Laura Smart Richman

Perceived Discrimination and Health: A Meta-Analytic Review

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each studys contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.

Reactions to discrimination, stigmatization, ostracism, and other forms of interpersonal rejection: a multimotive model.

This article describes a new model that provides a framework for understanding peoples reactions to threats to social acceptance and belonging as they occur in the context of diverse phenomena such as rejection, discrimination, ostracism, betrayal, and stigmatization. Peoples immediate reactions are quite similar across different forms of rejection in terms of negative affect and lowered self-esteem. However, following these immediate responses, peoples reactions are influenced by construals of the rejection experience that predict 3 distinct motives for prosocial, antisocial, and socially avoidant behavioral responses. The authors describe the relational, contextual, and dispositional factors that affect which motives determine peoples reactions to a rejection experience and the ways in which these 3 motives may work at cross-purposes. The multimotive model accounts for the myriad ways in which responses to rejection unfold over time and offers a basis for the next generation of research on interpersonal rejection.

Positive emotion and health : Going beyond the negative

This study examined the relationships between positive emotions and health. Two positive emotions were considered, hope and curiosity, in conjunction with 3 physician-diagnosed disease outcomes: hypertension, diabetes mellitus, and respiratory tract infections. Medical data were abstracted over a 2-year period from 1,041 patient records from a multispecialty medical practice, and emotions were assessed through a mailed questionnaire. Across 3 disease outcomes, higher levels of hope were associated with a decreased likelihood of having or developing a disease. Higher levels of curiosity were also associated with decreased likelihood of hypertension and diabetes mellitus. Results suggest that positive emotion may play a protective role in the development of disease.

Discrimination, Dispositions, and Cardiovascular Responses to Stress

OBJECTIVE Recent research suggests that past exposure to discrimination may influence perceptions of, and physiological responses to, new challenges. The authors examined how race and trait levels of hostility and optimism interact with past exposure to discrimination to predict physiological reactivity and recovery during an anger recall task. DESIGN A community sample of 165 normotensive Black and White adults participated in an anger recall task while having their cardiovascular function monitored. MAIN OUTCOME MEASURES Blood pressure and heart rate indicators of physiological reactivity and recovery. RESULTS AND CONCLUSION Participants had higher reactivity and slower recovery to the anger recall task when they had high past discrimination, low cynicism, or high optimism. The pattern of effects was similar for both racial groups, but Blacks had more acute reactivity and slower recovery than Whites. These results are consistent with the perspective of discrimination as a chronic stressor that is related to acute stress responses, particularly for Blacks.

The Effects of Perceived Discrimination on Ambulatory Blood Pressure and Affective Responses to Interpersonal Stress Modeled Over 24 Hours.

OBJECTIVE This research examined the impact of perceived discrimination on ambulatory blood pressure (ABP) and daily level affect during social interaction. DESIGN For 24 hrs, adult Black and White participants wore an ABP monitor and completed palm pilot diary entries about their social interactions. MAIN OUTCOME MEASURES Mean level and time-trend trajectories of blood pressure and heart rate were examined as well as mean level measures of positive and negative affect after stressful and nonstressful social interactions. RESULTS Analyses showed that, after controlling for important covariates, perceived discrimination predicted the slopes of both wake and nocturnal ABP responses, with those who reported more discrimination having steeper daytime trajectories for systolic and diastolic blood pressure and less nighttime dipping in heart rate over time as compared to those who had reported relatively infrequent discrimination. High levels of perceived discrimination were also related to positive and negative affective responses after stressful encounters. CONCLUSIONS These results suggest that, regardless of race, perceived discrimination is related to cardiovascular and affective responses that may increase vulnerability to pathogenic processes.

