Stephanie Cook

New York University | NYU · Biostatistics and Social Behavioral Sciences

Objective To examine the impact of resilience on the association between discrimination and trajectories of depressive symptoms during the COVID-19 pandemic across racial and ethnic groups. Methods Data were drawn from 5 waves of the All of Us Research Program’s survey on the impact of COVID-19 on the lives of American adults. Linear mixed-effects...

Background Race is a social determinant of cardiovascular (CVD) risk and the American Heart Association has called for increased research to understand how this social determinants of health (SDoH) impacts CVD risk. Carotid intima-media thickness (cIMT) and carotid plaque are reliable indicators of cardiovascular risk. Further, research highlights...

BACKGROUND Young sexual minority men (YSMM) engage in cardiometabolic risk behaviors (e.g., substance use) at higher rates than their heterosexual counterparts. Theory and previous research suggest that these risk behaviors may stem, in part, from exposure to minority stress (i.e., discrimination based on sexual identity and/or other identities suc...

Background: Research suggests that structural racism and homophobia are associated with mental well-being. However, structural discrimination measures which are relevant to lived experiences and that evade self-report biases are needed. Social media and global-positioning systems (GPS) offer opportunity to measure place-based negative racial senti...

Internalized homophobia, or the internalization of negative attitudes toward one’s sexual minority identity, is associated with sexual risk behaviors among young sexual minority men (YSMM). However, the formation and maintenance of secure or insecure socio-emotional bonds with friends, family members, and intimate partners (i.e., adult attachment)...

Adult attachment, or the ways in which individuals are able to develop and maintain trusting and loving relationships with peers and romantic partners has been demonstrated to influence hypothalamic-pituitary-adrenal (HPA) axis functioning among young sexual minority men. Theory and some preliminary evidence suggest that differences in the lived ex...

Cardiovascular disease (CVD) remains the number one cause of death among men in the United States. Emerging research demonstrates that socioemotional mechanisms such as adult attachment, or the ways in which individuals are able to form and maintain socioemotional bonds, may impact physical health via alterations in physiological stress functioning...

This report examines associations between everyday discrimination, microaggressions, and CRP to gain insight on potential mechanisms that may underlie increased CVD risk among sexual minority male young adults. The sample consisted of 60 participants taken from the P18 cohort between the ages of 24 and 28 years. Multinomial logistic regression mode...

Background: Young sexual and gender minorities (SGM) of color are at the intersection of multiple marginalized identities. In turn, young SGM may be faced with unique experiences of discrimination at the intersection of these identities (e.g., discrimination based on both racial/ethnic identity and sexual identity). Emerging evidence suggests that...

BACKGROUND Young sexual and gender minorities (SGMs) of color may face unique experiences of discrimination based on their intersectional positions (eg, discrimination based on both racial or ethnic identity and sexual identity). Emerging evidence suggests that mindfulness practices may reduce stress from discrimination and improve overall well-bei...

This study assessed the modifying role of primary source of COVID-19 information in the association between knowledge and protective behaviors related to COVID-19 among adults living in the United States (US). Data was collected from 6,518 US adults through an online cross-sectional self-administered survey via social media platforms in April 2020....

BACKGROUND Firefighters are often exposed to occupational stressors that can result in psychological distress. These occupational stressors have only intensified with the onset of the COVID-19 pandemic and will likely persist in the post-pandemic world. OBJECTIVE To address occupational stressors confronting firefighters and to improve their well-...

Background: Firefighters are often exposed to occupational stressors that can result in psychological distress (ie, anxiety and depression) and burnout. These occupational stressors have only intensified with the onset of the COVID-19 pandemic and will likely persist in the postpandemic world. Objective: To address occupational stressors confron...

Objective: This report examines associations between everyday discrimination, microaggressions, and CRP to gain insight on potential mechanisms that may underlie increased CVD risk among sexual minority male young adults.Methods: The sample consisted of 60 participants taken from the P18 cohort between the ages of 24 and 28 years. Multinomial logis...

Research suggests that young sexual minority men (YSMM), particularly YSMM of color, are more likely to have dysregulated physiological stress responses as compared to their heterosexual counterparts. In addition, the quality of social relationships has been demonstrated to impact physiological stress patterns among young adults. One key indicator...

The use of broad consent to store human biospecimens to be used in future research studies has increased over the years. However, it is currently unknown how young sexual minority men (YSMM) perceive broad consent in these specific types of studies. Therefore, in this study we aimed to determine the extent to which YSMM are comfortable with providi...

Retention of emerging adult sexual minority men (SMM) in longitudinal studies including biospecimens collection is often poor. To date, very few methodological examinations exist pertaining to strategies that may increase retention among potentially difficult-to-reach populations, including emerging adult SMM. This chapter describes a multifaceted...

Introduction Cardiovascular disease is the leading cause of death worldwide, and cardiovascular disease burden is increasing in low-resource settings and for lower socioeconomic groups. Machine learning algorithms are being developed rapidly and incorporated into clinical practice for cardiovascular disease prediction and treatment decisions. Signi...

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threa...

