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1.
J Affect Disord ; 358: 42-51, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38705522

ABSTRACT

BACKGROUND: The COVID-19 pandemic negatively impacted mental health in the general population in Britain. Ethnic minority people suffered disproportionately, in terms of health and economic outcomes, which may contribute to poorer mental health. We compare the prevalence of depression and anxiety across 18 ethnic groups in Britain during the COVID-19 pandemic. METHODS: Secondary analysis of cross-sectional data (February-November 2021) from 12,161 participants aged 18-60 years old (N with data on outcomes = 11,540 for depression & 11,825 for anxiety), obtained from the Evidence for Equality National Survey (EVENS). Data were weighted to account for selection bias and coverage bias. Weighted regression models examined ethnic differences in depression (Centre for Epidemiologic Studies Depression Scale) and anxiety (Generalised Anxiety Disorder-7). Effect modification analyses explored whether ethnic differences in outcomes were consistent within age and sex sub-groups. RESULTS: Compared to White British people, greater odds of anxiety caseness (and greater anxiety symptoms) were observed for Arab (OR = 2.57; 95 % CI = 1.35-4.91), Mixed White and Black Caribbean (1.57; 1.07-2.30), any other Black (2.22, 1.28-3.87) and any other Mixed (1.58; 1.08-2.31) ethnic groups. Lower odds of depression caseness (and lower depressive symptoms) were identified for Chinese (0.63; 0.46-0.85), Black African (0.60; 0.46-0.79), and any other Asian (0.55; 0.42-0.72) ethnic groups. LIMITATIONS: Cross-sectional data limits the opportunity to identify changes in ethnic inequalities in mental health over time. CONCLUSIONS: We have identified certain ethnic groups who may require more targeted mental health support to ensure equitable recovery post-pandemic. Despite finding lower levels of depression for some ethnic groups, approximately one third of people within each ethnic group met criteria for depression.


Subject(s)
COVID-19 , Ethnicity , Humans , COVID-19/ethnology , United Kingdom/epidemiology , United Kingdom/ethnology , Adult , Female , Male , Cross-Sectional Studies , Prevalence , Middle Aged , Adolescent , Ethnicity/statistics & numerical data , Ethnicity/psychology , Young Adult , Depression/ethnology , Depression/epidemiology , SARS-CoV-2 , Anxiety/ethnology , Anxiety/epidemiology , Mental Health/ethnology , Mental Health/statistics & numerical data , Anxiety Disorders/ethnology , Anxiety Disorders/epidemiology
2.
Psychiatry Res ; 337: 115973, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38776726

ABSTRACT

INTRODUCTION: On October 7, 2023, Israeli citizens came under an unprecedented terrorist attack that impacted the entire country. Recent research has begun to document the mental health impact of the attack but has yet to address the question of whether the attack had a differential impact across ethnic communities. In this nationwide prospective cohort study, we aimed to determine possible differences in psychopathology between Jews and Arabs in the post-October 7th attack. Specifically, we aimed to understand the role ethnicity may play in changes in probable PTSD, depression, and anxiety diagnoses from pre- to post-attack. METHODS: The sample comprised 656 participants (332 female, 50.7%) aged 18-85 (M = 41.01, SD = 13.72). Of this cohort, 557 participants (84.9%) were Jews, and 99 (15.1%) were Arabs, reflecting their national proportionality. Validated self-report questionnaires were completed to assess PTSD, depression, and anxiety at two time points: August 20 to 30th, 2023 (T1; 6-7 weeks before the attack) and November 9-19, 2023 (T2; 5-6 weeks after the attack). RESULTS: At T2, Arab Israeli participants reported significantly higher prevalences of probable PTSD, depression, and anxiety diagnoses than Jewish Israeli participants. A series of hierarchical logistic regressions revealed that, compared with Jews, Arab participants presented with higher prevalence of probable PTSD (OR = 2.53 95% CI = 1.46-4.37, p < 0.0001), depression (OR = 1.68 95% CI = 1.35-3.01, p < 0.0001) and anxiety (OR = 6.42 95% CI = 3.95-10.52, p < 0.0001), controlling for prevalences of probable diagnoses at T1 as well as for trauma-related variables. DISCUSSION: Citizens belonging to the Arab ethnic minority in Israel were found to be at higher risk for psychopathology in the aftermath of the October 7, 2023, terrorist attack compared with their Jewish majority counterparts. Thus, it becomes critical to employ culturally sensitive assessments and interventions following the attack to prevent the development of chronic symptoms and disorders.


