{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:49:19Z","timestamp":1794242959589,"version":"4.9.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To quantify the association between attributional ambiguity\u2013the uncertainty of whether an experience is discrimination\u2013and mental health.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using a nationally representative sample of U.S. adults recruited through an online survey by Ipsos (April 23 and May 3, 2021), attributional ambiguity was quantified by asking participants if they experienced anything in the past 6 months that they were unsure was discrimination. The survey also assessed the degree to which these experiences caused participants to feel bothered and to ruminate on them. Multiple linear regression models were used to analyze associations between attributional ambiguity and depressive symptoms and mental health status.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Black and Hispanic participants reported higher rates of attributional ambiguity than White participants. Experiencing attributional ambiguity was associated with higher levels of depressive symptoms and poorer self-reported mental health status. Among those who reported attributional ambiguity, increases in bother and rumination scores were positively associated with depressive symptoms.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Attributional ambiguity is an important yet overlooked social determinant of mental health. More research is needed to fully understand the impact of this stressor on population health, particularly among minoritized populations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-024-17664-1","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T09:02:15Z","timestamp":1704790935000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The cost of doubt: assessing the association between attributional ambiguity and mental health"],"prefix":"10.1186","volume":"24","author":[{"given":"Adolfo G.","family":"Cuevas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M.","family":"Krobath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adiammi","family":"Lyngdoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatoumata","family":"Kaba-Diakit\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer D.","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"key":"17664_CR1","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1111\/1475-6773.13222","volume":"54","author":"DR Williams","year":"2019","unstructured":"Williams DR, Lawrence JA, Davis BA, Vu C. Understanding how discrimination can affect health. Health Serv Res. 2019;54:1374\u201388.","journal-title":"Health Serv Res"},{"key":"17664_CR2","doi-asserted-by":"publisher","first-page":"e0138511","DOI":"10.1371\/journal.pone.0138511","volume":"10","author":"Y Paradies","year":"2015","unstructured":"Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A, et al. Racism as a determinant of health: a systematic review and Meta-analysis. PLoS ONE. 2015;10:e0138511.","journal-title":"PLoS ONE"},{"key":"17664_CR3","unstructured":"Lewis T, Cogburn C, Williams DR. Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues [Internet]., Rochester NY.; 2015 [cited 2023 Mar 21]. Available from: https:\/\/papers.ssrn.com\/abstract=2588399."},{"key":"17664_CR4","doi-asserted-by":"publisher","first-page":"975","DOI":"10.2105\/AJPH.2012.300702","volume":"102","author":"DR Williams","year":"2012","unstructured":"Williams DR, John DA, Oyserman D, Sonnega J, Mohammed SA, Jackson JS. Research on discrimination and health: an exploratory study of unresolved conceptual and measurement issues. Am J Public Health. 2012;102:975\u20138.","journal-title":"Am J Public Health"},{"key":"17664_CR5","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1111\/bjso.12145","volume":"55","author":"C Perozzo","year":"2016","unstructured":"Perozzo C, de la Sablonni\u00e8re R, Auger E, Caron-Diotte M. Social identity change in response to discrimination. Br J Soc Psychol. 2016;55:438\u201356.","journal-title":"Br J Soc Psychol"},{"key":"17664_CR6","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1002\/smi.3047","volume":"37","author":"AG Cuevas","year":"2021","unstructured":"Cuevas AG, Boen C. Tip of the iceberg: measuring racial discrimination in studies of health. Stress and Health. 2021;37:1043\u201350.","journal-title":"Stress and Health"},{"key":"17664_CR7","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/j.1559-1816.2003.tb01894.x","volume":"33","author":"KR King","year":"2003","unstructured":"King KR. Racism or sexism? Attributional ambiguity and simultaneous membership in multiple oppressed groups 1. J Appl Soc Psychol. 