SERIOUS PSYCHOLOGICAL DISTRESS AMONG AFRICAN AMERICANS: FINDINGS FROM THE NATIONAL SURVEY OF AMERICAN LIFE

Despite their low social standing, there remains a paucity of research on psychological distress among African Americans. We use data from the 2001–2003 National Survey of American Life to explore a wide array of social and economic predictors of psychological distress among African American adults aged 18 years and older, including previous incarceration, history of welfare receipt, and having a family member who is either currently incarcerated or homeless. Younger age, lower income, lower educational attainment, and lower self‐rated health and childhood health are associated with higher levels of psychological distress among African Americans. We also find a strong association between higher levels of material hardship, previous incarceration history, and the presence of a family member who is either incarcerated or homeless and higher levels of psychological distress. The findings highlight the importance of considering unique types of social disadvantage experienced by African Americans living in a highly stratified society.     

FMR1 premutation frequency in a large,ethnically diverse population referred for carrier testing

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability and is caused by an expansion of cytosine‐guanine‐guanine (CGG) repeats in the FMR1 gene. Female premutation allele carriers (55–200 CGG repeats) are at risk to have an affected child. Currently, specific population‐based carrier screening for FXS is not recommended. Previous studies exploring female premutation carrier frequency have been limited by size or ethnicity. This retrospective study provides a pan‐ethnic estimate of the Fragile X premutation carrier frequency in a large, ethnically diverse population of women referred for routine carrier screening during a specified time period at Progenity, Inc. Patient ethnicity was self‐reported and categorized as: African American, Ashkenazi Jewish, Asian, Caucasian, Hispanic, Native American, Other/Mixed/Unknown, or Sephardic Jewish. FXS test results were stratified by ethnicity and repeat allele category. Total premutation carrier frequency was calculated and compared against each ethnic group. A total of 134,933 samples were included. The pan‐ethnic premutation carrier frequency was 1 in 201. Only the Asian group differed significantly from this frequency. Using the carrier frequency of 1 in 201, a conservative pan‐ethnic risk estimate for a male fetus to have FXS can be calculated as 1 in 2,412. This risk is similar to the highest ethnic‐based fetal risks for cystic fibrosis and spinal muscular atrophy, for which population‐wide screening is currently recommended. This study adds to the literature and supports further evaluation into specific population‐wide screening recommendations for FXS.     

Intergenerational transmission of traumatization: Theoretical framework and implications for prevention

Intergenerational transmission of traumatization (ITT) occurs when traumatized parents have offspring with increased risk for emotional and behavioral problems. Although fetal exposure to the maternal biological milieu is known to be one factor in ITT, PTSD-driven parent–child interactions represent an additional important and potentially modifiable contributor. The Perinatal Interactional Model of ITT presented herein proposes that PTSD leads to social learning and suboptimal parent–child interactions, which undermine child regulatory capacity and increase distress, largely explaining poor social-emotional outcomes for offspring of parents with PTSD. Psychosocial intervention, particularly when delivered early in pregnancy, holds the possibility of disrupting ITT.     

Understanding needle‐related distress in children with cystic fibrosis

Objective. To explore the nature and management of needle‐related distress in children and adolescents with cystic fibrosis (CF). Design. Qualitative study using semi‐structured interviews. Methods. Fourteen child–parent dyads took part. Children (5 male; 9 female) had a mean age of 12.4 years (range 7–17) and were mostly diagnosed with CF at birth (N= 11). Frequency of needle procedures ranged from once to six times a year. Parents (3 male; 11 female) had a mean age of 41.5 years and were from a variety of socio‐economic backgrounds. Interviews were transcribed and analysed using thematic analysis. Results. Most participants identified previous needle experiences and pain as related to their needle anxiety. Over half of parents and children considered ‘taking control’ to be the optimum coping strategy. The majority of parents and children thought inhaled nitrous oxide gas during needle procedures was helpful in managing needle‐related distress. Parent and staff influences on needle‐related distress are also examined. Conclusions. Needle‐related distress in children with CF has a substantial impact on children and their parents, and may lead to management problems and treatment refusal. Psychological and pharmacological interventions could reduce distress and aid management.     

