found that young African American female offenders were three times more likely to have ever been pregnant than their European American counterparts. Factorial multivariate analysis of variance (MANOVA) procedures were conducted to identify the ecological risk domains that differentiated groups of female juvenile offenders in the sample of this study, based on their pregnancy history and racial background. The findings of this study suggest that female offenders who had experienced a pregnancy had significantly higher levels of health-related risks as compared to their counterparts who had never been pregnant. Furthermore, regardless of their pregnancy history, White female offenders reported significantly greater involvement in substance abuse behaviors as compared to Blacks. Taken together, these findings underscore the need to utilize comprehensive risk assessments when designing integrated intervention programs that are tailored to the unique needs of young female offenders who are at risk for early pregnancies. [ABSTRACT FROM PUBLISHER]

Despite greater acceptance of gay rights and relationships in recent decades, significant homophobia still exists in the U.S. population. There are consistent demographic differences in levels of homophobia; specifically, men, older persons, less educated persons, and conservatives tend to be more homophobic than women, younger persons, more highly educated persons, and liberals. Additionally, there is a perception that Blacks are more homophobic than Whites, and that this difference is because of the importance of religion in the Black community, another factor frequently associated with homophobic attitudes. This perception has not been empirically tested to any great extent. In the current study of 551 Midwestern college students, both independent t-test results and ordinary least squares (OLS) regression analysis find that there are no significant racial differences between Black and White students in indexes measuring views toward, rights for, and willingness to socialize with gays and lesbians. Gender is a significant predictor of homophobia for both groups, although age and measures for the importance of religion are significant predictors for White students only. [ABSTRACT FROM AUTHOR]