A theory of reservation-dwelling American Indian alcohol use risk.

The authors present a theory for understanding risk for problem drinking among reservation-dwelling American Indians. The theory offers an overall framework for understanding the risk process for this group. It considers the distinction between factors that influence mean levels of American Indian problem drinking and factors that influence individual differences in American Indian drinking. It proposes important contextual differences between reservation-dwelling American Indians and Caucasians that may help explain the higher mean levels of American Indian problem drinking. The theory further holds that, within the high mean level of problem drinking characteristic of many American Indian reservations, individual differences in problem drinking can be explained by very similar personality and learning factors as those that influence problem-drinking levels for other ethnic groups. (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)     

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.     

Research in American Indian and Alaska Native communities: navigating the cultural universe of values and process

The National Institutes of Health's guidelines for recruiting ethnic minorities and women into clinical research have raised numerous questions among investigators. Highlighted in this article are a number of important issues for those researchers seeking to include American Indians and Alaska Natives in their studies; that is, defining the population of American Indians and Alaska Natives for inclusion in a study, participation of the tribes in research and approval by the Institutional Review Board, issues of confidentiality and anonymity of individuals and tribes, identifying potential benefits to American Indian and Alaska Native communities, and the importance of evaluating the scientific merit of a proposed study. Awareness and a commitment to ongoing education regarding these issues will enhance the quality and benefits of research among American Indian and Alaska Native people.     

Morbidity and comorbidity among Great Lakes American Indians: predictors of functional ability

This article explores patterns of morbidity and comorbidity and their ability to predict functional disability among American Indian elders, using data from a sample of urban, rural off-reservation, and reservation Great Lakes American Indians age 55 and older. Higher rates are reported of a number of chronic illnesses than found in overall samples of U.S. elders. Results of multiple regression analyses predicting Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs) show age to be a consistent predictor of functional disabilities: The CMI (Index of Comorbidity) was found to be a more useful predictor of functional disability than was the simple summation of the number of chronic illnesses.     

Androstenedione conversion in human peripheral blood lymphocytes

Indigenous Indian groups comprise approximately 20% of Ecuador's population, the third largest percentage in all of Central or South America, yet immunogenetic data on these groups are lacking in the literature. In the course of population migration studies, sera collected from 65 Ecuadorians living in the northern province of Esmeraldas were typed for six GM and two KM markers. The study population consisted of 47 Cayapa Indians and 18 blacks of African origin, descendants of slaves imported into the area during the seventeenth century. The Cayapa demonstrated three GM phenotypes, two of which are common to other South American Indian tribes. The frequency of KM1 positive Cayapa Indians (63%) is similar to other South American Indian tribes, but is significantly greater than the Huaorani of eastern Ecuador (2%), the only other Ecuadorian Indian group for whom limited immunoglobulin allotype data are available (chi 2 = 35.8, P < 0.0001).     

An Indian-controlled mental health program

The control of health care programs for American Indians is shifting slowly from the federal government to the tribes. In 1971 the Apaches began operating a community mental health center on a reservation in northeastern Arizona. The tribal council appointed a 14-member board to administer the center; a majority of the members were Apaches. The board then hired an executive director who was not an Indian. There were 15 professional and paraprofessional staff members; 12 were Apaches or other Indians. In January 1976 the tribal council fired the director and disbanded the board of directors, although the clinic continued operation. The authors discuss sociocultural factors that influenced the center's development and give several reasons for the center's problems, including the general expectation that agencies run by Indians will not be successful.     

Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group

OBJECTIVE: To assemble standardized estimates of abnormal glucose tolerance in adults in diverse communities worldwide and provide guidelines for the derivation of comparable estimates in future epidemiological studies. RESEARCH DESIGN AND METHODS: The project was limited to population-based investigations that had used current WHO criteria for diagnosis and classification of abnormal glucose tolerance. Raw data were obtained by WHO from surveys conducted during 1976-1991 of over 150,000 persons from 75 communities in 32 countries. Data within the truncated age range of 30-64 yr were adjusted to the standard world population of Segi. Age-specific prevalences also are reported for selected populations. RESULTS: Within the chosen age range, diabetes was absent or rare (< 3%) in some traditional communities in developing countries. In European populations, age-standardized prevalence varied from 3 to 10%. Some Arab, migrant Asian Indian, Chinese, and Hispanic American populations were at higher risk with prevalences of 14-20%. The highest prevalences were found in the Nauruans (41%) and the Pima/Papago Indians (50%). Age-standardized prevalence of IGT was low (< 3%) in some Chinese, traditional American Indian, and Pacific island populations. Moderate (3-10%) or high (11-20%) prevalences of IGT were observed in many populations worldwide. The highest estimates for prevalence of IGT were seen in female Muslim Asian Indians in Tanzania (32%) and in urban male Micronesians in Kiribati (28%). Prevalence of diabetes rose with age in all populations in which age-specific data were examined. This trend was most pronounced in those at moderate to high risk. The ratio of prevalence of diabetes in men versus women varied markedly between populations with little discernable trend, although IGT was generally more common in women. In most communities, at least 20% of diabetes cases were unknown before the survey, and in many communities, > 50% were previously undiagnosed. In both Chinese and Indian migrant populations, relative prevalence was high when compared with indigenous communities. CONCLUSIONS: Diabetes in adults is now a global health problem, and populations of developing countries, minority groups, and disadvantaged communities in industrialized countries now face the greatest risk.     