Race/ethnicity, socioeconomic status and the health of pregnant women

We examined how traditional (income, education) and nontraditional (public assistance, material deprivation, subjective social standing) socioeconomic status (SES) indicators were associated with self-rated health, physical functioning, and depression in ethnically diverse pregnant women. Using multiple regression, we estimated the association of race/ethnicity (African American, Latino, Asian/Pacific Islander (PI) and white) and sets of SES measures on each health measure. Education, material deprivation, and subjective social standing were independently associated with all health measures. After adding all SES variables, race/ethnic disparities in depression remained for all minority groups; disparities in self-rated health remained for Asian/Pacific Islanders. Few race/ethnic differences were found in physical functioning. Our results contribute to a small literature on how SES might interact with race/ethnicity in explaining health.     

Parenting a child with Marfan syndrome: Distress and everyday problems

Marfan syndrome (MFS) is a multisystemic, autosomal dominant connective tissue disorder that occurs de novo in 25%. In many families, parent and child(ren) are affected, which may increase distress in parents. To assess distress, 42 mothers (29% MFS) and 25 fathers (60% MFS) of 43 affected children, completed the validated screening‐questionnaire Distress thermometer for parents of a chronically ill child, including questions on overall distress (score 0–10; ≥4 denoting “clinical distress”) and everyday problems (score 0–36). Data were compared to 1,134 control‐group‐parents of healthy children. Mothers reported significantly less overall distress (2, 1–4 vs. 3, 1–6; p = .049; r = ?.07) and total everyday problems (3, 0–6 vs. 4, 1–8; p = .03; r = ?.08) compared to control‐group‐mothers. Mothers without MFS reported significantly less overall distress compared to mothers with MFS, both of a child with MFS (1, 0–4 vs. 3.5, 2–5; p = .039; r = ?.17). No significant differences were found between the father‐groups, nor between the group of healthy parents of an affected child living together with an affected partner compared to control‐group‐parents. No differences in percentages of clinical distress were reported between mothers and control‐group‐mothers (33 vs. 42%); fathers and control‐group‐fathers (28 vs. 32%); nor between the other groups. Distress was not associated with the children's MFS characteristics. Concluding, parents of a child with MFS did not show more clinical distress compared to parents of healthy children. However, clinical distress was reported in approximately one‐third and may increase in case of acute medical complications. We advise monitoring distress in parents of a child with MFS to provide targeted support.     

Attachment linked predictors of women's emotional and cognitive responses to infant distress

The purpose of this study was to examine associations among women's emotional and cognitive responses to infant fear and anger and to identify attachment linked predictors of these responses. Four hundred and forty Caucasian and African American undergraduate college women viewed video clips of two crying infants, one displaying anger and the other displaying fear. They identified what the infants were feeling, made causal attributions about the cause of crying, rated their own emotional reactions to the crying infants, and reported on the extent to which their parents met their emotional needs in childhood and their current adult attachment patterns. Emotional and cognitive responses to infant fear and anger were interrelated. Consistent with prediction, a history of parental emotional rejection and adult attachment anxiety and avoidance correlated negatively with accurate identification of emotions and positively with negative attributions, amusement, and neutral responses to infant distress. Adult attachment security moderated the effects of early parental rejection on emotional and cognitive responses to infant distress, and these results varied based on race and parent gender. Results are discussed from an attachment theory perspective.     

First‐grade child risk behaviors for community violence exposure in middle school

This study examined behavioral indicators (measured by multiple informants) of young urban children's exposure to community violence during middle school. The community‐based school sample included 549 students (53% male; 86.8% African American, 13.2% Euro American). First‐grade aggressive behavior and anxiety symptoms were examined as predictors of later victimization and witnessing of community violence. Logistic regression analyses indicated that girls' first‐grade aggression significantly predicted witnessing violence in middle school, regardless of informant. Parent‐reported child aggression significantly predicted boys' later victimization. Teacher‐ and parent‐reported child aggression was associated with witnessing more community violence among boys with low self‐reported anxiety. Anxiety attenuated the relationship between aggression and witnessing community violence during adolescence for boys. The importance of the identifying early predictors of later community violence exposure in designing preventive interventions is discussed. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 297–314, 2003.     

