Predictors Of Self-Reported Physical Symptoms in Low-Income, Inner-City African American Women: The Role of Optimism, Depressive Symptoms, and Chronic Illness

In this study we examined the association of optimism and depressive symptoms with self-reported physical symptoms in 241 low-income, inner-city African American women with or without a chronic illness (HIV). Although optimism was not a unique predictor of self-reported physical symptoms over and above depressive symptoms, optimism interacted with depressive symptoms and health status. In the community sample, but not the chronically ill sample, optimism buffered the association between depressive symptoms and self-reported physical symptoms. Clinical implications and directions for future research are discussed.     

CD4 Count and Physical Symptoms Among Urban African American Mothers with HIV: An Examination of the Role of Optimism and Depressive Symptoms

The current study examined the link between immune functioning (CD4 count) and physical symptoms, as well as the moderating role of optimism and depressive symptoms, in a sample of 99 low income, inner city African American women with HIV. Although there was no main effect of CD4 count on physical symptoms, depressive symptoms moderated the association between CD4 count and physical symptoms. More compromised immune functioning (lower CD4 count) was associated with more physical symptoms under conditions of higher levels of depressive symptoms, but not lower levels of depressive symptoms. This finding was observed using both a self-report measure and a clinician-rating of women’s depressive symptoms. There were no main or interactive effects for optimism. Clinical implications and future research directions are presented.     

Individual and Family Contributions to Depressive Symptoms in African American Children with Sickle Cell Disease

Depressive disorders in children with chronic illnesses have received little attention despite some evidence suggesting that these children experience increased psychological difficulties as a result of their medical condition. Most of the research on depressive disorders among children has been conducted primarily with Caucasian youth, limiting generalizability to ethnically diverse populations. Further, even less research exists on depressive disorders among African American children with Sickle Cell Disease (SCD) and for African American youth from lower socioeconomic status who are at greater risk for depressive disorders. This paper is an extensive review of the major studies conducted on depression and psychosocial aspects of SCD in African American children. The Transactional Stress and Coping model is provided as a conceptual framework. Following the review, clinical and research implications are provided, as well as an illustration of a psychoeducational family intervention with an African American child who has SCD and internalizing behaviors.     

Maternal Depressive Symptoms and Behavior Problems in Preschool Children from Low-Income Families: Comparison of Reports from Mothers and Teachers

This study compared behavior problems of children of mothers with elevated depressive symptoms and children of mothers with non-elevated depressive symptoms, using the same measure for mothers and teachers. Participants included 914 mother–teacher dyads of low-income children (M age of child = 62.9 months, SD = 4.0) who participated in the Early Head Start Research and Evaluation Project. Mothers completed a shortened version of CES-D to evaluate their own depressive symptoms. Teachers and mothers completed the Family and Child Experiences Survey Interviews (FACES) to assess children’s behavior problems. The results showed that children of mothers with elevated depressive symptoms-higher than the cut-off score for possible depression- showed higher aggressive and hyperactive behaviors than did children of mothers with non-elevated depressive symptoms according to the mothers’ rating; however, teachers rated the children no differently. Both mothers and teachers reported higher internalizing behaviors in children of mothers with elevated depressive symptoms than did those of mothers with non-elevated depressive symptoms. Maternal depressive symptoms moderated the relations between informants (mothers and teachers) and externalizing behaviours (aggressive and hyperactive) of children. These findings underscore the need for research in different settings such as at home and at school, to measure children’s behavior problems in order to gain a more comprehensive perspective on child functioning. Results suggest an emphasis on intervention or prevention programs targeting internalizing behavior problems, specifically for children of depressed mothers in low-income families.     

PTSD, Depressive Symptoms, and Suicidal Ideation in African American Women: A Mediated Model

Although research has shown positive associations among post-traumatic stress disorder (PTSD), depressive symptoms, and suicidal ideation, the nature of these relations is unclear, especially in African American women. This study examined the associations among these comorbid psychological difficulties in a sample of 136 low-income, African American women. Specifically, the goal of this investigation was to ascertain if overall depressive symptoms, as well as both the cognitive-affective and somatic components of depression, mediated the PTSD-suicidal ideation link. Results from bootstrapping analyses revealed that overall depressive symptoms and the cognitive-affective components of depression, but not the somatic components, mediated the PTSD-suicidal ideation link.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.     

Neighborhood Violence and Psychosocial Adjustment in Low-Income Urban African American Children: Physical Symptoms as a Marker of Child Adjustment

We examined the association between neighborhood violence and three domains of psychosocial adjustment in low-income, urban African American children: internalizing, externalizing, and physical symptoms. Based on anecdotal and empirical evidence, it was hypothesized that, relative to internalizing and externalizing problems, a stronger association would emerge between physical symptoms and neighborhood violence. Mother-reported neighborhood violence was associated with child-reported physical symptoms, but not internalizing or externalizing symptoms. Child-reported neighborhood violence was associated with child-reported internalizing, externalizing, and physical symptoms; however, neighborhood violence accounted for a greater percentage of variance in physical symptoms than the other two symptom domains. Our findings were not moderated by the age or gender of the child. We discuss the importance of physical symptoms as a marker of child adjustment in low-income, urban, African American children, as well directions for future research.     

