An Emerging Integration of Universal and Culturally Specific Psychologies and its Implications for the Study of Psychopathology

There is an emerging consensus among researchers on the need to integrate universal and culturally specific psychological perspectives. Important tasks in this process have included identifying the appropriate level of generality for putatively universal processes, how to understand culturally different processes in light of shared universal capacities, and the development of transparent scientific means for investigating cultural differences. In this chapter, the authors discuss each of these issues. It appears to be true that many psychological processes appear to reflect culturally-specific instantiations of universal capacities. The authors then consider implications of this emerging integration for psychology, by applying it to the study of psychopathology. They report on formal models that explain why some cultures embrace dysfunction among members. They then use the integrative framework to describe methods for determining whether putative disorders bring universal or contextual life dysfunction, and to clarify etiological models of three disorders. Models of psychopathology can be more informed and precise if they include careful consideration of both universal and cultural influences on behavior. Cultural psychology is not a separate discipline within psychology; rather, it informs, and should be integrated with, the various content domains within the field

A Double‐Blind Randomized Placebo‐Controlled Trial of Oral Naltrexone for Heavy‐Drinking Smokers Seeking Smoking Cessation Treatment

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137315/1/acer13396.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137315/2/acer13396_am.pd

A conceptual framework for understanding alcohol use problems in racial/ethnic minorities: The role of impulsivity and stress

There is a robust relationship between impulsivity and alcohol use. The present review summarizes the existing literature on the influence of the dimensions of impulsivity and alcohol use problems among racial/ethnic groups. In particular, we focus on how chronic stress may influence the relationship between specific dimensions of impulsivity (e.g., negative and positive urgency) and alcohol use. While much of the existing literature has been conducted in White samples, individuals from minoritized backgrounds often deal with greater stress and stress specifically related to their identity as minority (e.g., minority stress). This unique source of stress may come from sources such as perceived discrimination and living in poverty, which exposes these individuals to additional stress and has a negative impact on substance use problems. In this chapter, we will integrate the literature on impulsivity, stress, and alcohol use in minoritized groups. We propose an organizing framework for how these constructs work together to increase alcohol-related problems in members from minoritized groups and discuss the implications of this research. Additionally, we suggest there is a strong need to develop unique treatment options that are culturally and developmentally appropriate, and that target each of these constructs for members from minoritized groups

The associations of Latino/a racial status and neighborhood discrimination to alcohol use and psychological distress

Minority Stress Theory posits that discrimination is associated with negative mental health outcomes; however, the location of the perceived discrimination may matter. This study examines whether race, inside-neighborhood discrimination, and their interaction are associated with hazardous drinking, alcohol-related consequences, and depressive/anxiety symptoms in a racially diverse sample of Latino/a adults. Participants (N = 296, 63% male, Mage =41, SD = 12.2) who met criteria for hazardous drinking (4/5 drinks per occasion for females/males, respectively) were separated into two racial groups: those who self-identified as either White (21%, n = 63) or a minoritized race (79%, n = 233). Regression analyses explored whether racial status (White/minoritized race), inside-neighborhood discrimination, and their interaction were associated with hazardous drinking, alcohol-related consequences, and anxiety/depressive symptoms. Perceiving more frequent inside-neighborhood discrimination was associated with greater hazardous drinking (B = 0.03, SE = 0.01, p=.003), alcohol-related consequences (B = 1.92, SE = 3.39, p=.001), and depressive symptoms (B = 0.79, SE = 0.25, p=.001). For anxiety symptoms, the interaction between discrimination and racial status was significant (B = 1.62, SE = 0.76, p=.034); greater perceived inside-neighborhood discrimination was related to more anxiety symptoms only for Latino/a individuals with a minoritized race (but not for those who are Latino/a and White). These findings suggest that perceiving neighborhood discrimination is associated with hazardous drinking, alcohol-related consequences, and depressive symptoms among Latino/a individuals regardless of racial status. Further, Latino/a individuals with a minoritized race who report inside-neighborhood discrimination show greater anxiety symptoms than Latino/a White individuals. Findings highlight the importance of exploring the roles of race and discrimination inside one’s neighborhood within the Latino/a population

Racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial individuals

Background: Alcohol use is disproportionately higher among multiracial than monoracial adults; yet, associated risk and protective factors are underexplored. The present study compared levels of experienced racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial and monoracial adults and tested whether racial identity affiliation, experienced racial discrimination, and their interaction were significantly associated with heavy alcohol use among multiracial individuals. Methods: We conducted secondary analyses of data from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants are a nationally representative sample of all U.S. adults (N = 29,026; 56.4% female) and were interviewed for the study from 2012 to 2013. The sample includes 598multiracial individuals. Results: Linear regression analyses showed that multiracial individuals experienced significantly greater racial discrimination than White (b = −1.26, 95% CI [−1.47, −1.05], p \u3c 0.001) or Asian individuals (b = −0.30, 95% CI [−0.53, −0.06], p = 0.013) but less than Black individuals (b = 0.29, 95% CI [0.08, 0.50], p = 0.007). Furthermore, multiracial individuals reported less affiliation with their racial identity than Black (b = 4.92, 95% CI [4.23, 5.62], p \u3c 0.001) or Asian individuals (b = 3.86, 95% CI [3.09, 4.63], p \u3c 0.001) but did not differ significantly from White individuals. Logistic regression analysis showed that multiracial individuals were significantly more likely to report heavy drinking than Asian individuals (OR = 0.53, 95% CI [0.36, 0.78], p = 0.001) but did not differ significantly from White or Black individuals. Finally, experienced racial discrimination was significantly related to heavy alcohol use in multiracial adults (b = 0.11, 95% CI [0.01, 0.20], p = 0.031), though neither racial identity affiliation nor the interaction of racial identity affiliation with experienced racial discrimination were significantly related to heavy alcohol use. Conclusions: Our results suggest that multiracial individuals, as compared to other minoritized individuals who are monoracial, report high levels of experienced racial discrimination and heavy alcohol use and low levels of racial identity affiliation. Further understanding of the effects of racial identity affiliation and experienced racial discrimination on the risk for heavy alcohol use could help in the development of interventions aimed at reducing alcohol use disparities among multiracial individuals

Risk and protective factors for opioid misuse in American Indian adolescents

Background: American Indian (AI) youth have disproportionately high rates of both heroin and other opioid misuse and recently have seen a large increase in negative outcomes due to opioid misuse. To address the dearth of research on within-group risk factors for heroin and other opioid misuse in AI adolescents, the goal of the present study is to explore the influence of peer, family, and school factors on opioid use among AI youth. Methods: Participants (n = 3498, 49.5 % female, Mage = 14.8) were drawn from a large school-based sample of AI youth living on or near reservations, across six geographic regions, between 2009 and 2013. Participants completed a self-report questionnaire regarding substance use and related factors. Multilevel logistic regression was utilized to examine the role of peer, family, and school-related factors on past-month and lifetime heroin and other opioid misuse. Results: Greater peer substance use (OR = 1.14, p\u3c0.001), lower family disapproval of use (OR =.98, p = 0.01), and lower school performance (OR =.90, p = 0.01) were associated with greater likelihood of lifetime opioid misuse. Greater peer substance use (OR = 1.05, p\u3c0.001) and lower family disapproval of use (OR =.99, p = 0.04) were associated with greater likelihood of past month opioid misuse. Greater peer substance use was the only variable significantly related to greater likelihood of lifetime (OR = 1.15, p\u3c0.001) or past month heroin use (OR = 1.02, p = 0.047). Conclusions: Findings highlight the need for interventions and offer potential factors to consider in developing interventions for heroin and/or other opioid misuse among AI adolescents

The factor structure of self-esteem and its association with alcohol use in American Indian (AI) adolescents.

American Indian (AI) adolescents experience disproportionately higher rates of alcohol use and related consequences. While self-esteem has been found to be associated with alcohol use in non-AI samples, little is known about this relationship in AI adolescents. Further, there is a dearth of literature examining the psychometric properties of self-esteem measures for AI adolescents. The current study aims to examine the factor structure of the self-esteem items of the American Drug and Alcohol Survey (ADAS) and to better understand the relationships among self-esteem, alcohol use, and alcohol-related problems in AI adolescents. The present study represents secondary analyses of cross-sectional data collected between 2009 and 2013. Participants (n = 3,498) were AI adolescents (Mage = 14.8, 47.7% female) attending schools on or near reservations across 11 states. Participants completed the American Drug and Alcohol Survey. Factor analytic results suggested 2 factors, representing intrapersonal (from intrinsic sources) and interpersonal self-esteem (from extrinsic sources). Multilevel regression analyses revealed that, with both factors entered into the model, intrapersonal self-esteem was negatively associated with alcohol consumption and alcohol-related problems, while interpersonal self-esteem was positively associated with alcohol consumption and alcohol-related problems. Results suggest the importance of examining the properties of assessment tools before they are used with a community for whom they were not developed. Further, self-esteem does not appear to be universally protective. Rather, interventions should aim to consider sources from which AI adolescents are drawing self-esteem and focus on promoting more intrinsic sources rather than aiming to increase self-esteem in general. (PsycInfo Database Record (c) 2020 APA, all rights reserved)Public Policy Relevance Statement—Alcohol use is among the most pressing health disparities facing Indigenous communities. There is a call within these communities to consider factors which confer protection against the development of alcohol use and related problems. Results of the present study suggest the importance of understanding sources from which Indigenous adolescents draw self-esteem, as it is not universally protective. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Regional and gender differences in tobacco use among American Indian youth

