Distinguishing distress from disorder: Black-white patterns in the determinants of and links between depressive symptoms and major depression

Tobin, Courtney S. Thomas

doi:10.1016/j.jad.2020.10.035

Cited by 16 publications

(20 citation statements)

References 39 publications

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“…Due to their documented association with variations in mental health [12], discrimination [17], and chronic conditions [2], we included age, socioeconomic status, and marital status as covariates. Respondents' age was measured in years and ranged from 22 to 69 years.…”

Section: Covariatesmentioning

confidence: 99%

“…Studies have also found an increased prevalence of chronic diseases including asthma, arthritis, cardiovascular disease, cancer, diabetes, hypertension, and obesity, among individuals with depressive disorders [8,11]. Despite relatively low rates of major depression among Black Americans, many studies document elevated levels of depressive symptoms [12,13]. Given that greater depressive symptoms have been linked to worsening physical health and more chronic conditions in the general population, addressing depressive symptoms' levels may be an important point of intervention to reduce the risk of chronic conditions among Black Americans.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, evidence from prior studies suggest that the association between depressive symptoms and chronic conditions may be distinct among Black Americans. For instance, studies indicate that depressive symptoms are more chronic and physically debilitating among Black relative to White Americans [12,[14][15][16]. Other studies showed that Black Americans face more stressors, including lifetime experience of racism and discrimination, which have been linked to both depressive symptoms and chronic conditions [17].…”

Section: Introductionmentioning

confidence: 99%

“…Finally, few studies have considered the indirect pathways through which individuals' lifetime experiences of major discrimination may modify their health risks. Recent studies suggest that Black Americans' lifetime stress experiences, including major discrimination, may modify the physical health consequences of depressive symptoms [12]. Thus, it is possible that major discrimination may shape the ways in which depressive symptoms influence the risk of chronic, comorbid mental and physical health conditions among Black Americans.…”

Section: Introductionmentioning

confidence: 99%

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Lifetime Major Discrimination Experiences Moderate the Impact of Depressive Symptoms on Chronic Conditions among Black Americans

et al. 2021

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To clarify the ways in which Black Americans’ experiences of structural racism may influence their mental and physical health in distinct ways, the present study evaluated whether major discrimination moderates the association between depressive symptoms and chronic physical health conditions among this population. t-tests and chi-squared tests of significance were used to determine significant differences between women and men. The association between major discrimination and depressive symptoms was examined by assessing mean depressive symptoms scores across levels of major discrimination. ANOVA tests indicated whether there were significant differences in symptom scores across each discrimination category. Additional t-tests determined significant gender differences within each level of discrimination. Gender-stratified negative binomial models were used, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the relationship between depressive symptoms, major discrimination, and chronic conditions. Our findings indicated that the association between depressive symptoms and chronic conditions depends on lifetime experiences of major discrimination among Black Americans and varies significantly between women and men. Considering that major discrimination conditioned the depressive symptom-chronic conditions association among our sample, this provides insight into potential pathways for intervention in efforts to offset the detrimental mental and physical consequences of experiencing racism.

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Section: Covariatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lifetime Major Discrimination Experiences Moderate the Impact of Depressive Symptoms on Chronic Conditions among Black Americans

et al. 2021

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“…Despite reporting a lower prevalence of psychiatric disorders, African Americans report higher levels of psychological distress than European Americans, creating a "race paradox in mental health" that may reflect different stress exposures and warrants further study (Barnes and Bates 2017;Tobin 2021;Williams et al 1997). In addition, African Americans demonstrate a later age of onset but more severe symptoms of depression relative to European Americans (Merikangas et al 2007), suggesting that diagnosis may be delayed in African Americans.…”

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confidence: 99%

Stressful social environment and financial strain drive depressive symptoms, and reveal the effects of a FKBP5 variant and male sex, in African Americans living in Tallahassee

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Gravlee

McCarty

et al. 2021

American J Phys Anthropol

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Objectives: The World Health Organization estimates that almost 300 million people suffer from depression worldwide. African Americans are understudied for depression-related phenotypes despite widespread racial disparities. In our study of African Americans, we integrated information on psychosocial stressors with genetic variation in order to better understand how these factors associated with depressive symptoms.Methods: Our research strategy combined information on financial strain and social networks with genetic data to investigate variation in symptoms of depression (CES-D scores). We collected self-report data on depressive symptoms, financial strain (difficulty paying bills) and personal social networks (a model of an individual's social environment), and we genotyped genetic variants in five genes previously implicated in depressive disorders (HTR1a, BDNF, GNB3, SLC6A4, and FKBP5) in 128 African Americans residing in Tallahassee, Florida. We tested for direct and gene-environment interactive effects of the psychosocial stressors and genetic variants on depressive symptoms.Results: Significant associations were identified between high CES-D scores and a stressful social environment (i.e., a high percentage of people in participants' social network who were a source of stress) and high financial strain. Only one genetic variant (rs1360780 in FKBP5) was significantly associated with CES-D scores and only when psychosocial stressors were included in the model; the T allele had an additive effect on depressive symptoms. Sex was also significantly associated with CES-D score in the model with psychosocial stressors and genetic variants; males had higher CES-D scores. No significant interactive effects were detected.Conclusions: A stressful social environment and material disadvantage increase depressive symptoms in the study population. Additional associations with FKBP5 and male sex were revealed in models that included both psychosocial and genetic data. Our results suggest that incorporating psychosocial stressors may empower

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Intersectional Approaches to Minority Aging Research

et al. 2023

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Purpose of Review Growing racial/ethnic diversity among America’s older adults necessitates additional research specifically focused on health and well-being among aging minoritized populations. Although Black and Latinx adults in the USA tend to face worse health outcomes as they age, substantial evidence points to unexpected health patterns (e.g., the race paradox in mental health, the Latino health paradox) that challenge our understanding of health and aging among these populations. In this review, we demonstrate the value of intersectionality theory for clarifying these health patterns and highlight the ways that intersectionality has been applied to minority aging research. To advance the field, we also make several recommendations for incorporating intersectional approaches in future scholarship on minority aging. Recent Findings Scholars have applied intersectional approaches to health and aging to unravel how social statuses and social conditions, such as race, ethnicity, gender, nativity, incarceration history, geographic region, and age, produce distinct shared experiences that shape health trajectories through multiple mechanisms. Summary We highlight common intersectional approaches used in minority aging research and underscore the value of this perspective for elucidating the complex, and often unexpected, health patterns of aging minoritized populations. We identify several key lessons and propose recommendations to advance scholarship on minority aging.

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Distinguishing distress from disorder: Black-white patterns in the determinants of and links between depressive symptoms and major depression

Cited by 16 publications

References 39 publications

Lifetime Major Discrimination Experiences Moderate the Impact of Depressive Symptoms on Chronic Conditions among Black Americans

Lifetime Major Discrimination Experiences Moderate the Impact of Depressive Symptoms on Chronic Conditions among Black Americans

Stressful social environment and financial strain drive depressive symptoms, and reveal the effects of a FKBP5 variant and male sex, in African Americans living in Tallahassee

Intersectional Approaches to Minority Aging Research

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