The proposed program project has stress, coping, and the adaptation of African Americans as its central focus and reflects the strengths of established and nw personnel of the Program for Research on Block Americans (PRBA). Conceptually and methodologically we emphasize a multiple level approach to the investigation of the racial, ethnic, systemic, and cultural influences on: 1) the distribution, risk, and protective factors relate to serious mental disorder and mental health services use; 2) phenomenological experiences of symptoms and disorders; and 3) diagnosis and treatment issues in community, inpatient, and outpatient populations. Administrative and Methodological/Statistical Cores and six interrelated substantive preliminary and pilot projects are proposed over a five year period. The Program Project Cores are designed to provide administrative support, a focal set of intellectual and research activities, and expert statistical and methodological support for the proposed empirical projects. Each of the six studies are tied to the central core concern of stress, coping, and adaptation among African Americans, and inter-related, and will provide critical data for the design and implementation of future competitive applications. Pathways and Barriers to Mental Health Care: Linkages Between a CMHC and County Jail will examine problems in initiating the search for help, pathways into care, the impact of informal networks on help-seeking, and barriers to care in two public settings: an urban community mental health center and the psychiatric wards of a county jail. It will also explore how experiences with discrimination relate to symptoms of distress and depression. A closely related project, the Clinical Interview Process study focuses on in-depth analyses of how race and ethnicity influence the nature of interchanges among patients and therapists. The Stress, Discrimination and Cortisol Response project addresses our longstanding interest in the influences of the perceptions of inequality and racism, and the experiences of discrimination, on the sociological, psychological and physical stress responses of African Americans. The Blocked Opportunities, Persistence and Mood study proposes to utilize the same community sample as the prior project but focuses directly on how mobility barriers, coping and adaptation are related to depressive symptomatology and major depression among African Americans. A conceptually related project, Racial Identity, Coping and Adaptation, proposed a short-term longitudinal investigation of African American college samples at HBCUs and white institutions to examine the multi-dimensional assessment and meaning(s) of racial identify, the relationship to process of coping and positive and negative adaptation. The final project, Appraisal of Religiosity, Coping and Church Support, builds on the prior proposed projects and examines the often cited, but empirically under-studied, role of religion, religious beliefs and religious institutional affiliation in mental health and mental disorders among African Americans.
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