The role of socially prescribed perfectionism in the link between perceived racial discrimination and African American adolescents' depressive symptoms

The Role of Self-Compassion Among Adaptive and Maladaptive Perfectionists in University Students

Using the tripartite model of perfectionism that accounts for combined characteristics of the Perfectionistic Strivings and Perfectionistic Concerns dimensions, this study explored the mediating role of self-compassion to explain differences between adaptive and maladaptive perfectionists in four psychological distress domains: depression, generalized anxiety, social anxiety, and academic distress. A sample of 3,112 university students were classified into adaptive, maladaptive, and nonperfectionists. Results of mediation analyses comparing adaptive and maladaptive perfectionists indicated that adaptive perfectionists reported significantly greater self-compassion and lower psychological distress levels in all four areas. Self-compassion significantly mediated the associations between perfectionist groups in all four domains. These findings were largely supported across various ethnic and international student groups in the analyses by subgroups. Furthermore, parallel mediation analyses demonstrated the unique contributions of individual self-compassion subscales as mediators. Implications for clinical practice, training, and future research are discussed.

Resilience and Family Socialization Processes in Ethnic Minority Youth: Illuminating the Achievement-Health Paradox

Youth in marginalized communities who "strive" to rise above adversity, including systemic racism and poverty, are considered "resilient." African-American, Latinx, and Asian-American youth often achieve admirable academic success despite limited social capital and high early life stress by adopting a "striving persistent behavioral style" (SPBS). SPBS may be supported by family socialization processes that facilitate reliance on self-regulation processes. Unfortunately, a young person's resilience in one domain (i.e., academic) can come at a cost in other domains, including physical and mental health morbidities that are under-identified and under-treated. Indeed, research suggests a link between SPBS in the face of adversity and later health morbidities among ethnic minority youth. Herein, we describe SPBS as an adaptation to minority stress that not only promotes social mobility but may also stoke physical and mental health disparities. We review how family processes related to academic, emotional, and ethnic-racial socialization can facilitate the striving persistent behavioral style. We emphasize the double bind that ethnic minority families are caught in and discuss directions for future research and clinical implications for individual and family-level interventions. While needed, we argue that individual and family-level interventions represent a near-term work around. Solutions and factors that shape the need for SPBS and its cost must be addressed structurally.

Beyond Trauma Exposure: Discrimination and Posttraumatic Stress, Internalizing, and Externalizing Problems Among Detained Youth

According to the race-based traumatic stress model, racial discrimination is proposed to comprise a traumatic experience that results in posttraumatic stress symptoms, as well as internalizing and externalizing problems among youth. Accordingly, a significant body of research has emerged that supports the associations among these constructs. However, the majority of these empirical studies have not accounted for the potential role of traditionally defined traumatic events in these associations. This study investigated whether self-reported racial discrimination was related to posttraumatic stress symptoms, internalizing, and externalizing symptoms above and beyond the impact of other trauma exposures in a sample of 266 detained youth (79% boys, 60% identified as an ethnic minority). Results of hierarchical linear regressions demonstrated that, after accounting for youths' other trauma exposures, racial discrimination accounted for significant variance in the models predicting delinquency and risk-taking but no other externalizing and internalizing problems, or posttraumatic stress symptoms. These findings indicate that racial discrimination may be particularly important for understanding offending behavior among detained youth.

Perfectly Tired: Perfectionism and Sleep in Adolescents With Chronic Pain

OBJECTIVE

Conceptual links between perfectionism and chronic pain have been proposed yet minimal empirical data exists. Poor sleep is associated with high levels of perfectionism and is common among youth with chronic pain. This study explores associations between perfectionism and sleep quality in adolescents with chronic pain while considering levels of functional disability.

METHODS

Adolescents (ages 12-18) with chronic pain (N = 423) completed baseline measures of self-oriented perfectionism (SOP), socially prescribed perfectionism (SPP), sleep quality, and functional disability as part of routine clinical care at an outpatient chronic pain clinic and a pain rehabilitation day treatment program. Multivariate multiple regression assessed associations between perfectionism (SOP and SPP) and sleep (falling asleep/reinitiating sleep, returning to wakefulness, and going to bed). Two moderation models explored how relations between perfectionism (SOP and SPP) and sleep quality (total score) varied depending on level of functional disability. All analyses controlled for clinic setting.

