Silvia M. Bigatti
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Improving the mental health of Latino youth
Professor Silvia Bigatti is concerned about the high rate of depression among Latino adolescents in Indianapolis who endure the stress of straddling two cultures. In 2012, she started a partnership with the Latino Health Organization and received funding from the Indiana Minority Health Coalition to pursue a pilot research project that investigated the stress and depressive outcomes in this population. The study revealed that nearly 60 percent of participants had some form of depressive symptoms—and that they were seven times more likely to have depression if they suffered from moderate levels of acculturative stress. Based on the ¬findings, the research team developed a program, “Your Life. Your Story.” The YLYS program begins with a one-week summer day camp that builds resilience and develops self-identities and future goals. In the second phase of the YLYS program, a monthly meeting cements components from the camp. Data suggest that one week of the YLYS camp has a statistically significant impact on participants, who showed an increase in resilience and a decrease in depressive symptoms. These differences were maintained at a six-month follow-up. YLYS has the potential to create a large and lasting impact on the Indianapolis community. While the program has been focused on Latino youth, it can be applied and tailored to any group of youth. Professor Bigatti’s work to improve the mental health of Latino youth in Indianapolis is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.
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Item Characterizing Burden, Role Strains and Psychological Distress of Husbands of Breast Cancer Patients During Treatment and Beyond(Wolters Kluwer, 2011) Wagner, Christina D.; Das, Lala Tanmoy; Bigatti, Silvia M.; Storniolo, Anna MariaBackground: Husbands, as the primary providers of support for women with breast cancer, can experience significant burden and role strain, but also perceive positive aspects to the caregiving. Little is known about the specific caregiving tasks husbands perform, for how long, or how burden and positive aspects relate to later psychological distress. Objective: Our primary aim was to better characterize the caregiving responsibilities and role strains of husbands during active cancer treatment and 1 year later. We also evaluated positive aspects during active treatment. Our second aim was to determine which of these predicted psychological distress 1 year later. Methods: Husbands of women undergoing chemotherapy for breast cancer completed a battery of surveys during the time of wives' treatment and again 1 year later. Results: Husbands performed a variety of caregiving tasks for wives during and after breast cancer treatment and also reported benefits associated with caregiving. Breast cancer-related worries were high at both time points. At 1 year after treatment, role strains improved in the social domain but worsened in the domestic domain. Domestic strains during active treatment were the strongest predictor of 1-year distress. Conclusions: Husbands who report persistent domestic role strain are at high risk for continued psychological distress following their wives' breast cancer treatment. Implications for practice: Health care providers should monitor husbands' caregiver burden regularly. Providing couples with resources to reduce domestic role strain (such as social support and communication training) may prevent or alleviate psychological distress in these husbands.Item Trajectory of Change in Pain, Depression, and Physical Functioning after Physical Activity Adoption in Fibromyalgia(Sage, 2015) Steiner, Jennifer L.; Bigatti, Silvia M.; Ang, DennisFibromyalgia (FM) is associated with widespread pain, depression, and declines in physical functioning. The study purpose was to examine the trajectory of these symptoms over time related to physical activity adoption and maintenance via Motivational Interviewing versus Education, to increase physical activity. There were no treatment group differences, we divided the sample (n = 184) based on changes in physical activity. Repeated measures analyses demonstrated differential patterns in depression, pain, and physical functioning at 24 and 36 weeks. Findings suggest increased physical activity may serve as a multiple-target intervention that provides moderate to large, long-lasting benefits for individuals with FM.Item Depression in Husbands of Breast Cancer Patients: Relationships to Coping and Social Support(Springer, 2011) Bigatti, Silvia M.; Wagner, Christina D.; Lydon, Jennifer R.; Steiner, Jennifer L.; Miller, Kathy D.PURPOSE: The purpose of the present study was to examine depression in husbands of women with breast cancer, as depression is typically as high in husbands as in patients, and impacts functioning in both. METHODS: We compared husbands of patients to husbands of women without chronic illness on depressive symptoms with the Center for Epidemiological Studies Depression