Reflections on a proposed theory of reservation-dwelling American Indian alcohol use: Comment on Spillane and Smith (2007).

In their recent article, N. Spillane and G. Smith (see record 2007-06095-002) suggested that reservation-dwelling American Indians have higher rates of problem drinking than do either non–American Indians or those American Indians living in nonreservation settings. These authors further argued that problematic alcohol use patterns in reservation communities are due to the lack of contingencies between drinking and “standard life reinforcers” (SLRs), such as employment, housing, education, and health care. This comment presents evidence that these arguments were based on a partial review of the literature. Weaknesses in the application of SLR constructs to American Indian reservation communities are identified as is the need for culturally contextualized empirical evidence supporting this theory and its application. Cautionary notes are offered about the development of literature reviews, theoretical frameworks, and policy recommendations for American Indian communities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the pursuit of sound science for the betterment of the American Indian community: Reply to Beals et al. (2009).

The authors of this reply argue that ongoing criticism of existing theories, the development of alternative theories, and empirical theory tests offer the best chance for advancing American Indian research. The authors therefore note their appreciation for the comments of J. Beals et al. (see record 2009-02580-012). The authors nevertheless disagree with many of the specific claims of Beals et al., noting that in their original article (see record 2007-06095-002), (a) the characterization of the existing literature on reservation-dwelling American Indian drinking was accurate; (b) no argument made by Beals et al. undermines their theoretical contention that there is a relative lack of contingency between access to basic life reinforcers and sobriety on many reservations; (c) the theory was developed in a responsible manner, specifically by a reservation-tied American Indian, and was reviewed by a reservation leadership team, a cultural consultant, and reviewers for this journal, at least one of whom consulted leaders of other reservations; and (d) the theory was based on previous interdisciplinary theory development. The authors encourage the development and testing of new, alternative theories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse effects of diabetes on multiple cardiovascular disease risk factors in women. The Strong Heart Study

OBJECTIVE: Many studies have shown that diabetes increases the risk of cardiovascular disease (CVD) in women to a greater extent than in men. One explanation could be that diabetes has more adverse effects on CVD risk factors in women than in men. We compared diabetes-associated differences in CVD risk factors in men and women in the Strong Heart Study, a population-based study of CVD and its risk factors in American Indians. RESEARCH DESIGN AND METHODS: A total of 1,846 men and 2,703 women between the ages of 45 and 74 years from 13 American Indian communities in three geographic areas underwent an examination that included a medical history; an electrocardiogram; anthropometric and blood pressure measurements; an oral glucose tolerance test; and measurements of fasting plasma lipoproteins, fibrinogen, insulin, HbA1c, and urinary albumin. RESULTS: Statistically significantly greater adverse differences in those with diabetes versus those without diabetes were observed in women than in men for waist-to-hip ratio, HDL cholesterol, apolipoprotein (apo)B, apoA1, fibrinogen, and LDL size. In multiple linear regression models adjusting for age, center, sex, and diabetes, the diabetes by sex interaction terms were statistically significant for waist-to-hip ratio, LDL cholesterol, HDL cholesterol, apoB, apoA1, fibrinogen, and LDL size. CONCLUSIONS: Compared with diabetes-associated differences in men, diabetes in women was related to greater adverse differences in levels of several CVD risk factors. Although the magnitude of the individual diabetes-related differences between men and women was not large, the combined effects of these risk factor differences in diabetic women may be substantial. The apparent greater negative impact of diabetes on CVD risk factors in women may explain, in part, the greater risk for CVD in diabetic women.     

Cultural considerations when providing rehabilitation services to American Indians.

American Indians make up a small percentage of the U.S. population but reside in all states and territories and in all major cities. It is critical for rehabilitation psychologists to have an understanding of the unique cultural and ethnic issues associated with service provision to American Indian clientele. Considerations to be taken into account when providing culturally competent care to American Indians include general knowledge about sociopolitical history and current demographics, acculturation and racial identity, important health issues, and beliefs about health and illness. This article provides a brief introduction to facilitate more effective and culturally appropriate rehabilitation and health care to patients of American Indian heritage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Paying a price: Culture, trust, and negotiation consequences.

