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Johnson EI, Planalp EM, Williams DT, Poehlmann J. Parental incarceration and health risks in a population-based study of U.S. early adolescents: Results among racialized groups. SSM Popul Health 2024; 27:101702. [PMID: 39184526 PMCID: PMC11342108 DOI: 10.1016/j.ssmph.2024.101702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/25/2024] [Accepted: 07/25/2024] [Indexed: 08/27/2024] Open
Abstract
Parental incarceration is an adverse childhood experience that inequitably burdens families of color and affects millions of U.S. children and adolescents. Although racialized disparities in exposure to parental incarceration are often acknowledged, researchers have yet to examine whether manifestations of racism may affect the link between parental incarceration and youth outcomes. This study provides a first look at how parental incarceration relates to health vulnerabilities in the Adolescent Brain Cognitive Development (ABCD) study, an ongoing, population-based study of U.S. children born between 2006 and 2008. We start by describing exposure to parental incarceration and then examine how parental incarceration, state-level racial prejudice, and discrimination relate to health risks among 9191 White (66%), Black (19%), or Hispanic (15%) youth. Consistent with what we know about pervasive racialized disparities in the U.S. criminal legal system, we find that 19.3% of Black children in our sample have experienced parental incarceration, followed by 7.8% of Hispanic children, and 4.8% of White children. Results of multilevel mixed models further indicate that parental incarceration was associated with increased health risks among White children whereas family economic hardship and discrimination experiences were more robustly associated with health vulnerabilities among Black and Hispanic children. Additional analyses explored whether parental incarceration was associated with other outcomes among Black and Hispanic children, revealing increased risk for behavior problems contingent upon parental incarceration and discrimination for Black children and Hispanic boys. Among Hispanic girls, parental incarceration was associated with increased risk of behavior problems in states with higher levels of racism. Results suggest that parental incarceration contributes to risk among early adolescents across racialized groups, but that the specific toll it takes depends on outcomes assessed and the context in which it occurs.
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Polanco-Roman L, Ebrahimi CT, Satinsky EN, Benau EM, Martins Lanes A, Iyer M, Galán CA. Racism-Related Experiences and Traumatic Stress Symptoms in Ethnoracially Minoritized Youth: A Systematic Review and Meta-Analysis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:690-707. [PMID: 38175945 DOI: 10.1080/15374416.2023.2292042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVE Despite growing evidence demonstrating the association between racial and ethnic discrimination and traumatic stress symptoms in adult populations, the research among youth remains sparse. Drawing upon race-based traumatic stress models, and following the PRISMA-2020 guidelines, this systematic review and meta-analysis aimed to identify the state of the empirical evidence in the association between racism-related experiences and traumatic stress symptoms in ethnoracially minoritized youth. METHOD Scientific databases were searched to identify articles with ethnoracially minoritized youth participants under age 18 years old that examined the association between racial and/or ethnic discrimination and traumatic stress symptoms. RESULTS A total of 18 articles comprising 16 studies (N = 4,825 participants) met inclusion criteria. Studies were largely cross-sectional, used nonrandom sampling strategies, focused on Black and Latinx youth, and were conducted in the United States. Furthermore, most studies were theoretically grounded and operationalized racism-related experiences as frequency of direct, personal, everyday discrimination. Few studies examined other dimensions of racism-related experiences. The meta-analysis demonstrated a significant positive association with a medium effect size, rpooled = .356, 95% confidence interval [CI] = 0.27, 0.44, between racism-related experiences and traumatic stress symptoms. No evidence of moderation by age, sex/gender, race/ethnicity, country, or recruitment setting was detected. CONCLUSION Racism-related experiences may confer risk for traumatic stress symptoms in ethnoracially minoritized youth. Attending to racism-related experiences is critical to improve the cultural responsiveness of trauma-informed services.
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Affiliation(s)
| | | | | | | | | | - Mythili Iyer
- Department of Psychology, University of Southern California
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Oshri A, Reck AJ, Carter SE, Uddin LQ, Geier CF, Beach SRH, Brody GH, Kogan SM, Sweet LH. Racial Discrimination and Risk for Internalizing and Externalizing Symptoms Among Black Youths. JAMA Netw Open 2024; 7:e2416491. [PMID: 38865126 PMCID: PMC11170300 DOI: 10.1001/jamanetworkopen.2024.16491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/11/2024] [Indexed: 06/13/2024] Open
Abstract
Importance Racial discrimination is a psychosocial stressor associated with youths' risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US. Objective To investigate the association between racial discrimination and risk for psychopathology moderated by neuroaffective processing. Design, Setting, and Participants This cohort study used longitudinal self-report and functional magnetic resonance imaging (fMRI) data from Black youth participants in the US from the Adolescent Brain Cognitive Development (ABCD) study. Data were analyzed from January 2023 to May 2024. Exposures At time 1 of the current study (12 months after baseline), youths self-reported on their experiences of interpersonal racial discrimination and their feelings of marginalization. Amygdalar response was measured during an emotionally valenced task that included blocks of faces expressing either neutral or negative emotion. Main Outcomes and Measures At 24 and 36 months after baseline, youths reported their internalizing (anxiety and depressive symptoms) and externalizing symptoms (aggression and rule-breaking symptoms). Results A total of 1596 youths were a mean (SD) age of 10.92 (0.63) years, and 803 were female (50.3%). Families in the study had a mean annual income range of $25 000 to $34 999. Two factors were derived from factor analysis: interpersonal racial discrimination and feelings of marginalization (FoM). Using structural equation modeling in a linear regression, standardized β coefficients were obtained. Neural response to faces expressing negative emotion within the right amygdala significantly moderated the association between FoM and changes in internalizing symptoms (β = -0.20; 95% CI, -0.32 to -0.07; P < .001). The response to negative facial emotion within the right amygdala significantly moderated the association between FoM and changes in externalizing symptoms (β = 0.24; 95% CI, 0.04 to 0.43; P = .02). Left amygdala response to negative emotion significantly moderated the association between FoM and changes in externalizing symptoms (β = -0.16; 95% CI, -0.32 to -0.01; P = .04). Conclusions and Relevance In this cohort study of Black adolescents in the US, findings suggest that amygdala function in response to emotional stimuli can both protect and intensify the affective outcomes of feeling marginalized on risk for psychopathology, informing preventive interventions aimed at reducing the adverse effects of racism on internalizing and externalizing symptoms among Black youths.
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Affiliation(s)
- Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Ava Jane Reck
- Department of Human Development and Family Science, University of Georgia, Athens
| | | | - Lucina Q. Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Charles F. Geier
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Steven R. H. Beach
- Center of Family Research, University of Georgia, Athens
- Department of Psychology, University of Georgia, Athens
| | - Gene H. Brody
- Center of Family Research, University of Georgia, Athens
| | - Steven M. Kogan
- Department of Human Development and Family Science, University of Georgia, Athens
- Center of Family Research, University of Georgia, Athens
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Mersky JP, Jeffers NK, Lee CP, Shlafer RJ, Jackson DB, Gómez A. Linking Adverse Experiences to Pregnancy and Birth Outcomes: A Life Course Analysis of Racial and Ethnic Disparities Among Low-Income Women. J Racial Ethn Health Disparities 2024; 11:1741-1753. [PMID: 37289344 DOI: 10.1007/s40615-023-01647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 06/09/2023]
Abstract
Racial and ethnic disparities in birth outcomes have persisted in the United States for decades, though the causes remain poorly understood. The life course perspective posits that poorer outcomes of Black birthing people stem from heightened exposure to stressors early in life and cumulative exposure to stressors over time. Despite its prominence, this perspective has seldom been investigated empirically. We analyzed longitudinal data gathered from 1319 women in low-income households in Wisconsin who received perinatal home visiting services. Variable- and person-centered analyses were performed to assess whether 15 adverse childhood experiences (ACEs) and 10 adverse adult experiences (AAEs) were associated, alone and in combination, with pregnancy loss, preterm birth, and low birth weight among Hispanic (i.e., Latinx) and non-Hispanic Black and White participants. As expected, there were disparities in preterm birth and low birth weight, and both ACEs and AAEs were linked to poorer pregnancy and birth outcomes. Unexpectedly, bivariate and multivariate analyses showed that the associated effects of ACEs and AAEs were most robust for non-Hispanic White women. A latent class analysis produced four patterns of life course adversity, and multigroup latent class analyses confirmed that, compared to White women, higher-adversity class assignments were associated with less robust effects for Hispanic women, and even less robust effects for Black women. We discuss interpretations of the paradoxical findings, including the possibility that alternative sources of stress such as interpersonal and structural racism may better account for the reproductive disparities that disproportionately affect Black birthing people.
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Affiliation(s)
- Joshua P Mersky
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
- Institute for Child & Family Well-Being, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | | | - ChienTi Plummer Lee
- Institute for Child & Family Well-Being, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Rebecca J Shlafer
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anthony Gómez
- Institute for Child & Family Well-Being, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA
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5
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Dadematthews A, Pangelinan MM, Bowen AE, Simon SL, Chandrasekhar JL, Musci R, Kaar JL. A Universal Program to Improve Mental Health among Youth from Low-Income Predominantly Minority Communities: Implementation of Advocates 4 ALL Youth (ALLY). Community Ment Health J 2024:10.1007/s10597-024-01292-5. [PMID: 38801627 DOI: 10.1007/s10597-024-01292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
Disparities in mental health care and access to care disproportionately affect youth from minoritized and low-income communities. School-based prevention programs have the potential to offer a non-stigmatized approach to mental health care as well as the ability to reach many students simultaneously. Advocates 4 All Youth (ALLY) is a program developed for 5-6th grade students aimed at improving self-efficacy and resilience via individualized sessions with a trusted adult (ALLYs). The feasibility of delivering ALLY in a racially and minoritized low-income community is discussed and modifications required to implement the program documented. Students completed questionnaires and sessions with an ALLY. Aspects of program delivery deemed feasible included training ALLYs to delivery program, stakeholder buy-in regarding missing class time, and students attending the sessions. Further modifications included adjustments to materials due to lower reading level and health literacy related-educational needs. Programs designed in one demographic setting may not work in a different setting.