UNDERSTANDING THE ROLE OF THE ETHNIC DENSITY EFFECT: ISSUES OF ACCULTURATION,DISCRIMINATION AND SOCIAL SUPPORT

Ecological factors in psychological acculturation research are often neglected, although recent work suggests that context and acculturation may interact in predicting adaptation outcomes. The ethnic density effect–the protective effect related to a greater proportion of people from the same ethnic group living in a particular neighborhood–might be one such ecological candidate. The current study integrates these constructs by unpacking the perceived ethnic density effect and examining how it is related to acculturation in a diverse sample (N = 146) of immigrant students in Montreal, Canada. It was found that the negative relation between perceived ethnic density and depression was mediated by discrimination but not by social support. Furthermore, a crossover interaction indicated that heritage acculturation was protective against depression for those residing in ethnically concentrated neighborhoods but not for those living in ethnically sparse neighborhoods. This strongly supports an ecology‐acculturation fit, highlighting the need to contextualize acculturation research.     

The interacting effects of psychological empowerment and ethnic identity on indicators of well‐being among youth of color

Decades of legislative actions and power imbalances have limited African American/Black and Hispanic/Latina(o) urban youth's perceptions of empowerment and ability to rely upon social and institutional resources. Youth who have access to supportive resources and are connected to their ethnic–racial group perceive themselves as empowered and score higher on indicators of well‐being. Among a sample of African American/Black and Hispanic/Latina(o) urban youth (N = 383) and using multivariate analysis of variance, the current study examined the relationship between psychological empowerment (PE) and ethnic identity among conceptually relevant outcome variables: community participation, neighborhood sense of community (SOC), school importance, and perceived substance use risk. Results indicated that PE and ethnic identity profile groups differed significantly on measures of community participation, neighborhood SOC, school importance, and perceived risk of using substances. Results provide preliminary support for the empirical and theoretical relationship between PE and ethnic identity on related empowerment measures, as well as indicators of well‐being. Implications and directions for future research are discussed.     

Discrimination and Depressive Symptoms Among Black American Men: Moderated-Mediation Effects of Ethnicity and Self-Esteem

Discrimination is related to depression and poor self-esteem among Black men. Poorer self-esteem is also associated with depression. However, there is limited research identifying how self-esteem may mediate the associations between discrimination and depressive symptoms for disparate ethnic groups of Black men. The purpose of this study was to examine ethnic groups as a moderator of the mediating effects of self-esteem on the relationship between discrimination and depressive symptoms among a nationally representative sample of African American (n = 1201) and Afro-Caribbean American men (n = 545) in the National Survey of American Life. Due to cultural socialization differences, we hypothesized that self-esteem would mediate the associations between discrimination and depressive symptoms only for African American men, but not Afro-Caribbean American men. Moderated-mediation regression analyses indicated that the conditional indirect effects of discrimination on depressive symptoms through self-esteem were significant for African American men, but not for Afro-Caribbean men. Our results highlight important ethnic differences among Black men.     

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.     

Family processes among Latino Early Head Start families: Understanding the role of caregiver acculturation

The Family Stress Model (FSM) provides a framework for how economic pressure can impact family processes and outcomes, including parent's mental health, parenting, and child problem behaviors. Although the FSM has been widely replicated, samples disproportionately impacted by poverty, including early childhood samples and in particular Latino families with young children, have been largely excluded from FSM research. Therefore, among a sample of Latino Early Head Start children (N = 127), the current study evaluated a modified FSM to understand the direct and indirect pathways among economic pressure, parental depression, parenting self‐efficacy, the parent–child relationship, child problem behaviors, and parental acculturation. Results showed that the majority of the direct FSM pathways were well‐replicated among Latino caregivers of young children. Further analyses illuminated how some pathways were replicated among more but not among less‐acculturated Latino parents. Implications for future FSM research with Latino families as well as for parent‐focused interventions are discussed.     

