Past racial discrimination exacerbates the effects of racial exclusion on negative affect,perceived control,and alcohol-risk cognitions among Black young adults

Racial discrimination is associated with alcohol use and risky sex cognitions and behaviors, which are risk factors for negative health outcomes, including human immunodeficiency virus infection. The current study investigated the causal impact of racial discrimination on alcohol and sexual-risk cognitions while exploring potential mediators that might help explain this relation: negative affect, perceived control, and meaningful existence. We also examined if past discrimination impacts the strength of (moderates) these effects. Participants were 287 Black/African American young adults aged 18–25. They were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted greater: perceived racial discrimination, negative affect, alcohol use willingness, and reduced perceived control and meaningful existence. Furthermore, excluded participants who experienced more past racial discrimination reported the lowest perceived control, and greatest negative affect and alcohol-risk cognitions. The findings suggest that past racial discrimination exacerbates the harmful health effects of immediate experiences of discrimination.     

Racial discrimination and substance use: longitudinal associations and identity moderators

Current research indicates that racial discrimination is pervasive in the lives of African Americans. Although there are a variety of ways in which discrimination may contribute to health, one potentially important pathway is through its impact on substance use. Addressing the paucity of longitudinal research on this topic, the present study examined the influence of teacher discrimination on changes in substance use over time among African American adolescents and considered three dimensions of racial identity as moderators of this association (centrality, private regard, and public regard). Latent variable SEM analyses indicated that, on average, levels of discrimination were associated with increases in substance use across the high school years. However, public regard was found to moderate this association such that discrimination was less strongly associated with increases in substance use for individual who reported lower levels of public regard. The implications of these findings are discussed.     

The association of perceived discrimination with low back pain

A handful of recent studies have documented perceived discrimination as a correlate of poor physical and mental health status among ethnic and racial minority groups. To date, however, despite a proliferation of research on ethnic disparities in the severity and impact of a number of persistent pain conditions, there have been no reports on associations between perceived discrimination and pain-related symptoms. Using data from a national survey (the National Survey of Midlife Development in the United States; MIDUS), we explore the relationships between perceived discriminatory events and the report of back pain among African-American and white men and women. As expected, African-American participants reported substantially greater perceptions of discrimination than white participants. Moreover, in models that included a variety of physical and mental health variables, episodes of major lifetime discriminatory events were the strongest predictors of back pain report in African-Americans, and perceived day-to-day discrimination was the strongest predictor of back pain report specifically in African-American women. Among white participants, perceptions of discrimination were minimally related or unrelated to back pain. To our knowledge, these are the first data documenting an association between perceived discrimination and report of back pain; the fact that perceptions of discrimination were stronger predictors than physical health variables highlights the potential salience and adverse impact of perceived discrimination in ethnic and racial minority groups.     

Focus group interviews on racial and ethnic attitudes regarding adult vaccinations

Adult immunizations have dramatically improved the health of many Americans. In the United States, researchers have documented disparities in the utilization of adult vaccinations between whites and racial and ethnic minority populations. This article examines racial and ethnic attitudes regarding recommended adult vaccinations. METHODS: Four adult focus groups (N=22) were conducted in community churches in San Francisco, CA. Participants were either age-appropriate or had clinical indications to receive a strong recommendation for influenza and pneumococcal immunizations but had not been routinely immunized against influenza and had never been vaccinated against pneumococcal disease. Content analysis was used to analyze narrative data and identify emerging themes. RESULTS: Participants reported that they lacked information about the benefits or potential side effects of influenza and pneumococcal vaccinations and that their physicians were not routinely informing them of, or recommending, these vaccinations. Meanwhile, most participants expressed a willingness to be vaccinated against pneumococcal infection and influenza. All focus group participants felt that community churches were a potential venue for delivery of adult vaccines. CONCLUSIONS: Many adult racial and ethnic minorities have basic information regarding the influenza vaccine but lack sufficient information regarding the benefits of pneumococcal vaccinations. Physicians should provide information regarding adult vaccinations to all patients. On-site vaccination and vaccine education programs in community churches may be successful in increasing the utilization of adult vaccinations in unvaccinated church populations.     

Perceived discrimination and youths' adjustment: sleep as a moderator

Adolescents' sleep duration was examined as a moderator of the association between perceived discrimination and internalizing (anxiety, depression) and externalizing symptoms. Participants were 252 adolescents (mean: 15.79 years; 66% European American, 34% African American) who reported on their perceived discrimination (racial and general) and adjustment. Sleep duration was measured using actigraphy. Moderation effects were evident. The lowest levels of internalizing symptoms were observed for adolescents with longer sleep duration in conjunction with lower levels of perceived racial discrimination. Further, general perceived discrimination was associated more strongly with externalizing behaviours for youth with shorter versus longer sleep. Findings highlight the importance of sleep as a bioregulatory system that can ameliorate or exacerbate the effects of discrimination on youths' adjustment.     