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Affiliation(s)
| | | | - Anne E Bowen
- Children's Hospital Colorado, 13123 East 16th Avenue B265, Aurora, CO, 80045, USA
| | - Stacey L Simon
- Children's Hospital Colorado, 13123 East 16th Avenue B265, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Rashelle Musci
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jill L Kaar
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
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6
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Voith LA, Salas Atwell M, D'Alessio AS, Evans KE, Korsch-Williams A. Examining adverse childhood experiences and Black youth's engagement in a hospital-based violence intervention program using administrative data. Acad Emerg Med 2024. [PMID: 38605493 DOI: 10.1111/acem.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Stemming from poverty and systemic racism, Black youth are disproportionately represented in hospital-based violence intervention programs (HVIPs) due to greater violence exposure. HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth. METHODS Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between-group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi-square and logistic regression. ACEs were approximated using a novel approach with administrative data. RESULTS Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups. CONCLUSIONS This study highlights a novel approach to understanding ACEs among a hard-to-reach population and illuminates the significant level of ACEs faced by violence-exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma-informed and healing-centered interactions during recruitment and later stages of engagement.
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Affiliation(s)
- Laura A Voith
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center on Trauma and Adversity, Cleveland, Ohio, USA
| | - Meghan Salas Atwell
- National Association for the Education of Young Children, Washington, DC, USA
| | - Alena Sorensen D'Alessio
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Amy Korsch-Williams
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center on Trauma and Adversity, Cleveland, Ohio, USA
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Rubi S, Monk JK, Shoemaker S, Miller C, Prabhu N, Flores LY, Bernard D, McCrae CS, Borsari B, Miller MB. Perpetuating and protective factors in insomnia across racial/ethnic groups of veterans. J Sleep Res 2024; 33:e14063. [PMID: 37778753 PMCID: PMC10947959 DOI: 10.1111/jsr.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023]
Abstract
Few studies have examined racial/ethnic differences in rates and correlates of insomnia among veterans. This study compared rates of insomnia and interest in sleep treatment among veterans of diverse racial/ethnic backgrounds. Consistent with the 3P model, we tested racial discrimination as a predictor of insomnia, with post-traumatic stress disorder symptoms and romantic partners as perpetuating and protective moderators of this association, respectively. A total of 325 veterans (N = 236 veterans of colour; 12% Asian, 36% Black, 14% Hispanic/Latine) completed questionnaires online from remote locations. Descriptive statistics were used to compare patterns across racial/ethnic groups. Linear regression was used to test moderators of the association between racial discrimination and insomnia severity. Overall, 68% of participants screened positive for insomnia: 90% of Asian; 79% of Hispanic/Latine; 65% of Black; and 58% of White participants. Of those, 74% reported interest in sleep treatment, and 76% of those with partners reported interest in including their partner in treatment. Racial discrimination and post-traumatic stress disorder were correlated with more severe insomnia, while romantic partners were correlated with less severe insomnia. Only post-traumatic stress disorder moderated the association between racial discrimination and insomnia severity. Rates of insomnia were highest among Asian and Hispanic/Latine participants, yet these groups were among the least likely to express interest in sleep treatment. Racial discrimination may exacerbate insomnia symptoms among veterans, but only among those who do not already have disturbed sleep in the context of post-traumatic stress disorder. Romantic partners may serve as a protective factor in insomnia, but do not seem to mitigate the impact of racial discrimination.
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Affiliation(s)
- Sofia Rubi
- Department of Psychiatry, University of Missouri, School of Medicine, Columbia, Missouri, USA
| | - J. Kale Monk
- Department of Human Development and Family Science, University of Missouri College of Education & Human Development, Columbia, Missouri, USA
| | - Sydney Shoemaker
- Department of Psychiatry, University of Missouri, School of Medicine, Columbia, Missouri, USA
| | - Colten Miller
- Department of Psychiatry, University of Missouri, School of Medicine, Columbia, Missouri, USA
| | - Nivedita Prabhu
- Department of Psychiatry, University of Missouri, School of Medicine, Columbia, Missouri, USA
| | - Lisa Y. Flores
- Department of Psychological Sciences, University of Missouri College of Arts & Sciences, Columbia, Missouri, USA
| | - Donte Bernard
- Department of Psychological Sciences, University of Missouri College of Arts & Sciences, Columbia, Missouri, USA
| | | | - Brian Borsari
- Mental Health Service, San Francisco VA Health Care System, San Francisco, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri, School of Medicine, Columbia, Missouri, USA
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Aikins M, Willems Y, Mitchell C, Goosby B, Raffington L. Linked emergence of racial disparities in mental health and epigenetic biological aging across childhood and adolescence. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.26.586786. [PMID: 38586008 PMCID: PMC10996608 DOI: 10.1101/2024.03.26.586786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Marginalization due to structural racism may confer an increased risk for aging-related diseases - in part - via effects on people's mental health. Here we leverage a prospective birth cohort study to examine whether the emergence of racial disparities in mental health and DNA-methylation measures of biological aging (i.e., DunedinPACE, GrimAge Acceleration, PhenoAge Acceleration) are linked across childhood and adolescence. We further consider to what extent racial disparities are statistically accounted for by perinatal and postnatal factors in preregistered analyses of N=4,898 participants from the Future of Families & Child Wellbeing Study, of which N=2,039 had repeated saliva DNA methylation at ages 9 and 15 years. We find that racially marginalized children had higher levels of externalizing and internalizing behaviors and diverging longitudinal internalizing slopes. Black compared to White identifying children, children living in more racially segregated neighborhoods, and racially marginalized children more affected by colorism tended to have higher age-9 levels of biological aging and more biological age acceleration over adolescence. Notably, longitudinal increases in internalizing and externalizing behavior were correlated with longitudinal increases in biological aging. While racial and ethnic disparities in mental health were largely statistically accounted for by socioeconomic variables, racial differences in biological aging were often still visible beyond covariate controls. Our findings indicate that racial disparities in mental health and biological aging are linked and emerge early in life. Programs promoting racial health equity must address the psychological and physical impacts of structural racism in children. Comprehensive measures of racism are lacking in current population cohorts.
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Affiliation(s)
- Muna Aikins
- Max Planck Research Group Biosocial – Biology, Social Disparities, and Development; Max Planck Institute for Human Development; Berlin, Germany
| | - Yayouk Willems
- Max Planck Research Group Biosocial – Biology, Social Disparities, and Development; Max Planck Institute for Human Development; Berlin, Germany
| | - Colter Mitchell
- Survey Research Center of the Institute for Social Research; University of Michigan, Ann Arbor, MI, USA
- Population Studies Center of the Institute for Social Research; University of Michigan, Ann Arbor, MI, USA
| | - Bridget Goosby
- Population Research Center; University of Texas at Austin, Austin, TX, USA
| | - Laurel Raffington
- Max Planck Research Group Biosocial – Biology, Social Disparities, and Development; Max Planck Institute for Human Development; Berlin, Germany
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Tyrell FA, Wang YS, Eboigbe LI, Skeeter BD. A multisystem model for understanding stress and adaptation in ethnically and racially diverse youth. Dev Psychopathol 2024:1-13. [PMID: 38506061 DOI: 10.1017/s0954579424000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Contemporary biological and contextually based theoretical frameworks have conceptualized how stress exposure may influence adaptation in youth. However, nearly all of this scholarship neglects the role of specific contextual features and/or biological processes that are involved in ethnic-racial minority youth's responses and adaptation to sociocultural stressors. Drawing on the theoretical principles of the developmental psychopathology framework and contemporary models of stress and adaptation, this article proposes a new multisystem model that explains how multiple levels and systems within and outside of individual youth influence their sociocultural adaptation. We provide empirical evidence to support components of this multisystem model. We propose that research based on our new theoretical framework will capture the sociocultural experiences of ethnic-racial minority youth by centering processes that are relevant to their lived experiences, coping, and adjustment. In doing so, this model will inform psychosocial interventions focused on promoting healthy adaptation among ethnic and racial diverse youth. Finally, we offer recommendations to guide future research on stress and adaptation among ethnic and racial diverse youth, in particular, and developmental psychopathology more broadly.
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Affiliation(s)
- Fanita A Tyrell
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Yuqi S Wang
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Loretta I Eboigbe
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Bailey D Skeeter
- Department of Psychology, University of Maryland, College Park, MD, USA
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10
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Willis HA, Polanco-Roman L, Derella OJ, Zayde A. Emotional impacts of racial discrimination on caregiver-child dyads: Can mentalizing-focused parenting groups buffer against racism-related stress? Dev Psychopathol 2024:1-12. [PMID: 38477321 DOI: 10.1017/s095457942400049x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Black and Latinx caregivers face high risk for parenting stress and racism-related stress due to experiences of racial discrimination (RD). This study aimed to explore the associations between RD, parenting stress, and psychological distress in caregiver-child dyads, as well as the impact of a mentalizing-focused group intervention on caregivers' experiences of RD distress. Ethnoracially minoritized caregivers of children aged 5-17 years old participated in a non-randomized clinical trial (N = 70). They received either a 12-session mentalizing-focused group parenting intervention or treatment-as-usual in outpatient psychiatry. We assessed self-reported frequency and distress related to RD, parenting stress, and psychological distress at baseline (T1) and post-intervention (T2). Caregiver- and self-reported child psychological distress were also measured. The results showed that greater RD frequency and greater RD distress separately predicted higher overall parenting stress and parental role-related distress. Greater RD distress was linked to increased psychological distress in caregivers. Similarly, greater RD frequency and distress among caregivers were associated with higher caregiver-reported, but not self-reported, child psychological distress. No significant changes in RD distress were observed between T1 and T2 for either of the treatment groups. These findings highlight the exacerbating role of RD on parenting stress and psychological distress among ethnoracially minoritized caregivers and their children.
