Depressive Symptoms and Self-Esteem in White and Black Older Adults in the United States

Assari, Shervin; Lankarani, Maryam Moghani

doi:10.3390/brainsci8060105

Cited by 6 publications

(7 citation statements)

References 95 publications

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“…A recent review discussed the differences between Blacks and Whites in social, emotional, and cognitive correlates of depression [ 48 ]. Some studies showed Blacks who are depressed maintain higher levels of overall sense of mastery and hope, which may reduce their suicidality [ 37 , 38 , 49 , 50 , 51 ]. However, higher education may not be as protective for Blacks as it is for Whites [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Suicide Attempts in Michigan HealthCare System; Racial Differences

Assari

2018

Brain Sciences

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Background. Community-based studies have documented racial differences in social, psychiatric, and medical determinants of suicidal ideation; however, less is known about racial differences in the profile of suicide attempts in clinical settings. Aim. The current study aimed to compare Blacks and Whites who attempted suicide for demographic factors, socioeconomic status, medical history, psychiatric disorders, and outcomes. Methods. This retrospective study was a retrospective chart review of DataDirect, which is an electronic data repository of the Michigan Health Care System, 2014 to 2017. This analysis included 6147 suicide attempts (5388 Whites and 759 Blacks). Race, sociodemographic factors, medical history, psychiatric disorders, and outcomes were measured. Results. Blacks and Whites with suicide attempt did not differ in age or gender, but varied by insurance type. Blacks were more commonly under Medicare and Medicaid, while Whites were more commonly under private insurance or self-pay (p < 0.05). Blacks with suicide attempt were more likely to be obese, while Whites with suicide attempt were more likely to be underweight. Frequency of psychiatric disorders, including depression, alcohol abuse, drug abuse, and psychosis, were not different between Whites and Blacks with suicide attempt; however, medical conditions showed a different profile across racial groups. When compared to Whites, Blacks had higher prevalence of uncomplicated hypertension, renal failure, chronic obstructive pulmonary disease, coagulopathy, and obesity (p < 0.05 for all comparisons). In contrast, Whites had higher prevalence of other neurological disorders than Blacks. There were no differences in in-patient survival rate between Whites and Blacks who attempted suicide. Conclusion. There are considerable differences between Blacks and Whites with at least one suicide attempt. Although their psychiatric diagnoses seem to be similar, Blacks who have attempted suicide attempt have more medical comorbidities than their White counterparts. Lack of racial disparities in in-patient mortality rate of suicide attempts in the Michigan Health Care System is promising news given the higher physical health needs of Blacks when compared to Whites.

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Section: Discussionmentioning

confidence: 99%

Suicide Attempts in Michigan HealthCare System; Racial Differences

Assari

2018

Brain Sciences

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“…Blacks demonstrate systemic resilience despite all the stressors [51,52]. Blacks report higher levels of optimism and hope than Whites under adversities [19,20,121,122]. This pattern is in contrast to the cumulative or multiple adversity hypotheses, that conceptualize Blacks and other minority groups as vulnerable groups [123].…”

Section: Discussionmentioning

confidence: 99%

“…Blacks use social support [118,135,136] and religion [135,137] to maintain a high level of mental well-being. They also maintain hope and positive emotions as well as a sense of mastery even in the presence of negative emotions and depression [19,20,121,122]. Keyes has discussed the “Black advantage” in mental health, possibly due to flourishing in response to adversity [138].…”

Section: Discussionmentioning

confidence: 99%

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Assari

2019

Geriatrics

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Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.

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“…Blacks and Whites also differ in the effect of stress on chronic disease and depression, possibly due to their differential behavioral coping strategies (82)(83)(84)(85)(86). Moderating effects of context, race, and ethnicity holds for a wide range of psychosocial domains and health (26,27,77,78). This is in part because race, ethnicity and culture shape experiences and expression of emotions (87,89).…”

Section: Discussionmentioning

confidence: 99%

Neuroticism polygenic risk score predicts 20-year burden of depressive symptoms for Whites but not Blacks

et al. 2019

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Background. Black-White differences are reported in social, psychological, behavioral, medical, and biological correlates of depression. This study was conducted to compare Black and White older adults for the association between neuroticism polygenic risk score (N-PRS) and chronicity of depressive symptoms over 20 years. Methods. Data came from the Health and Retirement Study (HRS), 1990 – 2012, a nationally representative sample of Americans above age 50. Current analysis followed 9,249 individuals (7,924 Whites and 1,325 Blacks) for up to 22 years. Depressive symptoms were measured every two years between 1992 and 2012 using the 8-item Center for Epidemiological Studies-Depression Scale (CES-D-8). The independent variable was N-PRS. The dependent variable was average depressive symptoms between 1992 and 2012. Linear regression was used for data analysis. Results. In the pooled sample, higher N-PRS was associated with higher average depressive symptoms over the 20-year follow up period [b=0.01, 95%CI=0.00 to 0.04], net of all covariates. We also found an interaction between race and N-PRS [b=-0.02, 95%CI=-0.03 to 0.00], suggesting a stronger effect of N-PRS on 20-year average depressive symptoms for Whites than Blacks. Based on our race-specific linear regression models, higher N-PRS was associated with higher depressive symptoms from 1992 to 2012 for Whites [b=0.01, 95%CI=0.01 to 0.02] but not Blacks [b=0.00, 95%CI=-0.02 to 0.02]. Conclusion. Black and White older adults may differ in the salience of the existing N-PRS for depressive symptoms, which better reflects the burden of depression for Whites than Blacks. This may be because the existing PRSs are derived from mostly or exclusively White samples, limiting their applicability in other race groups. Racial variation in psychosocial, clinical, and biological correlates of depression needs further research.

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Depressive Symptoms and Self-Esteem in White and Black Older Adults in the United States

Cited by 6 publications

References 95 publications

Suicide Attempts in Michigan HealthCare System; Racial Differences

Suicide Attempts in Michigan HealthCare System; Racial Differences

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Neuroticism polygenic risk score predicts 20-year burden of depressive symptoms for Whites but not Blacks

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