UV photography, masculinity, and college men’s sun protection cognitions

This study examined the impact of an ultraviolet (UV) photography intervention and masculinity on college men's sun protection cognitions, including: perceived vulnerability to skin damage, attitudes toward sun protection, willingness to engage in sun protection behaviors, and intentions to receive a skin cancer exam. After completing a baseline survey, participants (N = 152) viewed a black-and-white photo of their face. Half also viewed a photo showing their UV damage. Participants then completed a second survey assessing sun protection cognitions. Regressions revealed that masculinity predicted lower sun protection cognitions, and men in the UV photograph condition reported higher sun protection cognitions. Masculinity by condition interactions showed that the positive effect of UV photography was stronger among masculine men. Negative associations between masculinity and sun protection cognitions were significant only among men who did not receive the intervention. Findings suggest that UV photography is a promising sun protection intervention among masculine men.     

Written disclosure of experiences with racial discrimination and antibody response to an influenza vaccine

This study examined whether Blacks who wrote about their experiences with racial discrimination in a laboratory-based disclosure intervention would show greater levels of antibody production in response to an influenza vaccine compared with Blacks who wrote about a neutral topic. Forty-seven participants were randomized to write about their thoughts and feelings around their experiences with racism, or to write about their schedule for the week. Participants wrote on the same topic during each of three 20-min sessions. Blood was drawn prior to the intervention and at 1 and 3 months postvaccination to assess antibody production. Participants in the racism disclosure group produced significantly less antibodies to 2 of 3 viral strains. Post hoc analysis suggests that participants who were unsure about whether their events were due to racism or due to other factors had reduced levels of antibody to 1 viral strain. The attributional ambiguity sometimes associated with racism may inhibit the benefits of disclosure interventions for these types of stressors.     

A randomized control trial examining the effect of acceptance and commitment training on clinician willingness to use evidence-based pharmacotherapy

This study evaluated the effectiveness of acceptance and commitment training (ACT) for increasing drug and alcohol counselors' willingness to use evidence-based agonist and antagonist pharmacotherapy. Fifty-nine drug and alcohol counselors were randomly assigned to either a 1-day ACT workshop or a 1-day educational control workshop. Both groups then attended a 2-day workshop on empirically supported treatments for substance abuse. Measures were taken at pre- and posttraining and 3-month follow-up on reported use of pharmacotherapy, willingness to use pharmacotherapy, perceived barriers to implementing new treatments, and general acceptance. As compared with those in the education alone condition, participants in the ACT condition showed significantly higher rates of referrals to pharmacotherapy at follow-up, rated barriers to learning new treatments as less believable at posttraining and follow-up, and showed greater psychological flexibility at posttraining and follow-up. Mediational analyses indicated that reduced believability of barriers and greater psychological flexibility mediated the impact of the intervention. Results support the idea that acceptance-based interventions may be helpful in addressing the psychological factors related to poor adoption of evidence-based treatments.     

Anger episodes in high- and low-trait-anger community adults

Anger is a basic emotion, experienced by almost all human beings in response to the unwanted and unexpected behavior of others. Yet, there is little consensus as to which characteristics may differentiate people who experience normal versus exaggerated or pathological anger reactions. We examined the self-reported characteristics of specific anger episodes in 93 community adults who were high (HTA) or low (LTA) on trait anger. Using a componential model, they were asked to identify a recent anger episode and report on the triggers and associated cognitions, characteristics of the experience, desired and actual patterns of expression, and outcomes. HTA adults, in comparison to their LTA counterparts, exhibited anger reactions that were more frequent, intense, and enduring. They also reported more negative cognitions. Of particular importance, the HTA adults reported more physical aggression, negative verbal responses, drug use, and negative anger-related consequences. Thus, clinically important anger reactions may emerge as a function of the anger trait. Results are discussed in terms of implications for diagnosis and treatment.     

In the face of anger: Startle modulation to graded facial expressions

In the present study, the startle reflex was examined with respect to the degree of anger displayed in facial expressions. To this end, 52 participants viewed faces that were morphed to display 0, 20, 40, 60, 80, or 100% anger. As the percentage of anger in faces increased from 0 to 100%, faces were perceived as increasingly angry; however, relative to neutral facial expressions, startle amplitude was only potentiated to maximally angry faces. These data imply a non‐linear relationship between the intensity of angry faces and defensive physiological activity. This pattern of startle modulation suggests a categorical distinction between threatening (100% anger) and other facial expressions presented. These results are further discussed in terms of existing data, and how this paradigm might be utilized in psychopathology research.     