RESULTS

Results indicated SPP was associated with more difficulties across all sleep subdomains in adolescents with chronic pain, while SOP was unrelated to sleep quality. Associations between perfectionism and sleep quality were dependent on functional disability; perfectionism was most strongly associated with worse sleep quality for adolescents with less functional disability.

CONCLUSIONS

This study highlights the relationship between perfectionism and sleep quality in adolescents with chronic pain and suggests that perfectionistic youth with less disability are at the greatest risk for sleep problems. Longitudinal research is needed to understand how perfectionism, sleep, and disability interact over time in youth with chronic pain.

Striving While Black: Race and the Psychophysiology of Goal Pursuit

Population health scientists have largely overlooked anticipatory stressors and how different groups of people experience and cope with anticipatory stress. I address these gaps by examining black-white differences in the associations between an important anticipatory stressor-goal-striving stress (GSS)-and several measures of psychophysiology. Hypotheses focusing on racial differences in GSS and psychophysiology are tested using self-report and biomarker data from the Nashville Stress and Health Study (2011-2014), a cross-sectional probability survey of black and white working-age adults from Davidson County, Tennessee (n = 1,252). Compared to their white peers, blacks with higher GSS report greater self-esteem and fewer symptoms of depression and anxiety. However, increased GSS also predicts elevated levels of high-effort coping (i.e., John Henryism), neuroendocrine stress hormones, and blood pressure for blacks but not whites. I discuss the implications of these findings for scholars interested in the stress process and broader black-white health inequalities in the United States.

Racial/ethnic discrimination and well-being during adolescence: A meta-analytic review

This meta-analytic study systematically investigates the relations between perceived racial/ethnic discrimination and socioemotional distress, academics, and risky health behaviors during adolescence, and potential variation in these relations. The study included 214 peer-reviewed articles, theses, and dissertations, with 489 unique effect sizes on 91,338 unique adolescents. Random-effects meta-analyses across 11 separate indicators of well-being identified significant detrimental effects. Greater perceptions of racial/ethnic discrimination were linked to more depressive and internalizing symptoms; greater psychological distress; poorer self-esteem; lower academic achievement and engagement; less academic motivation; greater engagement in externalizing behaviors, risky sexual behaviors, and substance use; and more associations with deviant peers. Metaregression and subgroup analyses indicated differences by race/ethnicity, Gender × Race/Ethnicity interactions, developmental stage, timing of retrospective measurement of discrimination, and country. Overall, this study highlights the pernicious effects of racial/ethnic discrimination for adolescents across developmental domains and suggests who is potentially at greater risk. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Everyday discrimination, negative emotions, and academic achievement in Filipino secondary school students: Cross-sectional and cross-lagged panel investigations

Different forms of overt discrimination have been consistently linked to maladaptive psychological, physical health, and educational outcomes. However, limited research has been carried out to assess the link of subtle forms of discrimination like everyday discrimination on academic functioning in the school context. The current study addressed this research gap through examining the association of everyday discrimination with negative emotions and academic achievement among Filipino high school students. A cross-sectional study (Study 1) showed that everyday discrimination was positively associated with negative emotions and negatively linked to perceived academic achievement. Furthermore, everyday discrimination had indirect effects on academic achievement through the intermediate variable negative emotions. Then, a two-wave cross-lagged panel investigation (Study 2) demonstrated that Time 1 everyday discrimination was linked to higher Time 2 negative emotions. Reciprocal associations were also found among the constructs because Time 1 academic achievement was linked to lower levels Time 2 negative emotions and Time 2 everyday discrimination. The theoretical and practical implications of the research are elucidated.

Measuring perfectionism in children: a systematic review of the mental health literature

The adverse consequences of perfectionism in the lives of youth (children and adolescents) are now widely recognised, including impact on mental health and general well-being. In order to develop interventions to prevent and treat perfectionism and promote resilience for children, rigorous testing and examination of theoretical models is needed as well as having access to valid and reliable assessment tools. The aim of the current literature review was to examine the validity and reliability of the measures currently being used to measure perfectionism in children under the age of 15. A systematic review of the literature identified six instruments that had been utilised in children. Preliminary support with respect to reliability and validity was established for each of these measures, and there was evidence supporting the existence of both perfectionistic striving and perfectionistic concerns in this population. However, many of the measures lacked evaluation of key psychometric properties by independent authors. Further work distinguishing adaptive and maladaptive perfectionism will be necessary to promote future interventions and treatment in this area.

