种族健康差异的机制：应对方式与心理和生理应激反应之间的关系。
Mechanisms of Racial Health Disparities: Relationships between Coping and Psychological and Physiological Stress Responses.
机构信息
Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI.
School of Social Work, University of Michigan, Ann Arbor, MI.
出版信息
Ethn Dis. 2020 Sep 24;30(4):563-574. doi: 10.18865/ed.30.4.563. eCollection 2020 Fall.
OBJECTIVE
Psychological distress and physiological dysregulation represent two stress response pathways linked to poor health and are implicated in racial disparities in aging-related health outcomes among US men. Less is known about how coping relates to these stress responses. The purpose of this exploratory study was to examine whether midlife and older men's coping strategies and behaviors accounted, in part, for Black-White disparities in men's psychological and physiological stress responses.
METHODS
We examined racial differences in 12 coping strategies (COPE Inventory subscales, religious/spiritual coping, and behaviors such as stress eating and substance use) and their relationships with psychological distress (Negative Affect scale) and physiological dysregulation (blunted diurnal cortisol slopes) using regression models and cross-sectional data from 696 Black and White male participants aged 35-85 years in the National Survey of Midlife Development in the United States (MIDUS) II, 2004-2006.
RESULTS
Black men exhibited more psychological distress and physiological dysregulation than White men. Black and White men reported comparable use of most coping strategies, none of which demonstrated similar relationships with both stress responses. Coping strategies explained variations in psychological distress consistent with conventional protective-harmful categorizations. Coping accounted for racial disparities in men's psychological distress, as Black men reported using harmful strategies more often and were more susceptible to their negative effects. Neither differential use of coping strategies nor differing relationships accounted for racial disparities in physiological dysregulation.
CONCLUSIONS
Findings revealed complex relationships between coping and psychological and physiological stress responses and suggest the importance of differing approaches to reducing associated racial health disparities among men.
目的
心理困扰和生理失调代表了与健康状况不佳相关的两种应激反应途径，并且与美国男性与衰老相关的健康结果的种族差异有关。对于应对方式如何与这些应激反应相关，人们知之甚少。本探索性研究的目的是检验中年和老年男性的应对策略和行为是否部分解释了男性心理和生理应激反应中的黑-白差异。
方法
我们使用回归模型和横断面数据，从美国国家中年发展调查（MIDUS）II 中 696 名年龄在 35-85 岁的黑人和白人男性参与者（2004-2006 年）中，检查了 12 种应对策略（COPE 库存子量表、宗教/精神应对以及压力饮食和物质使用等行为）的种族差异，以及它们与心理困扰（负性情绪量表）和生理失调（皮质醇斜率变钝）的关系。
结果
黑人男性表现出比白人男性更多的心理困扰和生理失调。黑人和白人男性报告了类似的应对策略使用情况，但没有一种策略与两种应激反应都有相似的关系。应对策略可以解释与传统的保护-有害分类一致的心理困扰变化。应对方式解释了男性心理困扰中的种族差异，因为黑人男性更经常使用有害策略，并且更容易受到其负面影响。应对方式的差异使用或不同的关系都没有解释生理失调中的种族差异。
结论
研究结果揭示了应对方式与心理和生理应激反应之间的复杂关系，并表明在减少男性相关的种族健康差异方面采取不同方法的重要性。
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