Lindsey M. West

Coping with racism: What works and doesn't work for Black women?

Perceived racial discrimination (PRD) has deleterious effects on Black Americans. However, there is minimal empirical research on the influence of gender and coping on the relationship between PRD and mental health. This study posited that coping style (i.e., problem-focused coping and avoidant coping) would moderate the relationship between PRD and depressive symptoms in Black women. The sample included 91 Black women (mean age of 23.32 years) from an urban New England university. The Schedule of Racist Events, the Coping Orientations to Problems Experienced scale, and the Depression Anxiety Stress Scale were used to measure PRD, coping style, and depressive symptoms, respectively. Multiple regressions showed that problem-focused and avoidant coping significantly moderated the relationship between lifetime PRD and depressive symptoms. In addition, avoidant coping significantly moderated the relationship between recent PRD and depressive symptoms. The directions of these findings indicate that higher levels of problem-focused coping may buffer the effects of PRD on depressive symptoms, and higher levels of avoidant coping may exacerbate the effects. Implications for Black women’s resiliency and susceptibility to mental health distress are discussed.

Stress and Mental Health Moderating Role of the Strong Black Woman Stereotype

Research indicates that Black women highly endorse the Strong Black Woman (SBW) stereotype—a perception that Black women are naturally strong, resilient, self-contained, and self-sacrificing. This endorsement appears to be a good thing, providing Black women protection against the numerous stressors they must contend with daily. However, anecdotal and qualitative evidence suggests that SBW endorsement limits Black women’s ability to cope healthily which exacerbates the negative mental health outcomes of stress. Because few empirical studies of SBW have been conducted, how SBW endorsement might influence the stress–mental health association is unknown. The current study addresses this gap by quantitatively examining the relationships among SBW endorsement, stress, and anxious and depressive symptoms with a sample of 92 Black female college students. Results revealed that both moderate and high levels of SBW endorsement increase the relationship between stress and depressive symptoms, while low levels of SBW endorsement do not. These data extend previous qualitative findings and suggest that embracing the SBW stereotypic image increases Black women’s vulnerability to depressive symptoms associated with stress.

Understanding the Link Between Multiple Oppressions and Depression Among African American Women The Role of Internalization

The purpose of our study was to examine the multiple oppression experiences of sexual objectification, racism, and gendered racism as predictors of depressive symptoms among a clinical sample of low-income African American women. In addition, we examined coping with oppression via internalization (i.e., the tendency to attribute responsibility or the cause of an oppressive event to oneself) as a mediator between these three intersecting forms of oppression and depressive symptoms. Participants included 144 African American women who sought some type of mental health treatment at a U.S. southeastern, public, urban, university-affiliated hospital that attends to a primarily indigent and underserved population. The results of our mediational analysis using bootstrapping provided support for a theorized model in which coping with oppressive events via internalization mediated the links between sexual objectification and depression and between racist events and depression but not between gendered racism and depression. In addition, a unique and direct effect of racist events on depression was found. Finally, the four variables in the model accounted for 42% of variance in depression scores. The study includes implications for future research and clinical work such as exploration of other mediators and the importance of comprehensive intake assessments and multicultural/feminist coping interventions.

Student perspectives on sexual health: implications for interprofessional education

Abstract Interprofessional collaboration requires that health professionals think holistically about presenting concerns, particularly for multimodal problems like sexual dysfunction. However, health professions students appear to receive relatively little sexual health education, and generally none is offered on an interprofessional basis. To assess current degree of interprofessional thinking in sexual health care, 472 health professions students in Georgia, United States, were presented with a sexual dysfunction vignette and asked to rate the relevance of, and their familiarity with, interventions offered by several professionals. They also were asked to identify the most likely cause of the sexual dysfunction. Students rated relevance and familiarity with interventions as highest for physicians and lowest for dentists, with higher ratings of nurses by nursing students. More advanced students reported greater familiarity with mental health, physician, and physical therapy interventions. Finally, nursing students were less likely to attribute the dysfunction to a physical cause. These findings indicate that students may prioritize biomedical approaches in their initial assessment and may need additional supports to consider the spectrum of biopsychosocial factors contributing to sexual functioning. To encourage interprofessional critical thinking and prepare students for interprofessional care, sexual health curricula may be improved with the inclusion of interprofessional training. Specific recommendations for curriculum development are offered.

It's Supposed to Be Personal: Personal and Educational Factors Associated with Sexual Health Attitudes, Knowledge, Comfort and Skill in Health Profession Students

The health professional and the patient are cultural beings with beliefs and attitudes that are shaped by family traditions, social development, and exposure to novel experiences. As such, it is especially important for health profession students to gain awareness about the personal and educational factors that likely inform their practice and educational experiences and, as a result, impact their attitudes, knowledge, comfort, and skill in the area of sexual health. The current study sought to understand personal factors in health profession students associated with these sexual health competencies. Several early personal factors (gender, social class, and family sexuality communication), current personal factors (religion, spirituality, and relationship history), and educational factors (perceived quality of education and experience) were significantly related with sexual health competency. Results suggest that there is potential value to tailored interventions, student self-reflection, and interprofessional education among health profession students’ for the promotion of sexual health competency.