Three studies contrasting Indian and American negotiators tested hypotheses derived from theory proposing why there are cultural differences in trust and how cultural differences in trust influence negotiation strategy. Study 1 (a survey) documented that Indian negotiators trust their counterparts less than American negotiators. Study 2 (a negotiation simulation) linked American and Indian negotiators' self-reported trust and strategy to their insight and joint gains. Study 3 replicated and extended Study 2 using independently coded negotiation strategy data, allowing for stronger causal inference. Overall, the strategy associated with Indian negotiators' reluctance to extend interpersonal (as opposed to institutional) trust produced relatively poor outcomes. Our data support an expanded theoretical model of negotiation, linking culture to trust, strategies, and outcomes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Use of the MMPI-2 in American Indians: I. Comparability of the MMPI-2 Between Two Tribes and With the MMPI-2 Normative Group.

The comparability of the MMPI-2 in American Indians with the MMPI-2 normative group was investigated in a sample of 535 Southwestern and 297 Plains American Indian tribal members with contrasting sociocultural and historical origins. Both American Indian tribal groups had clinically significant higher T scores (>5 T points) on 5 validity and clinical scales, 6 content scales, and 2 supplementary scales than did the MMPI-2 normative group. There were no significant differences between the 2 tribal groups on any of the MMPI-2 clinical, content, or supplementary scales. Matching members of both tribes with persons in the MMPI-2 normative group on the basis of age, gender, and education reduced the magnitude of the differences between the 2 groups on all of these scales, although the differences in T scores still exceeded 5 T points. It appears likely that the MMPI-2 differences of these 2 American Indian groups from the normative group may reflect their adverse historical, social, and economic conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety and eating behavior in obese and nonobese American Indians and White Americans.

Compared 80 lower-SES obese and nonobese American Indians and 80 lower-SES obese and nonobese White Americans from multinational backgrounds on a test of emotional arousal theory (EAT), which proposes that obese people overeat when emotionally aroused while nonobese people do not. Ss were administered the trait anxiety form of the State-Trait Anxiety Inventory (STAI) and then assigned to a high-anxiety (HA) or low-anxiety condition. They were then administered the state form of the STAI and given a taste task to determine whether EAT is predictive of eating behaviors for both ethnic groups. Results indicate that women were more trait and state anxious than were men; HA women, all HA Ss, HA American Indians, and nonobese American Indians were more state anxious than were corresponding groups. Behavioral indicator results generally supported EAT: All obese and high-anxiety-condition obese Ss consumed more food than did nonobese and low-anxiety-condition obese Ss, respectively. The overall consumption of food was greater with American Indians than with White Americans, indicating that EAT does not fully explain American Indian eating behavior. An alternative stress-reaction theory is proposed to more fully account for American Indian eating behavior. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prostate cancer in American Indians, New Mexico, 1969 to 1994

PURPOSE: Prostate cancer is the most frequently diagnosed cancer as well as the leading cause of cancer death among American Indian men. MATERIALS AND METHODS: To describe further the occurrence of prostate cancer among American Indian men, we examined population based incidence, treatment, survival and mortality data for American Indians in New Mexico during the 25-year period 1969 to 1994. RESULTS: Although American Indian men have a lower risk of prostate cancer than nonHispanic white men, the incidence and mortality rates are rising for American Indians, and mortality rates are now equal to those for nonHispanic white men. During the 25-year period age adjusted incidence rates for American Indians increased from 42.2/100,000 (95% confidence interval 27.1 to 57.3) to 64.6/100,000 (95% confidence interval 46.2 to 83.0). The burden of prostate cancer among American Indian men compared with nonHispanic white men was reflected in disproportionately high mortality rates in relation to incidence rates. The mortality rates were high because American Indian cases were more advanced at diagnosis, 23.3% of prostate cancers were diagnosed after distant spread had occurred compared with 11.6% for nonHispanic white men and the 5-year relative survival rate was poorer (57.1% compared with 77.6% for nonHispanic white men). CONCLUSIONS: Effective and culturally sensitive cancer control efforts for prostate cancer in American Indian communities are urgently needed.     