Scale, social support with the Interpersonal Support Evaluation List, and coping with the Ways of Coping Questionnaire. Using the stress and coping model, we examined whether coping mediated social support and depression differently by group, as has been found in the literature. RESULTS: Husbands of patients reported higher scores on the measure of depression and lower use of problem-focused coping, while groups reported equivalent social support. Escape-avoidance coping emerged as a full mediator between social support and depression in husbands of patients, but only a partial mediator in comparison husbands. Accepting responsibility coping partially mediated social support and depression in both groups. Low social support appears particularly detrimental in husbands of patients as it is associated with ineffective coping and depression. CONCLUSIONS: Findings suggest that among husbands of patients, social support relates to depression only through its relationship with coping, indicating healthcare providers should direct attention and intervention to the coping strategies employed by husbands with low social support.Item Rates of Depression and Anxiety in Cancer Patients: A Review of Cross-National Findings(Pabst Publishers, 2012) Bigatti, Silvia M.; Steiner, Jennifer L.; Cronan, Terry A.Cancer is the leading cause of death worldwide. In this paper, we examine the similarities and differences between the United States (US) and the European Union (EU-27) in the incidences, deaths, types of screening, and screening rates for breast, cervical, colorectal, prostate, and lung cancers. We highlight the differences between the health care, economic, and sociopolitical systems in the US and EU-27 that result in different types of coverage, access to health care, and cancer screening. Finally, we discuss patient-directed, provider-directed, community-directed, and system-directed interventions and the outcomes of these approaches.Item Cancer Screening in the United States and Europe(2012) Cronan, Terry A.; Santoro, Maya; Van Liew, Charles; Bigatti, Silvia M.Item Matched and Mismatched Cognitive Appraisals in Patients with Breast Cancer and their Partners: Implications for Psychological Distress(Wiley, 2011) Bigatti, Silvia M.; Steiner, Jennifer L.; Makinabakan, Nermin; Hernandez, Ann Marie; Johnston, Erica; Storniolo, Anna MariaThe present study sought to identify couples’ cognitive appraisals of breast cancer and the extent to which matched or mismatched appraisals within a couple contribute to distress. Women with breast cancer (n = 57) and their partners completed the Cognitive Appraisals of Health Scale along with two self-report measures of distress, the Profile of Mood States and the Impact of Events Scale. Four groups were created based on their cognitive appraisals. Couples where both patient and partner scored highest on challenge or benign appraisals formed the positive outlook group (P+S+); when both scored highest on threat or harm/loss they formed the negative outlook group (P-S-). In the mismatched groups the patient had a positive outlook and their partner had a negative outlook (P+S-), or vice versa (P-S+). In general, lower distress was related to participants’ own positive outlook. Higher distress for patients was found in the matched group P-S-; for partners it was found in the mismatched group P+S-. These findings suggest partner effects for both patients and partners. When the patient had a negative outlook, a partner negative outlook was associated with the highest psychological distress. When the partner had a negative outlook, a patient positive outlook was associated with the highest psychological distress. There are several possible explanations for these findings, each with different implications for clinical practice. Future research with different groups of cancer patients and longitudinal, mixed methods designs may clarify their meaning.Item Racial differences in cumulative disadvantage among women and its relation to health: Development and preliminary validation of the CSI-WE(Mary Ann Liebert, 2022) Latham-Mintus, K.; Weathers, T. D.; Bigatti, Silvia M.; Irby-Shasanmi, A; Herbert, B. S.; Takana, H. Robison; Storniolo, A. M.Background: Cumulative disadvantage (CD) is a measure of accumulated social, economic, and person-related stressors due to unequal access to resources and opportunities, which increases a person's biological risk for disease. The purpose of this research was to develop an instrument tailored to women's experiences that had intervention and translational potential. In addition, we explored whether CD contributed to racial health disparities among black and white women. Methods: In-depth life course interviews were used to assess stressful experiences of 15 black and 15 white women. Using information from the interviews, we developed the Cumulative Stress Inventory of Women's Experiences (CSI-WE) as a quantitative instrument to measure stressful life experiences from childhood to adulthood. The CSI-WE was then administered to the original 30 women for validation