Adolescent Responses to Depressive Parental Behaviors in Problem-Solving Interactions: Implications for Depressive Symptoms

The purpose of this study was to explore the relations between child responses to interparental depressive behavior and subsequent child depressive symptomatology. Data were collected on 156 two-parent families. Families completed questionnaire data and participated in problem-solving interactions, which were coded using a microsocial observational system. Three potential child responses to interparental depressive behavior were examined: facilitative, aggressive, and depressive. Results indicated that for female adolescents the displays of facilitative and depressive behavior as well as the suppression of aggressive behavior in response to interparental depressive behavior were related to increases in depressive symptomatology. For males, on the other hand, the display of aggressive and depressive behavior in response to interparental depressive behavior was related to increases in depression. Results provide preliminary support both for the examination of child responses to conflictual marital behavior and for expanding the conceptualization of conflictual marital behaviors to include depressive as well as the more traditionally examined aggressive behaviors, in order to better understand the link between conflictual marital behavior and child depressive symptomatology.     

Self-Esteem, Teasing and Quality of Life: African American Adolescent Girls Participating in a Family-Based Pediatric Overweight Intervention

Two studies investigated overweight in African American girls. First, African American adolescent girls (BMI was ≥ 85th percentile) and their mothers participated in focus groups addressing weight and eating. Although mothers and daughters shared some similar views on these issues, there were important discrepancies, with mothers expressing greater doubt about the potential success of a healthy weight program. The second study evaluated baseline data from 39 African American girls participating in a weight management program; mothers' reports were also analyzed. In both studies, adolescents reported significant teasing, and in the second study, teasing was inversely associated with social quality of life (β=.55, t=3.01, p=.007). Motivation to participate was positively associated with teasing (r=.50, p < .01). Self-esteem was inversely related to positive health habits (all p < .05). Mothers who viewed their daughters as having higher self-esteem were less concerned about their daughters' weight. Differences in mothers' and daughters' perceptions highlight the importance of a family approach in pediatric overweight interventions. Results provide evidence that overweight African American girls face significant weight stigmatization and suggest areas to target regarding intervention implementation.

Transitions of Developmental Trajectories of Depressive Symptoms Between Junior and Senior High School Among Youths in Taiwan: Linkages to Symptoms in Young Adulthood

We investigated the heterogeneous developmental trajectories of depressive symptoms in junior and senior high school, the transitions to different trajectories after entering senior high school, and the linkages to the development of depressive symptoms in early adulthood among Taiwanese adolescents. An eight-wave longitudinal data set was analyzed, including 2687 Taiwanese adolescents (51.2% boys, M age?=?14.3 at first wave). Using a manual three-step latent transition growth mixture model, we found that a three-class solution fit the data for both junior high school (termed high-improving, cumulative, and JS-low-stable) and senior high school period (termed heightening, moderate-stable, and HS-low-stable). The depressive symptoms of most individuals maintained at a low level (i.e., low-stable) from adolescence to early adulthood; however, nearly a quarter of the adolescents reported depressive symptoms that were moderately or highly severe in senior high school and beyond. More than 30% of the participants experienced transitioning into a different developmental trajectory between junior and senior high school. When perceiving a higher level of paternal behavioral control, adolescents categorized in the high-improving class in junior high school would have a higher chance to transition to the moderate-stable class than to HS-low-stable class in senior high school. Adolescent boys and girls did not differ in the probability of transitioning between trajectories across junior and senior high school. However, a clear and consistent pattern of symptoms between late adolescence and early adulthood was not observed. These results help elucidate the heterogeneity and fluidity associated with the development of depressive symptoms between early adolescence and early adulthood in light of school transition among youths in Taiwan.     

Get the Message: Targeting Beliefs to Develop Risk Reduction Intervention Messages for African American Adolescents

Risk reduction interventions that promote condom use, a vital component of most HIV prevention interventions, have been successful in increasing condom use among African American adolescents. Understanding theoretical components that lead to behavior change and selecting relevant risk reduction messages remain important considerations for targeting new interventions and tailoring existing interventions. The present study sought to (1) identify the most important theoretical determinants of condom use intention in African American adolescent males and females, separately, using the integrative model of behavior prediction, and (2) identify underlying beliefs within the determinants that were good candidates for message development in similar interventions. Using 446 African American adolescents, multi‐group SEM indicated that the gender‐specific IM exhibited a better fit than the overall model. Specifically, the IM had a stronger capacity for predicting condom use intention and condom use behavior for adolescent boys. Using a specific criteria for message selection, specific condom use beliefs were discussed as potential candidate messages for both African American males and females.     

Cognitive,Behavioral and Goal Adjustment Coping and Depressive Symptoms in Young People with Diabetes: A Search for Intervention Targets for Coping Skills Training

The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for young people with Type 1 (T1) diabetes. A wide range of coping techniques was studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 78 young people with T1 diabetes participated. They were contacted through a social networking website, several Internet sites, and flyers. A wide range of coping techniques appeared to be related to depressive symptoms. Especially the cognitive coping strategies self-blame, rumination, refocus positive, and other-blame, together with goal adjustment coping, were of importance. A large proportion of the variance of depressive symptoms could be explained (65 %). These findings suggest that these specific coping strategies should be part of coping skills trainings for young people with T1 diabetes.     