Microcirculation in the labyrinth

Erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) activity and electrophoresis were investigated among 154 Indians living in a region hyperendemic for malaria at Alto Xingu, Mato Grosso, Brazil. No enzyme-deficient individual was found, and all subjects belonged to enzyme type B. No statistical difference in G-6-PD levels was found between tribes and sexes. The average of G-6-PD activity of the Indians was significantly higher than the normal mean values found by the same technique in Caucasians, Negroes and Japanese of S?o Paulo, Brazil. The high rates of G-6-PD activity of the Indians are not correlated to an increased reticulocytosis by hypochromic anaemia and appear to be typical of Indian or Indian-mixed populations. Resistance to malaria in those populations should not involve erythrocyte G-6-PD deficiency. It is suggested that the apparent association between G-6-PD deficiency and resistance to malaria found in other populations could be a statistical accident determined by the racial correlation between the incidence of G-6-PD deficiency and sickle-cell or thalassaemic haemoglobins among Negro and Mediterranean populations.     

Computed tomography-determined body composition in relation to cardiovascular risk factors in Indian and matched Swedish males

Relationships between cardiovascular risk factors, body composition, and tissue distributions were examined in 10 Indian and 10 Swedish males matched by age, height, and weight. The body was divided into 29 compartments by means of a multiscan computed tomography (CT) technique. Fasting glucose, insulin, and triglycerides (TG) were higher in Indians than in Swedes. During the oral glucose tolerance test (OGTT), the glucose area was similar in both groups, whereas the insulin area was 80% larger in Indians. Adipose tissue (AT) and skin volumes were larger and remaining lean tissues were smaller in Indians. Indians had proportionally less muscle and more skeleton in the legs, but no ethnic difference could be demonstrated with respect to AT distribution. The visceral AT to total AT volume ratio was positively related to insulin and TG, and with higher risk factors for Indians at any given ratio. TG and glucose were negatively related to the leg muscle to total muscle volume ratio, and this ratio was smaller in Indians. It is concluded that the metabolic disturbances of Indians are not necessarily dependent on a preponderance of visceral AT, and also that an upper-body muscle distribution-recognized as a new phenotypic companion to the metabolic syndrome-is statistically related to cardiovascular risk factors.     

The prevalence of risk factors among women in the United States by race and age, 1992-1994: opportunities for primary and secondary prevention

OBJECTIVE: To analyze the prevalence of 11 modifiable behavioral risk factors, including multiple risk factors, among white, black, Asian and Pacific Islander, American Indian, and Hispanic women in the United States. DESIGN: We used Behavioral Risk Factor Surveillance System (BRFSS) data for 1992 to 1994 to examine risk factors (smoking; obesity; diabetes; heavy alcohol consumption; sedentary lifestyle; and inadequate use of seat belts, pap smears, consumption of fruits or vegetables, mammography and colorectal screening, and immunization), among women age 18 to 49, 50 to 64, and 65 and older. We also conducted a multiple regression analysis, comparing the odds of having either 1-2 versus 0 or 3 or more versus 0 risk factors among racial/ethnic groups, controlling for education and family income, to see if racial/ethnic differences can be attributed to socioeconomic differences. RESULTS: US women engage in a variety of behaviors that place them at risk for many causes of morbidity and mortality. Risk profiles vary substantially among racial/ethnic populations: Pacific Islanders have relatively low prevalences of most major risk factors, while blacks and American Indians have relatively high prevalences of many major risk factors. Prevalence differences among racial/ethnic populations are diminished but not eliminated when socioeconomic factors are accounted for. CONCLUSIONS: Appropriately designed programs to help women reduce their behavioral risk factors are needed. Action by health care providers, communities, and policy makers can substantially improve the health of women in the United States.     

Hazardous alcohol use among active duty Air Force personnel: Identifying unique risk and promotive factors.

