Understanding the primary triggers of anxiety for African Americans, and the cultural factors associated with these triggers, can enhance our knowledge of emotional responding in African Americans and can ultimately influence how we assess and treat anxiety disorders in this population. In the current study, we investigated the experience of anxiety for African Americans following physical stressors, with an emphasis on cardiovascular arousal. Specifically, anxious responding, following cardiovascular arousal, other physical stressors, and a control task, was evaluated among African American (n = 23) and European American (n = 23) groups on affective, cognitive, and physiological measures of anxiety. Findings suggest physical stressors in general (as opposed to cardiovascular arousal specifically) may be a prominent trigger of anxiety for African Americans. Discussion centers on the idea that the observed relationship between anxiety and physical stressors for African Americans may stem from a cultural sense of vulnerability regarding physical disease.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
2.
AndersonN. B.McNeillyM.MyersH. (1993). A biopsychosocial model of race differences in cardiovascular reactivity. In BlascovichJ.KatkinE. S. (Eds.), Cardiovascular reactivity to psychological stress and disease (pp. 83-108). Washington, DC: American Psychological Association.
3.
AntonyM. M.LedleyD. R.LissA.SwinsonR. P. (2005). Responses to symptom induction exercises in panic disorder. Behaviour Research and Therapy, 44, 85-98.
4.
BarlowD. H.CraskeM. G. (1994). Mastery of your anxiety and panic II. Albany, NY: Graywind.
5.
Bar-OrT.Bar-OrH.WatersA.HirjiA.RussellS. (1996). Validity and social acceptability of the Polar Vantage XL as a means of measuring heart rate during rest, exercise, and recovery in 3- to 5-year-old children. Pediatric Exercise Science, 8, 115-120.
6.
BeckA. T.BrownG.SteerR. A. (1996). Beck Depression Inventory-II manual. San Antonio, TX: Psychological Corporation.
7.
BeckA. T.EmeryG.GreenbergR. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York, NY: Basic Books.
8.
BeckerG.NewsomeE. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill African Americans. American Journal of Public Health, 93, 742-748.
9.
BellR. A.CamachoF.GoonanK.Duren-WhitfieldV.AndersonR. T.KonenJ. C.GoffD. C. (2001). Quality of diabetes care among low-income patients in North Carolina. American Journal of Preventive Medicine, 21, 124-131.
10.
BetancourtH.LopezS. R. (1993). The study of culture, ethnicity, and race in American psychology. American Psychologist, 48, 629-637.
11.
BrownD. R.EatonW. E.SussmanL. (1990). Racial differences in prevalence of phobic disorders. Journal of Nervous and Mental Disease, 178, 434-441.
12.
ByersT. (2010). Two decades of declining cancer mortality: Progress with disparity. Annual Review of Public Health, 31, 121-132.
13.
CarterM. M.MillerO.SbroccoT.SuchdayS.LewisE. (1999). Factor structure of the anxiety sensitivity index among African American college students. Psychological Assessment, 11, 525-533.
14.
CarterM. M.SbroccoT.CarterC. (1996). African Americans and anxiety disorders research: Development of a testable theoretical framework. Psychotherapy: Theory, Research, & Practice, 33, 449-463.
15.
ChamblessD. L.CaputoG. C.BrightP.GallagherR. (1984). Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097.
16.
CossrowN.FalknerB. (2004). Race/ethnic issues in obesity and obesity-related comorbidities. Journal of Clinical Endocrinology and Metabolism, 89, 2590-2594.
17.
CraskeM. G.PoultonR.TsaoJ. C. I.PlotkinD. (2001). Paths to panic disorder/agoraphobia: An exploratory analysis from age 3 to 21 in an unselected birth cohort. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 556-563.
18.
CrookE.D.ClarkB.L.BradfordS.T.J.GoldenK.CalvinR.TaylorH.A.FlackJ.M. (2003). From 1960s Evans County Georgia to present-day Jackson, Mississippi: An exploration of the evolution of cardiovascular disease in African Americans. American Journal of the Medical Sciences, 325, 307-314.
19.
DragunsJ. G.Tanaka-MatsumiJ. (2003). Assessment of psychopathology across and within cultures: Issues and findings. Behaviour Research and Therapy, 41, 755-776.
20.
EatonW. W.DrymanA.WeissmanM. M. (1991). Panic and phobia. In RobinsL. N.RegierD. A. (Eds.), Psychiatric disorders in America (pp. 155-179). New York, NY: Free Press.
21.
EhlersA. (1993). Somatic symptoms and panic attacks: A retrospective study of learning experiences. Behavior Research and Therapy, 31, 269-278.
