Publications by authors named "Sierra Carter"

Previous research has found that both racism and sexual assault are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. Black women have unique relationships to these stressors situated within contexts of oppression, and little is known about factors that may exacerbate these associations among Black women. Among Black women experiencing both racism and sexual assault (n = 148), emotion clarity moderated the relation between PTSD and chronic pain, β = .

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Background: Access to evidence-based interventions is urgently required, especially for individuals of minoritized identities who experience unique barriers to mental health care. Digital mental health interventions have the potential to increase accessibility. Previous pilot studies testing HabitWorks, a smartphone app providing an interpretation bias intervention, have found strong engagement and adherence for HabitWorks; however, previous trials' samples consisted of predominantly non-Hispanic, White individuals.

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Objective: People living with HIV (PLWH) experience high rates of childhood trauma exposure, which is a significant risk factor for the development of posttraumatic stress disorder (PTSD). Because Black Americans living in urban environments are exposed to high levels of trauma, suffer from chronic PTSD, and are at increased risk for HIV infection, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology.

Methods: The current cross-sectional study assessed whether HIV status interacts with childhood maltreatment to influence PTSD symptom severity and heart rate variability during a dark-enhanced startle (DES) task in 88 Black women with (n=30) and without HIV (n=58).

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The objective of this study was to estimate the effect of geographic variation in historic slavery on perinatal outcomes (chronic hypertension, hypertensive disorders of pregnancy [HDP], very preterm birth [VPTB], or very low birth weight birth [VLBW]) among Black people living in states where slavery was legal in 1860; and to test mediation by Black homeownership. We linked data on the proportion of enslaved residents from the 1860 Census to natality data on outcomes (2013-2021) using resident county. The percentage of Black residents in a county who owned their home was a potential mediator.

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Article Synopsis
  • Racial discrimination may negatively impact brain health by affecting emotion processing networks and altering deep brain regions' connectivity, which could lead to increased health risks.
  • The study aimed to explore the relationship between racial discrimination and brainstem/midbrain functional connectivity, along with DNA methylation age acceleration, specifically in a sample of Black women in the US.
  • Conducted from 2012 to 2015, the research utilized various scales to measure racial discrimination and PTSD, while analyzing brain connectivity related to specific regions and assessing their epigenetic aging through a detailed assay.
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Importance: Racial discrimination is a psychosocial stressor associated with youths' risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US.

Objective: To investigate the association between racial discrimination and risk for psychopathology moderated by neuroaffective processing.

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Centuries of systemic racism in the United States have led to Black Americans facing a disproportionate amount of life stressors. These stressors can have negative effects on mental and physical health, contributing to inequities throughout the lifespan. The current study used longitudinal data from 692 Black adults in the rural South to examine the ways in which neighborhood stress, financial strain, and interpersonal experiences of racial discrimination operate independently and in tandem to impact depressive symptoms and sleep problems over time.

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Mindfulness-based cognitive therapy (MBCT) offers promise as a group-based intervention to alleviate posttraumatic stress disorder (PTSD) and depression symptoms in traumatized Black adults. Given the high level of barriers that exist for low-income Black adults, virtual delivery of MBCT may be helpful. This pilot randomized controlled trial assessed feasibility and acceptability of an adapted 8-week virtual MBCT group intervention for Black adults screening positive for PTSD and depression.

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Background: Race-related stress (RRS) is an unrecognized source of moral injury (MI)-or the emotional and/or spiritual suffering that may emerge after exposure to events that violate deeply held beliefs. Additionally, MI has not been explored as a mechanism of risk for post-traumatic stress disorder (PTSD) in trauma-exposed civilians. We examined relations among exposure to potentially morally injurious events (moral injury exposure, MIE), related distress (moral injury distress, MID), and RRS in Black Americans.

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Racism-related stressors, from experiences of both implicit and explicit racial discrimination to systemic socioeconomic disadvantage, have a cumulative impact on Black Americans' health. The present narrative review synthesizes peripheral (neuroendocrine and inflammation markers), psychophysiological (heart-rate variability, skin conductance), and neuroimaging (structural and functional) findings that demonstrate unique associations with racism-related stress. Emerging evidence reveals how racism-related stressors contribute to differential physiological and neural responses and may have distinct impacts on regions involved with threat and social processing.

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Objective: To characterize the association between percent of county-level elected officials who were female-presenting and perinatal outcomes in Georgia and variation by individual race, 2020-2021.

Materials And Methods: We gathered data on the gender composition of county-level elected officials for all Georgia counties ( = 159) in 2022 and calculated the percent of female elected officials (percent female, 0-100). We linked this to data from 2020 to 2021 birth certificates ( = 238,795) to identify preterm birth (PTB, <37 weeks), low birthweight (LBW, <2500 grams), hypertensive disorders of pregnancy, and cesarean delivery.

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Background: Mood disorders such as major depressive and bipolar disorders, along with posttraumatic stress disorder (PTSD), schizophrenia (SCZ), and other psychotic disorders, constitute serious mental illnesses (SMI) and often lead to inpatient psychiatric care for adults. Risk factors associated with increased hospitalization rate in SMI (H-SMI) are largely unknown but likely involve a combination of genetic, environmental, and socio-behavioral factors. We performed a genome-wide association study in an African American cohort to identify possible genes associated with hospitalization due to SMI (H-SMI).

