非裔美国人的神经处理和感知歧视压力。
Neural Processing and Perceived Discrimination Stress in African Americans.
机构信息
Kathy D. Wright, PhD, RN, PMHCNS-BC, KL2 Awardee, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. She is now Assistant Professor, College of Nursing Center for Healthy Aging, Self-Management and Complex Care, Discovery Themes Traumatic Brain Injury, The Ohio State University, Columbus. Anthony I. Jack, PhD, is Associate Professor, Department of Philosophy, and Director, the Brain, Mind and Consciousness Laboratory, Case Western Reserve University, Cleveland, Ohio. Jared P. Friedman, BA, is Doctoral Student, Organizational Behavior, and Research Associate, Brain, Mind and Consciousness Laboratory, Case Western Reserve University, Cleveland, Ohio. Lenette M. Jones, PhD, RN, CNS, Post-Doctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. She is now Assistant Professor, University of Michigan School of Nursing, Ann Arbor. Abdus Sattar, PhD, is Associate Professor, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio. David M. Fresco, PhD, is Professor, Department of Psychiatry and Research Professor, Institute for Social Research, University of Michigan, Ann Arbor. Shirley M. Moore, PhD, RN, FAAN, is Edward J. and Louise Mellen Professor of Nursing Emerita, and Director, SMART Center II: Brain-Behavior Connections in Self-Management Science, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
出版信息
Nurs Res. 2020 Sep/Oct;69(5):331-338. doi: 10.1097/NNR.0000000000000441.
BACKGROUND
Racial discrimination is one of many barriers experienced by African Americans that interfere with health self-care management. Discrimination stress may decrease the tendency for individuals to resonate with the social-emotional appeals embedded in persuasive health information, which are known to play a key role in producing behavior change. Understanding the neurobehavioral underpinnings of discrimination stress experienced by African Americans may help reduce or resolve this important health disparity.
OBJECTIVES
The purpose of this secondary analysis was to examine the association between neural processing of health information and perceived discrimination. In particular, we focused on three previously identified measures of health information processing associated with distinct brain areas: analytic network, empathy network, and the ventral medial prefrontal cortex.
METHODS
Data were obtained from 24 African Americans enrolled in a blood pressure self-care management study. Participants completed surveys assessing racial discrimination and global stress, as well as a 40-minute functional magnetic resonance imaging protocol used to measure neural activation associated with processing different types of health information.
RESULTS
Discrimination stress was significantly related to reduced activation of the empathy network and ventral medial prefrontal cortex, whereas there was a nonsignificant positive relationship with activity in the analytic network.
DISCUSSION
Uncovering associations between patient experiences, such as racial discrimination, and their neural processing of health information can lead to the development of tailored health messages and self-care management interventions. This may inform strategies to close the gap on health outcomes.
背景
种族歧视是非裔美国人面临的众多障碍之一，这些障碍会干扰他们的健康自我护理管理。歧视压力可能会降低个体对嵌入有说服力的健康信息中的社会情感诉求产生共鸣的倾向，而这些诉求在产生行为改变方面起着关键作用。了解非裔美国人经历的歧视压力的神经行为基础，可能有助于减少或解决这一重要的健康差距。
目的
本次二次分析旨在研究健康信息处理与感知歧视之间的关联。具体而言，我们专注于与三个先前确定的与特定大脑区域相关的健康信息处理措施：分析网络、同理心网络和腹内侧前额叶皮层。
方法
数据来自 24 名参与血压自我护理管理研究的非裔美国人。参与者完成了评估种族歧视和整体压力的调查，以及一项 40 分钟的功能磁共振成像协议，用于测量处理不同类型健康信息时的神经激活。
结果
歧视压力与同理心网络和腹内侧前额叶皮层的激活减少显著相关，而与分析网络的活动呈正相关。
讨论
揭示患者体验（如种族歧视）与其对健康信息的神经处理之间的关联，可以为量身定制的健康信息和自我护理管理干预措施的发展提供信息。这可能为缩小健康结果差距提供策略。
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