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Racial/ethnic minority status and physical abuse history are risk factors for higher mortality rates and lower adherence to antiretroviral therapy (ART) in women living with HIV (WLWH) in the United States. The current study tested the hypotheses that minority status and physical abuse history might lead women to silence the self (minimize and hide thoughts and feelings in order to avoid relational conflict, loss, and/or abuse) as measured by the Silencing the Self Scale (STSS), and that STSS might mediate and moderate relationships of physical abuse and racial/ethnic minority status with ART adherence. Divided Self (DS; acting in ways inconsistent with inner thoughts and feelings), an STSS subscale, was targeted for study along with the total STSS score. Participants were 513 women from the U.S. Women’s Interagency HIV Study (Mage?=?46; 387, 75%, Black; 66, 13%, Hispanic; 60, 12%, White). Multiple logistic regressions indicated that across all racial/ethnic groups, physical abuse history related to higher DS and lower adherence. DS significantly mediated relationships between abuse and adherence. Compared to White women, Black women demonstrated worse ART adherence, but had lower total STSS. Racial/ethnic minority women and women with a physical abuse history who had higher DS had lower adherence than other groups. Results indicate that being a racial/ethnic minority or having a history of physical abuse may increase vulnerability to the deleterious effects of DS on ART adherence, findings that can help inform interventions to decrease health disparities in WLWH.
相似文献The construct of trait guilt has played an important role in psychological theory across many fields of psychology (e.g., as a diagnostic criterion in clinical psychology, as an individual difference in personality psychology, and as a motivational antecedent or emotional moderator in social and organizational psychology); however, the measurement of guilt has received comparatively limited attention in the literature. Specifically, existing measures have limited factor analytic support, limited evidence of convergent validity among the measures, and although the theoretical distinction between guilt and shame is well established, there is limited empirical support for the discriminant validity of these constructs as they are currently measured. The current study investigates the psychometric properties of the most commonly used measure of guilt, the Test of Self-Conscious Affect-3 (TOSCA-3; in: Tangney, The Test of Self Conscious Affect-3. George Mason University, Fairfax, 2000), in order to (a) examine the factor structure of the measure, (b) estimate the convergent validity of the measure with other guilt assessment instruments, and (c) examine the discriminant validity of guilt and shame. Results involving a sample of 1760 participants provide support for a multitrait-multimethod model and the discriminant validity of guilt and shame. However, limited evidence of convergent validity between the TOSCA-3 and the Revised Mosher Guilt Inventory (φ?=?.21) and the Trauma-Related Guilt Inventory (φ?=?.10) suggested the TOSCA-3 is not assessing guilt in the same manner as more contextualized measures of guilt, highlighting the importance of measurement choice for guilt researchers. Implications for the measurement of trait guilt are discussed.
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