Hazardous drinking is a significant public health concern and an important target for prevention efforts within both military and civilian populations. For such efforts to be maximally effective, comprehensive information regarding factors that increase or decrease risk for hazardous drinking is necessary. This is the first study to investigate risk and promotive factors across individual, family, community, and organizational levels in a representative sample of Air Force personnel (N = 52,780). Unique predictors of men's and women's hazardous drinking were identified both within and across ecological levels. Predictors that accounted for the most variance in predicting hazardous versus non-hazardous drinkers included family income, number of children, depressive symptoms, religious involvement, and perceived financial stress for men and women; and years in the military for men. Among hazardous drinkers, a different set of predictors best explained variance in severity of drinking problems. Results of the current study help identify key targets for prevention efforts operating at different levels (e.g., individual therapy, community-wide programs). (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Lipoprotein(a) is an independent risk factor for coronary artery disease in NIDDM patients in South India

OBJECTIVE: Asian Indians have been reported to have very high prevalence rates of coronary artery disease (CAD) in the absence of traditional risk factors. Recently, elevated levels of lipoprotein(a) [Lp(a)] have been reported to be associated with premature CAD in migrant Asian Indians. However, there are very little data regarding Lp(a) in CAD patients from the Indian subcontinent and virtually none in individuals with NIDDM. The objective of this study was to assess the role of Lp(a) as a marker for CAD in South Indian NIDDM patients. RESEARCH DESIGN AND METHODS: We estimated serum Lp(a) in 100 control subjects, 100 NIDDM patients without CAD, and 100 NIDDM patients with CAD. Lp(a) values were transformed into natural logarithms. Statistical analysis included Student's t test, one-way analysis of variance, and chi2 test. Multiple logistic regression analysis was used to identify associations with CAD. RESULTS: Lp(a) levels were significantly higher in NIDDM patients with CAD compared with NIDDM patients without CAD and control subjects (geometric mean 24.6, 15.1, and 19.4 mg/dl, respectively, P < 0.05). Results of logistic regression analysis showed that Lp(a), age, and HDL were associated with CAD. In NIDDM patients with CAD, there was no correlation between Lp(a) and serum cholesterol, triglyceride, or HDL cholesterol levels, but there was a weak association with LDL cholesterol and systolic blood pressure. CONCLUSIONS: The data suggests that serum Lp(a) is an independent risk factor for CAD in NIDDM patients in South India.     

MR findings of hypoxic damage of the bilateral striate cortices: a case report

The frequency of accessory mental foramina (AMF) was studied in four population groups: 20th century Asian Indians, African Americans and American Whites, and Pre-Columbian Nazca Indians. AMF were found less frequently in the American White and Asian Indian populations than in the other groups (American White, 1.4%; Asian Indian, 1.5%; African American, 5.7% and Nazca, 9.0%). The incidence of AMFs did not differ significantly between right- and left-hand sides. In certain ethnic groups, i.e., African American, AMF may occur more often in males. Additional studies with larger samples are needed to show whether AMFs are more common in males.     

Toward a (Dys)functional anthropology of drinking: ambivalence and the American Indian experience with alcohol

This article explores the complex and contradictory experiences of urban American Indian drinkers. While previous anthropological accounts have emphasized the functions served by American Indian drinking, the testimony of drinkers also documents their awareness of the destructive effects of heavy drinking, particularly the way in which it often interferes with their ability to meet social obligations. Nevertheless, people often continue to use alcohol, and this means that many are profoundly ambivalent about their drinking; they see it simultaneously as something that is embedded in certain important relationships, but also something that is destructive of much that they value. Drawing on interviews with 35 self-defined problem drinkers, this article details the ambiguous nature of the American Indian experience with alcohol, highlighting the need for a clinically sophisticated anthropology of alcohol.     

Increased platelet activation and fibrinogen in Asian Indians. Potential implications for coronary risk

AIMS: To determine whether Asian Indians (Indians), a group known to have high rates of coronary heart disease, have increased platelet activation and fibrinogen levels relative to white Americans of European origin (whites). METHODS AND RESULTS: Forty healthy, non-smoking Indians, aged 25-45, were matched with 40 healthy whites for age (within 3 years) and gender. Platelet activation was tested in blood exiting a bleeding time wound at 1 and 2 min post-incision (wound-induced activation), as well as in venous blood stimulated in vitro with collagen, using whole blood flow cytometry. Other risk factors, including fibrinogen levels, family history of diabetes or coronary heart disease, fasting insulin and lipid levels, and Lp(a) were also assessed. Fibrinogen levels were higher among Indians than whites, even after adjustment for gender or family history of coronary heart disease (P < 0.05). Indians had higher levels of wound-induced glycoprotein IIb/IIIa binding and platelet secretion (P-selectin expression) than whites, with the greatest differences found when comparing the upper quintile of activation for each group (Ps < 0.05). Indians with a family history of coronary heart disease (n = 15) had higher levels of platelet secretion (wound-induced and in vitro) than Indians without a family history (Ps < 0.05), while the relationship was reversed among whites. Platelet activation measures were not consistently related to other coronary risk factors, while fibrinogen was related to triglyceride and insulin levels among Indians. CONCLUSION: Indians have elevated fibrinogen and platelet activation levels relative to whites. These factors may contribute to the increased coronary risk observed in Indians.     