and feedback. Results: Qualitative and quantitative assessments were highly correlated, which suggested that the CSI-WE reliably captured the experiences of the interviewed women. Black participants reported significantly higher numbers of childhood and adult stressors, more acute adulthood and lifetime stressors, and worse adult physical self-rated health. Conclusions: This study supports the preliminary validity of an instrument that once fully validated may be used in future studies to elucidate the experiences of CD among black and white women and examines how these experiences relate to perceived and objective health status.Item Perfectionism, impostor phenomenon, and mental health in medicine: a literature review(IJME, 2020-09-28) Thomas, Mary; Bigatti, Silvia; Social and Behavioral Sciences, School of Public HealthObjectives: The aims of this review, focused on medical students, residents, and physicians, were a) to determine the levels of perfectionism and prevalence of impostor phenomenon, b) to assess the relationship between perfectionism, impostor phenomenon, and mental health, and c) explore how medical culture may influence these personality characteristics. Methods: A narrative literature review was conducted. Search terms were entered into PubMed, PsychINFO, Web of Science, EMBASE, and Google Scholar without date or geographic restrictions. The McMaster Critical Review Forms for Quantitative and Qualitative Studies were used for article appraisal. Final decisions on inclusion and exclusion were reached through discussion. Sixteen articles were included in this review and summarized in a data extraction table. Results: Medical students had similar perfectionism scores to other student groups but scored lower in maladaptive perfectionism. The overall prevalence of the impostor phenomenon ranged from 22.5% to 46.6%. More females (41% - 52%) experienced clinical levels of impostor phenomenon compared to males (23.7% - 48%). Most studies did not find an association between the impostor phenomenon and academic year of training. Both personality characteristics were associated with negative mental health effects. Medical culture can train for and/or exacerbate these characteristics, affecting professional identity formation. Both characteristics contribute to distress for learners during commonly-used teaching methods in medical education. Conclusions: Comprehensive changes in medical education that consider the relationship between medical culture, professional identity formation, impostor phenomenon, and perfectionism are needed. Longitudinal studies will help identify the implications of these findings for professional identity formation and medical education.Item Cultural Stressors Described by Latina Young Women Living in a Tumultuous Sociopolitical Climate(2018) Stafford, Allison McCord; Bigatti, Silvia M.; Draucker, ClaireTo describe the types of cultural stressors that Latina young women living in the US experienced from 2016- 2018 with respect to generational status.Item Exploring Cumulative Disadvantage, Telomere Length, and Breast Cancer Among Black and White Women(Innovation in Aging, 2017) Latham-Mintus, K.; Weathers, T.; Irby-Shasanmi, A.; Bigatti, Silvia M.; Storniolo, A.; Robison, L.; Telomere Laboratory, I.Objectives: Cumulative disadvantage (CD) is a concept that recognizes the influence of social determinants on health over the lifecourse—emphasizing accumulated stressors as contributors to physiological damage. The shortening of telomeres has been found to have a direct relationship with increased cancer incidence and overall health. The purpose of this research is to develop a triangulated and biologically validated CD instrument to explore breast cancer disparities among Black and White women. Methods: We recruited a purposeful sample of 15 White and 15 Black pre-menopausal women (ages 25–50 years) who had donated normal tissue to the Susan G. Komen Tissue Bank. Semi-structured qualitative interviews, designed to investigate participants’ exposure to lifetime stressors, were conducted. Drawing from the qualitative interviews and previous research, a quantitative survey instrument was developed to capture the range of stressors experienced by our sample of women. All respondents completed the quantitative survey and their telomere length was assessed using DNA extracted from peripheral blood leukocytes. Results: Qualitative and quantitative assessments of CD were consistent across childhood, adult, and lifetime stressors. Black respondents reported more childhood stressors (t=-2.28, p=0.03), adult stressors (t=-1.87, p=0.07), and lifetime stressors (t=-2.17, p=0.04); however, there were no significant differences in subjective assessments of the perceived impact of stress on health. There was some evidence of shortened telomere length among Black respondents with more CD. Discussion: Preliminary analyses provide evidence of triangulation. Future research will further explore associations between CD and telomere length among a larger sample (N=100) of Black and White American women.