Sharon D. Johnson

A tripartite of HIV-risk for African American women: the intersection of drug use, violence, and depression

The intersection of drug use, violence, and depression with HIV-risk among African American women is an under explored area of research. The current analyses examine whether particular sexual risk behaviors are associated with exposure to violence, depression or both among 420 African American out-of-treatment female drug users. Women were stratified into four mutually exclusive groups: drug users with exposure to violence (n=64), drug users with clinical depression (n=62), drug users with both (n=41), and drug users only (n=253). Multinomial logistic regression analyses examined the association of demographics and sexual risk behaviors across the tripartite groups. Women with a history of sexually transmitted diseases were more likely to experience violence and depression both alone and jointly. Women who had two or more sexual partners in the last 30 days (OR=2.26) and women who had an early onset of alcohol use (OR=2.50) were at an increased risk for having the full tripartite of drug use, violence and depression. Never being married was a protective factor for the full tripartite. As expected, more risk factors were found among women who had the full tripartite than among women with one or two of the factors. The co-existence of the tripartite factors and sexual risk behaviors may indicate a need to ultimately provide more specialized prevention and intervention efforts to combat HIV infection. This area of research may improve our understanding of the numerous obstacles to HIV intervention among drug-using populations.

Psychiatric disorders among victims of a courthouse shooting spree: a three-year follow-up study.

This study examined the longitudinal course of psychiatric sequelae of a mass shooting incident at a courthouse. A sample of 80 individuals was examined 6–8 weeks after the incident and 77 of these were reassessed one and three years later using the Diagnostic Interview Schedule/Disaster Supplement. Only 5% of the study sample met criteria for PTSD after this incident. Universal distress, however, was evident as 96% of the respondents reported PTSD symptoms and 75% described the incident as “very upsetting.” The need for intervention among symptomatic individuals not meeting diagnostic criteria should not be discounted as subdiagnostic distress may warrant specific intervention.

A Brief Report: Factors Influencing African American Youth Decisions to Stay in School.

The goal of the study was to assess positive factors that contribute to African American students’intentions to stay in school. Two hundred and thirty-one African American students participated in this study. Using the theory of planned behavior (TPB) as a conceptual model, surveys measured student attitudes toward school-year completion, social support for completing the academic year, and their perceptions of personal control over school completion. The contributions of self-esteemand racial self-esteemwere also examined for their influence on academic strivings. The TPB was a better predictor of intentions to complete the school year than student grade point averages (GPAs). Self-esteemadded only slightly to the variance explained in predicting intentions to complete the school year, but neither self-esteemnor racial self-esteemwas a significant predictor of GPAs.

The Relationship of Social Support to African American Caregivers' Help-Seeking for Emotional Problems

This study analyzes whether social support serves as a link to or substitute for formal services among African American female caregivers seeking help with emotional problems. It also analyzes other determinants of help-seeking. It relies on data from the Black Rural and Urban Caregivers Mental Health and Functioning Study and is guided by a modified version of the behavioral model of health services use. Using hierarchical binary logistic regression, analyses reveal that only age, stress, and support from fellow church members are statistically significantly associated with the likelihood of help-seeking. These results support the linking hypothesis, suggesting that the social support received by African American women caregivers in the context of their religious organizations helps to link them to services.

History of sexual trauma and recent HIV-risk behaviors of community-recruited substance using women.

This study examines whether substance using women exposed to a lifetime sexual trauma (n = 457) are distinguishable from substance using women exposed to non-sexual trauma (n = 275) in terms of demographics, psychopathology and high-risk sexual behaviors. Baseline data were collected from out-of-treatment substance using women enrolled in an HIV prevention study. Logistic regression analyses revealed that when demographics, psychopathology and lifetime indicators of sexual risk were assessed simultaneously, poor health, depression, antisocial personality disorder and lifetime sex-trading were associated with sexual trauma exposure. When these significant factors were controlled, the experience of sexual trauma predicted recent (past 4 month) high risk sexual behaviors such as higher than average sexual partners. Treatment efforts with women who have experienced a sexual trauma may be enhanced by the inclusion of assessments of physical and mental health needs as well as sexual risk awareness training.

Self-Esteem Mediates the Relationship Between Volunteering and Depression for African American Caregivers

Research on the influence of volunteering on mental health outcomes has not placed enough focus on African American female caregivers who are at risk for adverse outcomes such as depression. This study addresses this gap by examining the mechanism through which volunteering might influence depressive symptoms using data collected from 521 African American female caregivers of older adults. Regression results indicate that although volunteering is inversely associated with depressive symptoms, self-esteem mediates this relationship. Findings suggest inclusion in volunteering for African American female caregivers may be relevant to promotion of their mental well-being.

African American Adolescents& Interactions With Their Substance-Using Mothers

Understanding the interactions that African American youth have with their substance-using mothers is important because of the increased likelihood that these youth depend on their mothers as their primary providers. In-depth interviews were conducted with 14 urban-dwelling, African American adolescents with substance-using mothers to explore the nature of their interactions. Youth report maternal influence on their attitudes in general and toward child-rearing and peer group affiliations. Communication between the dyads is often strained and youth assume roles of sibling protector and maternal confidant. Youth have supportive adults in their lives but their engagement with these supports is also shaped by maternal substance use. Implications for how direct practice with youth might address these outcomes are discussed.

Examining the impact of race/ethnicity and gender intersectionality on preferences of social distance from individuals with mental health conditions

ABSTRACT This study examined the difference between the relationship of socio-demographic variables as well as the intersection between race/ethnicity and gender on nine indicators of social distance from people with mental health conditions (MHC). Secondary analysis of a randomized telephone survey drawn from the Missouri Institute of Mental Health and the Missouri Mental Health Foundation in the spring of 2013 was conducted. The sample included 2,244 Midwestern respondents. Multivariate logistic regressions were utilized. The sample was mostly White (91.7%) and female (59.8%), with a mean age of 57.1 years. Being female, 65+ years of age, and having a higher annual income (

Stress, stressors, and substance use: Differential risk for hookah use among African American college students.

50,000+) was associated with a lower preference for social interactions with individuals experiencing MHC. Black males, however, had an increased willingness to interact with this population. Findings suggest that it may be beneficial for anti-stigma programs to target populations that seem to be consistently less willing to interact with individuals experiencing MHC (e.g., individuals who are older or who have a higher annual income). Additional research is needed to explore why Black men may be more willing to interact with people with MHC.

The association of sexual dysfunction and substance use among a community epidemiological sample.

Abstract Using differential, multivariable risk models, we assessed the contribution of substance use and stress/traumatic events to hookah use among African American college students (n = 1,402) using data from the Fall 2012 American College Health Association-National College Health Assessment (ACHA-NCHA) II. Lifetime hookah use was 24.8%, with 34.2% of lifetime users having done so in the past 30 days. Compared to nonusers, hookah users had significantly higher use rates of alcohol, marijuana, other tobacco, and other drugs. Furthermore, hookah use was more likely among those with cumulative stress, yet less likely among older students. An implication is that prevention messages may need to be tailored for African American college students and particularly target younger students, substance users, and those with cumulative stress. These findings also inform policy discussions regarding hookah use on college campuses.