Stephanie Cook
Stephanie H Cook
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Associate Professor of Social and Behavioral Sciences
Associate Professor of Biostatistics
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Professional overview
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Dr. Stephanie Cook’s overarching research focus is to understand how structural- and individual-level minority stressors contribute to mental health, physical health, and health behaviors across the life span. Further, she seeks to understand how features of close relationships can exacerbate or buffer the negative effects of minority stress on health. Her work primarily focuses on young adults transitioning to adulthood who are at the intersection of racial/ethnic and sexual orientation status. In addition, much of her current work examines the links between minority stress (i.e., daily experiences of discrimination) and biological markers of stress (e.g. cortisol and c-reactive protein).
Dr. Cook’s substantive methodological and statistical focus is in the development and application of longitudinal study designs (i.e., intensive longitudinal designs) for determining the ways in which dynamic changes in features of minority stress (e.g., daily and momentary discrimination events) are associated with changes in risk behaviors and physical health (e.g., sexual risk and substance use, pre-clinical cardiovascular disease, and biological stress) among racial/ethnic and/or sexual minority young adults.
Dr. Cook is the Director of the Attachment and Health Disparities Research Lab (AHDL) which is currently made up of about 20 undergraduate, graduate, and postdoctoral fellows. She developed an integrated theory of adult attachment (the Integrated Attachment and Sexual Minority Stress Model [IASMS]; i.e., the development, or lack, of strong socio-emotional bonds) and minority stress (i.e., social stress experienced by individuals in minority social groups) as a means to better understand and address the health needs of disadvantaged youth transitioning to adulthood. Dr. Cook and her team’s long-term goal is to continue creating, implementing, and refining sustainable interventions to reduce the influence of stress on health utilizing innovative methodologies.
Current Projects
- GeoSENSE: Geospatial Study on Intersectionality, Discrimination, and Cardiometabolic Health Behaviors Among Young Sexual and Gender Minorities
- Identifying Physiological and Behavioral Mechanisms Linking Discrimination and Subclinical Cardiovascular Disease among Racially Diverse Young Sexual Minority Men
- Minority Stress, Substance Use, and Pre-Clinical Cardiovascular Risk among Sexual Minority Men: Understanding the Protective Features of Social Support
- Optimizing a Daily Mindfulness Intervention to Reduce Stress from Discrimination among Sexual and Gender Minorities of Color
- Race modifies the association between post-traumatic stress disorder and cardiovascular risk in large US population-based study
Teaching
Social and Behavioral Sciences Department
- Global Issues in Social and Behavioral Health
- Research Methods in Public Health
Biostatistics Department
- Longitudinal Analysis of Public Health Data
- Regression I: Regression Analysis and Multivariate Modeling
- Regression II: Categorical Data Analysis
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Education
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BA, Psychology and Women’s Studies, University of Michigan, Ann Arbor, MIMPH, Sociomedical Sciences, Columbia University, New York, NYDrPH, Sociomedical Sciences, Columbia University, New York, NY
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Honors and awards
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National Institutes of Health (NIH) Summer Institute Fellowship on Randomized Behavioral Clinical Trials Fellowship (2023)New York University Faculty Fellow in Residence, New York University (2023)New York University James Weldon Johnson Professor (2023)NIH Loan Repayment Program Award, National Heart, Lung, and Blood Institute (2023)Outstanding Research Mentor, The Undergraduate Research Opportunity Program, The University of Michigan (2022)New York University Dr. Martin Luther King Jr. Faculty Award (2022)Loan Repayment Program, National Heart, Lung, and Blood Institute (2021)BioData Catalyst Fellowship, National Heart, Lung, and Blood Institute (NHLBI) (2021)Diverse Magazine Emerging Scholar: Issues In Higher Education Publication, (2021)Program to Increase Diversity in Cardiovascular Health Related Research (PRIDE) Fellowship (2020)American Psychosomatic Society (APS) Diversity Award (2020)National Institute of Minority Health Disparities Loan Repayment Award (2018)Inter-university Consortium for Political and Social Research (ICPSR) Summer Program in Quantitative Methods of Social Research Scholarship, The University of Michigan (2018)Robert Wood Johnson Fellow (RWJF) New Connections Sponsored Scholar (2018)HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI) Award (2017)Robert Wood Johnson Fellow (RWJF) New Connections Sponsored Scholar (2017)Matilda White Riley Distinguished Early Stage Investigator Award, National Institutes of Health (Office of Behavioral and Social Sciences) (2016)Outstanding Postdoctoral Fellow Award, The University of Michigan (2015)American Psychological Association Smoking Dissemination Award (2015)Poster Award, Excellence in Innovation and Advanced Research in the Field of Sexual Health, American Public Health Association (2014)Excellence in Abstract Submission, American Public Health Association (2011)
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Areas of research and study
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BiostatisticsCardiovascular DiseaseIntersectionality TheoryLongitudinal MethodsMinority HealthMinority StressMultiphase Optimization Strategy (MOST)Physiological StressSocial Behaviors
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Publications
Publications
Exploring the relationship between gender nonconformity and mental health among black South African gay and bisexual men
Cook, S. H., Sandfort, T. G., Nel, J. A., & Rich, E. P. (n.d.). In Archives of Sexual Behavior (1–).Publication year
2013Volume
42Issue
3Page(s)
327-330Online Network Influences on Emerging Adults' Alcohol and Drug Use
AbstractCook, S. H., Bauermeister, J. A., Gordon-Messer, D., & Zimmerman, M. A. (n.d.).Publication year
2013Journal title
Journal of Youth and AdolescenceVolume
42Issue
11Page(s)
1674-1686AbstractResearchers 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 = 2,153; M = 21 years old; 47 % female; 70 % White). We used regression analyses to examine the relationship between online ego network characteristics (i.e., characteristics of individuals directly related to the focal participant plus the relationships shared among individuals within the online network) and alcohol use and substance use, respectively. Alcohol use was associated with network density (i.e., interconnectedness between individuals in a network), total number of peer ties, and a greater proportion of emotionally close ties. In sex-stratified models, density was related to alcohol use for males but not females. Drug use was associated with an increased number of peer ties, and the increased proportion of network members' discussion and acceptance of drug use, respectively. We also found that online network density and total numbers of ties were associated with more personal drug use for males but not females. Conversely, we noted that social norms were related to increased drug use and this relationship was stronger for females than males. We discuss the implications of our findings for substance use and online network research.Participation in research involving novel sampling and study designs to identify acute HIV-1 infection among minority men who have sex with men.
