Explaining the Black-white depression paradox: Interrogating the Environmental Affordances Model.
Explaining the Black-white depression paradox: Interrogating the Environmental Affordances Model.
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DOI：
10.1016/j.socscimed.2021.113869
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Bates LM
中科院分区：
文献类型：
--
作者：
Pamplin JR 2nd;Kezios KL;Hayes-Larson E;Keyes KM;Susser ES;Factor-Litvak P;Link BG;Bates LM
环境负担能力（EA）模型假定，美国黑人参与不健康的行为（即吸烟，饮酒，吃高热量食物）来科普压力暴露可能同时解释了他们观察到的慢性身体疾病的更大风险，以及他们观察到的与白色美国人相同或更少的抑郁症患病率-所谓的“黑人-白色抑郁症悖论”。然而，这些影响可能产生的具体机制在不同研究中的理论化和分析并不一致，这引起了人们对该模型现有实证测试的适当性以及结论有效性的担忧。我们指定的两个机制最符合EA模型-“仅调解”和“调解和修改”-并推导出基于每个先验预测。我们使用儿童健康与发展研究的559名参与者的子集系统地测试了这些途径，这些参与者在2010-2012年期间被纳入成人随访研究，并自认为是黑人或白色。结果未能支持来自EA模型的两种机制，挑战的有效性和实用性的模型解释种族差异的抑郁症，努力发展替代假设来解释的悖论是必要的。
The Environmental Affordances (EA) model posits that Black Americans’ engagement with unhealthy behaviors (i.e. smoking, alcohol use, eating calorie-dense foods) to cope with stressor exposure may simultaneously account for their observed greater risk of chronic physical illness, and their observed equal or lesser prevalence of depression, relative to white Americans – the so-called “Black-white depression paradox.” However, the specific mechanisms through which such effects might arise have been theorized and analyzed inconsistently across studies, raising concerns regarding the appropriateness of existing empirical tests of the model as well as the validity of the conclusions. We specify the two mechanisms most consistent with the EA model – ‘Mediation-only’ and ‘Mediation and Modification’ - and derive a priori predictions based on each. We systematically test these pathways using a subset of 559 participants of the Child Health and Development Study who were included in an adult follow-up study between 2010-2012 and self-identified as Black or white. Results failed to support either of the two mechanisms derived from the EA model, challenging the validity and utility of the model for explaining racial differences in depression; efforts to develop alternative hypotheses to explain the paradox are needed.
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影响因子：
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