Subject(s)
Anxiety , Arabs , Depression , Jews , Stress Disorders, Post-Traumatic , Terrorism , Humans , Female , Arabs/statistics & numerical data , Arabs/psychology , Male , Israel/epidemiology , Israel/ethnology , Jews/statistics & numerical data , Jews/psychology , Adult , Middle Aged , Terrorism/psychology , Terrorism/statistics & numerical data , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/ethnology , Aged , Adolescent , Prospective Studies , Young Adult , Aged, 80 and over , Depression/epidemiology , Depression/ethnology , Anxiety/epidemiology , Anxiety/ethnology , Mental Health/ethnology , Mental Health/statistics & numerical data
3.
Neurotoxicol Teratol ; 103: 107355, 2024.
Article in English | MEDLINE | ID: mdl-38719081

ABSTRACT

BACKGROUND: Psychosocial stress and psychopathology frequently co-occur, with patterns differing by race and ethnicity. We used statistical mixtures methodology to examine associations between prenatal stress and child temperament in N = 382 racially and ethnically diverse maternal-child dyads to disentangle associations among maternal stressful life events, maternal psychological functioning in pregnancy, childhood neurobehavior, and maternal race and ethnicity. METHODS: This study utilized data from a longitudinal pregnancy cohort, PRogramming of Intergenerational Stress Mechanisms (PRISM). Mothers completed the Lifetime Stressor Checklist-Revised, Edinburgh Postnatal Depression Scale, and Spielberger State-Trait Anxiety Scale during pregnancy. When their children were 3-5 years of age, they completed the Children's Behavior Questionnaire, which yields three temperament dimensions: Negative Affectivity (NA), Effortful Control (EC), and Surgency (S). We used weighted quantile sum regression to derive a weighted maternal stress index encompassing lifetime stress and depression and anxiety symptoms and examined associations between the resulting stress index and child temperament. Differential contributions of individual stress domains by race and ethnicity also were examined. RESULTS: Mothers self-identified as Black/Black Hispanic (46.1 %), non-Black Hispanic (31.9 %), or non-Hispanic White (22 %). A higher maternal stress index was significantly associated with increased child NA (ß = 0.72 95 % CI = 0.35, 1.10). Lifetime stress was the strongest contributor among Hispanic (36.7 %) and White (17.8 %) mothers, whereas depressive symptoms in pregnancy was the strongest contributor among Black (16.7 %) mothers. CONCLUSION: Prenatal stress was most strongly associated with negative affectivity in early childhood. Consideration of multiple stress measures as a mixture accounted for differential contributions of individual stress domains by maternal race and ethnicity. These findings may help elucidate the etiology of racial/ethnic disparities in childhood neurobehavior.


Subject(s)
Prenatal Exposure Delayed Effects , Stress, Psychological , Temperament , Humans , Female , Pregnancy , Stress, Psychological/psychology , Child, Preschool , Prenatal Exposure Delayed Effects/psychology , Adult , Male , Ethnicity/psychology , Mothers/psychology , Anxiety/psychology , Anxiety/ethnology , Longitudinal Studies , White People/psychology , Depression/psychology , Hispanic or Latino/psychology , Psychosocial Functioning
4.
J Gerontol Soc Work ; 67(5): 575-587, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38627372

ABSTRACT

Using data from Korean-American residents (N = 343) in subsidized senior housing in the Los Angeles area, we examined the effect of peer bullying on mental health. About 18% of the sample had been a target of bullying, and over 31% had witnessed someone being bullied. Being a target of bullying was a significant predictor for both depressive symptoms and anxiety, whereas witnessing other residents being bullied was a significant predictor for anxiety only. Findings shed light on the adverse mental health impacts of peer bullying among ethnic minority older residents in senior housing.