Stigma Consciousness and Evaluative Concerns: A Pathway to Psychological Distress for Academically Stigmatized Students

The psychological health of ethnic minority college students, specifically Black and Hispanic/Latinx students, warrants particular attention given their experience of ethnic stigmatization in higher education settings (e.g., lowered expectations surrounding intellectual ability). When faced with ethnic stigmatization, especially in an inherently evaluative collegiate context, concerns about negative performance evaluation may trigger increased threat vigilance, self-monitoring for mistakes, and rumination about potential failure. Thus, the evaluative concerns component of perfectionism may be a mechanism through which ethnic stigma consciousness relates to psychological distress for these students. The current investigation explored the relationships between stigma consciousness, evaluative concerns perfectionism, and psychological distress (i.e., anxiety, depression) in a large sample of Hispanic/Latinx and Black college students in the United States. The moderated mediational analysis revealed that for Hispanic/Latinx students evaluative concerns served as a mechanism through which ethnic stigma consciousness related to psychological distress. For Black students, there was no relationship between stigma consciousness and psychological distress. Findings suggest that preventative and/or treatment approaches aimed at reducing psychological distress among Hispanic/Latinx college students take into consideration the contextual impact of ethnic stigmatization. Treatments may incorporate assessment and targeting of this maladaptive component of perfectionism to disrupt the pathway to psychological distress.

Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology

PURPOSE OF REVIEW

Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature.

RECENT FINDINGS

Metrics and analytic approaches used to assess discrimination remain largely unchanged. Theory and/or frameworks such as the stress and coping framework continue to be underused in majority of the studies. Adolescents and young adults experiencing racial/ethnic discrimination were at greater risk of adverse mental health outcomes, and the accumulation of stressors over the life course may have an aggregate impact on mental health. Some growth seems evident in studies examining the mediation and moderation of stress buffers and other key factors with the findings suggesting a reduction in the effects of discrimination on mental health.

SUMMARY

Discrimination scales should consider the multiple social identities of a person, the context where the exposure occurs, how the stressor manifests specifically in adolescents, the historical traumas, and cumulative exposure. Life course theory and intersectionality may help guide future work. Despite existing research, gaps remain in in elucidating the effects of racial and ethnic discrimination on mental health, signaling an opportunity and a call to social epidemiologists to engage in interdisciplinary research to speed research progress.

Risk and protective factors for comorbid internalizing and externalizing problems among economically disadvantaged African American youth

Comorbidity of internalizing and externalizing problems and its risk and protective factors have not been well incorporated into developmental research, especially among racial minority youth from high-poverty neighborhoods. The present study identified a latent comorbid factor as well as specific factors underlying internalizing and externalizing problems among 592 African American adolescents living in economically disadvantaged neighborhoods (291 male; M age = 15.9 years, SD = 1.43 years). Stressful life events and racial discrimination were associated with higher comorbid problems, whereas stressful life events and exposure to violence were associated with higher specific externalizing problems. Collective efficacy was associated with both lower specific externalizing problems and lower comorbid problems. Moreover, high collective efficacy buffered the risk effects of stressful life events and racial discrimination on comorbid problems. Our results demonstrated the advantages of latent variable modeling to understanding comorbidity by articulating impacts of risk factors on comorbid and specific components underlying internalizing and externalizing problems. They also highlighted the protective effect of collective efficacy in mitigating risks for these problems. These findings broadly call for more studies on comorbidities in developmental psychopathology among youth from diverse sociocultural backgrounds.

Effect of Environmental Risk and Externalizing Comorbidity on Internalizing Problems Among Economically Disadvantaged African American Youth

This study examined effects of racial discrimination, community violence, and stressful life events on internalizing problems among African American youth from high poverty neighborhoods (N = 607; 293 boys; Mage = 16.0 years, SD = 1.44 years). Mediated effects via externalizing problems on these relations were also examined, given the high comorbidity rate between internalizing and externalizing problems. Externalizing problems partially mediated the effect of stressful life events on internalizing problems and fully mediated the effect of racial discrimination for boys but not for girls. Exposure to violence had a significant indirect effect on internalizing problems via externalizing problems. The findings call for greater attention to internalizing problems among African American youth and pathways to internalizing problems via externalizing problems.