Resilience: Protective Factors for Depression and Post Traumatic Stress Disorder among African American Women?

K. B. Holden, N. D. Hernandez, G. L. Wrenn, A. S. Belton

Abstract


There is a great need to carefully examine issues that may elevate one’s risk for mental illness and develop strategies to mitigate risk and cultivate resilience.  African Americans, specifically African American women (AAW), are disproportionately affected by mental illness, including depression and post-traumatic stress disorder (PTSD).  Higher rates of PTSD among AAW may be explained by significant rates of trauma exposure.  Higher resiliency in individuals with mental illnesses is associated with better treatment response/outcomes.  An examination of two (2) promising psycho-educational curricula for AAW at risk for depression and PTSD supports consideration of resilience as a protective factor among this population.  Strengthening psychological resilience among diverse AAW at risk for depression and/or PTSD may serve as a protective factor for symptom severity.  Multidimensional prevention and intervention strategies should incorporate culturally-centered, gender-specific, and strengths-based (resilience) models of care to help encourage mental health help-seeking and promotion of wellness for AAW.


Keywords


African American Women; Post-Traumatic Stress Disorder; Resilience; Depression; Psycho-education

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References


Alegría, M., Fortuna, L.R.., Lin, J.Y., Norris, L.F., Gao, S., Takeuchi, D. T., & Valentine, A. (2013). Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder across Ethnic and Racial Minority Groups in the US. Medical Care, 51(12), 1114–1123. Retrieved from http://doi.org/10.1097/MLR.0000000000000007.

Alim, T.N., Graves, E., Mellman, T.A., Aigbogun, N., Gray, E., Lawson, W., & Charney, D.S. (2006). Trauma exposure, posttraumatic stress disorder and depression in an African-American primary care population. Journal of the National Medical Association, 98(10), 1630.

Alonso, J. (2012). Burden of mental disorders based on the World Mental Health surveys. Revista Brasileira de Psiquiatria, 34(1), 7-8.

American Psychiatric Association (APA). (2010). Mental Health Disparities: Ethnically and Racially Diverse Populations. American Psychiatric Association. Retrieved from http://www.psych.org/Share/OMNA/Mental-Health-Disparities-Fact-Sheet--Diverse-Populations.aspx.

American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Association.

Bailey, R., Patel, M., Barker, N., Ali, S., & Jabeen, S. (2011). Major depressive disorder in the African American population. Journal of the National Medical Association, 103(7), 548-557.

Beck, A., Crain, A.L., Solberg, L.I., Unützer, J., Glasgow, R.E., Maciosek, M.V., & Whitebird, R. (2011). Severity of Depression and Magnitude of Productivity Loss. Annals of Family Medicine, 9(4), 305–311. Retrieved from http://doi.org/10.1370/afm.1260

Bennett Jr., M.D., & Joe, S. (2015). Exposure to Community Violence, Suicidality, and Psychological Distress among African American and Latino Youths: Findings From the CDC Youth Violence Survey. Journal of Human Behavior in the Social Environment, 25(8), 775-789.

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162:214–227.

Brenes, G.A. (2007). Anxiety, Depression, and Quality of Life in Primary Care Patients. Primary Care Companion to the Journal of Clinical Psychiatry, 9(6), 437–443.

Breslau, N., Kessler, R.C., Chilcoat, H.D., Schultz, L.R., Davis, G.D., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 Detroit area survey of trauma. Archives of General Psychiatry, 55, 626–632. doi: 10.1001/archpsyc.55.7.626

Breslau, N., Davis, G.C., & Schultz, L.R. (2003). Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma. Archives of General Psychiatry, 60(3), 289-294.

Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748.

Campbell-Sills, L., Cohana, S.L., & Steina, M.B. (2006). Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behaviour Research and Therapy, 44(4), 585–599.

