UNASSIGNED: Older Black women experience structural and intersectional disadvantages at the intersection of age, race, and gender. Their disadvantaged social statuses can translate into serious psychological health consequences. One concept that may aid in understanding psychosocial determinants of older Black women\'s depression risk is the \"Strong Black Woman,\" which suggests that Black women have supernatural strength amidst experiencing adversity and are expected to \"be strong\" for others by providing self-sacrificial aid without complaint.
UNASSIGNED: Drawing inspiration from the \"Strong Black Woman\" concept, the current study examined whether three psychosocial factors (i.e., mastery, anger suppression, and relational demands (from spouse, children, relatives, and friends)) were associated with depressive symptoms, clinically significant depressive symptoms, and lifetime professionally diagnosed depression among older Black women (i.e., ages 50 years and older).
UNASSIGNED: This was a cross-sectional study. Data were drawn from the 2010 to 2012 waves of the Health and Retirement Study (N = 1,217).
UNASSIGNED: For past-week depressive symptoms, ordinary least squares regression analyses were conducted, and beta coefficients were reported. For clinically significant depressive symptoms (i.e., reporting three or more depressive symptoms in the past week) and lifetime professionally diagnosed depression, binary logistic regression analyses were performed, and odds ratios were reported.
UNASSIGNED: Higher levels of mastery were associated with lower risk for depressive symptoms and depression. Anger suppression was associated with higher risk for depressive symptoms and depression. Demands from children and one\'s spouse were associated with higher depressive symptoms while demands from family were associated with risk for lifetime depression diagnosis. Not having a spouse was associated with heightened risk of depressive symptoms and depression. Interestingly, demands from friends were not associated with depressive symptoms nor diagnosed depression.
UNASSIGNED: Study findings revealed important nuances in the determinants of depression among older Black women which, in turn, has implications for research and mental health care provision in this population.

Few studies examine how high-achieving Black women navigate chronic reproductive health morbidities. Black women are disproportionately more likely to experience uterine fibroids, with earlier onset and more severe symptoms. This study leverages a national mixed-methods data set of Black women academics to examine how they describe symptomatic fibroids impacting their careers and lives. We find that participants (1) actively coped by engaging in superwoman schema, (2) postponed treatment due to the demands of their tenure-track position, and (3) normalized pain. Our findings suggest a potentially high prevalence of uterine fibroids among Black women faculty, that symptomatic fibroids were an impediment to some women\'s careers, and that women with symptomatic fibroids often identified expectations of their careers as an impediment to seeking timely treatment. We provide insights for how highly educated, successful Black women cope and navigate career stress coupled with challenges resulting from chronic reproductive health morbidities.

Black women are less likely to seek psychological help and underutilize mental health services. Although help-seeking attitudes and intentions are associated in the general population, less is known about this relationship among Black women in college. In this cross-sectional study, we investigated the relationship between help-seeking attitudes and intention among 167 self-identified Black women in college. We also investigated if dimensions of the Superwoman Schema (i.e., an obligation to display strength, resistance to being vulnerable, an obligation to suppress emotions, an intense motivation to succeed despite limited resources, and an obligation to help others) moderated this relationship. Findings indicated a significant positive relationship between help-seeking attitudes and help-seeking intention. Regarding moderation, an obligation to suppress emotions, resistance to vulnerability, and an obligation to help others interacted with help-seeking attitudes in predicting help-seeking intention. Notably, low adherence to an obligation to suppress emotions, resistance to vulnerability, and an obligation to help others were associated with high levels of help-seeking intention. However, more favorable help-seeking attitudes improved help-seeking intention for participants high in adherence to these dimensions. Our findings suggest that understanding the relevance of the Superwoman Schema among Black women is critical for increasing help-seeking behavior.

BACKGROUND: African American Women (AAW) are at high risk for stress-related cardiometabolic (CM) conditions including obesity, heart disease, and diabetes. Prior interventions lack attention to culturally-nuanced stress phenomena (Superwoman Schema [SWS], contextualized stress, and network stress), which are positively and significantly associated with unhealthy eating and sedentary behavior.
OBJECTIVE: The HARMONY Study is designed to test a culturally tailored mindfulness-based stress management intervention to address SWS, contextualized stress, and network stress as potential barriers to adherence to healthy exercise and eating goals. The study will help AAW build on their strengths to promote cardiometabolic health by enhancing positive reappraisal, self-regulation, and self-efficacy as protective factors against chronic stress-inducing biobehavioral morbidity and mortality risk.
METHODS: This two-arm, randomized-controlled trial will test the effects of two group-based, online interventions. HARMONY 1 includes culturally-tailored exercise and nutrition education. HARMONY 2 includes mindfulness-based stress reduction, exercise, and nutrition education. We aim to recruit 200 AAW ≥ 18 years old with CM risk.
RESULTS: Primary outcomes (actigraphy and carotenoid levels) and secondary outcomes (body composition, inflammatory markers, glucose metabolism, and stress) are being collected at baseline and 4-, 8-, and 12-months post-intervention. Intent-to-treat, data analytic approaches will be used to test group differences for the primary outcomes.
CONCLUSIONS: This study is the first to address culturally-nuanced stress phenomena in AAW (SWS, network stress, and contextualized stress) using culturally-tailored stress management, exercise, and nutrition educational approaches to reduce biobehavioral CM risk among AAW. Quantitative and qualitative results will inform the development of scalable and sustainable CM risk-reduction programming for AAW.
BACKGROUND: The Multiple PIs registered the clinical trial (Identifier: NCT04705779) and reporting of summary results in ClinicalTrials.gov in accordance with the NIH Policy on the Dissemination of NIH-Funded Clinical Trial Information, within the required timelines.

