The relationships of discrimination and microaggressions with sleep quality in black Americans: the role of perseverative cognition
Date
2022Metadata
[+] Show full item recordAbstract
Disparities in health outcomes between Black and White Americans are well-documented, including sleep quality. Black Americans are more likely to report poor sleep quality sleep than their White counterparts. As sleep is a risk factor for many health conditions, it may serve as one mechanism for disparities in health over the life course. A meta-model explaining relationships between race, life events, and health outcomes through biological, psychological, and behavioral pathways suggests that cognitive processes may underly the connection between race and poor sleep quality, and ultimately, health disparities. That is, there are race-specific stressors which disproportionately affect Black Americans, which are associated with poor health through biological, cognitive, and behavioral mechanisms (e.g., sleep). Among these race-specific stressors is discrimination. Studies have found a connection between discrimination and sleep quality, and there is a body of literature connecting perseverative cognition (e.g., rumination and worry or vigilance) to poor sleep. Another kind of race-specific stressor are microaggressions, a more subtle but pervasive form of discrimination. Less research has considered the connection of microaggressions to perseverative cognition, but there are some studies linking microaggressions to health outcomes. While these reactions to discrimination and microaggressions (i.e., perseverative cognition) are normative and reflect understandable distress at an experience of unfair treatment, perseverative cognition focused on experiences of discrimination may reduce sleep quality. This project, therefore, tested four hypotheses. First, rumination was predicted to mediate the relationship between discrimination and poor sleep quality. Second, it was hypothesized that racism-related vigilance would mediate the association between discrimination and poor sleep quality. Third, rumination was predicted to mediate the association between microaggressions and poor sleep quality. Finally, it was hypothesized that racism-related vigilance would mediate the association between microaggressions and poor sleep quality. Results showed that neither rumination nor racism-related vigilance mediated a relationship between discrimination and poor sleep quality. However, rumination partially mediated a relationship between microaggressions and poor sleep quality, but racism-related vigilance did not. Overall, these findings indicate support for the meta-model, demonstrating a specific pathway from racial microstressors to poor sleep quality. Clinicians should explicitly acknowledge this, and culturally tailored approaches should be developed with this in mind.
Table of Contents
Introduction -- Review of literature -- Methodology -- Results -- Discussion -- Appendix A. Measures -- Appendix B. Data management
Degree
Ph.D. (Doctor of Philosophy)