Correlates of Psychological Distress and Major Depressive Disorder Among African American Men

This study examines the demographic correlates of depressive symptoms, serious psychological distress (SPD), and major depressive disorder (MDD; 12-month and lifetime prevalence) among a national sample of African American men. Analysis of the National Survey of American Life (NSAL) data set provides first-time substantiation of important demographic differences in depressive symptoms (measured by the Center for Epidemiological Studies Depression scale [CES-D]), SPD (measured by the K6), and 12-month and lifetime MDD among African American men. Findings illuminate the heterogeneity within the African American male population. Findings also demonstrate the need for additional research focusing on within-group differences and a comprehensive research and mental health promotion agenda that recognizes the importance of improving access to education and employment and promoting healthy coping behaviors, while acknowledging the larger social context in which African American men live.     

Ethnic Differences in the Effects of Parental Depression on Preschool Children's Socioemotional Functioning

The present study describes the depressive symptomatology of 393 parents of prekindergarten children and assesses ethnic differences in the depression scores of these parents and their differential consequences for children's social competence. Data are drawn from the National Center for Early Development and Learning (NCEDL) classroom study, a national, longitudinal study examining the quality and outcomes of prekindergarten programs operated in schools or under the direction of state and local educational agencies, and the supplemental NCEDL familial and social environments study. Analyses indicated that Latino parents were more likely than African‐American and White parents to be depressed. However, as reported by both parents and teachers, behavioral outcomes for African‐American children of parents with elevated depressive symptomatology were worse than children of their Latino and White counterparts. Interactions between ethnicity and depressive symptomatology emerged in the parent‐child relationship, with African‐American parents with elevated depressive symptoms reporting significantly greater levels of conflict in the parent–child relationship than their non‐depressed counterparts. African‐American parents with elevated depression scores were also less likely to be in marital relationships than their non‐depressed counterparts. Among African‐American families, parent–child conflict served as a mediator of the effects of parental depression on child outcomes. Implications for intervention are discussed.     

Mosaic of difference: enhancing culturally competent aging-related knowledge among social workers

The professional literature has not adequately addressed the behavioral and social factors that contribute to different coping outcomes for African American elder caregivers as compared to non African Americans. Awareness and understanding of these unique experiences would better prepare professionals to work with such clients. This study examines the predictors of emotional distress among 46 African American women who provide care to dependent elderly parents. Multivariate statistical analyses show that elder caregivers' rating of quality of life, their years of caregiving, as well are their poor heath constitute significant predictors of risk for depression. The results of the study provide support for the inclusion of more culturally appropriate measures of caregiver distress, and provide insights to inform social work practice, policy and research concerning African American female elder caregivers in the 21st century.     

Mosaic of Difference

Summary

The professional literature has not adequately addressed the behavioral and social factors that contribute to different coping outcomes for African American elder caregivers as compared to non African Americans. Awareness and understanding of these unique experiences would better prepare professionals to work with such clients. This study examines the predictors of emotional distress among 46 African American women who provide care to dependent elderly parents. Multivariate statistical analyses show that elder caregivers' rating of quality of life, their years of caregiving, as well are their poor heath constitute significant predictors of risk for depression. The results of the study provide support for the inclusion of more culturally appropriate measures of caregiver distress, and provide insights to inform social work practice, policy and research concerning African American female elder caregivers in the 21st century.     

Major Depressive Disorder and Cardiovascular Disease in African-American Women

Major depression is a risk factor for cardiovascular disease (CVD). This study used the National Survey of American Life (NSAL) to examine the co-occurrence of major depressive disorder (MDD) and CVD in a nationally representative sample of African American women (n = 2,216). Results from a series of logistic regression models indicated high rates of MDD and CVD in the sample, and the African American women with MDD were 1.59 times more likely to have CVD compared to those without MDD. High rates of MDD/CVD co-morbidity appeared across those living in and not living in poverty. These individuals demonstrated greater functional impairment and were high users of mental health services. Our findings validate that MDD and CVD co-occur and the need for more holistic interventions are warranted. The interface of co-morbid health conditions is critical to developing integrated models of care. Integrated health care systems are central for improving physical and mental health outcomes. These findings facilitate developing targeted assessment procedures and culturally appropriate treatment interventions. Increased knowledge regarding the role of gender, chronic health conditions, and the burden of mental illness in African American Women provides the opportunity to examine other chronic health conditions co-occurring with MDD.     