Carr, E.R., Woods, A.M., Vahabzadeh, A., Sutton, C., Wittenauer, J., & Kaslow, N.J. (2012). PTSD, Depressive Symptoms, and Suicidal Ideation in African American Women: A Mediated Model. Journal of Clinical Psychology in Medical Settings, 20:37-45.

Carrington, C.H. (2006). Clinical depression in African American women: Diagnoses, treatment, and research. Journal of Clinical Psychology, 62(7), 779-791. [PubMed: 16703605]

Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/

Cloitre, M., Stovall-McClough, C., Zorbas, P., & Charuvastra, A. (2008). Attachment organization, emotion regulation, and expectations of support in a clinical sample of women with childhood abuse histories. Journal of Traumatic Stress, 21(3), 282-289.

Connor, K.M., & Davidson, J.R. (2003). Development of a new resilience scale: The Connor‐Davidson resilience scale (CD-RISC). Depression and Anxiety, 18(2), 76-82.

Fava, G.A. (2003). Can long-term treatment with antidepressant drugs worsen the course of depression? Journal of Clinical Psychiatry, 64(2), 123-133.

Fothergill, K.E., Doherty, E.E., Robertson, J.A., & Ensminger, M.E. (2012). A prospective study of childhood and adolescent antecedents of homelessness among a community population of African Americans. Journal of Urban Health, 89(3), 432-446.

Garrett, D. (1996). The Cambridge Companion to Spinoza. Cambridge University Press.

Gartlehner, G., Forneris, C.A., Brownley, K.A., Gaynes, B.N., & Sonis, J. (2013). Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma. Rockville (MD): Agency for Healthcare Research and Quality (US).

Hayes, S.C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639-665.

Holden, K.B. & Xanthos, C. (2009). Disadvantages in mental health care among African Americans. Journal of Health Care for the Poor and Underserved, 20(2A), 17-23.

Holden, K.B., Hall, S.P., Robinson, M., Triplett, S., Babalola, D., Plummer, V., & Bradford, LD. (2012). Psychosocial and sociocultural correlates of depressive symptoms among diverse African American women. Journal of the National Medical Association, 104(11), 493-504. PMC3660963

Holden, K.B. & Bradford, L.D. (2013). Ladies First!: A Psychoeducational Resilience Curriculum for African American Women with Depressive Symptoms in Primary Care. Self-Published Curriculum.

Holden, K., Bradford, D., Hall, S., & Belton, A. (2013). Prevalence and Correlates of Depressive Symptoms and Resiliency among African American Women in a Community Based Primary Healthcare Center. Journal of Healthcare for the Poor and Underserved, 24(4), 79-93.

Holden, K., McGregor, B., Thandi, P., Fresh, E., Sheats, K., Belton, A., ... & Satcher, D. (2014). Toward culturally centered integrative care for addressing mental health disparities among ethnic minorities. Psychological Services, 11(4), 357.

Holden, K., Belton, A., & Hall, S. (2015). Qualitative Examination of African American Women’s Perspectives about Depression. Health, Culture, and Society, 8(1), 48-60.

Jacobson, N.S., Martell, CR., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255-270.

Jain, G., Roy, A., Harikrishnan, V., Yu, S., Dabbous, O., & Lawrence, C. (2013). Patient-reported depression severity measured by the PHQ-9 and impact on work productivity: results from a survey of full-time employees in the United States. Journal of Occupational and Environmental Medicine, 55(3), 252-258.

Kent, M., Davis, M. C., Stark, S. L., & Stewart, L. A. (2011). A resilience-oriented treatment for posttraumatic stress disorder: Results of a preliminary randomized clinical trial. Journal of Traumatic Stress, 24(5), 591-595. 10.1002/jts.20685

Kent, M., Rivers, C., & Wrenn, G., (2015). Goal-Directed Resilience in Training (GRIT): A Biopsychosocial Model of Self-Regulation, Executive Functions, and Personal Growth (Eudaimonia) in Evocative Contexts of PTSD, Obesity, and Chronic. Behavior Sciences, 5(2), 264-304; doi:10.3390/bs5020264

Kessler, R.C. (2000). Posttraumatic stress disorder: The burden to the individual and to society. Journal of Clinical Psychiatry, 61(suppl. 5), 5−12.

Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602.

Kessler, R.C., Chiu, W.T., Demler, O., & Walters, E.E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627.

Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060.

Lehman, A.F. (1996). Measures of quality of life among persons with severe and persistent mental disorders. Social Psychiatry and Psychiatric Epidemiology, 31(2), 78-88.

Leppin, A. L., Bora, P. R., Tilburt, J. C., Gionfriddo, M. R., Zeballos-Palacios, C., Dulohery, M. M., ... & Montori, V. M. (2014). The efficacy of resiliency training programs: a systematic review and meta-analysis of randomized trials. PloS One, 9(10), e111420.

Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

Matthieu, M., & Ivanoff, A. (2006). Treatment of human-caused trauma Attrition in the adult outcomes research. Journal of Interpersonal Violence, 21(12), 1654-1664.

McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education & Behavior, 15(4), 351-377.

Murray, C.J., Abraham, J., Ali, M.K., Alvarado, M., Atkinson, C., Baddour, L.M., ... & Bolliger, I. (2013). The state of U.S. health, 1990-2010: burden of diseases, injuries, and risk factors. Journal of the American Medical Association, 310(6), 591-606.

Najavits, L.M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. Guilford Press.

National Institute of Mental Health. (n. d.). Post-Traumatic Stress Disorder. Accessed on June 26, 2016 from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

National Institute of Mental Health (2016). Major Depression Among Adults. Accessed on June 26, 2016 from http://www.nimh.nih.gov/health/statistics/prevalence/major-depression-omamong-adults.shtml.

Oxford English Dictionary (n.d.). Resilience. Accessed on June 26, 2016 from http://www.oxforddictionaries.com/us/definition/learner/resilience

Resilience Alliance (2010). Assessing resilience in social-ecological systems: workbook or practitioners. Accessed on June 26, 2016 from http://www.lsln.net.au/jspui/handle/1/8086

Rickert, V.I., Wiemann, C.M., & Berenson, A.B. (2000). Ethnic differences in depressive symptomatology among young women. Obstetrics & Gynecology, 95(1), 55-60.

Roberts, A.L., Gilman, S.E., Breslau, J., Breslau, N., & Koenen, K.C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine, 41(1), 71–83. Retrieved from http://doi.org/10.1017/S0033291710000401

Rust, G., Kondwani, K., Martinez, R., Dansie, R., Wong, W., Fry-Johnson, Y., & Strothers, H. (2006). A CRASH-Course in cultural competence. Ethnicity & Disease, 16, 29-36.

Rutter, M. (2006). Implications of resilience concepts for scientific understanding. Annals of the New York Academy of Sciences, 1094(1), 1-12.

Sanders Thompson, V.L., Noel, J.G., & Campbell, J. (2004). Stigmatization, discrimination, and mental health: The impact of multiple identity status. American Journal of Orthopsychiatry, 74(4), 529.

Schneider, K.T., Hitlan, R.T., & Radhakrishnan, P. (2000). An examination of the nature and correlates of ethnic harassment experiences in multiple contexts. Journal of Applied Psychology, 85(1), 3.

Shim, R.S., Baltrus, P., Bradford, L.D., Holden, K.B., Fresh, E., & Fuller, L.E. (2013). Characterizing depression and comorbid medical conditions in African American women in a primary care setting. Journal of the National Medical Association, 105(2), 183-191.

Siebert, A. (2005). The Resiliency Advantage: Master Change, Thrive Under Pressure, and Bounce Back from Setbacks. Berrett-Koehler. Portland, OR

Sledjeski, E.M., Speisman, B., & Dierker, L.C. (2008). Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R). Journal of Behavioral Medicine, 31(4), 341–349. Retrieved from http://doi.org/10.1007/s10865-008-9158-3

Spoont, M., Sayer, N., & Nelson, D.B. (2005). PTSD and treatment adherence: the role of health beliefs. The Journal of Nervous and Mental Disease, 193(8), 515-522.