Positive Parenting and Callous-Unemotional Traits: Their Association With School Behavior Problems in Young Children

The current study tested the associations of both positive (i.e., warm and responsive) and negative (i.e., harsh and inconsistent) aspects of parenting with callous-unemotional (CU) traits and conduct problems. Caregivers and teachers of 92 ethnically diverse (33% African American) kindergarten students (61% female) were recruited to complete a series of survey measures. Students’ average age was 6.2 (SD = 0.42) years. Parent report of positive parenting practices, but not negative parenting practices, was associated with teacher report of conduct problems. Further, positive parenting interacted with CU traits in their association with conduct problems. Parental use of positive reinforcement was more strongly negatively related to conduct problems for youth with high levels of CU traits, whereas parent–child cooperation was positively related to conduct problems only for youth with low levels of CU traits. Finally, only parental warmth was negatively correlated with CU traits after controlling for level of conduct problems. Results were generally not moderated by the child’s gender or ethnicity. These findings highlight the importance of positive parenting practices for understanding CU traits and as potential targets in clinical interventions to treat children who show elevated levels of these traits.     

Sticks and stones may break my bones, but names will make me feel sick: the psychosocial, somatic, and scholastic consequences of peer harassment.

This study examined associations among peer victimization, psychosocial problems, physical symptoms, and school functioning across the 1st year in middle school. An ethnically diverse sample of urban 6th graders (N=1,526) reported on their perceptions of peer victimization, psychosocial adjustment, and physical symptoms during fall and spring. Objective measures of school functioning (i.e., grade point average and absences) were also collected. In Model 1, peer victimization in the fall was associated with spring psychosocial maladjustment and physical symptoms, which in turn predicted poor spring school functioning. Model 2 suggested that psychosocial difficulties increase the risk of victimization, although physical symptoms did not predict victimization. No sex or ethnic group (African American, Asian, European American, and Latino) differences were found in the model structure or the strength of the path coefficients for either model, suggesting that the process is the same for boys and girls and students from different ethnic groups.     

The Role of Parental Emotional Distress in Parent Report of Child Anxiety

Evaluated the role of maternal and paternal emotional distress in parent report of anxiety in their child. Participants were 239 children (ages 7.5 to 15 years) diagnosed with a primary anxiety disorder and their parents (193 fathers, 238 mothers). Parents individually completed the State-Trait Anxiety Inventory, the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory for Children-Parent Version (a report of the child's anxiety). Children completed the State-Trait Anxiety Inventory for Children. Mothers and fathers reported more anxiety in their children than the children reported themselves. No significant relations were found between parental anxiety and parent report of child anxiety. When we examined girls only, both maternal and paternal BDI scores were significant predictors of parent report of the child's anxiety after we controlled for parental anxiety. Separate analyses by child age revealed that parent reports of child anxiety were more correlated with the self-reports of younger children. The implications of these findings are discussed.     

Tuning in to kids: an emotion‐focused parenting program—initial findings from a community trial

This study evaluated a new group parenting program, Tuning in to Kids, which taught emotion coaching skills to parents of preschool children. In a randomized control trial, 218 primary caregiver parents of children aged 4.0–5.11 years completed questionnaires assessing parent emotion socialization (emotion coaching vs. emotion dismissing), parent emotional competence, parent wellbeing and child behavior. Assessment occurred at preintervention and 10 weeks later. Parents randomized to the intervention condition (n=107) attended a 6‐session parenting program. Results showed parents in the intervention condition reported significant increases in emotion coaching and significant reductions in emotion dismissing with their children. Child behavior was also reported to improve. Of those with clinical levels of behavior difficulties, more than half were no longer at clinical level postprogram. These findings suggest that an emotion‐focused parenting intervention may assist parents to learn emotion‐coaching skills that have been linked to improved child behavior. © 2009 Wiley Periodicals, Inc.     

Parents have both implicit and explicit biases against children with obesity

Weight bias (negative attitudes towards individuals with obesity) has been widely observed, but not examined in parents. In this study, we measured parents’ (N?=?658; 74.2% female) explicit and implicit weight bias against children with obesity. Many parents (n?=?612; 93%) endorsed some moderate explicit weight bias. Fathers had greater explicit bias than mothers and parents with overweight/obesity had less bias than those with healthy-weight. Other parent/child variables (i.e., parent age, child sex, child weight, child age) were not significantly associated with explicit bias. Parents also demonstrated implicit weight bias. No parent or child variables were significantly associated with implicit bias. Parents may contribute, among many others, to the stigmatizing environment experienced by youth with overweight/obesity, which has been associated with negative child psychosocial functioning and health. Clinical research into strategies to reduce parental weight bias against children with obesity or increase children’s resilience to weight discrimination is needed to improve children’s health and well-being.