Arthur L. Whaley

Cross-cultural perspective on paranoia: a focus on the black American experience.

A cross-cultural perspective on paranoia is developed, based on a synthesis of three distinct areas of research, with particular attention to the Black experience in America. This perspective is applied in a two-phase program of research. Phase I was the secondary analysis of data from an epidemiologic study of schizophrenia and depression: It examined differences in paranoid symptom expression among Black, Latino, and White Americans. Phase II, called the Culturally-Sensitive Diagnostic Interview Research Project, is currently underway and involves primary data collection, focusing exclusively on African Americans. Phase I results and some pilot data from the phase II study are reported. It is concluded that cultural mistrust among Black psychiatric patients should not be construed as psychopathology.

Evaluating cohort and intervention effects on black adolescents' ethnic-racial identity: A cognitive-cultural approach

The importance of ethnic-racial socialization and ethnic-racial identity as protective factors in the psychological and social adjustment of Black youth is well established in the literature. Whaley (2003) developed a cognitive-cultural model of identity to explicate the process by which ethnic-racial socialization impacts ethnic-racial identity and subsequent social and behavioral outcomes among adolescents of African descent. The present study tests the cognitive-cultural model of identity utilizing pilot data from a modified Africentric intervention program. Both explicit and implicit aspects of ethnic-racial identity were evaluated between two cohorts: one group in 2003, which represented historical controls, and another group in 2008 which received the intervention and has pre-test and post-test data. We hypothesized that the evaluation of underlying implicit or schematic processes would be more sensitive to changes in ethnic-racial identity resulting from cohort and intervention effects. Our results confirmed this hypothesis. Implications of applying mainstream behavioral science research paradigms to issues of special concern to the Black community are discussed.

Ethnic/racial differences in the self-reported physical and mental health correlates of adolescent obesity.

Adolescent obesity has increased significantly during the past 20 years disproportionately affecting African-Americans. We tested the cultural hypothesis which suggests that the acceptance of a larger body size among African-Americans serves as a protective factor against negative physical and mental health consequences. Secondary analyses of data from a subsample of 5158 Black and White participants in the 2009 Youth Risk Behavior Survey were conducted to assess the relationship between weight status and global self-reports of physical and psychological health. Planned comparisons revealed support of our hypotheses for some outcomes but not others. Implications for interventions targeting adolescent obesity are discussed.

Clinicians’ Competence in Assessing Cultural Mistrust Among African American Psychiatric Patients

A two-stage culturally sensitive diagnostic procedure allows for the assessment of cultural factors in paranoid symptom expression among African Americans. The first stage eliminates clinician bias by ensuring that diagnosticians adhere to DSM criteria. The second stage removes cultural bias by having cultural experts (i.e., African American mental health professionals) give best-estimate diagnoses using the same symptom data along with cultural knowledge. The present study uses the culturally sensitive diagnostic interview paradigm and structural equation modeling to examine the effects of demographic background, patients’ self-report of paranoid symptoms, and patients’ self-report of cultural mistrust on clinicians’ ratings of cultural mistrust for a sample of 116 Black psychiatric inpatients. Full and reduced models were tested using structural equation modeling, and the reduced model was the best fit to the data. The results suggest that clinicians can identify cultural mistrust in Black psychiatric patients. Implications for cultural competence training to prevent psychiatric misdiagnosis are discussed.

Psychiatric and Demographic Predictors of Memory Deficits in African Americans with Schizophrenia: The Moderating Role of Cultural Mistrust

Although African Americans are overrepresented among schizophrenia diagnoses, assessments of memory deficits in schizophrenia often do not consider issues of race, ethnicity, and culture. Digit span testing (DST) is often used to assess memory problems associated with schizophrenia. The purpose of the current study was to examine the effects of psychiatric symptoms and demographic background on the DST performances of 128 African American schizophrenic patients. It was hypothesized that level of cultural mistrust would moderate the relationship of psychiatric and demographic variables to memory deficits. The study involved the secondary analysis of data from the Culturally-Sensitive Diagnostic Interview Research Project. Different models of the relationship among predictor variables in their impact on DST performance were tested via structural equation modeling (SEM); and the moderating effects of level of cultural mistrust were evaluated with the best SEM model. The results supported the hypothesis that level of cultural mistrust moderates the relationship among variables in the SEM model. Specifically, psychiatric symptoms negatively impacted DST performance in the low cultural mistrust group, but they had no significant association to the memory deficits of the high cultural mistrust group. The pattern of findings for the effects of psychiatric symptoms on DST performance is consistent with the view of cultural mistrust as an adaptive mechanism in African Americans. One implication is that cultural factors should be taken into account when assessing memory deficits in African Americans with schizophrenia.

Effects of Africentric Socialization on Psychosocial Outcomes in Black Girls: The Critical Role of Gender

ABSTRACT African American social work scholars recommend rigorous research and evaluation of Africentric interventions as one approach to building culturally appropriate, evidence-based treatments for the Black community. Following this approach, this pilot study evaluates the Imani Rites of Passage program, a 15-week Africentric curriculum with 10 Black adolescent females (mean age = 12.40), comparing their pre- and post-intervention data to that of a no-intervention group of 13 Black males (mean age = 12.08). The program evaluation is based on the degree of correspondence between theory and the measurement model spelled out by the cognitive-cultural view of African-American identity. The findings for Black females were consistent with the cognitive-cultural model in some ways but not in others, and they were more complex than the predictions. Future Africentric interventions guided by the cognitive-cultural model must consider gender differences in the outcomes. Implications for social work research and practice are discussed.

Confluent paranoia and memory deficits in schizophrenia among African Americans

Whether or not there is a cultural dimension to paranoid symptom expression among African Americans has been debated for decades. A companion study has demonstrated the significance of culture as a moderator variable in African Americans expression of paranoia in terms of cognitive deficits among schizophrenics. Also, there is evidence that confluent paranoia or the interaction between culture and pathology yields significant correlations with psychosocial outcomes. To date, no study has examined the interaction between culture and pathology on the cognitive functioning of Black schizophrenics. The present study examined the relationship between confluent paranoia and digit span testing among 156 African Americans patients diagnosed with schizophrenia. Patients were classified into Ridleys typology using the Cultural Mistrust Inventory and the scale of False Beliefs and Perceptions. Findings provide preliminary evidence of the protective function of the cultural component of confluent paranoia with regard to cognitive functioning. Ethnicity, race, and culture are important considerations when conducting assessments of cognitive functioning in African Americans with schizophrenia.