Tobacco use is among the top preventable causes of death in the United States, and American Indian (AI) adolescents tend to use tobacco at higher rates compared to the general population. To examine regional and gender differences in rates of smoked, smokeless, and poly-tobacco use among AI adolescents as compared to White counterparts, participants were sampled as part of a larger ongoing study examining substance use among American Indian adolescents who completed the American Drug and Alcohol Survey. A multilevel analytic approach was used to examine the effects of demographic variables on tobacco use. AI disparities were present for past month and lifetime rates of smoked and smokeless tobacco use, and these disparities varied by region and gender. AI disparities in smoked tobacco use were largest in the Upper Great Lakes region, with odds of current and ever smoking among AIs 3.34 to 4.15 times that of Whites, respectively, p \u3c.001. Regional differences in AI disparities were not significant for lifetime smokeless or poly-tobacco use, p ≥.675. With regard to gender differences, AI disparities in reports of ever smoking were largest among females, OR = 2.61, p \u3c.001. Similar to cigarette smoking, AI disparities in reports of ever using smoked, smokeless, or poly-tobacco were largest among females, OR = 2.51 and 2.56, respectively, p \u3c.001. Our results suggest a need for prevention and intervention programs to be implemented with consideration for adolescents’ demographic characteristics, including geographic region, gender, and AI status

A Call to Action: A Systematic Review Examining the Failure to Include Females and Members of Minoritized Racial/Ethnic Groups in Clinical Trials of Pharmacological Treatments for Alcohol Use Disorder

Alcohol use disorder (AUD) presents a significant public health concern given the high prevalence estimates and numerous deleterious-associated consequences. The FDA currently has approved 3 pharmacological treatments for alcohol use disorder: acamprosate, naltrexone, and disulfiram. Previous research suggests that there may exist differences in the prevalence of and outcomes related to AUD across sex and racial/ethnic groups. Other work indicates that there may be differences in the efficacy of existing pharmacological treatments for AUD across demographic groups. The purpose of the present study was to examine the inclusion of women and members of minoritized racial/ethnic groups in published randomized clinical trials of pharmacological treatments for alcohol use disorder since 1994, in accordance with the NIH Revitalization Act of 1993. PubMed was systematically searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The initial search located 842 articles. After exclusion of ineligible articles, 102 remained for analysis. Of those included in the review, only 11.8% reported full sex and racial/ethnic characteristics of their study participants. Of the total sample, 6 articles were specifically examining 1 racial/ethnic group, and 11 were specifically examining 1 sex. Two articles (2.2%) did not report information regarding the sex breakdown of their participants, while 47 (49.0%) did not report any information regarding the racial/ethnic breakdown of their sample. Despite guidelines set forth by NIH, only 5.9% of articles conducted subgroup analyses to examine differences in treatment outcomes by sex or race/ethnicity, and only 16.7% of articles included considerations related to cultural inclusion when discussing study limitations. These results varied by medication type. Results suggest that considerably greater efforts must be put forth by the larger scientific community regarding the inclusion, analysis, and reporting of data focused on women and non-White racial and ethnic groups

Social contextual risk factors for stimulant use among adolescent American Indians

Objective Stimulants are the most common and efficacious treatment for Attention-Deficit Hyperactivity Disorder (ADHD). We examined the relationship between stimulant misuse and social factors that could be malleable to prevention among American Indian (AI) adolescents. Method Participants were AI students (N = 3498) sampled from 33 schools in 11 states. Participants completed the American Drug and Alcohol Survey. A multilevel analytic approach was used to evaluate the effects of participant-level (level 1) variables (i.e., gender, grade, peer, school, family, stimulant prescribed by doctor) on lifetime and current simulant use to ‘get high.’ Results Nearly 7% of our sample had been prescribed stimulants and nearly 6% of the sample reported using stimulants to get high. Age [OR = 1.22; 95% CI = 1.09, 1.36, p \u3c 0.001], perception of peer substance use [OR = 1.19; 95% CI = 1.14, 1.23, p \u3c 0.001], parental monitoring [OR = 0.96; 95% CI = 0.92, 1.99, p = 0.04], and stimulants prescribed by a doctor [OR = 8.79, 95% CI = 5.86, 13.18, p \u3c 0.001] were associated with ever using stimulants to get high. Perception of peer substance use, [b = 0.09, SE = 0.02, p \u3c 0.001, 95%CI [0.05, 0.13], and having stimulants prescribed by a doctor, [b = 0.58, SE = 0.21, p = 0.006, 95%CI [0.17, 0.99], were associated with frequency of past month use to get high. There was also a significant quadratic effect for parental monitoring, suggesting that low and high levels were associated with increased stimulant use. Conclusions Our results suggest a need for prevention efforts to be directed to AI youth who are prescribed stimulants