Depressive Symptoms among Former Spousal Caregivers: Comparing Stressors,Resources, and Circumstances of Caregiving Cessation among Older Husbands and Wives

Little research focuses on the mental health of caregivers (CGs) who stop providing care to their community-dwelling spouse. We examine depressive symptoms of former primary CG spouses who stopped caregiving over a two-year follow-up period when the care recipient (CR): (1) no longer has functional problems; (2) continues having functional problems; or (3) dies. Using data from the Health and Retirement Study (2000–2014), we located 2,370 couples who were both 50+ at baseline and where one partner provided help with ADL and/or IADL limitations but did not do so two years later. OLS regressions stratified by gender indicated that both male and female former spousal CGs whose CR died had significantly more depressive symptoms than those who ceased caregiving when their spouse did or did not still have functional problems. Former wife CGs who were older and whose husbands had more baseline ADLs had fewer follow-up depressive symptoms; wife CGs whose husbands had a nursing home stay had more depressive symptoms. Former husband CGs who had provided longer monthly hours of care had fewer follow-up symptoms. Findings underscore the importance of targeting mental and physical health services to both former caregiving husbands and wives, especially after spousal death.     

Reported Coping Strategies and Depressive Symptoms Among African American and White Residents of Congregate Housing

Chronic health conditions and living in congregate housing, both stressors and losses, are risk factors for late life depressive symptoms. We examined self-reported coping strategies and their associations with depressive symptoms among residents of congregate living facilities. Despite demographic differences between the African American and the White participants, reported coping for the 2 groups was similar, though more African Americans reported spiritual coping. Participants who reported coping through either positive attitude and adaptations or activity participation had fewer depressive symptoms, after controlling for demographics, health, functioning, and other types of coping.     

Life stress, social support, coping and depressive symptoms: a comparison between the general population and family caregivers

Major depression is one of the four most prevalent psychiatric diseases in Taiwan. Furthermore, a study showed that 45 per cent of the family caregivers of persons with persistent psychiatric disability were at risk of depression. The present study aimed at examining if caregivers experienced more depressive symptoms than the general population while controlling for other variables (direct effect), and if the constellation of correlates of depressive symptoms was different between the general population and caregivers (interaction effect). Data from 1979 subjects were gathered in a national survey, using stratified random sampling. The results revealed that the caregivers experienced significantly more depressive symptoms than the general population. However, the effect disappeared when other variables were taken into account. Life stress appeared to be more important than coping and social support. The other two common correlates of depressive symptoms were age and being unmarried. Relational stress mattered especially for caregivers. Lastly, social support variables were significant only for the general population; satisfaction with support could buffer the negative effect of survival stress on depressive symptoms.     

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.     

A racial comparison of Family Group Decision Making in the USA1

This study examined Family Group Decision Making (FGDM) among a nationally representative sample of African‐American and White children investigated for maltreatment in the US. While FGDM was developed for work with ethnic minority families, there is no research on how this is being carried out in the US, where African‐American children are overrepresented in child welfare services. The study views racial differences in child, caregiver and maltreatment characteristics related to FGDM; composition of FGDM meetings; service referrals and receipt; and service satisfaction. Data are from the National Survey of Child and Adolescent Well‐being (NSCAW), a study of 5501 children ages 0–14. Current analyses include African‐American and White children (n= 4129). Stratified, bivariate and multivariate regression analyses were used. Results showed that while race was not related FGDM receipt, different characteristics lead to FGDM among African‐American and White families. Surprisingly, caregivers report feeling no more involved in decision‐making in association with FGDM. FGDM is provided at low rates overall (10%) and less frequently among White caseworkers. Child access to mental health services increases in relation to FGDM. Implications are discussed.     

Relationships Among Caregiving,Income, Gender,and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans

Although there is substantial evidence to support the effect of burden on caregivers, few studies have compared caregivers to their noncaregiving counterparts on the basis of health and well-being outcomes. This study examines the relationship between caregiving and health and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (N = 3,005), this study examines relationships between caregiving status, gender, and income, and 9 outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models. Results support that paradoxically, caregiving was associated with increased likelihood of PSA test in male caregivers, although data also indicated higher levels of anxiety and stress, as might be expected. Income was associated with 8 of 9 outcomes, and gender predicted depression, anxiety, stress, and self-rated mental health. The study highlighted the importance of psychosocial stressors, such as income and gender, on the health outcomes of older adults who may be caregiving. Considering complexity of unique experience is necessary to accurately assess vulnerability to poor mental health or health-related outcomes.     