Subject(s)
Asian , Bullying , Peer Group , Humans , Los Angeles , Aged , Male , Female , Bullying/psychology , Asian/psychology , Aged, 80 and over , Mental Health , Depression/ethnology , Depression/psychology , Housing for the Elderly , Anxiety/psychology , Anxiety/ethnology
5.
Cyberpsychol Behav Soc Netw ; 27(5): 328-335, 2024 May.
Article in English | MEDLINE | ID: mdl-38526233

ABSTRACT

Individuals suffering from social anxiety disorder (SAD) are increasingly turning to online support communities for self-disclosure and social support. Despite the extensive body of research on online mental health discourses, the cultural nuances within SAD-related discussions remain underexplored. In this study, we examine the cultural differences in online expression of social anxiety by analyzing individuals' self-disclosure and support-seeking behaviors in social media posts. Using two-week data (n = 1,681) from two SAD support communities on the Reddit and Douban groups, we used both qualitative thematic analysis and quantitative semantic analysis to discern prevalent themes and linguistic attributes characterizing these online expressions. Our findings not only uncover common themes such as sharing personal experiences and seeking mutual validations in both communities but also identify their divergences, as Western users primarily sought advice and information in posts, whereas Chinese users were more inclined toward networking. Cultural variations in language use were evident, particularly in individuals' affect and their expression of personal and social concerns. Western users were more likely to convey negative emotions and delve into personal matters related to SAD, whereas Chinese users tended to grapple more with workplace anxieties. This study contributes to the cultural understanding of online mental health discourses and offers insights for crafting culturally sensitive interventions and supports for people with SAD.


Subject(s)
Cross-Cultural Comparison , Social Media , Social Support , Humans , Phobia, Social/psychology , Phobia, Social/ethnology , Adult , Female , Male , Self Disclosure , Online Social Networking , Anxiety/psychology , Anxiety/ethnology
6.
Res Child Adolesc Psychopathol ; 52(6): 865-876, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38407776

ABSTRACT

Negative affect (depression/anxiety) and alcohol use among Indigenous youth in Canada remain a concern for many communities. Disparate rates of these struggles are understood to be a potential outcome of colonization and subsequent intergenerational trauma experienced by individuals, families, and communities. Using a longitudinal design, we examined change in alcohol use and negative affect, and reciprocal associations, among a group of Indigenous adolescents. Indigenous youth (N = 117; 50% male; Mage=12.46-16.28; grades 6-10) from a remote First Nation in northern Quebec completed annual self-reported assessments on negative affect (depression/anxiety) and alcohol use. A Latent Curve Model with Structured Residuals (LCM-SR) was used to distinguish between- and within-person associations of negative affect and alcohol use. Growth models did not support change in depression/anxiety, but reports of drinking increased linearly. At the between-person level, girls reported higher initial levels of depression/anxiety and drinking; depression/anxiety were not associated with drinking. At the within-person level, drinking prospectively predicted increases in depression/anxiety but depression/anxiety did not prospectively predict drinking. When Indigenous adolescents reported drinking more alcohol than usual at one wave of assessment, they reported higher levels of negative affect than expected (given their average levels of depression/anxiety) at the following assessment. Our findings suggest that when Indigenous youth present for treatment reporting alcohol use, they should also be screened for negative affect (depression/anxiety). Conversely, if an Indigenous adolescent presents for treatment reporting negative affect, they should also be screened for alcohol use.


Subject(s)
Anxiety , Depression , Underage Drinking , Humans , Adolescent , Male , Female , Depression/psychology , Depression/epidemiology , Depression/ethnology , Quebec/epidemiology , Longitudinal Studies , Underage Drinking/psychology , Underage Drinking/statistics & numerical data , Child , Anxiety/psychology , Anxiety/ethnology , Alcohol Drinking/psychology , Alcohol Drinking/epidemiology , Alcohol Drinking/ethnology , Indigenous Canadians/psychology , Indigenous Peoples/psychology
7.
J Immigr Minor Health ; 26(3): 453-460, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38244119

ABSTRACT

Latinxs experience greater risk for type 2 diabetes, discrimination, and poor mental health. The pathways linking these factors, however, are not well understood. This study tested whether depression and anxiety mediated the relationship between discrimination and well-being. Bootstrapped mediation tests were conducted using a sample of Latinx adults with type 2 diabetes (n = 121) and regression models adjusted for demographic and health covariates. Depression and anxiety fully and jointly mediated the effect of discrimination on well-being; everyday discrimination was linked to elevated symptoms of depression and anxiety which were, in turn, independently linked to reduced emotional well-being. Moreover, the effect size for the anxiety pathway (ß=-0.13) was 60% larger than for depression (ß=-0.08). Dual mediation suggests depression, and especially anxiety, may be important targets for interventions seeking to mitigate the deleterious effects of discrimination. Findings have important implications for psychotherapeutic treatments and public health policy.