Applicability of cognitive-behavior therapy with American Indian individuals.

There is little empirical evidence to support the claim that cognitive- behavior therapy (CBT) is an especially suitable treatment for culturally diverse clients. The purpose of this study was to compare the applicability of CBT in a community sample of European American and American Indian individuals. Participants completed the Cognitive Behavior Therapy Applicability Scale (CBT-AS), in which they rated their preference for characteristics consistent with three tenets of CBT. European Americans rated a stronger preference for CBT's focused in-session behavior and structured therapeutic relationship than did American Indians. Both groups rated the active stance domain of CBT as mutually acceptable. On the basis of the findings, several modifications to CBT for therapists working with American Indian clients are proposed for future investigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The American Indian Holocaust: healing historical unresolved grief

American Indians experienced massive losses of lives, land, and culture from European contact and colonization resulting in a long legacy of chronic trauma and unresolved grief across generations. This phenomenon, labeled historical unresolved grief, contributes to the current social pathology of high rates of suicide, homicide, domestic violence, child abuse, alcoholism and other social problems among American Indians. The present paper describes the concept of historical unresolved grief and historical trauma among American Indians, outlining the historical as well as present social and political forces which exacerbate it. The abundant literature on Jewish Holocaust survivors and their children is used to delineate the intergenerational transmission of trauma, grief, and the survivor's child complex. Interventions based on traditional American Indian ceremonies and modern western treatment modalities for grieving and healing of those losses are described.     

Mitochondrial aldehyde dehydrogenase polymorphism in Asian and American Indian populations: detection of new ALDH2 alleles

Genetic deficiency of the mitochondrial aldehyde dehydrogenase (ALDH2) is frequent in Asian peoples where it is an important factor negatively regulating drinking behavior. To obtain additional information on gene geography of known ALDH2 alleles, and look for new variants, ALDH2 genes were evaluated in a Chinese population from Taiwan, a Yakut population of Siberia, and in five North American Indian populations. A novel approach based on a single-strand conformation polymorphism assay, and polymerase chain reaction-directed mutagenesis was developed for genotyping. In the Taiwan Chinese population, the ALDH2(2) allele frequency was 0.319 +/- 0.025, and this allele was not detected in the Yakut population nor in the five North American Indian populations. However, a new allele, ALDH2(3), was detected in Pima Indians at a frequency of 0.044 +/- 0.022, and this allele was also observed in 1 of 49 Pueblo samples. ALDH2(3) is a silent transition 1464 G-->A, and it possibly has a wide distribution among North American Indians. A new subtype of the ALDH2(2) allele, designated as ALDH2(2Taiwan), was found in 1 of 174 Chinese from Taiwan. ALDH2(2Taiwan) is characterized by two G-->A transitions at bases 1486 and 1510, resulting in Glu-->Lys substitutions at both the 479 and 487 positions. Thus, this second nonconservative ALDH2 substitution occurs within the sequence of the already inactive ALDH2(2) allele.     

Positive alcohol expectancies partially mediate the relation between delinquent behavior and alcohol use: Generalizability across age, sex, and race in a cohort of 85,000 Iowa schoolchildren.

The extent to which positive alcohol expectancies mediated the association between delinquency and alcohol use, as well as whether age, sex, or race moderated this mediational relation, was examined in a population-based sample of Iowa schoolchildren (N = 85,301) from the 6th, 8th, and 11th grades. Positive alcohol expectancies were found to partially mediate the association between delinquency and alcohol use (alcohol use initiation, past-month drinking, and past-month binge drinking) across the full sample and in each age, sex, and racial subgroup. Evidence for moderated mediation was found for age and race but not for sex, which suggests that the magnitude of the relations among delinquency, positive alcohol expectancies, and alcohol involvement is different in younger versus older children and White, African American, Native American, Asian, and Hispanic youths but is similar in boys versus girls. (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)     

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.     

Preventing Substance Abuse in American Indian and Alaska Native Youth: Promising Strategies for Healthier Communities.