Previous research has used cortisol, the major hormonal byproduct of the hypothalamic pituitary adrenal (HPA) axis system, to explore how environmental stressors influence daily physiological functioning. Most of the research focused on diurnal cortisol has examined specific cortisol markers, with little consideration of how different components of...

Background: Cardiovascular disease (CVD) is the number one cause of death worldwide, and CVD burden is increasing in low-resource settings and for lower socioeconomic groups worldwide. Machine learning (ML) algorithms are rapidly being developed and incorporated into clinical practice for CVD prediction and treatment decisions. Significant opportun...

We study malicious online content via a specific type of hate speech: race, ethnicity and national-origin based discrimination in social media, alongside hate crimes motivated by those characteristics, in 100 cities across the United States. We develop a spatially-diverse training dataset and classification pipeline to delineate targeted and self-n...

Background: Exposure to sexual orientation-related discrimination among sexual minorities may lead to elevated levels of C-reactive protein (CRP) as compared to their heterosexual counterparts. However, little is known about factors that may buffer the association between discrimination and CRP among sexual minorities versus heterosexuals. The cur...

Objectives: Attachment insecurity may be more pronounced among young gay and bisexual men (YGBM). Further, attachment insecurity is associated with dysregulated patterns of emotion regulation, which can lead to depression. However, pathways linking attachment insecurity to depression are underexplored among YGBM. Methods: This study used pilot data...

We study malicious online content via a specific type of hate speech: race, ethnicity and national-origin based discrimination in social media, alongside hate crimes motivated by those characteristics, in 100 cities across the United States. We develop a spatially-diverse training dataset and classification pipeline to delineate targeted and self-n...

We seek to move beyond a deficits-based approach, which has dominated our understanding of health and wellbeing in in young sexual minority males (YSMM), by examining how indicators of positive development are associated with development of positive self-rated health in YSMM. Using data from a prospective cohort study of YSMM (n = 514; 18–22 years...

Early experiences with parents may be particularly difficult for lesbian, gay, and bisexual (LGB) individuals who face stigma that is linked to potentially distinct stress-related biobehavioral profiles. This study examined the association between parental bonding in relation to acute stress (cortisol reactivity) and chronic stress (allostatic load...

We conducted a mixed-methods study to identify factors that influence transitions in attachment style between childhood and adulthood among 28 young Black gay and bisexual men (YBGBM) in the United States. We used a phenomenological approach to data integration, with the major component to the results being garnered from the qualitative interviews....

Childhood poverty is hypothesized to increase risk for mental and physical health problems at least in part through dysregulation of the hypothalamic-pituitary-adrenal axis. However, less is known about the specific psychosocial stressors associated with cortisol reactivity and regulation for children living in poverty. The current study investigat...

Exposure to violence during adolescence is associated with increased risk behaviors and mental health problems in adulthood. Friendship attachment during adolescence may, however, mitigate the negative effects of exposure to violence on trajectories of depression and anxiety in young adulthood. In this study, we used growth curve modeling to examin...

Objectives: To examine trajectories of adolescent psychosocial risk-drug use, depressive and anxiety symptoms, and violence victimization and observation-and the longitudinal relationship between psychosocial risk trajectories during adolescence and HIV risk behaviors in adulthood. Methods: The eighteen-year longitudinal study was conducted from...

Objective: Sexual minority men (SMM) in the United States continue to experience adverse health problems and psychosocial burdens. However, there is limited psychometric research seeking to quantify the life worries of this population. Informed by syndemic theory, the Life Worries Scale (LWS) was developed to measure the concerns of young SMM. Me...

Objective: The present study examined the moderating effect of adult attachment on the association between childhood traumatic experiences, (i.e., physical abuse, emotional abuse, emotional neglect, and being bullied), age of childhood traumatic experience, and young adult depression symptoms among young Black gay and bisexual men (YBGBM). Method...

This study examines how romantic relationship cognitions are associated with changes of condomless anal sex among emerging adult gay and bisexual men. The sample was drawn from four waves of a prospective cohort study (N = 598; Mage = 18.2). Results suggest that condomless anal sex increased over the emerging adulthood period. Romantic relationship...

Much of the extant scientific research examining hypothalamic-pituitary-adrenal (HPA)-axis functioning is conducted among White heterosexuals. Very little research examines HPA-axis functioning between different minority groups. Individuals who identify as both sexual and racial minorities may experience increased stigma and discrimination that can...

Gay and bisexual boys and men experience social stigma associated with their sexual minority status that can negatively influence health. In addition, experiencing sexual orientation stigma may be linked to a decreased capacity to effectively form and maintain secure attachment relationships with parents, peers, and romantic partners across the lif...

This mixed methods study used an explanatory sequential design to examine the relationship between attachment and sexual behaviour among young Black gay and bisexual men (YBGBM). Cross sectional online surveys and sex diaries were completed by a sample of YBGBM in New York City (n = 153) to assess the association between adult attachment insecurity...

Experiences of internalized homophobia and HIV stigma in young Black gay and bisexual men (GBM) may lead to psychological distress, but levels of distress may be dependent upon their sexual identity or HIV status. In this study, we set out to explore the associations between psychological distress, sexual identity, and HIV status in young Black GBM...

