Date of Award

Summer 8-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Program/Concentration

Health Psychology

Committee Director

Abby L. Braitman

Committee Member

Sarah J. Ehlke

Committee Member

Natalie M. Yarish

Abstract

Black Americans experience disproportionately poorer physical health outcomes than White Americans despite often reporting comparable or better mental health, a phenomenon known as the Black–White mental health paradox. High-effort coping (HEC), a culturally relevant coping style characterized by working harder in the face of adversity, has been proposed as a potential factor underlying this paradox. However, little is known about how HEC relates to mental distress and health-harming behaviors among college students, a population at elevated risk for both mental health issues and health-harming behaviors. This study used a person-centered approach to examine profiles of mental distress and psychosocial stressors and their associations with HEC, race (Black vs. White), and health-harming behaviors. Participants included 415 young adult college students (35.18% Black, 60% White) who reported past-month substance use. Latent profile analyses were conducted using indicators of depression, anxiety, stress, financial well-being, academic environment, and interpersonal issues (Aim 1). HEC, race, and their interaction were examined as predictors of profile membership (Aim 2). Differences in health-harming behaviors across latent profiles (Aim 3) interacting with HEC and race (Aim 4) were also examined. A three-profile solution emerged, consisting of Low, Moderate, and High Distress profiles. Higher levels of HEC were associated with a lower likelihood of membership in higher distress profiles, suggesting a potential protective effect. Discrimination was a strong predictor of higher distress profile membership, whereas race was not significant when discrimination was included in the model. Students in higher distress profiles reported greater engagement in health-harming behaviors overall with neither race nor HEC significantly moderating these associations. Findings suggest HEC as a modest protective factor against distress with discrimination, instead of only racial identity, as an important contributor to elevated risk. Higher distress profiles are associated with elevated risk to engaging in multiple health-harming behaviors, highlighting the importance of designing college health interventions to target co-occurring behaviors.

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DOI

10.25777/8ynb-nv62

ISBN

9798173751591

ORCID

0000-0001-6433-7313

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