Subject(s)
Anxiety , Depression , Diabetes Mellitus, Type 2 , Hispanic or Latino , Humans , Hispanic or Latino/psychology , Female , Diabetes Mellitus, Type 2/ethnology , Diabetes Mellitus, Type 2/psychology , Depression/ethnology , Middle Aged , Male , Anxiety/ethnology , Adult , Mediation Analysis , Aged , Mental Health/ethnology , Socioeconomic Factors , Sociodemographic Factors , Racism/psychology
8.
J Med Internet Res ; 25: e51320, 2023 10 12.
Article in English | MEDLINE | ID: mdl-37824179

ABSTRACT

This study replicates and extends findings that "healing attempt"-a brief digital music-based mindfulness intervention-represents a feasible and potentially effective intervention for race-based anxiety in the Black community.


Subject(s)
Anxiety , Black or African American , Mindfulness , Music Therapy , Racism , Humans , Anxiety/ethnology , Anxiety/etiology , Anxiety/psychology , Anxiety/therapy , Anxiety Disorders/ethnology , Anxiety Disorders/etiology , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Music , Music Therapy/methods , Race Factors , Racism/ethnology , Racism/psychology
9.
Compr Psychiatry ; 125: 152398, 2023 08.
Article in English | MEDLINE | ID: mdl-37421849

ABSTRACT

INTRODUCTION: Despite consistent reports of the association between problematic internet gaming (PIG) and non-suicidal self-injury (NSSI), an increase in PIG does not necessarily lead to increased NSSI. This apparent paradox indicates the presence of other mediators and moderators in the PIG-NSSI association. This study aimed to investigate the role of anxiety as a potential moderating and mediating factor of the PIG-NSSI association in Chinese adolescents. METHODS: A cross-sectional study was conducted among 10,479 Chinese adolescents (50.5% male; age range, 9-18 years). Standardized self-report questionnaires were used to assess the severity of PIG, anxiety, and NSSI. Spearman correlation and multiple linear regression were applied to examine the relationships among PIG, anxiety, and NSSI. Both moderating and mediating effects of anxiety were assessed using Hayes' methods. RESULTS: PIG, anxiety symptoms, and NSSI significantly correlated with one another. Anxiety significantly moderated the relationship between PIG and NSSI [B = 0.002, standard error (SE) = 0.000, p < 0.001], and it partially mediated the PIG-NSSI association [B = 0.017, SE = 0.001, 95% confidence interval (CI) 0.014-0.021]. Social concern and concentration were the two dimensions of anxiety that exerted the strongest mediation effect (B = 0.017, SE = 0.002, 95% CI 0.014-0.020). CONCLUSIONS: Adolescents with PIG and high anxiety are likely to suffer more severe NSSI and may benefit from interventions to reduce anxiety symptoms.


Subject(s)
Anxiety , Internet Addiction Disorder , Self-Injurious Behavior , Adolescent , Child , Female , Humans , Male , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/ethnology , Anxiety/psychology , Cross-Sectional Studies , East Asian People/psychology , East Asian People/statistics & numerical data , Self-Injurious Behavior/diagnosis , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/ethnology , Self-Injurious Behavior/psychology , Video Games/psychology , Internet Addiction Disorder/diagnosis , Internet Addiction Disorder/epidemiology , Internet Addiction Disorder/ethnology , Internet Addiction Disorder/psychology
10.
Drug Alcohol Depend ; 245: 109808, 2023 04 01.
Article in English | MEDLINE | ID: mdl-36857843