The Effects of Race-related Stress on Cortisol Reactivity in the Laboratory: Implications of the Duke Lacrosse Scandal

BackgroundThe experience of race-related stressors is associated with physiological stress responses. However, much is unknown still about the complex relationship between how race-related stressors are perceived and experienced and potential moderators such as strength of racial identity.PurposeThis research examines the impact of a real-life stressor and strength of race identity on physiological responses to a social evaluative threat induced in the laboratory.MethodsSalivary cortisol measures were collected throughout a stressor protocol. African-American participants were also randomized to one of two conditions designed to promote either racial identification or student identification, before the experimental task. Unexpectedly, a highly publicized real-life racial stressor, the Duke Lacrosse (LaX) scandal, occurred during the course of the data collection. This allowed for pre–post LaX comparisons to be made on cortisol levels.ResultsThese comparisons showed that across both priming conditions, participants post-LaX had highly elevated cortisol levels that were nonresponsive to the experimental stress task, while their pre-LaX counterparts had lower cortisol levels that exhibited a normal stress response pattern. Furthermore, this effect of LaX was significantly moderated by gender, with women having lower mean cortisol levels pre-LaX but significantly greater cortisol levels than all other groups post-LaX.ConclusionsThese results suggest that recent exposure to race-related stress can have a sustained impact on physiological stress responses for African Americans.

The relationship between mental vitality and cardiovascular health.

Past measurement of vitality has included both emotional and physical components. Since aspects of physical vitality such as fatigue can be indicative of physical illness, the usefulness of existing measures of vitality to predict health is limited. This research was designed to examine the psychometric properties of a new Mental Vitality Scale and to test its associations with measures of cardiovascular health over the course of 2 years. The measure of mental vitality was administered in a two-part study using three different samples. In part 1, the reliability and validity of the scale was assessed with a student and a clinic sample. In part 2, medical data on mental and physical health were abstracted over a two-year period from 1041 patient records from a multi-specialty medical practice, and mental vitality assessed through a mailed questionnaire. The findings indicate that the Mental Vitality Scale is a valid and reliable questionnaire for measuring this construct. Mental vitality was also associated with reduced odds of several cardiovascular outcomes and prospective analyses suggest that mental vitality may serve a protective function in the development of cardiovascular disease. The results lend support for the importance of mental vitality as a construct that may be relevant for considering resilience in relation to cardiovascular disease.

An online daily diary study of alcohol use using Amazon's Mechanical Turk

INTRODUCTION AND AIMS In recent years, unprecedented levels of Internet access and the widespread growth of emergent communication technologies have resulted in significantly greater population access for substance use researchers. Despite the research potential of such technologies, the use of the Internet to recruit individuals for participation in event-level research has been limited. The purpose of this paper is to provide a brief account of the methods and results from an online daily diary study of alcohol use. DESIGN AND METHODS Participants were recruited using Amazons Mechanical Turk. Eligible participants completed a brief screener assessing demographics and health behaviours, with a subset of individuals subsequently recruited to participate in a 2 week daily diary study of alcohol use. RESULTS Multilevel models of the daily alcohol data derived from the Mechanical Turk sample (n = 369) replicated several findings commonly reported in daily diary studies of alcohol use. DISCUSSION AND CONCLUSIONS Results demonstrate that online participant recruitment and survey administration can be a fruitful method for conducting daily diary alcohol research.

Self-regulatory processes underlying structural stigma and health.

In this article, we examine self-regulatory processes that are initiated by structural stigma. To date, the literature on self-regulation as a mechanism that underlies stigma and health outcomes has focused primarily on harmful health-related behaviors that are associated with perceived discrimination. Numerous studies find that when people experience discrimination, they are more likely to engage in behaviors that pose risks for health, such as overeating and substance use. However, a large body of literature also finds that low power - which is also a chronic, though often more subtle, experience for stigmatized groups - is associated with a heightened activation of inhibitory processes. This inhibition system has wide-ranging influences on cognition, behavior, and affect. We provide an overview of these two literatures, examine synergies, and propose potential implications for measurement and research design.

Discrimination hurts, but mindfulness may help: Trait mindfulness moderates the relationship between perceived discrimination and depressive symptoms

Discriminatory experiences are not only momentarily distressing, but can also increase risk for lasting physical and psychological problems. Specifically, significantly higher rates of depression and depressive symptoms are reported among people who are frequently the target of prejudice. Given the gravity of this problem, this research focuses on an individual difference, trait mindfulness, as a protective factor in the association between discrimination and depressive symptoms. In a community sample of 605 individuals, trait mindfulness dampens the relationship between perceived discrimination and depressive symptoms. Additionally, mindfulness provides benefits above and beyond those of positive emotions. Trait mindfulness may thus operate as a protective individual difference for targets of discrimination.