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      Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans

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          Abstract

          Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women ( n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community ( p < .001) and U.S. ( p < .001) and low social support ( p < .001) were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.

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          Most cited references40

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          Stress, social support, and the buffering hypothesis.

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            Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).

            We derived and tested a short form of the Center for Epidemiologic Studies Depression Scale (CES-D) for reliability and validity among a sample of well older adults in a large Health Maintenance Organization. The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D (kappa = .97, P or = 16 for the full-length questionnaire and > or = 10 for the 10-item version. We discuss other potential cutoff values. The CESD-10 showed an expected positive correlation with poorer health status scores (r = .37) and a strong negative correlation with positive affect (r = -.63). Retest correlations for the CESD-10 were comparable to those in other studies (r = .71). We administered the CESD-10 again after 12 months, and scores were stable with strong correlation of r = .59.
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              Social relationships and health.

              Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health. Prospective studies, which control for baseline health status, consistently show increased risk of death among persons with a low quantity, and sometimes low quality, of social relationships. Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes. The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 April 2016
                2016
                : 11
                : 4
                : e0154035
                Affiliations
                [1 ]Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, United States of America
                [2 ]Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
                [3 ]Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
                [4 ]College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States of America
                [5 ]USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
                [6 ]Department of Psychology, Rice University, Houston, Texas, United States of America
                [7 ]Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas, United States of America
                [8 ]Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
                Katholieke Universiteit Leuven, BELGIUM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: SKM LHM. Performed the experiments: SKM LRR LHM. Analyzed the data: SKM YL NTN. Contributed reagents/materials/analysis tools: DWW LHM. Wrote the paper: SKM YL KBE REL DT DWW LRR LHM. Critically reviewed the manuscript and provided feedback: SKM YL KBE REL DT DWW NTN LRR LHM.

                ‡ These authors also contributed equally to this work.

                Author information
                http://orcid.org/0000-0003-1935-7707
                Article
                PONE-D-15-42303
                10.1371/journal.pone.0154035
                4847864
                27119366
                6610db51-ba41-49b4-8268-76f5805fed59

                This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

                History
                : 7 October 2015
                : 7 April 2016
                Page count
                Figures: 1, Tables: 2, Pages: 12
                Funding
                Funded by: University Cancer Foundation
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100007314, Duncan Family Institute for Cancer Prevention and Risk Assessment;
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100001249, Morgan Family Foundation;
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100000054, National Cancer Institute;
                Award ID: R25TCA057730
                Funded by: funder-id http://dx.doi.org/10.13039/100000054, National Cancer Institute;
                Award ID: P30CA016672
                Project CHURCH was generously supported by funding from the University Cancer Foundation; the Duncan Family Institute through the Center for Community-Engaged Translational Research; the Ms. Regina J. Rogers Gift: Health Disparities Research Program; the Cullen Trust for Health Care Endowed Chair Funds for Health Disparities Research; and the Morgan Foundation Funds for Health Disparities Research and Educational Programs. Support was also provided by the Center for Energy Balance in Cancer Prevention and Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment. Scherezade K. Mama was supported in part by a cancer prevention fellowship through MD Anderson Cancer Center’s Cancer Prevention Research Training Program, funded by the National Cancer Institute (R25T CA057730 and P30 CA016672). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                People and places
                Population groupings
                Ethnicities
                African Americans
                Medicine and Health Sciences
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Social Sciences
                Sociology
                Social Discrimination
                Racial Discrimination
                Medicine and Health Sciences
                Health Care
                Environmental Health
                Medicine and Health Sciences
                Public and Occupational Health
                Environmental Health
                Social Sciences
                Sociology
                Social Research
                Custom metadata
                Data for this study were obtained from a third party upon request. Interested researchers can contact the Project CHURCH Ancillary Studies Committee at: Project CHURCH Ancillary Studies Committee, (Attention: Lorna McNeill), Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Email: lmcneill@ 123456mdanderson.org .

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                Uncategorized

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