22.
EllsworthP. C. (1994). Sense, culture, and sensibility. In KitayamaS.MarkusH. R. (Eds.), Emotion and culture (pp. 23-50). Washington, DC: American Psychological Association.
23.
FriedmanS.ParadisC. (1991). African-American patients with panic disorders and agoraphobia. Journal of Anxiety Disorders, 5, 35-41.
24.
FriedmanS.ParadisC. (2002). Panic disorder in African-Americans: Symptomatology and isolated sleep paralysis. Culture, Medicine, and Psychiatry, 26, 179-198.
25.
FriedmanS.ParadisC.HatchM. (1994). Characteristics of African American and White patients with panic disorder and agoraphobia. Hospital and Community Psychiatry, 45, 798-803.
26.
GoodB. J.KleinmanA. M. (1985). Culture and anxiety: Cross-cultural evidence for the patterning of anxiety disorders. In TumaA. H.MaserJ. D. (Eds.), Anxiety and the anxiety disorders (pp. 297-323). Hillsdale, NJ: Erlbaum.
27.
GordonT. L.TeachmanB. A. (2004, November). Ethnic variations in anxious cognitions. Poster session presented at the annual conference of the Association for the Advancement of Behavioral Therapy, New Orleans, LA.
28.
GordonT. L.TeachmanB. A. (2008). Ethnic differences in affective, behavioral, and cognitive markers of anxiety. Journal of Cross-Cultural Psychology, 39, 424-446.
29.
GuyllM.MatthewsK. A.BrombergerJ. T. (2001). Discrimination and unfair treatment: Relationship to cardiovascular reactivity among African American and European American women. Health Psychology, 20, 315-325.
30.
HarrisY.GorelickP. B.SamuelsP.BempongI. (1996). Why African Americans may not be participating in clinical trials. Journal of the National Medical Association, 88, 630-634.
31.
HorwathE.JohnsonJ.HoringC. D. (1994). Epidemiology of panic disorder. In FriedmanS. (Ed.), Anxiety disorders in African Americans (pp. 53-64). New York, NY: Springer.
32.
HreybeH.SabaS. (2004). Effect of race and health insurance on the rates of pacemaker implantation for complete heart block in the United States. American Journal of Cardiology, 94, 227-229.
33.
HunterL. R.SchmidtN. (2010). Anxiety psychopathology in African American adults: Literature review and development of an empirically informed sociocultural model. Psychological Bulletin, 136, 211-235.
34.
JenkinsJ. H. (1994). Culture, emotion, and psychopathology. In KitayamaS.MarkusH. R. (Eds.), Emotion and culture (pp. 23-50). Washington, DC: American Psychological Association.
35.
JohnsonM. R.HartzemaA. G.MillsT. L.De LeonJ. M.YangM.FruehC.SantosA. (2007). Ethnic differences in the reliability and validity of a panic disorder screen. Ethnicity and Health, 12, 283-296.
36.
KalinowskiL.DobruckiI. T.MalinskiT. (2004). Race-specific differences in endothelial function: Predisposition of African Americans to vascular diseases. Circulation, 109, 2511-2517.
37.
KarnoM.GoldingJ. M. (1991). Obsessive-compulsive disorder. In RobinsL. N.ReigerD. A. (Eds.), Psychiatric disorders in America: The epidemiologic catchment area study (pp. 204-219). Orlando, FL: Academic Press.
38.
KeefeS. E. (1992). Ethnic identity: The domain of perceptions of and attachments to ethnic groups and cultures. Human Organization, 51, 35-45.
39.
KirmayerL. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychology, 62, 22-28.
40.
KirmayerL. J.YoungA.HaytonB. C. (1995). The cultural context of anxiety. Cultural Psychiatry, 18, 503-519.
41.
KitayamaS.MarkusH. R. (1994). Early work on culture and emotion. In KitayamaS.MarkusH. R. (Eds.), Emotion and culture (pp. 23-50). Washington, DC: American Psychological Association.
42.
KuligJ. C. (2006). African American beliefs about diabetes: Commentary by Kulig. Western Journal of Nursing Research, 28, 30-32.
43.
LangP. J. (1985). The cognitive psychophysiology of emotion: Fear and anxiety. In TumaA. H.MaserJ. D. (Eds.), Anxiety and the anxiety disorders (pp. 131-170). Hillsdale, NJ: Erlbaum.
44.
LeporeS. J.RevensonT. A.WeinbergerS. L.WestonP.FrisinaP. G.RobertsonR. (2006). Effects of social stressors on cardiovascular reactivity in black and white women. Annals of Behavioral Medicine, 31, 120-127.