Prevalence and risk factors for diabetic retinopathy in the multiethnic population of Mauritius

This study examines the prevalence of, and risk factors for, diabetic retinopathy in Asian Indian, Chinese, and Creole Mauritians in whom there is an increasing prevalence of non-insulin-dependent diabetes mellitus (NIDDM). As part of a population-based survey on the Indian Ocean island of Mauritius in 1992, glucose tolerance was classified using a 75-g oral glucose tolerance test on 6,553 persons. Subjects with newly diagnosed (n = 358) or known diabetes (n = 388), and a random sample of one in four subjects with impaired glucose tolerance (n = 165), had stereoscopic 45 degrees retinal photographs taken of three fields in the right eye after mydriasis. Photographs were graded according to a modified version of the Airlie House criteria. The prevalence of nonproliferative and proliferative retinopathy was: 14.5% and 0.3%, respectively, in newly diagnosed diabetic subjects; 42.0% and 2.3%, respectively, in known diabetic subjects; and 9.1% and 0%, respectively, in persons with impaired glucose tolerance. Muslim Indians had the lowest prevalence of retinopathy (10.8% and 34.0% for new and known diabetes, respectively), but after adjusting for other factors, this was significantly different only to Creoles (18.8% and 53.8%, respectively). Univariate analysis revealed significant differences between diabetic subjects with and without retinopathy in mean age, body mass index, fasting and 2-hour plasma glucose levels, systolic and diastolic blood pressure, fasting triglycerides, serum creatinine, and urinary albumin levels. For known diabetes, mean duration of diabetes and the proportion using insulin were also greater in those with retinopathy. Multivariate analysis using logistic regression confirmed that increasing duration of diabetes, fasting plasma glucose, systolic blood pressure, and urinary albumin concentration, and decreasing body mass index, were independently associated with retinopathy. The high prevalence of diabetic retinopathy observed in all major ethnic groups in Mauritius portends a serious public health problem, given the relative recency of the NIDDM epidemic in that country and the limited resources for laser photocoagulation. Strategies to minimize this problem among those already known to have diabetes should include strict control of plasma glucose and blood pressure.     

The underreporting of deaths of American Indian children in California, 1979 through 1993

OBJECTIVES: This study linked birth and death certificates to determine misclassification of deaths of American Indian children in California. METHODS: Birth records for 1979 to 1993 were matched with mortality records through a computerized system. RESULTS: The number of deaths to American Indians was estimated to be three to four times greater than that reported on death certificates. Children in urban counties and those who died before 1987 were more likely to be misclassified. CONCLUSIONS: California death certificates identify less than one third of the deaths among American Indian children. Adjusting for racial misclassification provides a more accurate accounting of child mortality among American Indians.     

Culture, context, and the development of moral accountability judgments.

Examined the impact of contextual factors on Indian and American adults' and children's (N?=?180) tendencies to hold agents morally accountable for justice breaches. Results revealed that Indians more frequently absolved agents of moral accountability for breaches performed under emotional duress or by young children than did Americans. Breaches were less frequently categorized in moral terms when moral reasoning and accountability judgments were assessed simultaneously than when only moral reasoning was assessed. Discussion considered (1) the impact of nonmoral beliefs on cultural and age differences in everyday moral judgment; (2) the use of personal-choice reasoning in weighting of extenuating circumstances; and (3) the methodological importance of focusing simultaneously on responsibility appraisals and social domain categorizations in understanding contextual influences on moral reasoning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)