ABSTRACT

BACKGROUND: African Americans who smoke cigarettes and experience heightened anxiety symptoms may have low quit smoking rates. Identifying which particular barriers to cessation are associated with specific types of anxiety symptoms in African Americans could inform cessation treatments for this population. This cross-sectional, correlational study examined associations of anxiety-related symptoms and distinct barriers to cessation among non-treatment-seeking African Americans who smoke cigarettes daily. METHODS: African Americans who smoke (N = 536) enrolled in a clinical research study on individual differences in tobacco addiction between 2013 and 2017 completed self-report measures of anxiety-related symptoms (i.e., social anxiety, panic, and posttraumatic intrusions) and types of barriers to cessation (i.e., addiction-related, social-related, and affect-related barriers). Linear regression models tested associations of anxiety symptoms with cessation barriers with and without adjusting for age, sex, depressive symptoms, and nicotine dependence. RESULTS: All anxiety-related symptoms were associated with each cessation barrier (ßs = 0.240-0.396). After covariate adjustment, panic and trauma-related symptoms were not associated with cessation barriers, and the strength of association of social anxiety with external barriers was reduced but remained significant (ß = 0.254). CONCLUSION: Symptoms of social anxiety, but not trauma or panic-related symptoms, may play a unique, but modest, role in certain barriers to cessation in non-treatment-seeking African Americans who smoke cigarettes over. Further research is needed to uncover why African Americans who smoke and have anxiety might experience these barriers, and how future interventions can mitigate these obstacles.


Subject(s)
Anxiety , Cigarette Smoking , Smoking Cessation , Humans , Anxiety/ethnology , Black or African American , Cigarette Smoking/ethnology , Cross-Sectional Studies
11.
Curr Psychiatry Rep ; 25(2): 31-43, 2023 02.
Article in English | MEDLINE | ID: mdl-36645562

ABSTRACT

PURPOSE OF REVIEW: The literature on racism and anxiety-related disorders, especially social anxiety, specific phobia, and generalized anxiety disorder, is notably lacking. This report aims to review recent evidence demonstrating the link between racial discrimination and various anxiety-related disorders. RECENT FINDINGS: Anxiety-related disorders were the most significant mediator for daily discrimination and suicidal thoughts, above both depression and substance use. Further, studies showed that racial discrimination promotes posttraumatic stress and racial trauma among people of color. Systemic racism puts people of color at a higher risk for anxiety disorders than White people. Clinical case examples provide lived evidence of diverse racial and ethnic individuals suffering from anxiety-related disorders, with the development and worsening of symptoms due to racism and microaggressions. There is a prominent need for recent research on anxiety-related disorders and racism. Recommendations for clinicians and future research directions are provided. These actions are required to address bias and mental health inequities and empower people of color.


Subject(s)
Anxiety , Racism , Humans , Anxiety/ethnology , Anxiety/psychology , Anxiety Disorders/ethnology , Anxiety Disorders/psychology , Racism/psychology
13.
BMC Nephrol ; 23(1): 80, 2022 02 24.
Article in English | MEDLINE | ID: mdl-35209868

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has caused significant psychological distress globally. Our study assessed the prevalence of psychological distress and associated factors during COVID-19 pandemic among kidney transplant recipients and kidney donors. METHODS: A cross-sectional survey of 497 participants (325 recipients and 172 donors) was conducted from 1st May to 30th June 2020 in Singapore. The survey questionnaire assessed knowledge levels of COVID-19, socio-demographic data, health status, psychosocial impact of COVID-19, and precautionary behaviors during the pandemic. Psychological distress was defined as having anxiety, depression, or stress measured by the validated Depression, Anxiety and Stress Scale-21. Linear regression analyses were used to assess factors associated with higher psychological distress. RESULTS: The prevalence of psychological distress was 14.3% (95% confidence interval: 11.5-17.6%) in the overall population; it was 12.8% (9.79-16.6%) in recipients and 13.4% (9.08-19.6%) in donors with no significant difference (P = 0.67). Younger age (21-49 vs. ≥50 years), unmarried status, non-Singapore citizen, worse health conditions, and worrying about physical and mental health were associated with higher psychological distress. Malays (versus Chinese), taking precautionary measures (hand sanitization), and receiving enough information about COVID-19 were associated with lower psychological distress. No interactions were observed between recipients and donors. CONCLUSIONS: At least one in ten recipients and donors suffer from psychological distress during COVID-19 pandemic. Focused health education to younger adults, unmarried individuals, non-Singapore citizens, and those with poor health status could potentially prevent psychological distress in recipients and donors.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Psychological Distress , Tissue Donors/psychology , Transplant Recipients/psychology , Adult , Age Factors , Aged , Anxiety/ethnology , COVID-19/prevention & control , China/ethnology , Cross-Sectional Studies , Depression/ethnology , Female , Health Knowledge, Attitudes, Practice/ethnology , Health Status , Humans , Kidney Transplantation , Malaysia/ethnology , Male , Marital Status , Middle Aged , Prevalence , Psychiatric Status Rating Scales , SARS-CoV-2 , Singapore/epidemiology , Surveys and Questionnaires , Young Adult
14.
PLoS One ; 17(1): e0263089, 2022.
Article in English | MEDLINE | ID: mdl-35085364