Perceived racial discrimination as an independent predictor of sleep disturbance and daytime fatigue

Perceived discrimination is a potential cause of racial and ethnic disparities in health. Disturbed sleep may serve as a mechanism linking perceived racism with health consequences. This study investigates data from 7,148 adults from Michigan and Wisconsin who participated in the 2006 Behavioral Risk Factor Surveillance System. Hierarchical logistic regression analyses explored associations between perceived racial discrimination and self-reported sleep disturbance and daytime fatigue. Sleep disturbance and daytime fatigue were reported in 19% and 21% of the sample, respectively. Black/African American respondents (21%) report perceiving worse experiences, compared to people of other races, when seeking health care at higher rates than non-Hispanic White respondents (3%). Results from logistic regression models show that perceived racial discrimination is associated with increased risks of sleep disturbance (odds ratio [OR] = 2.62, p < .0001) and daytime fatigue (OR = 2.07, p < .0001). After adjustment for all covariates, perceived discrimination remains a significant predictor of sleep disturbance (OR = 1.60, p = .04). The interaction between perceived racism and race (Black/African American vs. non-Hispanic White) was nonsignificant. This population-based research adds to the growing body of data, suggesting that perceived racism may impact health via its influence on sleep-wake behaviors.     

Peripheral responses to attended and unattended angry prosody: A dichotic listening paradigm

We investigated the effects of angry prosody, varying focus of attention, and laterality of presentation of angry prosody on peripheral nervous system activity. Participants paid attention to either their left or their right ear while performing a sex discrimination task on dichotically presented pseudo‐words. These pseudo‐words were characterized by either angry or neutral prosody and presented stereophonically (anger/neutral, neutral/anger, or neutral/neutral, for the left/right ear, respectively). Reaction times and physiological responses (heart period, skin conductance, finger and forehead temperature) in this study were differentially sensitive to the effects of anger versus neutral prosody, varying focus of attention, and laterality of presentation of angry prosody.     

The effects of expressive writing on pain, depression and posttraumatic stress disorder symptoms in survivors of intimate partner violence

This study examined the effects of expressive writing on depression, posttraumatic stress disorder (PTSD) and pain symptoms among women who have survived intimate partner violence (IPV). Forty-seven women completed baseline and four-month follow-up assessments and were randomly assigned to four writing sessions of either expressive writing focused on traumatic life events or writing about a neutral topic. Main effects were not significant for changes in depression, pain or PTSD symptoms. However, among depressed women, those assigned to expressive writing showed a significantly greater drop in depression. For depressed women with IPV histories, expressive writing may lead to reduced depression.     

Role of appraisals in expressed anger after trauma

Anger is a common problem in trauma-exposed individuals. This study investigated factors that contribute to post-traumatic anger in civilian trauma survivors. Fifty-one trauma-exposed individuals were assessed for expressed anger, post-traumatic stress disorder (PTSD), daily hassles, maladaptive cognitions and blame. PTSD and non-PTSD participants reported comparable levels of anger. Anger expression was associated with maladaptive appraisals about oneself, daily hassles, and self-blame. Multiple regression analyses indicated that catastrophic appraisals about oneself and time since trauma were the only significant predictor of anger expression. These findings suggest that the influence of daily hassles on post-traumatic anger may be mediated by trauma survivors' appraisals.     

Neighborhood social processes as moderators between racial discrimination and depressive symptoms for African American adolescents

Racial discrimination is associated with numerous psychological consequences, including increased depressive symptoms for African American adolescents (Brody et al., 2006; Wong, Eccles, & Sameroff, 2003). Adolescents’ perceptions of their neighborhood can influence how youth interpret and manage racial discrimination (Sampson, Morenoff, & Gannon‐Rowley, 2002). Yet little is known about how adolescent perceptions of neighborhood cohesion and neighborhood disorganization protect or exacerbate the effects of racial discrimination, or how these effects vary by youth's gender. Therefore, the current study examined whether neighborhood social cohesion and neighborhood disorganization moderated the association between racial discrimination and depressive symptoms for African American adolescents and how the effects differ for boys and girls. Participants were 106 African American adolescents (57% female; mean age 15.14) from an urban metropolitan area. Regression analyses suggest that perceptions of neighborhood social cohesion protected against racial discrimination for boys and girls. Additionally, the results indicate that when boys perceive less neighborhood disorganization, racial discrimination has a greater influence on their depressive symptoms. Findings have implications for intervention and prevention efforts that enhance and utilize positive neighborhood social processes for youth contending with racial discrimination.     

Social support schemas, trait anger, and cardiovascular responses.