Purpose: Forming secure friendship attachments during adolescence are important for mental health; few, however, have specifically examined the ways in which the transitions in attachment during adolescence may influence future mental health outcomes among African Americans. Methods: The present study examines how transitions in attachment in ad...

Young Black gay/bisexual men (YBGBM) are affected by contextual stressors—namely syndemic conditions and minority stress—that threaten their health and well-being. Resilience is a process through which YBGBM achieve positive psychosocial outcomes in the face of adverse conditions. Self-efficacy, hardiness and adaptive coping, and social support may...

Emerging adults (EAs) aged 18–24 account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased influence of online media on decision making, we examined how EA online networks were associated with sexual risk behaviors. We used egocentric network da...

The rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A part...

Background: Emerging adults (ages 18 to 24) account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased availability and usage of online social networking sites, we examined how emerging adults’ online peer networks were associated with recent sex...

Given the high morbidity and mortality among children in low- and middle-income countries as a result of preventable causes, the U.S. government and the United Nations Children's Fund convened an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change on June 3-...

This study examined cancer knowledge, mental health, and tobacco use in formerly incarcerated men. The Cancer-Health Research Study with Formerly Incarcerated Men in New York City used a cross-sectional research design to examine cancer knowledge and prevention (CKP) outcomes among 259 justice-involved males, ages 35-67. CKP was assessed using item...

Introduction: Cigarette smoking declined from 42.4% in 1965 to 19.3% in 2010 in the general population, but it remains the leading cause of preventable death and illness in the United States especially among high-risk populations, including those with criminal justice involvement.

Cigarette smoking declined from 42.4% in 1965 to 19.3% in 2010 in the general population, but it remains the leading cause of preventable death and illness in the United States especially among high-risk populations, including those with criminal justice involvement. A mixed methods approach was used to investigate the smoking behaviors of men unde...

This study explored the challenges of informed consent and understanding of the research process among Black and Latino men under community supervision (e.g., parole and/or probation). Between February and October 2012, we conducted cognitive face-to-face interviews using open-ended questions on the significant areas of research participation (i.e....

Studies in Western countries have consistently demonstrated that, as a consequence of more frequent discrimination, gender nonconforming gay and bisexual men experience more mental distress than gender conforming gay and bisexual men (D’Augelli, Grossman, & Starks, 2006; Grossman, D’Augelli, Salter, & Hubbard, 2005; Henning-Stout, James, & Macintos...

Abstract HIV-1 infection disproportionally affects African-American and Latino men who have sex with men (MSM). Their inclusion in biomedical and behavioral research is critical to understanding and addressing HIV vulnerability. Using focus groups, we sought to understand the perceptions related to participating in biomedical research of acute/rece...

Researchers have reported that network characteristics are associated with substance use behavior. Considering that social interactions within online networks are increasingly common, we examined the relationship between online network characteristics and substance use in a sample of emerging adults (ages 18-24) from across the United States (N = 2...

Background: HIV incidence among young Black men who have sex with men (Y-BMSM) is disproportionately high relative to other populations. Traumatic life experiences may enhance Y-BMSM's vulnerability to HIV and increase risk-taking behaviors. Understanding the relative contributions of different traumatic experiences on HIV risk is important in iden...

Men who have sex with men (MSM) make up nearly half of all people living with HIV in the United States. The prevalence of the epidemic in this population makes it vitally important to understand the transmission of the infection and to develop methods to prevent its spread. The current study uses longitudinal diary methods to examine relationships...

Positron emission tomography (PET) imaging studies have shown that addiction to a number of substances of abuse is associated with a decrease in dopamine D(2/3) receptor binding and decreased presynaptic dopamine release in the striatum. Some studies have also shown that these reductions are associated with the severity of addiction. For example, i...

Background: Behaviorally bisexual men have been identified as critical nodes in the transmission of HIV between heterosexual and homosexual sexual networks, but have been underrepresented in prevention research. Studies focusing on behaviorally bisexual Latino men have been particularly lacking, despite data indicating that Latinos are disproportio...

Background: Recent research has suggested that methamphetamine use is prevalent among younger MSM, while crack usage among Black men of low socioeconomic status (SES) continues to rise. Few studies aim to understand the relationship between sexual risk behavior and drug use at the situational level. The current study examines whether crack, inhal...

Men with HIV who have sex with men (MSM) represent the largest group of people living with HIV/AIDS in the United States. It is important to understand the sexual risk-taking behaviours that may be linked to the transmission of HIV and other sexually transmitted infections in this population. Models of HIV risk that focus solely on personal factors...

Background: The relationship between disease progression and mental health remains understudied among HIV-positive men who have sex with men (MSM). Many HIV-positive MSM experience poor mental health, which may result from the stress of living with a chronic illness. While studies of heterosexual populations suggested that supportive romantic part...

Background: HIV+ men who have sex with men (MSM) represent the largest group of people living with HIV/AIDS in the U.S. It is important to understand sexual risk-taking behaviors that may be linked to poor health outcomes among these men and their partners. Models of HIV risk behavior that focus solely on personal factors have been demonstrated to...