The Price of Strength: Black College Women’s Perspectives on the Strong Black Woman Stereotype

Black feminist scholars posit that the Strong Black Woman stereotype (SBW) is a compelling image that depicts Black women as strong, independent, and self-sacrificing. Research suggests SBW internalization is related to mental and physical health problems. This study asked Black college women open-ended questions on several SBW-related topics. Thematic analysis of approximately 90 participants revealed definitions of SBW, including, strong, independent, hardworking, and caring. Contrary to SBW’s positive perception, the majority of participants reported SBW’s negative effects on their health, highlighting SBW’s paradox. Findings increase awareness of the SBW stereotype for mental health professionals who work with Black college women.

The mediating role of internalized racism in the relationship between racist experiences and anxiety symptoms in a Black American sample.

OBJECTIVES The current study explores the potential mediating role of internalized racism in the relationship between racist experiences and anxiety symptomology in a Black American sample. METHOD One hundred and 73 Black American participants, between 18 and 62 years of age, completed a questionnaire packet containing measures of anxious arousal and stress symptoms, internalized racism, and experiences of racist events. RESULTS Results indicated that internalized racism mediated the relationship between past-year frequency of racist events and anxious arousal as well as past-year frequency of racist events and stress symptoms. CONCLUSIONS Internalized racism may be 1 mechanism that underlies the relationship between racism and anxious symptomology for Black Americans. These preliminary findings suggest that internalized racism may be an avenue through which clinicians can target the anxiety elicited by racist experiences. The clinical implications of these findings and future research directions are discussed. (PsycINFO Database Record

Existential Well-Being, Drug Abuse, and Parenting Stress in African American Women

The current study examined the influence of existential well-being and drug abuse on parenting stress in a sample of low-income African American women (n = 152). Whereas existential well-being served as a protective factor against all three forms of parenting stress measured (parental distress, difficult child, and parent–child dysfunctional interaction), drug abuse was a risk factor for all three. Existential well-being was also inversely related to drug abuse. A path analysis was conducted to further elucidate the cross-sectional associations among these variables. A positive, indirect effect of existential well-being on two of the three components of parenting stress, parental distress and perceived child behavior problems, but not the third, parent–child relationship quality, through level of drug abuse was found in support of partial meditation. Clinical implications regarding enhancing and using existential well-being as a culturally-relevant coping mechanism for African American caregivers are considered, and the etiological mechanisms of parenting stress are discussed.

Attitudes Toward HIV Among Health Professions Students in the Southeastern United States: Implications for Interprofessional Education

INTRODUCTION The Southeastern United States is disproportionately affected by HIV, and unfavorable attitudes toward HIV among healthcare providers in these communities can negatively impact persons living with HIV (PLWH). Moreover, attitudinal differences between providers impede collaboration in interdisciplinary HIV treatment teams and can have detrimental effects on patient care. Identifying attitudinal differences during health professions training and student characteristics associated with those differences may help narrow these gaps by revealing potential areas for improving education. METHODS Health professions students in nursing, allied health, medical, mental health, and dental training programs in Georgia (n = 475) completed measures of attitudes toward HIV and patient care for PLWH, and measures of personal and educational characteristics including religiosity, attitudes toward lesbian, gay, bisexual, and transgender (LGBT) patients, and clinical and classroom experiences relevant to sexual health. RESULTS Beliefs about disclosing patients’ HIV status without consent, concerns about the effects of working with PLWH on students’ health, and perceptions of adequacy of HIV education differed across disciplines. Several personal and educational factors were correlated with students’ attitudes (e.g., having positive attitudes toward LGBT patients, more patient contact hours relevant to sexual health). CONCLUSION Addressing HIV-related concepts in health professions training (e.g., exposure to patients with sexual health concerns or who are LGBT) could improve attitudes about HIV and patient care. Interprofessional clinical and classroom opportunities, where students with varied personal and educational backgrounds can learn from and with each other about HIV, also could improve student attitudes and interdisciplinary collaboration in HIV clinical care. Received: 12/26/2013 Accepted: 03/19/2013 Published: 04/22/2014

‘Something’s Gotta Give:’ Advanced-Degree Seeking Women’s Experiences of Sexism, Role Overload, and Psychological Distress

With the rise in advanced-degree seeking women and the minimal research on the dual impact of sexism and role overload, the current study aims to better understand the impact of sexism and role overload on psychological distress in a particular sample of advanced-degree seeking women. Seventy-six female medical student participants (mean age 24.7) from a southeastern health sciences university were recruited to participate in this study. Perceived sexist events were significantly correlated with depressive symptoms, with the exception of lifetime sexist events, anxious symptoms, and stress. Consistent with predictions, perceived sexist events were also positively correlated with role overload. In addition, role overload was positively correlated with psychological distress. Role overload was found to mediate the relationships between perceived sexist events and psychological distress in this sample, suggesting that it may impact psychological distress more than sexist events. Directions for future research and implications for women who experience sexism and role overload and who suffer from psychological distress are discussed.