Stress, coping, and depression: Testing a new hypothesis in a prospectively studied general population sample of U.S.-born Whites and Blacks
Stress, coping, and depression: Testing a new hypothesis in a prospectively studied general population sample of U.S.-born Whites and Blacks
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DOI：
10.1016/j.socscimed.2010.12.005
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发表时间：
2011-03-01
影响因子：
5.4
通讯作者：
Bates, L. M.
中科院分区：
文献类型：
--
作者：
Keyes, K. M.;Barnes, David M.;Bates, L. M.
对于美国抑郁症中黑人和白人患病率的差异，缺乏经验支持的解释是文献中一个明显的缺口。最近的证据表明，与白人相比，美国黑人抑郁风险降低但身体疾病发生率上升的矛盾观察可能是因为暴露在高压力水平下的黑人使用了应对行为(例如，饮酒和尼古丁消费，暴饮暴食)。这种应对行为可能会减轻压力暴露对心理健康的有害影响，同时增加身体疾病的风险。因此，如果a)这些行为在黑人中比白人更普遍，和/或b)这些行为对压力的影响因种族而不同，这种心理和身体健康结果的种族模式可以用这种机制来解释。本研究使用具有全国代表性的纵向数据和全面的DSM-IV诊断来挑战这一假设。数据来自第一波(2001-2002年)和第二波(2004-2005年)中的34,653人，这是美国全国酒精及相关疾病流行病学调查的一部分。结果表明，a)与白人相比，黑人在低、中和高压力水平下不太可能饮酒或消费尼古丁，b)种族、压力和应对行为之间存在显著的三向交互作用(F=2.11，df=12，p=0.03)，但与假设相反，在低压力水平而不是高压力水平下，黑人的BMI升高对抑郁具有保护作用。此外，参与不健康的行为，特别是在病态水平上，并不能预防黑人或白人的抑郁。总而言之，压力和应对过程对抑郁的影响在黑人和白人身上似乎没有什么不同。有必要对解释黑人/白人抑郁症患病率差异的创新假设进行进一步研究。(C)2010爱思唯尔有限公司。保留所有权利。
The scarcity of empirically supported explanations for the Black/White prevalence difference in depression in the U.S. is a conspicuous gap in the literature. Recent evidence suggests that the paradoxical observation of decreased risk of depression but elevated rates of physical illness among Blacks in the U.S. compared with Whites may be accounted for by the use of coping behaviors (e.g., alcohol and nicotine consumption, overeating) among Blacks exposed to high stress levels. Such coping behaviors may mitigate deleterious effects of stressful exposures on mental health while increasing the risk of physical ailments. The racial patterning in mental and physical health outcomes could therefore be explained by this mechanism if a) these behaviors were more prevalent among Blacks than Whites and/or b) the effect of these behavioral responses to stress was differential by race. The present study challenges this hypothesis using longitudinal, nationally-representative data with comprehensive DSM-IV diagnoses. Data are drawn from 34,653 individuals sampled in Waves 1 (2001-2002) and 2 (2004-2005) as part of the US National Epidemiologic Survey on Alcohol and Related Conditions. Results showed that a) Blacks were less likely to engage in alcohol or nicotine consumption at low, moderate, and high levels of stress compared to Whites, and b) there was a significant three-way interaction between race, stress, and coping behavior for BMI only (F = 2.11, df = 12, p = 0.03), but, contrary to the hypothesis, elevated BMI was protective against depression in Blacks at low, not high, levels of stress. Further, engagement in unhealthy behaviors, especially at pathological levels, did not protect against depression in Blacks or in Whites. In sum, the impact of stress and coping processes on depression does not appear to operate differently in Blacks versus Whites. Further research testing innovative hypotheses that would explain the difference in Black/White depression prevalence is warranted. (C) 2010 Elsevier Ltd. All rights reserved.