ABSTRACT

The present study investigated resilience profiles (based on levels of symptoms of anxiety and depression and five dimensions of protective factors) of 1,160 students from Germany (n = 346, 46.0% females, Mage = 12.77, SDage = 0.78), Greece (n = 439, 54.5% females, Mage = 12.68, SDage = 0.69), and Switzerland (n = 375, 44.5% females, Mage = 12.29, SDage = 0.88) using latent profile analyses. We also checked for measurement invariance and investigated the influence of gender and migration on class membership. A three-profile-solution was found for Switzerland (nonresilient 22.1%, moderately resilient 42.9%, untroubled 34.9%), and a four-profile-solution was the best fitting model for Germany (nonresilient 15.7%, moderately resilient 44.2%, untroubled 27.3%, resilient 12.7%) and Greece (nonresilient 21.0%, moderately resilient 30.8%, untroubled 24.9%, resilient 23.3%). Measurement invariance did not hold across the three countries. Profile differences regarding class membership predictions were detected for Germany and Greece, but none for Switzerland. Results implicate that resilience profiles are highly contextually sensitive, and resilience research findings should not be generalized considering the particularity of contexts, people, and outcomes.


Subject(s)
Anxiety , Depression , Students/psychology , Adolescent , Anxiety/epidemiology , Anxiety/ethnology , Anxiety/psychology , Child , Depression/epidemiology , Depression/ethnology , Depression/psychology , Ethnicity , Female , Germany/epidemiology , Germany/ethnology , Greece/epidemiology , Greece/ethnology , Humans , Male , Protective Factors , Sex Factors , Switzerland/epidemiology , Switzerland/ethnology
15.
Lancet Psychiatry ; 8(11): 957-968, 2021 11.
Article in English | MEDLINE | ID: mdl-34563316