This study examined the influence of activated support schemas on cardiovascular reactivity (CVR) during an anger-recall interview. Eighty Chinese female undergraduates wrote about a supportive tie or a casual acquaintance and subsequently disclosed an anger-provoking event while their heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Compared to participants in the 'acquaintance' condition, those in the 'support' condition showed lower HR, SBP and DBP reactivity, as well as smaller state anger increases and less negative appraisals of the recalled anger event. Reactivity increased as a function of trait anger. High trait anger individuals also had greater increases in state anger and more negative appraisals of the recalled event compared to their low trait anger counterparts. Support schema activation reduced the effects of trait anger on CVR such that high trait anger individuals in the 'support' condition had significantly lower CVR compared to high trait anger individuals in the 'acquaintance' condition. These findings suggest that social support schemas may have beneficial effects even in the absence of actual, enacted support.     

Whole body donation for medical science: a population-based study

Although cadaveric whole-body donation for the purposes of medical science is extremely important for medical education, the number of persons who choose to donate remains low. We assessed persons' willingness to consider whole body donation in a standardized telephone survey of Maryland households, identified using random digit dialing. In multivariable analyses, we assessed the independent relation of sociodemographics and attitudinal factors to willingness to consider donation, and we determined the amount of variation in willingness to consider donation among the study population that could be explained by these factors. Of 385 participants (84% of randomized homes), 49% reported they would consider whole body donation. In bivariate analysis, younger age, African-American race/ethnicity, less education and income, greater number of dependents, marital status, and attitudes about religion/spirituality, trust in hospitals, and income, gender, and racial/ethnic discrimination in hospitals were statistically significantly associated with 40-70% less odds of willingness to consider donation. After adjustment, persons of African-American race/ethnicity, less education, and those agreeing with the statements, "Rich patients receive better care at hospitals than poor patients," and "White patients receive better care at hospitals than other racial or ethnic groups," had 40-60% less odds of willingness to consider donation when compared to their counterparts. Respondents' race/ethnicity and education contributed most to willingness to consider donation. We conclude that demographic and attitudinal factors are strongly related to willingness to consider whole body donation. Efforts to enhance donation should seek to identify ways in which potential barriers to donation can be addressed by health professionals.     

Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination

This article examines the extent to which racial differences in socio-economic status (SES), social class and acute and chronic indicators of perceived discrimination, as well as general measures of stress can account for black-white differences in self-reported measures of physical and mental health. The observed racial differences in health were markedly reduced when adjusted for education and especially income. However, both perceived discrimination and more traditional measures of stress are related to health and play an incremental role in accounting for differences between the races in health status. These findings underscore the need for research efforts to identify the complex ways in which economic and non-economic forms of discrimination relate to each other and combine with socio-economic position and other risk factors and resources to affect health.     

Relationships with adults as predictors of substance use,gang involvement,and threats to safety among disadvantaged urban high‐school adolescents

Using a resilience framework, the authors examined the protective effects of parental support, self‐disclosure to parents, parent‐initiated monitoring of adolescent behavior, and relationships with school personnel on three critical problems of adolescents: substance use, gang involvement, and perceived threats to safety at school. The sample consisted of 342 ethnically diverse high‐school students in an economically disadvantaged urban area in the southwestern United States. The regression analyses controlled for academic performance, poor anger management, risk‐seeking propensities, co‐occurring substance use, and co‐occurring gang involvement. Interactions as well as main effects were examined. The specific protective roles of all four adult relationships were identified with respect to problematic outcomes. Adolescent self‐disclosure to parents, a variable rarely examined in resilience research, was associated with less chance of substance use for two high‐risk groups: those already involved with gangs, and those with high risk‐seeking tendencies. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 1053–1071, 2007.     

Reciprocal Effects of Positive Future Expectations,Threats to Safety,and Risk Behavior Across Adolescence

We examined the reciprocal relationships among positive future expectations, expected threats to future safety, depression, and individual substance use and delinquency using 4 waves of data (N = 248–338) from African American and Latino adolescent male participants in the Chicago Youth Development Study. Individual positive future expectations and expected threats to safety were assessed at each wave and modeled as latent constructs. Individual substance use and delinquency were assessed at each wave and represented as ordinal variables ranging from low to high. Categorical autoregressive cross-lagged structural models were used to examine the hypothesized reciprocal relationships between both aspects of future expectations construct and risk behavior across adolescence. Analyses show that future expectations has important effects on youth substance use and involvement in delinquency, both of which in turn decrease positive expectations and increase expectation of threats to future safety across adolescence. Similarly, low positive expectations for the future continued to predict increased substance use and involvement in delinquency. The expected threats to safety construct was significantly correlated with delinquency within time. These effects are observed across adolescence after controlling for youth depression and race. Findings support the reciprocal effects hypothesis of a negative reinforcing cycle in the relationships between future expectations and both substance use and involvement in delinquent behavior across adolescence. The enduring nature of these relationships underscores the importance of future expectation as a potential change mechanism for intervention and prevention efforts to promote healthy development; vulnerable racial and ethnic minority male adolescents may especially benefit from such intervention.