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Affiliation(s)
- Henry A Willis
- Department of Psychology, University of Maryland at College Park, College Park, MD, USA
| | | | - Olivia J Derella
- Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA
| | - Amanda Zayde
- Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA
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11
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Reynolds A, Greenfield EA, Williams-Butler A. Early life adversity, race, and childhood socioeconomic status: intersecting drivers of later life cognition. Aging Ment Health 2024; 28:511-519. [PMID: 37572032 PMCID: PMC10859546 DOI: 10.1080/13607863.2023.2242296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/06/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES Research on associations between early life adversity (ELA) and later life cognition has yielded mixed results and generally have not considered how broader societal systems of stratification potentially influence associations. The current study addresses this gap by exploring if racialized identity and childhood socioeconomic status (cSES) moderate associations between ELA exposure and later life cognition. METHODS Using data from the Health and Retirement Study (Waves 2010-2018), we used growth curve modeling to examine if the confluence of ELA, cSES, and racialized identity is associated with cognition. RESULTS Among White participants, greater exposure to ELA was associated with poorer baseline cognitive functioning, and higher cSES buffered against this association. Among Black participants, exposure to ELA was not associated with baseline cognitive functioning, regardless of cSES. We did not find evidence of any associations between main predictors nor their interactions with change in cognition over time. CONCLUSIONS This study provides evidence that associations between ELA and later life cognition is contingent upon multiple social positions in the United States. These findings support the importance of integrating insights on intersecting social positions within life-course-oriented efforts to reduce racialized cognitive disparities.
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Affiliation(s)
- Addam Reynolds
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
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12
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Barboza-Salerno GE, Meshelemiah JCA. Associations between early child adversity and lifetime suicide attempts among gender diverse individuals: A moderated mediation. CHILD ABUSE & NEGLECT 2024; 149:106705. [PMID: 38422580 DOI: 10.1016/j.chiabu.2024.106705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND This study examines the effect of adverse childhood experiences (ACEs) on lifetime suicide attempts (LSA) across five gender subgroups (i.e., transgender men, transgender women, transgender non-binary, cisgender men and cisgender women). OBJECTIVE To examine (1) the prevalence of LSA across gender identity subgroups; (2) whether the association between ACEs and LSA is moderated by gender identity subgroup; (3) depressive symptoms, alcohol use disorder, social support, and social well-being as mechanisms linking ACEs with LSA; and (4) the moderating role of gender identity on the four putative mediators. PARTICIPANTS AND SETTINGS We used nationally representative data from a population-based survey of N = 1368 transgender and cisgender individuals collected between 2016 and 2019. METHODS Structural equation modeling was used to explore the indirect effect of depressive symptoms on the relation between ACEs and LSA, and the moderating impact of gender identity. RESULTS LSA was significantly more prevalent among transgender respondents (cisgender man = 5 %; cisgender woman = 9 %; transgender man = 42 %; transgender woman = 33 %; transgender non-binary = 37 %; p < 0.001). Individuals with more ACEs had a greater risk of engaging in LSA regardless of gender identity; however, moderation results showed that the impact of each additional ACE on LSA was stronger for individuals with transgender identities: the likelihood of engaging in LSA was statistically similar for transgender men with no ACEs and cisgender men with all 8 ACEs. Indirect effects of ACEs on LSA via depressive symptoms were also observed, and the mediating effect was moderated by gender identity. CONCLUSIONS By examining the mechanisms linking childhood adversity to LSA, this study demonstrates that not all ACEs impact gender minority subgroups equally.
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Affiliation(s)
- Gia E Barboza-Salerno
- The Ohio State University, College of Public Health & College of Social Work, 352 Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
| | - Jacquelyn C A Meshelemiah
- The Ohio State University, College of Social Work, 325D Stillman Hall, 1947 North College Road, Columbus, OH 43210, United States of America.
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Garcia RS, Hollis T, Baratta J, King Z, Faulks M, Ricketts M, Brown-Johnson C, Shankar M, Guerin A, Wong HN, Zulman DM, Floyd BD. Building Trust and Partnership with Black Pediatric Patients and their Caregivers. Acad Pediatr 2024; 24:216-227. [PMID: 37659602 DOI: 10.1016/j.acap.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023]
Abstract
Systemic racism embedded within the US health care system results in disproportionately worse health outcomes for Black pediatric patients and their caregivers. One meaningful mechanism through which these health disparities persist is through discriminatory treatment and anti-Black bias from clinicians. Strengthening care provided to Black pediatric patients and their caregivers requires that clinicians adopt culturally tailored communication strategies that promote health equity and counter racism. We conducted a scoping review of evidence-based communication practices in the medical literature that improve care for Black pediatric patients. We mapped the specific practices to the Presence 5 for Racial Justice framework and identified cross-cutting themes to describe practices across the five domains. There are three cross-cutting themes that underlie the recommended practices: 1) promote unbiased implementation of clinician communication strategies (eg, providing equitable recommendations for preventive care), 2) tailor care to Black pediatric patients (eg, explore the importance of the family unit), and 3) address racism experienced by Black pediatric patients and their caregivers (eg, acknowledge any previous negative experiences with the health care system). This review highlights communication practices that clinicians can adopt to build trusting relationships, empower Black families, and promote racial justice in clinical care. Future opportunities include expanding to system level change and validating these practices with patients and clinicians.
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Affiliation(s)
- Raquel S Garcia
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Department of Medicine (RS Garcia), Duke University School of Medicine, Durham, NC
| | - Taylor Hollis
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; University of Alabama at Birmingham Heersink School of Medicine (T Hollis)
| | - Juliana Baratta
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Massachusetts Institute of Technology Sloan School of Management (J Baratta), Cambridge, Mass
| | - Zoe King
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Stanford Prevention Research Center (Z King), Stanford University School of Medicine, Palo Alto, Calif
| | - Melvin Faulks
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif
| | - Maya Ricketts
- Meharry Medical College School of Medicine (M Ricketts), Nashville, Tenn
| | - Cati Brown-Johnson
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif
| | - Megha Shankar
- Division of General Internal Medicine (M Shankar), Department of Medicine, University of California San Diego, La Jolla, Calif; Presence Center (M Shankar), Stanford University School of Medicine, Stanford, Calif
| | - Allison Guerin
- Department of Pediatrics (A Guerin), Office of Pediatric Education and Office of Diversity, Equity, Inclusion, and Justice in Pediatrics, Stanford University School of Medicine, Palo Alto, Calif
| | - Hong-Nei Wong
- Lane Medical Library (HN Wong), Stanford University School of Medicine, Stanford, Calif
| | - Donna M Zulman
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif
| | - Baraka D Floyd
- Department of Pediatrics (BD Floyd), Division of General Pediatrics and Office of Diversity Equity, Inclusion, and Justice in Pediatrics, Stanford University School of Medicine, Palo Alto, Calif.
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Mersky JP, Lee CP, Hami D. Adverse Childhood Experiences and Sexual Orientation: An Intersectional Analysis of Nationally Representative Data. Am J Prev Med 2024; 66:483-491. [PMID: 37884176 DOI: 10.1016/j.amepre.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION This study compared the prevalence of adverse childhood experiences across intersections of sexual orientation, gender, race/ethnicity, and economic status. METHODS Data collected between 1994 and 2018 from 12,519 participants in the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2023 to generate adverse childhood experience prevalence estimates. Unadjusted 1-way ANOVAs and multivariate regressions were performed to compare differences in independent and cumulative adversity measures by sexual orientation, gender, race/ethnicity, and poverty status. A multilevel analysis of individual heterogeneity and discriminatory accuracy was conducted to estimate adversity scores across 24 groups that were stratified by sexual orientation, gender, race/ethnicity, and poverty status. RESULTS Adolescents with same-sex attractions and adults who identified with a sexual minority group reported more adverse childhood experiences overall than straight participants, although associations varied by type of adversity. Strikingly, adversity scores were higher among White youth with same-sex attractions than among Black youth with same-sex attractions, among more economically advantaged bisexual adults than among poorer ones, and among poor White participants than among poor Black and Hispanic participants, suggesting that the combination of disadvantaged and marginalized statuses does not necessarily correspond with greater childhood adversity. A multilevel analysis of individual heterogeneity and discriminatory accuracy interaction model showed that sexual orientation and poverty status contributed significant variance to cumulative adversity scores, whereas gender and race/ethnicity did not. CONCLUSIONS The results show that disparities in adverse experiences can be more fully and accurately represented when sexual orientation and other social identities are modeled as intersectional configurations. Given that adverse childhood experiences are linked to morbidity and mortality, the findings have salient implications for understanding health disparities that affect population subgroups.