ABSTRACT

BACKGROUND: Racial and ethnic minorities face disparities in access to health care. Culturally competent care might lessen these disparities. Few studies have studied the patients' view of providers' cultural competence, especially in psychiatric care. We aimed to examine the associations of race, ethnicity, and mental health status with patient-reported importance of provider cultural competence. METHODS: Our retrospective, population-based, cross-sectional study used data extracted from self-reported questionnaires of adults aged at least 18 years who participated in the US National Health Interview Survey (NHIS; 2017 cycle). We included data on all respondents who answered supplementary cultural competence questions and the Adult Functioning and Disability survey within the NHIS. We classified participants as having anxiety or depression if they reported symptoms at least once a week or more often, and responded that the last time they had symptoms the intensity was "somewhere between a little and a lot" or "a lot." Participant answers to cultural competency survey questions (participant desire for providers to understand or share their culture, and frequency of access to providers who share their culture) were the outcome variables. Multivariable ordinal logistic regressions were used to estimate adjusted odds ratios (aORs) for the outcome variables in relation to sociodemographic characteristics (including race and ethnicity), self-reported health status, and presence of symptoms of depression, anxiety, or both. FINDINGS: 3910 people had available data for analysis. Mean age was 52 years (IQR 36-64). 1422 (39·2%, sample weight adjusted) of the participants were men and 2488 (60·9%) were women. 3290 (82·7%) were White, 346 (9·1%) were Black or African American, 31 (0·8%) were American Indian or Alaskan Native, 144 (4·8%) were Asian American, and 99 (2·6%) were Mixed Race. 380 (12·5%) identified as Hispanic ethnicity and 3530 (87·5%) as non-Hispanic. Groups who were more likely to express a desire for their providers to share or understand their culture included participants who had depression symptoms (vs those without depression or anxiety symptoms, aOR 1·57 [95% CI 1·13-2·19], p=0·008) and participants who were of a racial minority group (Black vs White, aOR 2·54 [1·86-3·48], p=0·008; Asian American vs White, aOR 2·57 [1·66-3·99], p<0·001; and Mixed Race vs White, aOR 1·69 [1·01-2·82], p=0·045) or ethnic minority group (Hispanic vs non-Hispanic, aOR 2·69 [2·02-3·60], p<0·001); these groups were less likely to report frequently being able to see providers who shared their culture (patients with depression symptoms vs those without depression or anxiety symptoms, aOR 0·63 (0·41-0·96); p=0·030; Black vs White, aOR 0·56 [0·38-0·84], p=0·005; Asian American vs White, aOR 0·38 [0·20-0·72], p=0·003; Mixed Race vs White, aOR 0·35 [0·19-0·64], p=0·001; Hispanic vs non-Hispanic, aOR 0·61 [0·42-0·89], p=0·010). On subgroup analysis of participants reporting depression symptoms, patients who identified their race as Black or African American, or American Indian or Alaskan Native, and those who identified as Hispanic ethnicity, were more likely to report a desire for provider cultural competence. INTERPRETATION: Racial and ethnic disparities exist in how patients perceive their providers' cultural competence, and disparities are pronounced in patients with depression. Developing a culturally competent and humble approach to care is crucial for mental health providers. FUNDING: None.


Subject(s)
Anxiety/psychology , Cultural Competency/psychology , Depression/psychology , Ethnicity/statistics & numerical data , Perception/physiology , Adult , Anxiety/ethnology , Cross-Sectional Studies , Depression/ethnology , Female , Health Personnel/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/ethnology , Healthcare Disparities/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Humans , Male , Mental Competency/psychology , Middle Aged , Minority Groups , Retrospective Studies , Self Report/statistics & numerical data , Surveys and Questionnaires
16.
J Nerv Ment Dis ; 209(7): 533-536, 2021 Jul 01.
Article in English | MEDLINE | ID: mdl-34170862

ABSTRACT

ABSTRACT: Although anxiety and depression have been central topics for scholars and clinicians in the United States, few studies have examined their correlates in sub-Saharan Africa and none have examined large urban slums. Using face-to-face interviews in two African cities, we analyze self-reported symptoms of anxiety and depression in a community-based sample (n = 495). Ordinary least squares regression was used to analyze a variety of demographic and social predictors including sex, child-rearing, marital status, education, income, age, and neighborhood for residents of Agbogbloshie (Accra, Ghana) and Kangemi (Nairobi, Kenya). Controlling for other factors, two personal network dimensions were significant. Total network size is positively associated with symptoms of anxiety and depression in Kenya but not in Ghana. However, one factor was predictive of symptoms of anxiety and depression in both locations: the reported percentage of ties with older persons. Higher levels of anxiety and depression are associated with a larger share of older individuals in one's personal network.


Subject(s)
Anxiety/ethnology , Depression/ethnology , Family/ethnology , Poverty Areas , Residence Characteristics , Social Networking , Urban Population , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Female , Ghana/ethnology , Humans , Kenya/ethnology , Male , Middle Aged , Young Adult
17.
Public Health Rep ; 136(4): 508-517, 2021.
Article in English | MEDLINE | ID: mdl-34034574

ABSTRACT

OBJECTIVES: Experiences of vicarious racism-hearing about racism directed toward one's racial group or racist acts committed against other racial group members-and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans. METHODS: We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance. RESULTS: Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: ß = 1.92 [95% CI, 0.97-2.87]; Black: ß = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: ß = 2.40 [95% CI, 1.48-3.32]; Black: ß = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: ß = 1.54 [95% CI, 0.58-2.50]; Black: ß = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: ß = 1.98 [95% CI, 1.05-2.91]; Black: ß = 1.64 [95% CI, 0.82-2.45]). CONCLUSIONS: Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.