BACKGROUND: Black young adult women (ages 18-35) are at disproportionate risk for obesity and emotional eating. Emotional eating interventions target psychological flexibility, such as reducing experiential avoidance and increasing acceptance of food-related thoughts. Yet Black women face gendered racism, and some endorse roles that reduce psychological flexibility, such as the superwoman schema role. Culturally centered stress and coping has often been overlooked, leading to an incomplete understanding of processes that engender emotional eating and the implications for appropriate and effective interventions for Black young adult women.
OBJECTIVE: We investigated direct and indirect pathways of associations between stress from gendered racial microaggressions to emotional eating through the endorsement of superwoman schema and two aspects of psychological flexibility.
METHODS: Black young adult women (N = 504; Mage = 24.72; 75.2% African American; 98.4% cisgender) participated in an online survey wherein they reported demographics, stress from gendered racial microaggressions, superwoman schema, experiential avoidance, acceptance of food-related thoughts, and emotional eating. Path analysis was conducted to examine direct and indirect effects.
RESULTS: Results provided evidence for indirect associations between more stress from gendered racial microaggressions and more emotional eating. More stress was associated with greater endorsement of the superwoman schema which was associated with more experiential avoidance and less acceptance of food-related thoughts, which were each associated with more emotional eating.
CONCLUSIONS: Endorsement of superwoman schema and concomitant avoidance and less acceptance may be one way that gendered racial stress propels emotional eating. Future research could test intervention components that disrupt this path.
Emotional eating is eating in order to alleviate negative emotions, like those from stress. Black young adult women face particular forms of stress from being mistreated at the intersection of their race and gender. This research was needed to better understand processes that engender emotional eating for Black young adult women so that appropriate and effective interventions can be developed for this group. In this correlational study, Black young adult women (ages 18–35) completed an online survey wherein they answered questions about their experiences, thoughts, and behaviors. The study results indicated that stress from mistreatment due to being a Black woman was associated with endorsing a need to be strong. This need to be strong was associated with avoiding experiences that may lead to negative emotional states and being less accepting of distressing thoughts about food. More avoidance and less acceptance were each associated with more emotional eating. Therefore, if emotional eating or obesity-related interventions already target acceptance and avoidance, but do not reference or contextualize them for Black young adult women—particularly in terms of stress from mistreatment as a Black woman and the need to be strong—such interventions may be less effective.

OBJECTIVE: Similar to women overall, Black women are socialized to be communal and \"self-sacrificing,\" but unlike women from other racial/ethnic backgrounds, Black women are also socialized to be \"strong\" and \"invulnerable.\" This phenomenon is labeled Superwoman schema. This study examined associations between Superwoman schema endorsement and subjective sleep quality.
METHODS: Participants included 405 Black women (ages 30-46). Superwoman schema was measured using a 35-item scale capturing five dimensions: obligation to present strength, suppress emotions, resistance to vulnerability, motivation to succeed, and obligation to help others. Superwoman schema overall and the five dimensions/subscales were analyzed. The Pittsburgh Sleep Quality Index (PSQI) was used to investigate overall subjective sleep quality (range: 0-19), poor sleep quality (PSQI >5), and specific sleep domains (eg, sleep duration, sleep disturbances). We fit linear and binary logistic regression models, adjusting for health-related and sociodemographic factors.
RESULTS: Superwoman schema dimension obligation to help others was associated with lower overall subjective sleep quality (β: .81, 95%CI=0.29, 1.32) and poor sleep quality (OR: 1.55, 95%CI=1.10, 2.19), as well as bad subjective sleep quality (OR: 1.76, 95%CI=1.18, 2.66), sleep disturbances (β: .73, 95%CI =0.07, 1.41), and daytime sleepiness (OR: 2.01, 95%CI=1.25, 3.26). Suppress emotions (OR: 1.41, 95%CI=1.01, 1.99) was associated with poor subjective sleep quality. Superwoman schema overall was associated with daytime sleepiness (OR: 2.01, 95%CI=1.06, 3.82).
CONCLUSIONS: Superwoman schema endorsement, especially obligation to help others and suppress emotions, may be important psychosocial risk factors for Black women\'s sleep health.