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Affiliation(s)
- Joshua P Mersky
- Institute for Child and Family Well-being, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin.
| | - ChienTi Plummer Lee
- Institute for Child and Family Well-being, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Davin Hami
- School of Medicine and Public Health, University of Wisconsin-Madison, Milwaukee, Wisconsin
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Cheung CK, Miller KA, Goings TC, Thomas BN, Lee H, Brandon RE, Katerere-Virima T, Helbling LE, Causadias JM, Roth ME, Berthaud FM, Jones LP, Ross VA, Betz GD, Simmons CD, Carter J, Davies SJ, Gilman ML, Lewis MA, Lopes G, Tucker-Seeley RD. BIPOC experiences of (anti-)racist patient engagement in adolescent and young adult oncology research: an electronic Delphi study. Future Oncol 2024; 20:547-561. [PMID: 38197386 PMCID: PMC10988539 DOI: 10.2217/fon-2023-0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
Aims: To characterize Black, Indigenous and People of Color (BIPOC) adolescent and young adult (AYA) cancer patients' experiences of patient engagement in AYA oncology and derive best practices that are co-developed by BIPOC AYAs and oncology professionals. Materials & methods: Following a previous call to action from AYA oncology professionals, a panel of experts composed exclusively of BIPOC AYA cancer patients (n = 32) participated in an electronic Delphi study. Results: Emergent themes described BIPOC AYA cancer patients' direct experiences and consensus opinion on recommendations to advance antiracist patient engagement from BIPOC AYA cancer patients and oncology professionals. Conclusion: The findings reveal high-priority practices across all phases of research and are instructional for advancing health equity.
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Affiliation(s)
| | - Kimberly A Miller
- Department of Preventive Medicine and Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Bria N Thomas
- Temple University School of Podiatric Medicine, Philadelphia, PA 19107, USA
| | - Haelim Lee
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - Rachel E Brandon
- University of Michigan School of Social Work, Ann Arbor, MI 48109, USA
| | | | - Laura E Helbling
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - José M Causadias
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ 85287, USA
| | - Michael E Roth
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | - Valentina A Ross
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - Gail D Betz
- University of Maryland Baltimore Health Sciences & Human Services Library, Baltimore, MD 21201, USA
| | - Cole D Simmons
- Bryn Mawr Graduate School of Social Work and Social Research, Bryn Mawr, PA 19010, USA
| | - Jay Carter
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | | | - Megan L Gilman
- AYA Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mark A Lewis
- Department of Gastrointestinal Oncology, Intermountain Healthcare, Salt Lake City, UT, 84107 USA
| | - Gilberto Lopes
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Belisle LA, Pinchevsky GM, Ortega G. Examining the prevalence of adverse childhood experiences (ACEs) among justice-involved youth in the U.S.: The importance of accounting for race/ethnicity, gender, and gendered racial/ethnic groups. CHILD ABUSE & NEGLECT 2024; 149:106514. [PMID: 38359774 DOI: 10.1016/j.chiabu.2023.106514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Youth in the U.S. juvenile justice system are exposed to adverse childhood experiences (ACEs) at higher rates than youth in the general public. Additionally, research has demonstrated ACEs can vary by race/ethnicity and gender. However, little is known about how ACEs are experienced across gendered racial/ethnic groups of justice-involved youth. OBJECTIVE To address this gap, this exploratory study is the first to apply an intersectional lens to examine the prevalence of ACEs among a group of justice-involved youth in the U.S. PARTICIPANTS & SETTING Using secondary data, this study examines ACEs by gender, race/ethnicity, and six gendered racial/ethnic groups of justice-involved youth referred to the Division of Youth and Family Services (DYFS) in Milwaukee, Wisconsin. METHODS Descriptive analyses are presented by gender and race/ethnicity separately, followed by gendered racial/ethnic groups to understand differential rates of exposure to ACEs. RESULTS The study's findings align with previous research and reinforce that justice-involved youth experience higher rates of adversity than the general public. The results also support the feminist pathway's perspective within an intersectional context, emphasizing the importance of accounting for race/ethnicity and gender simultaneously to identify the unique experiences of ACEs among justice-involved youth. CONCLUSION Recommendations related to these findings and considerations surrounding ACE measures are discussed. Specifically, findings from this study stress the importance of accounting for gender and race/ethnicity simultaneously when measuring experiences of adversity. This is a critical step to providing equitable treatment and services to address trauma-related needs across gendered racial/ethnic groups of system-involved youth.
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17
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King WM, Fleischer NL, Operario D, Chatters LM, Gamarel KE. Inequities in the distribution of adverse childhood experiences and their association with health among transgender people of color. CHILD ABUSE & NEGLECT 2024; 149:106654. [PMID: 38350400 DOI: 10.1016/j.chiabu.2024.106654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Racism and cisgenderism expose transgender people of color to adversity across the life course. However, little is known about the prevalence of adverse childhood experiences (ACEs) in this population or their association with health in comparison to other groups. OBJECTIVE Guided by the structural trauma framework, we examined race/ethnicity/gender group differences in the prevalence of ACEs and their association with adult mental and physical health. PARTICIPANTS AND SETTING 2019-2021 Behavioral Risk Factor Surveillance Survey. METHODS Transgender participants (n = 551) were matched with two cisgender men (n = 1102) and two cisgender women (n = 1102) on key covariates. We compared age-adjusted predicted probabilities of nine ACEs by race/ethnicity/gender group. We then fit adjusted logistic regression models predicting poor mental and physical health by each ACE and compared marginal effects between groups. RESULTS Transgender people of color had higher age-adjusted probabilities of six ACEs than at least one other group; for example, household incarceration was 0.16 (95 % CI: 0.11-0.22) compared to 0.09 (95 % CI: 0.06-0.13) for cisgender men of color (p = 0.032). The relationship between five ACEs and poor mental health was greater for transgender people of color than at least one other group. For instance, the marginal effect of household alcoholism on poor mental health was 0.28 (95 % CI: 0.11-0.45) compared to 0.07 (0.01-0.14) for White cisgender men (p = 0.031). There were no statistically significant differences regarding effects on poor physical health. CONCLUSIONS ACEs inequitably impact transgender people of color, reflecting the need to restructure the interlocking systems that drive adversity among transgender children of color and exacerbate ACEs' health effects among adults.
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Affiliation(s)
- Wesley M King
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1525 Clifton Road, Atlanta, GA 30329, United States of America.
| | - Linda M Chatters
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America; University of Michigan School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, United States of America.
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
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Rancher CE, Bernard DL, Moreland AD. Measurement Invariance of Adverse Childhood Experiences Across Teacher Age and Race. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2024; 33:727-742. [PMID: 38939647 PMCID: PMC11207200 DOI: 10.1080/10926771.2024.2323651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 02/13/2024] [Indexed: 06/29/2024]
Abstract
Adverse Childhood Experiences (ACEs) confer considerable risk for negative outcomes across the lifespan, but there is limited research examining whether the measurement of ACEs can be interpreted the same way across diverse groups of individuals. In particular, the measurement of ACEs among early child education teachers has received little attention. Given that millions of children receive care from early child education teachers, and evidence that ACEs can severely disrupt teacher's abilities to support young children, it is critical to accurately assess for and respond to teacher ACEs. The present study examined the factor structure and measurement invariance of the 11-item Behavioral Risk Factor Surveillance Survey (BRFSS) version of the ACEs measure across a diverse group of teachers. Data were collected from 605 teachers in a southeastern state between 2018 and 2021. Teachers ranged in age from 18 to 81 years (35% young; 56% middle; and 9% older adults) and were diverse across race (46% White; 53% Black). Teachers completed the BRFSS version of the ACEs measure and a demographics questionnaire. Factor analyses replicated the theorized three-factor solution, with household dysfunction, emotional/psychological abuse, and sexual abuse emerging as distinct factors. Multigroup confirmatory factor analyses demonstrated measurement invariance across teacher age and race. Comparisons of scores indicated ACEs levels varied across teacher age and race. Overall, findings suggest the BRFSS version of the ACEs measure can be used to assess adverse childhood experiences across diverse groups of early child education teachers.
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Affiliation(s)
- Caitlin E Rancher
- National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC
| | - Donte L Bernard
- Department of Psychological Sciences Columbia, University of Missouri, Columbia, MO
| | - Angela D Moreland
- National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC
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19
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Kogan SM, Reck AJ, Curtis MG, Oshri A. Childhood adversity and racial discrimination forecast suicidal and death ideation among emerging adult Black men: A longitudinal analysis. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024:2024-50864-001. [PMID: 38330370 PMCID: PMC11306413 DOI: 10.1037/cdp0000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Disproportionate exposure to childhood adversity and the effects of racial discrimination take a toll on Black American men's mental health. Despite increasing rates of suicidal behaviors and thoughts among young adult, Black American men, few longitudinal studies examine their risk for suicidal and death ideation (SDI). We tested a developmental model linking childhood adversity (experiences of deprivation and threatening experiences) and emerging adult exposure to racial discrimination to increases in SDI and examined a potential mechanism for these effects, negative relational schemas. METHOD A sample of 504 Black men (Mage = 20.7) from rural Georgia were recruited with respondent-driven sampling and completed a baseline survey. Men participated in two additional follow-up surveys (Mage = 21.9 and Mage = 23.5). Hypotheses were tested using structural equation modeling. RESULTS Analyses largely supported the proposed model. Childhood adversities were associated directly with reports of SDI. Childhood deprivation indirectly predicted SDI via negative schemas (β = 0.03, 95% CI [.014, .046]). Racial discrimination also indirectly predicted SDI via negative relational schemas (β = 0.01, 95% CI [.001, .018]). CONCLUSION Study results suggest that clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Steven M. Kogan
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Ava J. Reck
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Michael G. Curtis
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
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20
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Sterrett-Hong EM, Smith AB, Bullock NA, Combs RM, Krigger K, Kerr J. Post-traumatic stress disorder symptoms and PrEP intentions among Black American young adults at high-risk for HIV. ETHNICITY & HEALTH 2024; 29:100-111. [PMID: 37743543 DOI: 10.1080/13557858.2023.2259639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES Black Americans bear the greatest burden of HIV, accounting for 43% of new diagnoses. Yet Black Americans also evidence the lowest utilization rates of Pre-Exposure Prophylaxis (PrEP), a highly effective biomedical strategy for preventing HIV infection. Predictors of PrEP acceptance vary; however, little is known about psychological distress, such as post-traumatic stress disorder (PTSD) symptoms, as a predictor. DESIGN In this cross-sectional study, n = 195 Black Americans, evidencing behaviors found in the research literature to heighten risk for contracting HIV (e.g. sex work, injection drug use) ages 18-29, 55% cisgender women, 39.5% cisgender men, 3% transgender/non-binary, completed audio-computer-assisted self-interviews. RESULTS Bivariate analyses indicated significant positive associations between PTSD symptoms and PrEP acceptance and self-confidence. In multinomial logistic regression analyses, after controlling for Perceived HIV Risk, participants had a higher likelihood of responding they 'probably would' take PrEP (as opposed to 'definitely would not' take PrEP) if they reported higher levels of PTSD symptoms. Post-hoc analyses revealed a curvilinear relationship between PTSD symptoms and PrEP acceptance with those reporting the highest level of PTSD in the sample having slightly lower PrEP acceptance than those reporting moderately high levels of PTSD. CONCLUSION Findings are discussed in the context of the negative impacts of high levels of PTSD and potential positive adaptations subsequent to moderate levels of PTSD that could be relevant to advances in HIV prevention efforts.
