The costs of high self-control in Black and Latino youth with asthma: Divergence of mental health and inflammatory profiles

• Published in: Brain, behavior, and immunity Vol. 80; pp. 120 - 128
• Main Authors: Chen, Edith, Shalowitz, Madeleine U., Story, Rachel E., Hayen, Robin, Leigh, Adam K.K., Hoffer, Lauren C., Austin, Makeda K., Lam, Phoebe H., Brody, Gene H., Miller, Gregory E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.08.2019
• Subjects: Academic Success; Adolescent; African Americans - psychology; Asthma; Asthma - etiology; Asthma - physiopathology; Child; Cytokines - immunology; Depression - ethnology; Depression - metabolism; European Continental Ancestry Group - psychology; Female; Hispanic Americans - psychology; Humans; Immune; Male; Mental Disorders - ethnology; Mental Disorders - metabolism; Mental Health - ethnology; Minority Groups - psychology; Psychological stress; Race; Risk Factors; Self-Control - psychology; Stress, Psychological - immunology; Stress, Psychological - physiopathology; Th1 Cells - immunology; Th2 Cells - immunology; Psychological stress; Immune; Race; Asthma
• ISSN: 0889-1591; 1090-2139
• DOI: 10.1016/j.bbi.2019.02.031

•Working to ‘overcome the odds’ in school can heighten asthma risks in minority youth.•Minority youth who showed high self-control when school stress was high had better mental health outcomes.•Minority youth who exerted high self-control when school stress was high had larger Th-1/Th-2 cytokine responses.•Minority youth who exerted high self-control when school stress was high had reduced glucocorticoid sensitivity.•Minority youth who exerted high self-control when school stress was high had more frequent physician contacts. Emerging evidence in psychology suggests a paradox whereby high levels of self-control when striving for academic success among minority youth can have physical health costs. This study tested the skin-deep resilience hypothesis in asthma- whether minority youth who are striving hard to succeed academically experience good psychological outcomes but poor asthma outcomes. Youth physician-diagnosed with asthma (N = 276, M age = 12.99; 155 = White, 121 = Black/Latino) completed interviews about school stress and a self-control questionnaire. Outcomes included mental health (anxiety/depression) and ex-vivo immunologic processes relevant to asthma (lymphocyte Th-1 and Th-2 cytokine production, and sensitivity to glucocorticoid inhibition). Physician contacts were tracked over a one-year follow-up. For minority youth experiencing high levels of school stress, greater self-control was associated with fewer mental health symptoms (beta = −0.20, p < .05), but worse asthma inflammatory profiles (larger Th-1 and Th-2 cytokine responses, lower sensitivity to glucocorticoid inhibition), and more frequent physician contacts during the one-year follow-up (beta’s ranging from 0.22 to 0.43, p’s < .05). These patterns were not evident in White youth. In minority youth struggling with school, high levels of self-control are detrimental to asthma inflammatory profiles and clinical outcomes. This suggests the need for health monitoring to be incorporated into academic programs to ensure that ‘overcoming the odds’ does not lead to heightened health risks in minority youth.