Stevens, D., Wilcox, H.C., MacKinnon, D.F., Mondimore, F.M., Schweizer, B., Jancic, D. & Potash, J.B. (2013). Posttraumatic stress disorder increases risk for suicide attempt in adults with recurrent major depression. Depression and Anxiety, 30(10), 940-946.

Substance Abuse and Mental Health Services Administration (2012). Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-45, HHS Publication No. (SMA) 12-4725. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Sullivan, T.P., Cavanaugh, C.E., Buckner, J.D., & Edmondson, D. (2009). Testing posttraumatic stress as a mediator of physical, sexual, and psychological intimate partner violence and substance problems among women. Journal of Traumatic Stress, 22 (6), 575–584.

Sullivan, T.P. & Holt, L.J. (2008). PTSD symptom clusters are differentially related to substance use among community women exposed to intimate partner violence. Journal of Traumatic Stress, 21 (2), 173–180.

Teasdale, J.D., Segal, Z.V., Williams, J.M.G., Ridgeway, V.A., Soulsby, J.M., & Lau, M.A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615.

Tugade, M.M. & Fredrickson, B.L. (2004). Resilient Individuals Use Positive Emotions to Bounce Back From Negative Emotional Experiences. Journal of Personality and Social Psychology, 86(2), 320-333. Retrieved from http://dx.doi.org/10.1037/0022-3514.86.2.320

U.S. Department of Health and Human Services (2001). Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General.

U.S. Department of Health and Human Services. (2014). Mental Health and African Americans. Accessed on June 26, 2015 from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=24

U.S. Housing and Urban Development (2010). Washington, DC: U.S. Housing and Urban Development, 2010. Accessed from https://www.onecpd.info/resources/documents/2010HomelessAssessmentReport.pdf.

Van Etten, M.L. & Taylor, S. (1998). Comparative Efficacy of Treatments for Post-traumatic Stress Disorder: A Meta-Analysis. Clinical Psychology & Psychotherapy, 5, 126-144.

Waite, R. & Killian, P. (2008). Health beliefs about depression among African American women. Perspectives in Psychiatric Care, 44(3), 185-195.

Weiss, N.H., Dixon-Gordon, K.L., Duke, A.A., & Sullivan, T.P. (2015). The underlying role of posttraumatic stress disorder symptoms in the association between intimate partner violence and deliberate self-harm among African American women. Comprehensive Psychiatry, 59, 8-16.

Weiss, N.H., Tull, M.T., Viana, A.G., Anestis, M.D., & Gratz, K.L. (2012). Impulsive behaviors as an emotion regulation strategy: examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. Journal of Anxiety Disorders, 26, 453–458.

Weiss, N.H., Tull, M.T., Borne, M.E., & Gratz, K.L. (2013). Posttraumatic stress disorder symptom severity and HIV-risk behaviors among substance-dependent inpatients. AIDS Care, 25, 1219–1226.

West, C. (2014). Violence in the Lives of Black Women: Battered, Black, and Blue. Routledge.

Wrenn, G, Wingo, A.P, Pelletier, T, Gutman, A.R, Bradley, B, & Ressler, K.J. (2011). The Effect of Resilience on Posttraumatic Stress Disorder in Trauma-exposed Inner City Primary Care Patients. Journal of the National Medical Association, 103(7).

Zimmerman, M.A. (2013). Resiliency Theory A Strengths-Based Approach to Research and Practice for Adolescent Health. Health Education & Behavior, 40(4), 381-383.

Zlotnick, C., Franklin, C.L., & Zimmerman, M. (2002). Does “subthreshold” posttraumatic stress disorder have any clinical relevance? Comprehensive Psychiatry, 43(6), 413-419.




DOI: https://doi.org/10.5195/hcs.2017.222

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