AbstractRodriguez, K., Castor, D., Mah, T. L., Cook, S. H., Auguiste, L. M., Halkitis, P. N., & Markowitz, M. (n.d.).Publication year
2013Journal title
Unknown JournalVolume
25Issue
7Page(s)
828-834AbstractHIV-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/recent HIV-1 infection (AHI) using complex sampling and data collection methods to reach this hidden group at highest risk of acquiring and transmitting HIV. Given the potential impact of AHI on HIV transmission in MSM, it is important to understand this intersection for HIV prevention, care, and treatment purposes. The aim of this study was to understand how recruitment and data collection methods affect AHI research participation willingness particularly among MSM of color. Findings suggest that major barriers to research participation with complex sampling to identify AHI and intensive risk behavior collection such as diary methods are lack of anonymity, partner disclosure, and study fatigue. The authors explore implications for future study designs and development based on these findings.Substance use and sexual risk behavior in HIV-positive men who have sex with men: An episode-level analysis
AbstractBoone, M. R., Cook, S. H., & Wilson, P. (n.d.).Publication year
2013Journal title
AIDS and BehaviorVolume
17Issue
5Page(s)
1883-1887AbstractMen 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 between substance use and unprotected anal intercourse in a sample of 158 HIV-positive, mostly ethnic minority MSM. Results indicate that both general substance use and use of specific drugs (i.e., inhalants, cocaine, crack, and club drugs) have a substantial impact on the sexual risk behavior of this population.Deficits in dopamine D 2 receptors and presynaptic dopamine in heroin dependence: Commonalities and differences with other types of addiction
AbstractMartinez, D., Saccone, P. A., Liu, F., Slifstein, M., Orlowska, D., Grassetti, A., Cook, S., Broft, A., Van Heertum, R., & Comer, S. D. (n.d.).Publication year
2012Journal title
Biological PsychiatryVolume
71Issue
3Page(s)
192-198AbstractPositron 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, in cocaine dependence, low dopamine release is associated with the choice to self-administer cocaine. The goal of the present study was to investigate these parameters of striatal dopamine transmission in heroin dependence and their association with drug seeking behavior. Heroin-dependent and healthy control subjects were scanned with [ 11C]raclopride before and after stimulant administration (methylphenidate) to measure striatal D 2/3 receptor binding and presynaptic dopamine release. After the PET scans, the heroin-dependent subjects performed heroin self-administration sessions. Both striatal D 2/3 receptor binding and dopamine release were reduced in the heroin-dependent subjects compared with healthy control subjects. However, neither PET measure of dopamine transmission predicted the choice to self-administer heroin. These findings show that heroin addiction, like addiction to other drugs of abuse, is associated with low D 2/3 receptor binding and low presynaptic dopamine. However, neither of these outcome measures was associated with the choice to self-administer heroin.Intimate-partner violence and HIV in South African women
Castor, D., Cook, S., Leclerc-Madlala, S., & Shelton, J. (n.d.). In The Lancet (1–).Publication year
2010Volume
376Issue
9748Page(s)
1219Situational predictors of sexual risk episodes among men with HIV who have sex with men
AbstractWilson, P. A., Cook, S., McGaskey, J., Rowe, M., & Dennis, N. (n.d.).Publication year
2008Journal title
Sexually transmitted infectionsVolume
84Issue
6Page(s)
506-508AbstractBackground: 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 have been demonstrated to be ineffective at explaining risk behaviour. Rather, in order to fully understand sexual risktaking, it is important to examine the factors linked to high-risk sexual situations and not solely the factors linked to potentially high-risk people. Methods: A diverse sample of 100 MSM with HIV completed a 6-week internet-based sex diary that collected detailed information on recent sexual encounters. In total, information on over 250 sexual episodes was collected and analysed. Generalised linear mixed models were used to examine situational predictors of risk episodes. Results: Analyses revealed that drug use by self and sex partners (examined individually and together) were positively related to risk episodes. Likewise, having a sex partner met online and having a sexual encounter in a sex party or bathhouse setting was linked to risk episodes. Sexual episodes that involved a sex-partner who was perceived as sexually desirable and those involving communication about HIV and/or condom use with partners each were negatively related to risk. Conclusions: Situational factors play an important role in explaining sexual risk-taking among MSM with HIV. Researchers should place a greater focus on drug use and characteristics of sex partners and settings in which sexual behaviours occur as situational predictors of risk in order to comprehensively understand sexual risk-taking in this population.