2003;33:223\u201347.","journal-title":"J Appl Soc Psychol"},{"key":"17664_CR8","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1037\/0022-3514.60.2.218","volume":"60","author":"J Crocker","year":"1991","unstructured":"Crocker J, Voelkl K, Testa M, Major B. Social stigma: the affective consequences of attributional ambiguity. J Personal Soc Psychol. 1991;60:218\u201328.","journal-title":"J Personal Soc Psychol"},{"key":"17664_CR9","unstructured":"Lazarus RS, Folkman S. Stress, appraisal, and coping. Springer publishing company; 1984."},{"key":"17664_CR10","first-page":"29","volume":"9","author":"RA Sansone","year":"2012","unstructured":"Sansone RA, Sansone LA, Rumination. Relationships with physical health. Innovations in Clinical Neuroscience. 2012;9:29.","journal-title":"Innovations in Clinical Neuroscience"},{"key":"17664_CR11","doi-asserted-by":"publisher","first-page":"103573","DOI":"10.1016\/j.brat.2020.103573","volume":"127","author":"ER Watkins","year":"2020","unstructured":"Watkins ER, Roberts H. Reflecting on rumination: consequences, causes, mechanisms and treatment of rumination. Behav Res Ther. 2020;127:103573.","journal-title":"Behav Res Ther"},{"key":"17664_CR12","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.jpsychores.2008.02.004","volume":"64","author":"DK Marcus","year":"2008","unstructured":"Marcus DK, Hughes KT, Arnau RC. Health anxiety, rumination, and negative affect: a mediational analysis. J Psychosom Res. 2008;64:495\u2013501.","journal-title":"J Psychosom Res"},{"key":"17664_CR13","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.jrp.2012.05.013","volume":"46","author":"JF Finch","year":"2012","unstructured":"Finch JF, Baranik LE, Liu Y, West SG. Physical health, positive and negative affect, and personality: a longitudinal analysis. J Res Pers. 2012;46:537\u201345.","journal-title":"J Res Pers"},{"key":"17664_CR14","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1177\/0956797618763097","volume":"29","author":"KA Leger","year":"2018","unstructured":"Leger KA, Charles ST, Almeida DM. Let it go: lingering negative affect in response to Daily Stressors is Associated with Physical Health years later. Psychol Sci. 2018;29:1283\u201390.","journal-title":"Psychol Sci"},{"key":"17664_CR15","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1037\/0022-3514.94.2.278","volume":"94","author":"WB Mendes","year":"2008","unstructured":"Mendes WB, McCoy S, Major B, Blascovich J. How attributional ambiguity shapes physiological and emotional responses to social rejection and Acceptance. J Pers Soc Psychol. 2008;94:278\u201391.","journal-title":"J Pers Soc Psychol"},{"key":"17664_CR16","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/S0022-1031(02)00547-4","volume":"39","author":"B Major","year":"2003","unstructured":"Major B, Quinton WJ, Schmader T. Attributions to discrimination and self-esteem: impact of group identification and situational ambiguity. J Exp Soc Psychol. 2003;39:220\u201331.","journal-title":"J Exp Soc Psychol"},{"key":"17664_CR17","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s10865-008-9185-0","volume":"32","author":"DR Williams","year":"2009","unstructured":"Williams DR, Mohammed SA. Discrimination and racial disparities in health: evidence and needed research. J Behav Med. 2009;32:20.","journal-title":"J Behav Med"},{"key":"17664_CR18","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12939-021-01609-w","volume":"21","author":"TJ Stopka","year":"2022","unstructured":"Stopka TJ, Feng W, Corlin L, King E, Mistry J, Mansfield W, et al. Assessing equity in health, wealth, and civic engagement: a nationally representative survey, United States, 2020. Int J Equity Health. 2022;21:12.","journal-title":"Int J Equity Health"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-024-17664-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-024-17664-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-024-17664-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T09:03:15Z","timestamp":1704790995000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-024-17664-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,9]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["17664"],"URL":"https:\/\/doi.org\/10.1186\/s12889-024-17664-1","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,9]]},"assertion":[{"value":"3 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study is exempt from ethics approval by Tufts Institutional Review Board (protocol 00000428). Informed consent was obtained from all individual participants included in the study. All the methods included in this study are in accordance with the declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"126"}}