Department of Sociology, Biola University, 13800 Biola Ave., La Mirada, CA, 90639, USA.
J Racial Ethn Health Disparities. 2019 Oct;6(5):935-943. doi: 10.1007/s40615-019-00594-9. Epub 2019 May 3.
Prior research indicates that there is a black-white paradox in the relationship between physical health and mental health among American adults. However, none have considered black-white differences in psychosocial coping and depressive symptoms during the transitional stages from health to chronic illness. Using a nationally representative sample of chronically ill adults from the American Changing Lives study, this study builds on literature on chronic illness and the black-white paradox to examine if (1) growth in depressive symptoms across 16 years differs for black and white adults as they transition from healthy to chronically ill and (2) if the protective coping resource, mastery, provides an equal benefit to black and white chronically ill adults during that transition. Findings indicate that among chronically ill adults, not only do black-white disparities exist in how much mastery each group possesses, but that mastery's utility as a protective resource against depressive symptoms differs by race, with black ill adults experiencing a poorer return on their mastery than white adults. Moreover, findings that black adults maintain the same level of depressive symptoms as white adults despite this mastery disadvantage provide additional support for Minorities' Diminishing Returns Theory and some support for an emerging theory of collective resilience with regard to black American mental health.
先前的研究表明，在美国成年人的身心健康关系中存在一种黑白悖论。然而，目前还没有研究考虑到在从健康到慢性疾病的过渡阶段中，心理社会应对和抑郁症状的黑白差异。本研究利用美国生活变化研究中的一个具有全国代表性的慢性疾病成年人样本，基于慢性疾病和黑白悖论的文献，探讨了以下两个问题：（1）在从健康到慢性疾病的过渡过程中，黑人成年人和白人成年人的抑郁症状是否会随着时间的推移而增加；（2）在这一过渡过程中，保护应对资源（掌控感）是否对黑人慢性疾病患者和白人慢性疾病患者同样有益。研究结果表明，在慢性疾病患者中，不仅黑人患者和白人患者在掌控感方面存在差异，而且掌控感作为对抗抑郁症状的保护资源的效用也因种族而异，黑人患者从掌控感中获得的益处不如白人患者。此外，黑人患者尽管在掌控感方面处于劣势，但抑郁症状与白人患者保持一致，这进一步支持了少数族裔回报递减理论，并在一定程度上支持了关于美国黑人心理健康的集体韧性的新兴理论。