Religious Characteristics,Spirituality, and Depressive Symptoms Among 10th- to 12th-Graders Living in a Buddhist or Daoist Culture: A Short-Term Longitudinal Study

This study examines changes in and the relationship among religiosity, spiritual well-being, and depressive symptoms in primarily Buddhist or Daoist Taiwanese adolescents. A total of 2,239 16- to 18-year-old adolescents from 4 high schools were randomly selected and completed a questionnaire at baseline and at 6-month follow-up. Half of the Taiwanese adolescents reported being religious (50%), with Buddhism or Daoism predominating in terms of religious affiliation. Around 80% of adolescents believed in a God, but less than 40% believed that religion is important. Mixed models found no significant relationships between religiosity and spirituality or between religiosity and depressive symptoms. Self-efficacy and life scheme are valid domains for the spirituality construct, and a reciprocal relationship was found between spiritual well-being and depressive symptoms. This reciprocal relationship in adolescents is discussed in terms of a Buddhist or Daoist cultural context.     

Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives

HIV treatment adherence interventions increasingly rely on peer facilitators to promote treatment adherence and improve patient retention, yet little is known about how participants perceive the role performed by peer facilitators. The present study examined participant perceptions in terms of the social support from peer facilitators in a hospital‐based intervention in Chicago. Content analysis was conducted with reference to four types of social support (instrumental, informational, emotional and affiliational) on exit interviews with 11 participants enrolled in the intervention that targeted African‐American patients living with HIV/AIDS. We examined how the type of social support perceived by participants was related to their self‐reported behaviours in three domains: adherence, sexual safety and general coping. Our analysis revealed that most participants perceived informational and emotional support from their peer facilitators, followed by instrumental support. Affiliational support was the least frequently perceived type of social support. We found that perceived informational support from peer facilitators with regard to adherence had greater impact and credibility amongst participants than the same type of support from medical providers. Informational support was cited most frequently with regard to influencing adherence and sexual safety behaviours, whereas perceived emotional support was cited primarily with helping participants cope with HIV. Copyright © 2015 John Wiley & Sons, Ltd.     

Thinking About the Future as a Way to Succeed in the Present: A Longitudinal Study of Future Orientation and Violent Behaviors Among African American Youth

Previous research has linked higher levels of hopelessness about one's future to violent behavior during adolescence; however, little is known about this relationship over time for adolescents. Using growth curve modeling, we tested the association between future orientation and violent behavior across the high school years of adolescence in a sample of African American youth (n = 681). Variation based on demographic characteristics (i.e., sex, SES, previous violence) was explored. At baseline, differences in violent behavior varied by demographic characteristics. Overall, violent behavior decreased with age. Higher levels of future orientation were associated with greater decreases in violent behavior over time. Demographic characteristics were not associated with change in violent behavior overtime. Our findings suggest that future orientation can act as a promotive factor for at risk African American youth. Interventions that help support the development of future goals and aspirations could play a vital role in violence prevention efforts.     

Infant Mental Health Intervention for Preterm Infants in Japan: Promotions of Maternal Mental Health,Mother–Infant Interactions,and Social Support by Providing Continuous Home Visits until the Corrected Infant Age of 12 Months

The aim of this study was to investigate the effectiveness of the Japanese Infant Mental Health Program (JIMHP) for preterm mother–infant dyads until the infants reached 12 months of corrected age. Mothers in the JIMHP group (n = 26) received one hospital visit in addition to standard care in the Growing Care Unit (GCU) and five home visits based on the principles of infant mental health (IMH) after discharge from the hospital, until the infant reached 12 months of corrected age. In contrast, mothers in the control program group (n = 40) received standard care in the GCU and three conventional home visits during the same period. The dyads were then compared across groups, revealing that the JIMHP dyads showed less maternal depressive symptoms, better maternal interaction, increased social support by medical workers and healthcare professionals, a high persistence rate for attending the program, and a more positive perception toward the program (p < .05). However, there were no significant differences in the impact of parenting stress or in child development. These results are discussed in terms of their significance and the practical/clinical availability of IMH principles and the JIMHP as a new support model for preterm infants in Japan.     

Physical,Psychological and Social Adaptation of African American Nuns to Their Religious Communities as They Age: Implications for Aging in Place

ABSTRACT

This study examined the association between health status, stress, depression, satisfaction with the relationship with the religious community, alienation from significant persons, racial/cultural identity and “aging in place,” as measured by length of time in the same religious community, for a purposive sample of 72 African American nuns. Aging in place was significantly associated with perceptions of better health status, less stress and depression and greater satisfaction with relationships with the religious community. However, the study also found that the longer the nuns lived in their respective communities, the less racially/culturally identified they became. These findings underscore the need for finding ways to keep nuns in their religious communities as they age and to provide avenues of racial/cultural expression for African American nuns.