Prior to the mid-1980's, our knowledge of African American mental health was primarily derived from clinical and community studies that emphasized race-comparative analyses [1-3]. Furthermore, life span research has largely neglected African American adults. As emphasized by the Surgeon General's Report on Mental Health, there is a pressing need to understand the unique experiences and determinants of mental health among African Americans. Understanding the environmental contexts in which African American families live is a crucial component of this endeavor. African American families live in a broad range of contexts, from abject poverty to affluence; important environmental effects are frequently ignored in studies of African American families and contextual influences are sometimes attributed to race. Our analyses of previous waves of data from this sample showed significant neighborhood-level contributions to both symptoms of distress and diagnosable disorder [4, 5]. At the same time, it is increasingly important to incorporate the potential role of genetics into culturally sensitive, longitudinal investigations of African Americans. Twin and adoption studies indicate that there is substantial heritability for a number of psychiatric outcomes [6, 7]. The data for the proposed project will be collected from an existing sample of over 700 African American women and their spouses or co-caregivers from Iowa and Georgia who were recruited to participate in the Family and Community Health Study (FACHS). The primary focus will foe predicting anxiety and depression symptoms and disorders (major depression and generalized anxiety disorder). Three waves of data have been completed and a fourth wave is in the process of being collected. We seek to collect two additional waves of data. In the first four waves, information was obtained regarding the neighborhood characteristics, personal characteristics, psychological symptoms, psychiatric diagnoses, health, attitudes, close relationships, and stressful experiences of the participants. The new data will build upon and extend the existing data, including new and more precise measurement of neighborhood characteristics using GPS technology, specific dimensions of life events (severity, loss, entrapment, humiliation, and danger), more precise dating of life events and disorder onset, and the measurement of potential candidate genes that have been associated with depression and anxiety disorders. This analysis of multi-level influences will offer a unique opportunity to understand the complex etiological factors that contribute to mental health outcomes in midlife African American women, a significantly under-studied population. The information we gain can be used to develop culturally-sensitive interventions to improve the mental health of African American women. ? ? ?
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