Superwoman schema and arterial stiffness in Black American women: assessing the role of environmental mastery.

Abstract

Background: Emerging evidence suggests that the Superwoman Schema (SWS)-the sociocultural representation of Black women as naturally strong, independent, and nurturing-may play an important role in Black women's cardiovascular health; but findings have been relatively mixed. One interesting possibility is that environmental mastery, a sense of control over one's environment, may mitigate negative aspects of SWS.

Purpose: We investigated whether mastery moderated the association between SWS and pulse wave velocity (PWV), the gold standard measure of arterial stiffness linked to cardiovascular morbidity and mortality.

Methods: Participants were N = 368 early middle-aged (30-45 years old) Black women from the southeastern USA who completed the 35-item Giscombé Superwoman Schema Questionnaire and Ryff's 14-item environmental mastery scale. Carotid-femoral PWV was assessed using the SphygmoCor device. Linear regression models examined the main and interactive associations of SWS and mastery on PWV, adjusting for age, education, income, body mass index, smoking status, blood pressure, and antihypertensive medication use.

Results: Analyses revealed a significant overall SWS endorsement by mastery interaction [β = -.11, P = .02], such that SWS was positively associated with higher PWV only when mastery was low. Three SWS dimensions drove this association: SWS strength, SWS suppress emotions, and SWS resistance to vulnerability (all P-values < .05) showing similar patterns to the overall SWS interaction with mastery.

Conclusions: In Black women, high endorsement of SWS is associated with greater arterial stiffness when environmental mastery is low. Thus, SWS may be more physiologically taxing when one senses less control over their environment.