Resilience and Biomarkers of Health Risk in Black Smokers and Nonsmokers

• Type of Material: Article
• Authors: Carla Berg, Emory University; Regine Haardorfer, Emory University; Colleen M. McBride, Emory University; Varun Kilaru, Emory University; Kerry Ressler, Emory University; Aliza Wingo, Emory University; Nabil F Saba, Emory University; Jackelyn B. Payne, Emory University; Alicia Smith, Emory University
• Language: English
• Date: 2017-11-01
• Publisher: American Psychological Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American Psychological Association.
• Final Published Version (URL): http://dx.doi.org/10.1037/hea0000540
• Title of Journal or Parent Work: Health Psychology
• ISSN: 0278-6133
• Volume: 36
• Issue: 11
• Start Page: 1047
• End Page: 1058
• Grant/Funding Information: This work was primarily supported by the National Institute of Mental Health (MH071537, MH100122, MH102890, MH096764) and the National Institute of Child Health and Human Development (HD071982).; APW is supported by VA grant IK2CX000601.; Support also included Emory and Grady Memorial Hospital General Clinical Research Center, NIH National Centers for Research Resources (M01 RR00039), the Burroughs Welcome Fund, and Emory University’s Winship Cancer Institute (co-PIs: McBride, Berg).
• Keywords: CHILDHOOD SEXUAL-ABUSE; Social Sciences; health disparities; UNITED-STATES; C-REACTIVE PROTEIN; POSTTRAUMATIC-STRESS-DISORDER; resilience; DEPRESSIVE SYMPTOMS; trauma; Psychology; ALLOSTATIC LOAD; SMOKING-CESSATION; tobacco use; CUMULATIVE BIOLOGICAL RISK; depression; Psychology, Clinical; CARDIOVASCULAR-DISEASE; CONNOR-DAVIDSON RESILIENCE
• Research Categories: Psychology, Behavioral; Health Sciences, Obstetrics and Gynecology

Abstract

Objectives: Blacks are disproportionately affected by tobacco-related illnesses as well as traumatic events associated with psychiatric conditions and smoking. We examined the potential protective nature of resilience within this context, hypothesizing resilience differentially moderates the associations of traumatic experiences to depressive symptoms and to biomarkers of health risk among Black ever versus never smokers. Method: Measures of resilience, traumatic experiences, depressive symptoms, and biomarkers (interleukin-6 [IL-6], C-reactive protein [CRP], allostatic load) were obtained among 852 Blacks recruited from Grady Memorial Hospital in Atlanta. Results: Ever smokers experienced more trauma (p < .001) and depressive symptoms (p = .01). Structural equation modeling indicated that, in ever smokers, childhood trauma was positively associated with depressive symptoms (p < .001); resilience was negatively associated with depressive symptoms (p = .01). Depressive symptoms were positively associated with IL-6 (p = .03), which was positively associated with allostatic load (p -= .01). Adulthood trauma was associated with higher CRP levels (p = .03). In never smokers, childhood (p < .001) and adulthood trauma (p = .01) were associated with more depressive symptoms. Adulthood trauma was also associated with higher CRP levels (p < .001), which was positively associated with allostatic load (p < .001). Never smokers with higher resilience had a negative association between childhood trauma and depressive symptoms whereas those with lower resilience had a positive association between childhood trauma and depressive symptoms. Resilience was negatively associated with CRP levels (p < .001). Conclusions: Interventions targeting resilience may prevent smoking and adverse health outcomes.