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Affiliation(s)
- Emma M Sterrett-Hong
- Kent School of Social Work and Family Science, University of Louisville, Louisville, USA
| | - Adrienne B Smith
- School of Public Health and Information Sciences, University of Louisville, Louisville, USA
| | - Nana Ama Bullock
- School of Public Health and Information Sciences, University of Louisville, Louisville, USA
| | - Ryan M Combs
- School of Public Health and Information Sciences, University of Louisville, Louisville, USA
| | - Karen Krigger
- School of Medicine, University of Louisville, Louisville, USA
| | - Jelani Kerr
- School of Public Health and Information Sciences, University of Louisville, Louisville, USA
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21
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Grigsby TJ, Claborn KR, Stone AL, Salcido R, Bond MA, Schnarrs PW. Adverse Childhood Experiences, Substance Use, and Self-Reported Substance Use Problems Among Sexual and Gender Diverse Individuals: Moderation by History of Mental Illness. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1089-1097. [PMID: 38045841 PMCID: PMC10689681 DOI: 10.1007/s40653-023-00560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 12/05/2023]
Abstract
Recent research has highlighted the alarmingly high rates at which sexual and gender diverse (SGD) individuals experience Adverse Childhood Experiences (ACE). ACE, in turn, are strongly related to mental illness-an important correlate of substance use. The present study explores whether mental illness moderates the relationship between ACE and substance use outcomes among SGD adults. As part of a larger community-based participatory research study, we assessed ACE, self-reported mental illness, and past-year substance use and misuse among a large and diverse sample of SGD community members in South Central Texas (n = 1,282). Multivariate logistic regression models were used to assess relationships between ACE, mental illness, substance use, and substance misuse (DAST > 3). Interaction terms between ACE and history of mental illness were created to assess moderation effects. Cumulative ACE scores were associated with a significantly higher odds of self-reported past year substance use (AOR = 1.43, 95% CI = 1.34-1.54) and substance misuse (AOR = 1.21, 95% CI = 1.11-1.32). History of mental illness was associated with an increased odds of self-reported substance misuse (AOR = 2.07, 95% CI = 1.20-3.55), but not past year substance use. There was a significant interaction of ACE and history of mental illness on the odds of past year substance use (AOR = 0.78, 95% CI = 0.69-0.89), but not for substance misuse. These results provide support for theoretical models linking ACE, mental illness, and substance use among SGD adults. Longitudinal research designs are needed to address temporality of outcomes and test mediation models of trauma, mental illness, and substance use. Future directions for prevention and intervention are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-023-00560-y.
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Affiliation(s)
- Timothy J. Grigsby
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, Nevada USA
| | - Kasey R. Claborn
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas USA
- Addictions Research Institute, Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas USA
| | - Amy L. Stone
- Department of Sociology and Anthropology, Trinity University, San Antonio, Texas USA
| | | | | | - Phillip W. Schnarrs
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas USA
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22
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Jones MS, Worthen MGF. Measuring the prevalence and impact of adverse childhood experiences in the lives of LGBTQ individuals: A much-needed expansion. CHILD ABUSE & NEGLECT 2023:106560. [PMID: 38001009 DOI: 10.1016/j.chiabu.2023.106560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Numerous studies indicate that LGBTQ people have extensive experiences with adverse childhood experiences (ACEs), more so than their heterosexual and cisgender counterparts. Research also shows that LGBTQ youth endure traumatic experiences with victimization, including bullying, harassment, and violence, based on their non-hetero-cis-normative genders and/or sexual identities. Yet, most ACE measurement strategies fail to: (1) explicitly link the risk of ACE exposure to the discrimination and stigmatization of LGBTQ people, and (2) account for the breadth of potential ACE exposure in LGBTQ populations. OBJECTIVE In the current article, we develop and present a more comprehensive ACE measurement strategy for understanding the cumulative and deleterious impacts of ACEs in the lives of LGBTQ individuals. METHODS Here, we offer three expansions to the current ACE framework: (1) the inclusion of an LGBTQ-specific ACE in addition to the standard ACE measures, (2) the addition of LGBTQ qualifiers for current ACE items (when applicable), and (3) the expansion of ACE measures to capture the unique ACE experiences of LGBTQ individuals in family life, schools, and faith communities. CONCLUSIONS The implementation of a more comprehensive ACE measurement strategy will assist scholars and policymakers in better understanding the impacts of ACEs in the lives of LGBTQ individuals. In all, ACE measurement strategies that capture the breath of exposure of ACEs in the lives of LGBTQ individuals will assist in ACE screening, public health policy, and clinical intervention efforts.
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23
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Charak R, Cano-Gonzalez I, Ronzon-Tirado R, Schmitz RM, Tabler J, Karsberg S, Flores A, Ford JD. LGBTQ+ identity-related abuse during childhood and associations with depression and suicide behavior: Role of adulthood cisheterosexism and expressive suppression. CHILD ABUSE & NEGLECT 2023; 145:106433. [PMID: 37660426 DOI: 10.1016/j.chiabu.2023.106433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/28/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Exposure to minority stressors specific to LGBTQ+ individuals, such as heterosexism and cissexism (or cisheterosexism) is not covered under the traditional adverse childhood experiences framework. This is important because childhood identity-related abuse by a parent/caregiver can lead to mental health challenges in later life through the adoption of maladaptive coping mechanisms. OBJECTIVE The present study aimed to examine the role of cisheterosexism and expressive suppression as serial mediators in the associations between identity-related abuse and depressive symptoms and suicide behavior. PARTICIPANTS AND SETTING Participants included 563 LGBTQ+ identifying adults between 18 and 64 years (M = 30.02, SD = 9.05) from different regions of Spain and were recruited through social media (e.g., Twitter, Facebook, and Instagram). METHOD A serial mediation model was conducted with cisheterosexism and expressive suppression as the mediators in the associations between LGBTQ+ identity-related childhood abuse and depressive symptoms and suicide behavior. RESULTS Findings indicated a positive indirect effect of identity-related abuse on depressive symptoms through cumulative cisheterosexism (B = 0.628, p < .01), and via cumulative cisheterosexism and suppression (B = 0.146, p < .05). No significant indirect effect was found for identity-related abuse on depressive symptoms via suppression (B = 0.086). An indirect effect was found for identity-related abuse on suicide behavior via cumulative cisheterosexism (B = 0.250, p < .01). CONCLUSIONS Findings reveal that LGBTQ+ identity-related cisheterosexist experiences perpetrated by parents or caregivers are associated with harmful, long-term impacts on symptoms of depression and suicide behavior via experiences of cisheterosexism and expressive suppression.
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Affiliation(s)
- Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA.
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | - Rachel M Schmitz
- Department of Sociology, Oklahoma State University, Stillwater, OK, USA
| | - Jennifer Tabler
- Department of Criminal Justice and Sociology, University of Wyoming, Laraime, USA
| | - Sidsel Karsberg
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Ayleen Flores
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
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Kogan SM, Kwon E, Brody GH, Azarmehr R, Reck AJ, Anderson T, Sperr M. Family-Centered Prevention to Reduce Discrimination-Related Depressive Symptoms Among Black Adolescents: Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2340567. [PMID: 37910105 PMCID: PMC10620615 DOI: 10.1001/jamanetworkopen.2023.40567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/16/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Racial discrimination undermines the mental health of Black adolescents. Preventive interventions that can attenuate the effects of exposure to racial discrimination are needed. Objective To investigate whether participation in the Strong African American Families (SAAF) program moderates Black adolescents' depressive symptoms associated with experience of racial discrimination. Design, Setting, and Participants This secondary analysis used data from a community-based randomized clinical trial of SAAF (SAAF vs no treatment control). Participants were followed up at 10, 22, and 34 months after the baseline assessment. Assessment staff were blind to participant condition. Participants in this trial lived in 7 rural counties in Georgia. SAAF was delivered at local community centers. Eligible families had a child aged 11 to 12 years who self-identified as African American or Black. The joint influence of random assignment to SAAF and exposure to racial discrimination was investigated. Data were analyzed from September 2022 to March 2023. Intervention SAAF is a 7-session (14 hours) family skills training intervention that occurs over 7 weeks. Small groups of caregivers and their adolescents participate in a structured curriculum targeting effective parenting behavior, adolescent self-regulation, and Black pride. Main Outcomes and Measures The main outcome was adolescent-reported depressive symptoms, assessed at 34 months via the 20-item Center for Epidemiologic Studies Depression Scale for Children. Results Of 825 families screened randomly from public school lists, 472 adolescents (mean [SD] age, 11.6 years; 240 [50.8%] female) were enrolled and randomized to SAAF (252 participants) or a no treatment control (220 participants). Exposure to racial discrimination at age 13 years was associated with increased depressive symptoms at age 14 years (β = 0.23; 95% CI, 0.13 to 0.34; P < .001). Interaction analyses indicated that the experimental condition significantly moderated the association of racial discrimination with depressive symptoms: (β = -0.27; 95% CI, -0.47 to -0.08; P = .005). Probing the interaction with simple slopes at ±SD revealed that for the control group, racial discrimination was significantly associated with depressive symptoms (β = 0.39; 95% CI, 0.23 to 0.54; P < .001), while for the SAAF group, there was no association between racial discrimination and depressive symptoms (β = 0.12; P = .09). Conclusions and Relevance This randomized clinical trial found that the SAAF intervention reduced the incidence of racism-associated mental health symptoms among Black adolescents. SAAF is recommended for dissemination to health care practitioners working with rural Black adolescents. Trial Registration ClinicalTrials.gov Identifier: NCT03590132.