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From its inception, development and psychopathology theorists have sought to uncover the earliest forms of risk for mental health challenges in children, to prevent the development of more severe, intractable manifestations of psychopathology. Large familial risk registries have advanced our understanding of early, potentially modifiable factors that could prevent or mitigate the expression of challenging symptoms of neurodevelopmental conditions, and similar registries have been proposed to advance understanding of ADHD and related phenotypes. Data from single-site studies, largely focused on perinatal exposure to maternal mood disorders, reveal that a robust predictor of child psychopathology is parental psychopathology.

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Background: Race-related stress negatively impacts the mental health of Black Americans to a greater degree than other racialized groups. Additionally, trauma exposure is associated with more severe levels of posttraumatic stress disorder for individuals who also experience race-related stress. Therefore, an accurate assessment of race-related stress in a trauma-exposed sample of Black Americans is necessary to ensure the validity and reliability of empirical findings regarding race-related stress and intervention efficacy.

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Objectives: Black older adults have a higher vascular burden compared to non-Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden was associated with depressive symptoms in Black older adults.

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Article Synopsis
  • The study investigates the impact of maternal childhood trauma on the mental health of their offspring, highlighting that while many children show increased psychopathology, some exhibit resilience.
  • It explores the role of epigenetic aging—measured through DNA methylation—in moderating the effects of maternal childhood adversity, particularly focusing on self-reported experiences of trauma.
  • Results reveal that while maternal sexual abuse is linked to offspring symptoms, this relationship diminishes in children who display accelerated epigenetic aging, suggesting a mechanism for resilience against intergenerational trauma.
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Prior research has shown that racial discrimination (RD) impacts activation in threat network regions, including the ventromedial prefrontal cortex (vmPFC) and middle occipital cortex during attention to threat-relevant stimuli. However, little is known about the biological mechanisms that may modulate these effects; inflammation may be a pathway linking RD and threat network activation. As such, the current study aimed to explore whether systemic inflammation, measured by C-reactive protein (CRP) levels, may moderate the relationship between RD and activation in the vmPFC and middle occipital cortex during attention to threat.

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Purpose: Our goal was to estimate differences in perinatal outcomes by racial differences in political representation, a measure of structural racism.

Methods: We gathered data on the racial composition of county-level elected officials for all counties in Georgia (n = 159) in 2022. We subtracted the percent of non-White elected officials from the percent of non-White residents to calculate the "representation difference," with greater positive values indicating a larger disparity.

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This article serves as an introduction to the special section in the Journal of Traumatic Stress related to the 38th annual meeting of the International Society for Traumatic Stress Studies, held in Atlanta, Georgia (USA) in November 2022. The theme of this meeting, "Trauma as a Transdiagnostic Risk Factor Across the Lifespan," provided an opportunity to recognize the far-reaching impact of trauma and how traumatic experiences can become embedded into the mind, body, and societal spirit. This introductory article outlines the importance of harnessing multiple perspectives to address these wide-ranging sequelae of trauma and provides an overview of the series of contributions to the special section.

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Article Synopsis
  • Experiencing racism negatively impacts individuals' subjective social status (SSS), which is how they view their position in society, affecting mental health.
  • In a study of 173 trauma-exposed Black Americans, findings showed that race-related stress leads to lower SSS and higher symptoms of PTSD and depression.
  • The research underscores the importance of addressing cultural race-related stress to improve mental health outcomes and suggests systemic interventions to combat the ongoing oppression faced by Black Americans.
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This study examines whether shift-and-persist coping, a coping strategy defined by accepting challenges and remaining hopeful for the future, is associated with psychosocial and physical health and/or moderates the effects of contextual stress (i.e., racial discrimination, financial strain) on health among African American adolescents living in the rural Southeastern United States.

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Objective: Racism is a multifaceted system of oppression that disproportionately harms Black mothers and children across the lifespan. Despite reliable evidence that racism is associated with worse mental health outcomes (eg, increased depressive symptoms), less is known about potential intergenerational effects of Black mothers' experiences of racism on children's mental health, as well as how traumatic experiences influence these pathways. In this cross-sectional quantitative study, we aimed (1) to replicate the finding that maternal experiences of racism are associated with both maternal and child depression; (2) to identify whether maternal experiences of racism are indirectly associated with child depression via the effect of maternal depression; and (3) to test whether the indirect effect of racism on child depression via maternal depression is conditioned on maternal trauma.

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Black Americans living in urban environments are disproportionately impacted by posttraumatic stress disorder (PTSD). Both racial discrimination and neighborhood poverty are factors that contribute to this health disparity. However, studies focused on the intersection of these two oppressive systems on PTSD symptoms are lacking.

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Article Synopsis
  • - The COVID-19 pandemic significantly impacted Black Americans, leading to heightened stress and mental health issues, particularly increased depressive symptoms.
  • - Research using data from the ProSAAF study showed that improved couple functioning after participating in the intervention helped mitigate the negative effects of pandemic-related stress on mental health.
  • - The findings indicate that relationship interventions like ProSAAF may enhance resilience and support mental health during widespread crises, demonstrating a protective effect against stress-induced depressive symptoms.
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