Aren't they just black kids? Biracial children in the child welfare system

In the USA, African‐American children are overrepresented in the child welfare system. However, little is known about the child welfare system experiences of biracial children, who are predominately both White and African‐American. To better understand this population, data from public child welfare in a US county were used to examine biracial children in the child welfare system. Results showed significant racial differences between children in the child welfare system. Despite the common belief that biracial children will have experiences similar to African‐American children, the child welfare system seems to view them differently. Biracial children are more likely to be referred, rated as high risk and investigated compared with White or African‐American children. Their mothers were younger, and were more often assessed as having physical, intellectual or emotional problems. These caregivers were also considered to have lower parenting skills and knowledge compared with White or African‐American caregivers. Although the disproportionate representation of African‐American children in the system has been well documented, this study provides evidence that biracial children are also overrepresented. Despite the fact that this is a rapidly growing population in the USA, there is little research available about biracial children and their families.     

Racial Differences in Attitudes Toward Professional Mental Health Treatment: The Mediating Effect of Stigma

Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.     

Adolescents at risk of mental health problems in the COVID-19 pandemic: A prospective population-based study of the effects of government mandates and school closures

There is increasing evidence that the COVID-19 pandemic has had substantial mental health impacts for adolescents. Yet, few definitive studies have investigated which adolescents were at higher risk of poor mental health and well-being during the pandemic. Data were drawn from the Childhood to Adolescence Transition Study, a prospective cohort study of students in Australia (N = 1211). Prevalence of mental health outcomes (depressive symptoms, anxiety symptoms, self-harm and good subjective well-being) was estimated in school Years 5–12, where Years 11 (2020) and 12 (2021) coincided with the pandemic. The age- and sex-adjusted relative risk of each mental health outcome for each priority group during the pandemic were estimated. During the pandemic, over 50% of study participants reported depressive symptoms, and one quarter reported anxiety symptoms. There was a decrease in good subjective well-being compared with pre-pandemic years, while self-harm prevalence remained similar. History of mental health problems, school disengagement and frequent peer victimisation increased the risk of experiencing mental health problems during the pandemic. Schools play a central role in maintaining the mental health and good subjective well-being of students, and this is particularly important during periods of social disruption, such as the COVID-19 pandemic.     

Predictors of Depression Among Caregivers of Older Adults With Severe Mental Illness

Caregivers of older persons with severe mental illness (SMI) contend with the double challenge of providing assistance related to both the psychiatric condition and older age of their family member. Study explored factors influencing negative psychological outcomes experienced by caregivers (n = 96) of older adults with SMI. One-quarter of caregivers scored at or above the clinical point for depression. Low income, care recipient gender, poor health, problems dealing with care recipient’s symptoms and the interaction of health and problems dealing with symptoms were associated with higher rates of depression. Implications for service provision and future research are discussed.     

The Associations Between Socioeconomic Status,Caregivers' Depressive Symptoms,Children's Health‐Promoting Behavior,and Children's Physical Health: A Mediation Model

The aim of this study was to examine the mediating effects of children's health‐promoting behaviors on the association between socioeconomic status, caregivers' depressive symptoms, and children's physical health outcomes. We used the first wave of “Seoul Education and Health Welfare Panel.” Data were collected from 820 fourth‐grade elementary and first‐year middle school students and their caregivers using self‐administered surveys. Structural equation modeling was employed to analyze the mediating effects of health‐promoting behaviors. Bias‐corrected bootstrap confidence intervals were used to test the mediating effect. The results showed that both low socioeconomic status and caregivers' depressive symptoms were negatively associated with a child's health‐promoting behaviors. Children's health‐promoting behaviors were positively associated with physical health. However, children's physical health was not significantly associated with socioeconomic status but was marginally associated with caregivers' depressive symptoms. We found that children's health‐promoting behaviors significantly mediated associations between both socioeconomic status and children's physical health and between caregivers' depressive symptoms and children's physical health. Based on the findings, we suggest the development and implementation of school‐based, health‐enhancement programs as a means to improve the general health of all children and to reduce health inequalities.     

Assessing low‐income African‐American pre‐schoolers' behaviour problems in relationship to community violence,inter‐partner conflict,parenting, informal social support and social skills

This study examined the relations among community violence exposure, inter‐partner conflict and informal social support and the behaviour problems of pre‐schoolers, and explored how mothers' parenting skills and children's social skills may mediate the child outcomes associated with such exposure. Participants were 185 African‐American mothers and female caregivers of Head Start children who completed study measures in a structured interview. Path analyses revealed that greater inter‐partner conflict was associated with more internalizing and externalizing child behaviour problems. Positive parenting was associated with fewer internalizing and externalizing behaviours. Higher levels of child social skills were associated with fewer internalizing and externalizing behaviour problems. Child social skills fully mediated the relationship between community violence and externalizing behaviours as well as between informal support and externalizing behaviours. Social skills partially mediated the relationships between positive parenting and externalizing behaviours. No mediating effect was found on the relationships between inter‐partner conflict and child behaviour problems. Implications of the findings for intervention and future research are discussed.