Subject(s)
Anxiety/ethnology , Asian/psychology , Black or African American/psychology , COVID-19/psychology , Depression/ethnology , Racism/psychology , Adult , Anxiety/etiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Linear Models , Male , Racism/statistics & numerical data , United States/epidemiology
18.
Public Health Nurs ; 38(4): 596-602, 2021 07.
Article in English | MEDLINE | ID: mdl-33844868

ABSTRACT

OBJECTIVE: This study explored stress and coping among pregnant Black women prior to and during the COVID-19 pandemic. DESIGN: Prospective, longitudinal, cohort study. SAMPLE: Thirty-three women enrolled in the Biosocial Impact on Black Births study prior to the COVID-19 pandemic and who were still pregnant during the pandemic. MEASUREMENTS: Questionnaires included the Perceived Stress Scale, Prenatal Coping Inventory, and questions related to sociodemographic characteristics, worry about COVID-19, and coping strategies used during the pandemic. RESULTS: Women reported very much being worried about my child getting COVID-19 (46%) and my family member getting COVID-19 (46%). Women reported specific active coping strategies very much reduced their feelings of discomfort during COVID-19: God, religion, or spirituality (24%), social media (24%), and following government advice (24%). Higher use of avoidance coping prior to the pandemic was associated with higher levels of stress both prior to (r = 0.60, p < .001) and during (r = 0.47, p < .01) the pandemic. CONCLUSION: Women reported worries about COVID-19 and used various strategies to cope with feelings of discomfort due to the pandemic. Nurses should assess the stress level of pregnant Black women and recommend active coping strategies during the pandemic.


Subject(s)
Adaptation, Psychological , Black or African American/psychology , COVID-19/psychology , Pandemics , Pregnant Women/ethnology , Stress, Psychological/ethnology , Adult , Black or African American/statistics & numerical data , Anxiety/ethnology , Anxiety/psychology , COVID-19/epidemiology , Female , Humans , Longitudinal Studies , Pregnancy , Pregnant Women/psychology , Prospective Studies , Stress, Psychological/nursing , Stress, Psychological/psychology , Surveys and Questionnaires , United States/epidemiology , Young Adult
19.
Anthropol Med ; 28(1): 109-121, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33880983

ABSTRACT

Affect has not been entirely established as a casual explanation in social science. The classic academic accounts of millennial movements emphasise both a period of 'unease' in the ambient atmosphere or 'of tension' at the actual start, and then a periodic culmination of fear or extreme emotion as the movement gains a following and the prophecy accelerates so much so, that 'apocalyptic expectation' equates with 'anxiety'. In the instance examined here, a new Caribbean religion, there may well have been identified anxieties around the time of the founder's visions, but once established the group have little strong emotion, negative or otherwise, although always facing the imminent end of all things.


Subject(s)
Anxiety/ethnology , Attitude/ethnology , Christianity/psychology , Religion and Psychology , Anthropology, Medical , Caribbean Region/ethnology , Humans
20.
Anthropol Med ; 28(1): 47-61, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33886376

ABSTRACT

Drawing on ethnographic fieldwork in Trinidad, this paper examines how the framing of a particular apocalyptic future provided a moral commentary and model for wellbeing in contemporary everyday life. Changing social, political, and economic circumstances and relations had brought a range of new risks and anxieties into daily life. These more recent problems originating from beyond the village (such as climate change, criminality, inequality, pollution, neglect by the State) could not be resolved through working with obeah spirits as might have been used previously for more local issues, or through the long-established Catholic and Anglican churches. Instead evangelical Christian cosmology and practices gave a means of making sense of such issues and for protecting oneself. The development of a strong individual relationship with God connected individuals to a greater power and a global community, framing such problems not only as the work of the Devil but as evidence of the coming of the End of Days. Political protest or attempts at wider change were futile therefore; individuals should focus on their own practices to develop a strong relationship with God. Health and wellbeing relied on an individualised and deep relationship with the Holy Spirit. This was developed through practices that both drew on, and helped create, a type of neoliberal logic and global subjectivity to understand and live within current times, evangelical Christianity promoting ways of living without anxiety in the present through understandings of an apocalyptic future.


Subject(s)
Anxiety/ethnology , Christianity , Religious Philosophies , Anthropology, Medical , Humans , Trinidad and Tobago/ethnology
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