Substance abuse has had profoundly devastating effects on the health and well-being of American Indians and Alaska Natives. A wide variety of intervention methods has been used to prevent or stem the development of alcohol and drug problems in Indian youth, but there is little empirical research evaluating these efforts. This article is an overview of the published literature on substance use prevention among Indian adolescents, providing background epidemiological information, a review of programs developed specifically for Indian adolescents, and recommendations for the most promising prevention strategies currently in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Canadian Indians.

Indian education programmes have consistently failed and therefore, radical re-thinking on research and practical action is warranted. In considering Indians as a single cultural group in research, two points are frequently neglected. First, culture is always dynamic. Secondly, there is a great deal of cultural diversity within the classification of North American Indians. Further, it is suggested that rather than consider what it is about the Indian culture that causes school failure, a close examination should be made of the characteristics of the educator's culture that makes it difficult to teach children that are different. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Cytomegalovirus retinitis and viral resistance: 3. Culture results. CMV Retinitis and Viral Resistance Study Group

PURPOSE: The Strong Heart Study is a study of cardiovascular disease and its risk factors among American Indian men and women aged 45-74 yr representative of 13 communities from Arizona (AZ), Oklahoma (OK), and North/South Dakota (N/SD). This investigation sought to characterize the amount and type of physical activity and to determine the association between activity and lipids in this population. METHODS: Total physical activity (occupational plus leisure) was assessed with a validated questionnaire. RESULTS: Men and women from OK (21 +/- 19 and 16 +/- 15 h.wk-1; respectively) and N/SD (23 +/- 21 and 17 +/- 17 h.wk-1; respectively) had activity levels that were similar if not lower than the U.S. population with the AZ communities (17 +/- 21 and 10 +/- 14 h.wk-1; respectively) being substantially lower than the other two communities. Total cholesterol (TC), high density lipoprotein cholesterol (HDL-c), and low density lipoprotein cholesterol (LDL-c) levels were lower than the U.S. population. CONCLUSIONS: For most of the population (diabetic men and nondiabetic men and women), activity was significantly associated (P < 0.05) with apolipoprotein (apo) AI after controlling for covariates. With levels of activity as low if not lower than the general U.S. population coupled with high prevalence of obesity and diabetes, efforts to increase physical activity in American Indians are warranted. Hopefully these increases in activity will result in favorable lipid changes as well as decreasing the risk of diabetes which is epidemic in these populations.     

Culture and the role of choice in agency.

Three cross-cultural studies conducted among U.S. and Indian adults compared perceptions of helping friends in strongly versus weakly expected cases, views of helping family versus strangers, and responses to a self-determination motivation scale. Expectations to help family and friends were positively correlated with satisfaction and choice only among Indians and not among Americans. Also, whereas U.S. respondents associated lesser satisfaction and choice with strongly versus weakly socially expected helping, Indian respondents associated equal satisfaction and choice with the 2 types of cases. Providing evidence of the importance of choice in collectivist cultures, the results indicate that social expectations to meet the needs of family and friends tend to be more fully internalized among Indians than among Americans. Methodologically, the results also highlight the need to incorporate items that tap more internalized meanings of role-related social expectations on measures of motivation in the tradition of self-determination theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Trends in alcohol-related mortality among New Mexico's American Indians, Hispanics, and non-Hispanic whites

Reduction of alcohol-related mortality is a national goal for health promotion and disease prevention. We conducted this analysis to determine whether trends in New Mexico's Hispanics, non-Hispanic Whites, and American Indians were consistent with national trends in alcohol-related mortality, and whether differences in drinking patterns could account for racial and ethnic differences in rates. Age-adjusted, race-specific, and ethnic-specific alcohol-related mortality rates and 95% confidence intervals were calculated for 5-year periods for 1958-1991 using New Mexico vital statistics data. We estimated the prevalence of acute and chronic at-risk drinking behaviors and abstinence from data collected by the Behavioral Risk Factor Surveillance System (BRFSS) for the period 1986-1992. We found that alcohol-related mortality rates varied substantially by race, ethnicity, sex, age, and calendar period. American Indians had the highest rates for both sexes. Rates increased sharply from the period 1958-1962 until the late 1970s and the early 1980s, and then began to decrease rapidly. However, during the most recent decade, the rates have followed contrasting trends in the three ethnic and racial groups. Although rates have continued to decline among non-Hispanic Whites, rates for Hispanics and American Indians have not declined, and still remain substantially higher than rates during the 1958-1962 period. Differences in at-risk drinking behaviors reported to the BRFSS do not explain the contrast in race-specific and ethnic-specific mortality rates. Although progress has been made in reducing national per capita alcohol consumption and alcohol-related mortality, certain high-risk racial and ethnic groups may not be sharing in the progress.