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Affiliation(s)
- Steven M. Kogan
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Elizabeth Kwon
- Department of Public Health, Baylor University, Waco, Texas
| | - Gene H. Brody
- Center for Family Research, University of Georgia, Athens
| | - Rabeeh Azarmehr
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Ava J. Reck
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Tracy Anderson
- Center for Family Research, University of Georgia, Athens
| | - Megan Sperr
- Center for Family Research, University of Georgia, Athens
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Zhen-Duan J, Nuñez M, Solomon MB, Geracioti T, Jacquez F. Adverse Childhood Experiences and alcohol use among U.S.-born and immigrant Latinx youth: the roles of social support and stress hormones. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:3568-3580. [PMID: 38404361 PMCID: PMC10888520 DOI: 10.1007/s10826-023-02550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/27/2024]
Abstract
The biobehavioral correlates of Adverse Childhood Experiences (ACEs) among Latinx youth have been strikingly understudied. The purpose of this study was to 1) examine the effects of T-ACEs (e.g., maltreatment, family dysfunction) and E-ACEs (e.g., family deportation, community violence) in alcohol use, 2) test whether social support moderated these associations and 3) explore whether ACEs and alcohol use were related via adrenocortical hormones (i.e., cortisol, dehydroepiandrosterone [DHEA]). A total of 100 Latinx youth, between the ages of 13 and 19, participated in this study (53% female). Community samples of United States (U.S.)-born (N = 54) and immigrant Latinx (N = 46) youth provided morning saliva samples and completed self-report questionnaires. Results highlighted that for immigrant youth, social support buffered the effects of E-ACEs on alcohol use, F(9,89)= 3.34, p = .01, R2 = .25. Although our mediation hypothesis was not supported, the direct effects of T-ACEs (β = .25, t (94) = 2.21, p = .03) and E-ACES (β = -.24, t (94) = -2.23, p = .03) on DHEA were significant for the entire sample. Preventing maltreatment and reducing community-level adversities seem critical for optimal child development, as exposure to these may increase alcohol use risk and affect HPA Axis functioning. Increasing extrafamilial support may be particularly salient for immigrant Latinx youth, as many experience extended immigration-related periods of separation from family members.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street Suite 830 Boston, MA 02114 United States
- Department of Psychiatry, Harvard Medical School, 401 Park Drive Boston, MA 02215 United States
| | - Miguel Nuñez
- Department of Psychology, University of Cincinnati, 66 Corry Blvd, Cincinnati, OH 45219 United States
| | - Matia B. Solomon
- Department of Psychology, University of Cincinnati, 66 Corry Blvd, Cincinnati, OH 45219 United States
| | - Thomas Geracioti
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, 2631 Erie Ave, Suite 3, Cincinnati, Ohio 45208 United States
| | - Farrah Jacquez
- Department of Psychology, University of Cincinnati, 66 Corry Blvd, Cincinnati, OH 45219 United States
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26
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Valentino K, Zhen-Duan J, Padilla J, Bernard D. Intergenerational Continuity of Child Maltreatment, Parenting, and Racism: Commentary on Valentino et al., (2012). CHILD MALTREATMENT 2023; 28:556-562. [PMID: 37491779 PMCID: PMC10543487 DOI: 10.1177/10775595231191395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Recent editorials published in Child Maltreatment bring much needed attention to racism in child maltreatment reporting and investigation. In this commentary, we extend these efforts by responding to Valentino et al., (2012) and addressing prior omissions in our race-related work by explicitly discussing the role of racism in our explanation of key study findings. Together with scholars with expertise in the impact of racism on children and families, this commentary (a) discusses theoretical models of child maltreatment and of the influence of racism on parenting and child development; (b) discusses parental responses to racism in relation to the Valentino et al., (2012) findings; and (c) highlights future research directions.
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Affiliation(s)
- Kristin Valentino
- Department of Psychology, University of Notre Dame, Notre
Dame, IN, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital,
Boston, MA, USA
| | - Jenny Padilla
- Department of Psychology, University of Notre Dame, Notre
Dame, IN, USA
| | - Donte Bernard
- Department of Psychological Sciences, University of
Missouri, Columbia, MO, USA
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27
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Hamad H, Angelöw A, Psouni E. Protocol for evaluation of effects of a psychoeducational trauma-informed intervention directed at schools. Eur J Psychotraumatol 2023; 14:2263322. [PMID: 37824172 PMCID: PMC10572043 DOI: 10.1080/20008066.2023.2263322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/30/2023] [Indexed: 10/13/2023] Open
Abstract
Background: Adverse childhood experiences (ACE) can have negative effects on cognitive, social and emotion regulation abilities, which can threaten the child's school integration and capacity to learn. While steady relations to sensitive, understanding adults may moderate these negative outcomes, the difficulties of children with ACEs pose a major challenge for teachers, whose insufficient preparation may lead to career attrition.Objective: Psychoeducational trauma-informed care (TIC) interventions targeting teachers may strengthen teacher preparation and buffer the deleterious outcomes of ACEs, yet the evidence-base for these interventions is limited. Importantly, while minority groups are overrepresented among those with ACEs and additionally risk exposure to ethno-racial trauma, TIC interventions lack a social disadvantage/discrimination perspective. The Present trial addresses these issues.Method: The study protocol employs a quasi-experimental design for assessing effects of a psychoeducational TIC intervention carried out in Swedish schools by Save the Children, Sweden (SCS). We compare, for the first time, an intervention group (N = 160) and a control group (N = 160) over time (pre-intervention, immediately after, 6 and 12 months post-intervention), assessing teacher stress, compassion fatigue, self-efficacy and trauma-informed knowledge. We monitor teacher attitudes and attributions of students' academic weaknesses and behavioural and mental difficulties. The trial is preregistered (DOI:10.17605/OSF.IO/V7SH8).Results: We hope that the mitigating effects of the SCS-TIC school intervention may be independent of social category, and that the trial will additionally generate knowledge of how providers and recipients of TIC may respond to it differently depending on their social and cultural identities. As school-based TIC practices and interventions are expansively relied on as means of preventing teacher burnout and career attrition, and buffering negative consequences of ACEs for children, establishing their effects with methodological robustness is important and timely.Conclusion: Such knowledge may be used to tailor and target interventions to specific populations, while ensuring maximum effectiveness.
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Affiliation(s)
- Hussein Hamad
- Department of Psychology, Lund University, Lund, Sweden
| | | | - Elia Psouni
- Department of Psychology, Lund University, Lund, Sweden
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28
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Miller AP, Agrawal A. Genetic Contributions to Reported Childhood Maltreatment: What It Means and How It Could Mean More. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:587-589. [PMID: 37881533 PMCID: PMC10593938 DOI: 10.1016/j.bpsgos.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Alex P. Miller
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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29
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Polanco-Roman L, DeLapp RCT, Dackis MN, Ebrahimi CT, Mafnas KSW, Gabbay V, Pimentel SS. Racial/ethnic discrimination and suicide-related risk in a treatment-seeking group of ethnoracially minoritized adolescents. Clin Child Psychol Psychiatry 2023; 28:1305-1320. [PMID: 36210796 PMCID: PMC10082132 DOI: 10.1177/13591045221132682] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND AIMS Despite growing evidence demonstrating the negative mental health effects of racism-related experiences, racial/ethnic discrimination is seldom examined in youth suicide risk. The present study tested the association between racial/ethnic discrimination and well-supported correlates of suicide-related risk including emotion reactivity and dysregulation, and severity of psychiatric symptoms in a sample of ethnoracially minoritized adolescents receiving outpatient psychiatric services. METHODS Participants were adolescents (N = 46; 80.4% female; 65.2% Latinx) who ranged in age from 13-20 years old (M=15.42; SD=1.83) recruited from a child outpatient psychiatry clinic in a low-resourced community in Northeast US. Youth completed a clinical interview and a battery of surveys. RESULTS Findings from separate linear regression models show that increases in frequency of racial/ethnic discrimination were associated with increases in severity of suicidal ideation (SI), independent of emotion reactivity and dysregulation, and symptoms of PTSD and depression. Discriminatory experiences involving personal insults, witnessing family being discriminated, and school-based contexts were uniquely associated with SI. DISCUSSION AND CONCLUSION Preliminary findings support the association between racial/ethnic discrimination and increased severity of suicide-related risk in ethnoracially minoritized adolescents. Accounting for racial/ethnic discrimination may improve the cultural responsiveness of youth suicide prevention strategies within outpatient psychiatric care.