45.
LiY.YinJ.CaiX.Temkin-GreenerJ.MukamelD. B. (2011). Association of race and sites of care with pressure ulcers in high-risk nursing home residents. Journal of the American Medical Association, 306, 179-186.
46.
Lloyd-JonesD.AdamsR.CarnethonM.De SimoneG.FergusonT. B.FlegalK.. . .HongY. (2009). Heart disease and stroke statistics: 2009 update. A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 27, 121-181.
47.
McArdleW. D.KatchF. L.PecharG. S.JacobsonL.RuckS. (1972). Reliability and interrelationships between maximal oxygen intake, physical work capacity and step-test scores in college women. Medicine and Science in Sports and Exercise, 4, 182-186.
48.
McBrideD. F. (2011). Manifesting empowerment: How a family health program can address racism. Journal of Black Psychology, 37, 336-356.
49.
MinekaS.ZinbargR. (2006). A contemporary learning theory perspective on the etiology of anxiety disorders: It’s not what you thought it was. American Psychologist, 61, 10-26.
50.
MorenoffJ. D.HouseJ. S.HansenB. B.WilliamsD. R.KaplanG. A.HunteH. E. (2007). Understanding social disparities in hypertension prevalence, awareness, treatment, and control: The role of neighborhood context. Social Science & Medicine, 65, 1853-1866.
51.
National Center for Health Statistics. (2011). Health, United States, 2010: With special feature on death and dying. Hyattsville, MD: U.S. Department of Health and Human Services.
52.
NealA. M.RichL. N.SmuckerW. D. (1994). The presence of panic disorder among African American hypertensives: A pilot study. Journal of Black Psychology, 20, 29-35.
53.
OhaeriJ. U.OdejideA. O.IkuesanB. A.AdeyemiJ. D. (1989). The pattern of isolated sleep paralysis among Nigerian medical students. Journal of the National Medical Association, 81, 805-808.
54.
PetrieJ. M.ChapmanL. K.VinesL. M. (2013). Utility of the PANAS-X in predicting social phobia in African American females. Journal of Black Psychology, 39, 131-155. doi:10.1177/0095798412454677
55.
PhinneyJ. S. (1992). The multigroup ethnic identity measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7, 156-176.
56.
PhinneyJ. S. (1996). When we talk about American ethnic groups, what do we mean?American Psychologist, 51, 918-927.
57.
PhinneyJ. S.AlipuriaL. (1990). Ethnic identity in college students from four ethnic groups. Journal of Adolescence, 13, 171-184.
58.
RegierD. A.MyersJ. K.KramerM.RobinsL. N.BlazerD. G.HoughR. L.LockeB. Z. (1984). The NIMH Epidemiologic Catchment Area program. Archives of General Psychiatry, 41, 934-941.
59.
ReissS.PetersonR. A.GurskyD. M.McNallyR. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behavior Research and Therapy, 24, 1-8.
60.
SmithL. C.FriedmanS.NevidJ. (1999). Clinical and sociocultural differences in African American and European American patients with panic disorder and agoraphobia. Journal of Nervous and Mental Disease, 187, 549-560.
61.
SpielbergerC. D. (1983). Manual for the State-Trait Anxiety Inventory (STAI). Palo Alto, CA: Consulting Psychologists Press.
62.
TaylorS.RachmanS. (1994). Klein’s suffocation theory of panic. Archives of General Psychiatry, 51, 505-506.
63.
TerbizanD. J.DolezalB. A.AlbanoC. (2002). Validity of the seven commercially available heart rate monitors. Measurement in Physical Education and Exercise Science, 6, 243-247.
64.
TownsendT. G.BelgraveF. Z. (2009). Eliminating health disparities: Challenges for African American psychologists. Journal of Black Psychology, 35, 146-153.
65.
WatsonD.ClarkL. A.TellegenA. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070.
66.
WattG.McConnachieA.UptonM.EmslieC.HuntK. (2000). How accurately do adult sons and daughters report and perceive parental deaths from coronary disease?Journal of Epidemiology and Community Health, 54, 859-863.
67.
WilliamsD. R. (1999). Race, socioeconomic status, and health: The added effects of racism and discrimination. Annals of the New York Academy of Sciences, 896, 173-188.
68.
WilliamsD. R.NeighborsH. W.JacksonJ. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200-208.
69.
WoodyS. R.SandersonW. C. (1998). Manuals for empirically supported treatments: 1998 update. The Clinical Psychologist, 51(1), 17-21.