BACKGROUND: The Superwoman Schema (SWS) construct elucidates Black women\'s socialization to be strong, suppress their emotions, resist vulnerability, succeed despite limited resources, and help others at their own expense. Drawing from intersectionality and social psychological research on self-schemas, this study examined the extent to which SWS was associated with Black women\'s self-rated health. We also investigated whether socioeconomic status (SES) moderated the association between SWS, its five dimensions, and self-rated health.
METHODS: Data were from the Mechanisms Underlying Stress and Emotions (MUSE) in African-American Women\'s Health Study, a cohort of African American self-identified women. SWS was assessed using Giscombé\'s 35-item Superwoman Schema Scale. Socioeconomic status was measured by household income and educational attainment. Ordered logistic regression models were used and statistical interactions were run to test for moderation (N = 408).
RESULTS: First, SWS dimension \"obligation to help others\" was associated with worse self-rated health (p < .05). Second, household income, but not education, moderated the association between SWS and self-rated health (p < .05): SWS overall was associated with worse self-rated health among higher income women but better self-rated health among lower income women. Third, income moderated the association between SWS dimension \"obligation to present an image of strength\" and self-rated health (p < .05): presenting strength was associated with better self-rated health for lower income women only. Fourth, moderation results revealed that SWS dimension \"obligation to help others\" was inversely associated with self-rated health particularly among higher income women.
CONCLUSIONS: Findings speak to the complex interplay between SES and SWS dimensions as they relate to Black women\'s perceived health.

Superwoman Schema, a conceptual framework that reflects Black women\'s ability to overcome gendered racism and stress, affects the way Black women choose to cope with health-related issues. The purpose of this study was to investigate how Black women perceive they should cope with sexual pain using the Superwoman Schema as an analytic and interpretative guide. Data were derived from participants who completed an individual interview on sexual pain and pleasure. Deductive thematic analysis was conducted. Results indicated whereas some Black women endorsed all five components of Superwoman Schema as coping strategies for sexual pain, other Black women resisted SWS completely. Additionally, one participant was an outlier and did not endorse or resist SWS. Implications for generational sexual health interventions for Black women are discussed.

The Superwomen Schema (SWS) describes a social framework that encompasses the role that many Black women adopt in response to chronic stress, financial pressures, and an intersection of oppression. Woods-Giscombé (Superwoman Schema: African American Women\'s Views on Stress, Strength, and Health. Qualitative Health Research 20 (5): 668-683, 2010) characterizes SWS using five tenets: obligation to manifest strength, obligation to suppress emotions, resistance to vulnerability or dependency, determination to succeed despite a lack of resources, and an obligation to help others. The goal of this study is to determine the connection between SWS among Black women and substance use as a means of maintaining mental health, garnering resilience, and coping with external pressures. We aimed to highlight systemic and infrastructural racism and prejudice and how they relate, not only to the adoption of SWS, but also how they may contribute to substance use. This study is a secondary analysis of a larger study on HIV prevention Black and Latine women at high risk for HIV. Only Black participants (n = 10) were included in this secondary analysis. The interviews were conducted 3 times across 3 months. Interviews were coded and analyzed using thematic content analysis in NVivo. Themes of undiagnosed mental health symptoms, medical mistrust, institutional distrust, and aversion to help-seeking were recurrent in our data. Our research confirmed and assessed dual repercussions of SWS among Black women both as a defense that granted resilience in the face of seemingly insurmountable odds and as a construct that encouraged substance use as a coping mechanism for compromised mental health. This study contextualized this subset of coping and substance use to address and dismantle systemic contributors.

John Henryism and Superwoman Schema (SWS) are dispositional characteristics adopted to overcome the challenges of chronic psychosocial stress, and have particular salience for African American women. Both show protective and harmful effects on health and share conceptual similarities and distinctions, yet there is no empirical evidence of the potential overlap resulting in uncertainty about the unique roles they may each play concerning the health of African American women.
We examined: 1) whether and to what extent John Henryism and SWS represent similar or distinct constructs relevant to the unique sociohistorical and sociopolitical position of African American women, and 2) whether the two differentially predict health outcomes.
Data are from a purposive and socioeconomically diverse sample of 208 African American women in the San Francisco Bay Area. First, we conducted a progressive series of tests to systematically examine the conceptual and empirical overlap between John Henryism and SWS: correlation analysis, exploratory factor analysis (EFA), principal component analysis and k-modes cluster analysis. Next, we used multivariable regression to examine associations with psychological distress and hypertension.
John Henryism and SWS were moderately correlated with one another (rs = 0.30-0.48). In both EFA and cluster analyses, John Henryism items were distinct from SWS subscale items. For SWS, feeling an obligation to present an image of strength and an obligation to help others predicted higher odds of hypertension (p < 0.05); having an intense motivation to succeed predicted lower odds (p = 0.048). John Henryism did not predict hypertension. Feeling an obligation to help others and an obligation to suppress emotions predicted lower levels of psychological distress (p < 0.05) whereas John Henryism predicted higher distress (p = 0.002).
We discuss the implications of these findings for the measurement of culturally specific phenomena and their role in contributing to the unequal burden of ill health among African American women.