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Affiliation(s)
| | - Ryan CT DeLapp
- Psychiatry and Behavioral Sciences, Montefiore Medical Center, USA
- Albert Einstein College of Medicine, USA
| | | | | | | | - Vilma Gabbay
- Psychiatry and Behavioral Sciences, Montefiore Medical Center, USA
- Albert Einstein College of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, USA
| | - Sandra S Pimentel
- Psychiatry and Behavioral Sciences, Montefiore Medical Center, USA
- Albert Einstein College of Medicine, USA
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30
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LeMasters K, Renson A, Zalla L, Martin CL, Edwards JK. Understanding the Accumulation of Health-Related Inequities Over the Life Course Using the Mean Cumulative Count. Am J Epidemiol 2023; 192:1425-1431. [PMID: 37218618 PMCID: PMC10666969 DOI: 10.1093/aje/kwad123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/26/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
Understanding how health inequities develop over time is necessary to inform interventions, but methods for doing so are underutilized. We provide an example of the accumulation of stressful life events using the mean cumulative count (MCC), which estimates the expected number of events per person as a function of time, allowing for censoring and competing events. Data came from the National Longitudinal Survey of Youth 1997, a nationally representative data set. To compare the MCC with standard practice, we present the proportions of persons experiencing 1, 2, and ≥3 stressful events and the cumulative probability of experiencing at least 1 event by the end of follow-up. Our sample included 6,522 individuals aged 18-33 years who were followed for a median of 14 years. Using the MCC, by age 20 years the expected number of encounters was 56 events per 100 participants for Black non-Hispanic persons, 47 per 100 for White non-Hispanic persons, and 50 per 100 for Hispanic persons. By age 33 years, inequities grew to 117, 99, and 108 events per 100 persons, respectively. The MCC revealed that inequities in stressful events accumulate over the course of early adulthood, partially driven by repeat events; this information was not evident from conventional approaches. This method can be used to identify intervention points for disrupting the accumulation of repeat events to improve health equity.
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Affiliation(s)
- Katherine LeMasters
- Correspondence to Dr. Katherine LeMasters, Division of General Internal Medicine, School of Medicine, Anschutz Medical Campus, University of Colorado, Academic Office 1, 12631 East 17th Avenue, Aurora, CO 80045 (e-mail: )
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31
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Obenauf C, Mekawi Y, Lathan EC, Hinojosa CA, Thomas JG, Stevens JS, Powers A, Michopoulos V, Carter S. Indirect effect of race-related stress on traumatic stress and depression symptoms via subjective social status in a Black community sample. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:116-126. [PMID: 37434412 DOI: 10.1002/ajcp.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 05/25/2023] [Accepted: 06/19/2023] [Indexed: 07/13/2023]
Abstract
Experiencing racism is linked to lower subjective social status (SSS), defined as one's perception of their position in society. SSS is influenced by power, prestige, and objective socioeconomic status (SES). Previous findings suggest that race-related stress may be related to adverse mental health outcomes through SSS in Black Americans, a population that has been deeply affected by continuing legacies of oppression. The current study examines the indirect association between race-related stress and posttraumatic stress disorder (PTSD) and depression symptoms through SSS in a community sample of largely trauma-exposed Black Americans (N = 173). Hierarchical regression analyses indicated that overall race-related stress significantly predicted lower SSS, higher PTSD symptoms, and higher depression symptoms. Analyses also revealed indirect effects of cultural race-related stress on PTSD and depression symptoms through SSS after controlling for SES. Results suggest that the experience of race-related stress, particularly cultural race-related stress, which involves the degradation and disparagement of one's culture and worldview, is associated with more severe PTSD and depression symptoms potentially due to these experiences decreasing Black Americans' SSS. Findings support the need for systemic intervention strategies to disrupt the cultural oppression of Black Americans and improve the societal value and mental health of this population.
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Affiliation(s)
- Caterina Obenauf
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Emma C Lathan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Cecilia A Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Joel G Thomas
- Department of Psychology, Agnes Scott College, Decatur, Georgia, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Emory National Primate Research Center, Atlanta, Georgia, USA
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
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Atallah DG, Koslouski JB, Perkins KN, Marscio C, Robinson RL, Del Rio MG, Porche MV. The trauma and learning policy initiative (TLPI)'s inquiry-based process: Mapping systems change toward resilience. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2943-2963. [PMID: 37289472 DOI: 10.1002/jcop.23067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/22/2022] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
Trauma is much more than our individual experiences. Fundamentally, trauma is rooted in our social conditions, interrelated with the oppression and violence in our communities and in societies at large. Trauma is knotted within cycles of harm in our relationships and in our communities and institutions. Not only are our communities and institutions sites of trauma, however, but they can also be sites of great healing, restoration, and resilience. Educational institutions hold the potential for contributing to resilient change toward the creation of transformative communities for children to feel safe and to thrive, even in the face of accumulating adversities that are endemic in the United States and beyond. This study investigated the impact of an initiative that strives to support K-12 schools in transforming towards greater trauma-sensitivity: trauma and learning policy initiative (TLPI). We share findings from our qualitative, situational analysis of the impact of TLPI's support to three schools in Massachusetts, USA. Although TLPI's framework on trauma does not explicitly include an antiracism lens, when engaging in data analysis, with the aim to shed light on possible schoolwide approaches to promote equity, our team of researchers specifically attended to ways intersecting systems of oppression may have impacted student education. A visual diagram, "Map of Educational Systems Change Towards Resilience," emerged from our data analysis, with four themes that represent how educators understood the shifts in their schools. These were: (1) facilitating empowerment and collaboration; (2) integrating whole-child approaches; (3) affirming cultural identity and promoting a sense of belonging; and (4) re-envisioning discipline toward relational accountability. We discuss pathways that educational communities and institutions can take to create trauma-sensitive learning environments for the promotion of greater resilience.
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Affiliation(s)
- Devin G Atallah
- Psychology Department, University of Massachusetts Boston, Boston, Massachusetts, USA
- Department of Psychology, Decolonial Antiracism Research & Action (DARA) Collective for Healing & Liberación, University of Massachusetts, Boston, Massachusetts, USA
| | - Jessica B Koslouski
- Educational Psychology Department, The University of Connecticut, Storrs, Connecticut, USA
| | - Kesha N Perkins
- Disparities Research Unit, Mongan Institute at Mass General Hospital, Boston, Massachusetts, USA
| | - Christine Marscio
- Department of Counseling Psychology & Applied Human Development, Wheelock College of Education and Human Development, Boston University, Boston, Massachusetts, USA
| | - Rhyann L Robinson
- Psychology Department, University of Massachusetts Boston, Boston, Massachusetts, USA
- Department of Psychology, Decolonial Antiracism Research & Action (DARA) Collective for Healing & Liberación, University of Massachusetts, Boston, Massachusetts, USA
| | - Michelle G Del Rio
- Psychology Department, University of Massachusetts Boston, Boston, Massachusetts, USA
- Department of Psychology, Decolonial Antiracism Research & Action (DARA) Collective for Healing & Liberación, University of Massachusetts, Boston, Massachusetts, USA
| | - Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
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Compton AB, Panlilio CC, Humphreys KL. What's the matter with ACEs? Recommendations for considering early adversity in educational contexts. CHILD ABUSE & NEGLECT 2023; 142:106073. [PMID: 36774310 PMCID: PMC10293056 DOI: 10.1016/j.chiabu.2023.106073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Currently, some trauma-informed education practices use "ACE scores," a number that represents the sum of endorsed items from a survey derived from the Adverse Childhood Experiences (ACEs) study in 1998. We caution that the survey provides limited information within education, and such scores have limited utility for designing and delivering individualized intervention to support students who have experienced adversity. OBJECTIVE We sought to illustrate why ACEs are not well-suited for use in trauma-informed education, provide definitions for adversity-related terms from which a broader and common understanding of adversity can stem, and provide recommendations for integration of adversity-informed approaches to the educational context. METHODS We compiled definitions of adversity-related constructs and made recommendations based on review of relevant research from the fields of psychology and education. RESULTS Rather than tailoring educational practices to specific children based on the "traumatic" events they experience, we recommend educators focus their efforts on building supportive classrooms geared toward supporting students with best practices drawn from the Science of Learning, and with the understanding that early adversity can influence heterogeneous trajectories in student development and behavior. In addition, further research on educational practices, including the use of a shared language for describing and defining adversity-related experiences, are the concrete steps needed to better support a goal of adversity-informed education.
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Arrojo MJ, Bromberg J, Walter HJ, Vernacchio L. Pediatric Primary-Care Integrated Behavioral Health: A Framework for Reducing Inequities in Behavioral Health Care and Outcomes for Children. Pediatr Clin North Am 2023; 70:775-789. [PMID: 37422314 DOI: 10.1016/j.pcl.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Nearly half of US children and adolescents will suffer a behavioral health (BH) disorder, with substantially higher rates among more disadvantaged children such as racial/ethnic minorities, LGBTQ + youth, and poor children. The current specialty pediatric BH workforce is inadequate to meet the need and the uneven distribution of specialists as well as other barriers to care, such as insurance coverage and systemic racism/bias, further exacerbate disparities in BH care and outcomes. Integrating BH care into the pediatric primary care medical home has the potential to expand access to BH care and reduce the disparities inherent in the current system.
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Affiliation(s)
- Maria J Arrojo
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Jonas Bromberg
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Heather J Walter
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Louis Vernacchio
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
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Gaylord-Harden NK, Gilreath T, Burnside A, Mintah P, Lindsey MA. Profiles of Suicidal Ideation Among Black Male Adolescents: Examination of Individual and Socioecological Predictors. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-15. [PMID: 37418319 DOI: 10.1080/15374416.2023.2222395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
OBJECTIVE The current study utilized latent profile analysis to identify distinct profiles of suicidal ideation among Black male adolescents and compared profiles on socioecological determinants of suicide and psychological symptoms. METHOD A sample of 457 Black male adolescents (mean age = 15.31, SD = 1.26) completed self-report measures of suicidal ideation, racial discrimination, community violence exposure, anxiety symptoms, depressive symptoms, and posttraumatic stress symptoms. RESULTS Results of the latent profile analysis revealed a three-profile model: a low ideation profile, with low levels of all forms of suicidal ideation; a general death ideation profile with elevated general thoughts of death and dying; and a high, concealed ideation profile with high levels on all suicidal ideation items, except communicating the ideation to others. ANOVAs revealed that levels of psychological symptoms were significantly different for each profile, with the high, concealed ideation profile showing the highest levels. The low ideation profile had significantly lower scores than the two other profiles on community violence exposure, but the other two profiles did not differ significantly from one another. Further, the general death ideation profile had significantly higher scores on racial discrimination than the other two profiles, but the other two profiles did not differ significantly from one another. CONCLUSIONS The current study supports recent socio-cultural theories of suicidal ideation and behavior in Black youth and highlights the need for increased access to care and services for Black boys who are exposed to socioecological factors that heighten suicidal ideation.
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Affiliation(s)
| | - Tamika Gilreath
- Center for Health Equity and Evaluation Research, Texas A&M University
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Panisch LS, Murphy HR, Wu Q, Brunner JL, Duberstein ZT, Arnold MS, Best M, Barrett ES, Miller RK, Qiu X, O’Connor TG. Adverse Childhood Experiences Predict Diurnal Cortisol Throughout Gestation. Psychosom Med 2023; 85:507-516. [PMID: 37199406 PMCID: PMC10524578 DOI: 10.1097/psy.0000000000001218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with negative prenatal and perinatal health outcomes and may, via these pathways, have intergenerational effects on child health and development. We examine the impact of ACEs on maternal salivary cortisol, a key measure of prenatal biology previously linked with pregnancy-related health outcomes. METHODS Leveraging assessments across three trimesters, we used linear mixed-effects models to analyze the influence of ACEs on maternal prenatal diurnal cortisol patterns in a diverse cohort of pregnant women (analytic sample, n = 207). Covariates included comorbid prenatal depression, psychiatric medications, and sociodemographic factors. RESULTS Maternal ACEs were significantly associated with flatter diurnal cortisol slopes (i.e., less steep decline), after adjusting for covariates, with effects consistent across gestation (estimate = 0.15, standard error = 0.06, p = .008). CONCLUSIONS ACEs experienced before pregnancy may have a robust and lasting influence on maternal prenatal hypothalamic-pituitary-adrenal activity throughout gestation, a key biological marker associated with perinatal and child health outcomes. The findings suggest one route of intergenerational transmission of early adverse experiences and underscore the potential value of assessing prepregnancy adverse experiences for promoting perinatal and maternal and child health.
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Affiliation(s)
- Lisa S. Panisch
- Wayne State University School of Social Work, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Hannah R. Murphy
- Translational Biomedical Science, University of Rochester School of Medicine & Dentistry, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Qiuyi Wu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Saunders Research Building, 265 Crittenden Blvd., Box 630, Rochester, NY 14642
| | - Jessica L. Brunner
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Zoe T. Duberstein
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, New York, 14627, USA
| | - Molly S. Arnold
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, New York, 14627, USA
| | - Meghan Best
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Emily S. Barrett
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, New Jersey, 08854, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd., Piscataway, New Jersey, 08854, USA
| | - Richard K. Miller
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Xing Qiu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Saunders Research Building, 265 Crittenden Blvd., Box 630, Rochester, NY 14642
| | - Thomas G. O’Connor
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, New York, 14627, USA
- Neuroscience, University of Rochester, 601 Elmwood Avenue, Box 603, KMRB G.9602, Rochester, New York, 14642, USA
- Psychiatry, University of Rochester, 300 Crittenden Blvd., Rochester, New York, 14642, USA
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Leslie CE, Walsh CS, Sullivan TN. Implications of intergenerational trauma: Associations between caregiver ACEs and child internalizing symptoms in an urban African American sample. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:877-887. [PMID: 35901424 PMCID: PMC10191152 DOI: 10.1037/tra0001334] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The link between adverse childhood experiences (ACEs) and negative mental health outcomes is well established. However, the intergenerational link between caregiver ACE history and their child's psychosocial outcomes is understudied, particularly within minoritized groups. This study aimed to delineate relations between caregiver ACE exposure and their child's depression and posttraumatic stress disorder (PTSD) symptoms by proposing a serial mediation of caregiver PTSD, family management problems, and child ACEs. METHOD Two hundred seventy-three caregiver (Mage = 39.27; 88% female) and adolescent (Mage = 14.26; 57% female) dyads from low-income urban communities completed electronic questionnaires measuring PTSD symptoms and ACEs. Child participants also completed a measure of depression and family management problems. Regression and serial mediation analyses were conducted to examine associations among these variables. RESULTS Caregiver ACEs were significantly associated with their child's PTSD symptoms but were not related to their child's depression scores. Serial mediation analyses indicated that child ACEs mediated the relation between caregiver ACEs and their child's PTSD symptoms. Evidence for an overall indirect effect via caregiver PTSD, family management problems, and child ACEs was not found. No indirect effects between caregiver ACEs and child depression were found. CONCLUSIONS Findings demonstrate that higher levels of caregiver ACE exposure are associated with their child's PTSD symptoms in a sample of African American dyads living in urban, high-burden communities. These results suggest a need for ACE screening during medical visits and provides guidance for future clinical interventions. The distinct intergenerational consequences for caregivers with ACEs and their children's psychosocial wellbeing warrant further study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Baiden P, Onyeaka HK, Aneni K, Wood B, LaBrenz CA, Muoghalu C, Peoples JE, Szlyk HS, Gobodzo EC, Baiden JF, Adeku Y, Mets VE, Brown FA, Cavazos-Rehg P. Perceived racial discrimination and polysubstance use among racial/ethnic minority adolescents in the United States. Drug Alcohol Depend 2023; 248:109894. [PMID: 37167795 PMCID: PMC11003345 DOI: 10.1016/j.drugalcdep.2023.109894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/28/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Polysubstance use among adolescents is a significant public health concern, yet most studies on adolescent substance use focus on a singular substance. This study is one of the first to investigate the association between perceived racial discrimination (PRD) in school and polysubstance use among racial/ethnic minority adolescents using a nationally representative sample. METHODS Data was from the 2021 Adolescent Behaviors and Experiences Survey. The sample included 4145 racial/ethnic minority adolescents (52.8% female). Hierarchical binary logistic regression was used to examine the association between PRD in school and polysubstance use among racial/ethnic minority adolescents. RESULTS About 12% of racial/ethnic minority adolescents engaged in polysubstance use and 23.4% reported experiencing PRD in school sometimes/most of the time/always. Controlling for other factors, experiencing PRD in school sometimes/most of the time/always was associated with 1.52 times higher odds of polysubstance use when compared to adolescents who never experienced PRD in school (OR=1.52, p=.044, 95% CI=1.01-2.30). Cyberbullying victimization, symptoms of depression, and being emotionally abused by a parent during COVID-19 were also associated with polysubstance use. CONCLUSION Controlling for demographic characteristics and psychosocial stressors, PRD in school was significantly associated with higher odds of polysubstance use among racial/ethnic minority adolescents. The findings of this study could inform clinicians and policymakers of the association between PRD in school and polysubstance use, which could contribute to early identification of polysubstance use among racial/ethnic minority adolescents.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA.
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Boston, MA02115, USA; Massachusetts General Hospital, Department of Psychiatry, Boston, MA02115, USA; McLean Hospital, Department of Psychiatry, Boston, MA02478, USA
| | | | - Bethany Wood
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Chioma Muoghalu
- Plains Regional Medical Center, Clovis, New Mexico, NM88101, USA
| | - JaNiene E Peoples
- The Brown School at Washington University in St. Louis, One Brookings Drive, St. Louis, MO63130, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
| | | | - John F Baiden
- East Airport International School, P.O. Box KAPM 57, KIA, Accra, Ghana
| | - Yvonne Adeku
- Western University, Department of Sociology, Social Science Centre, Room 5306, London, OntarioN6A 5C2, Canada
| | - Vera E Mets
- University of Ghana, Legon, Department of Social Work, P.O. Box LG 419, Legon, Accra, Ghana
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr, Box 19528, Arlington, TX76019, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
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Hartwell M, Hendrix-Dicken A, Terry R, Schiffmacher S, Conway L, Croff JM. Trends and forecasted rates of adverse childhood experiences among adults in the United States: an analysis of the Behavioral Risk Factor Surveillance System. J Osteopath Med 2023; 123:357-363. [PMID: 36947857 DOI: 10.1515/jom-2022-0221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023]
Abstract
CONTEXT Many studies have shown increases in negative social aspects in the United States that may increase the likelihood of a child experiencing adversity. These rising trends include household dysfunction, poor mental health and substance use, crime rates, and incarceration. Additionally, the pathway of adverse childhood experiences (ACEs) may also perpetuate intergenerational trauma. OBJECTIVES Given these increased trends, our objective was to determine the mean ACEs reported among adults by year of birth to assess trends of ACEs over time. METHODS To assess ACEs trends in the United States, we utilized data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey. We summed individuals' reported ACEs and then calculated the mean ACE score within age cohorts (in 1-year increments) by year of birth. We utilized an auto-regressive integrated moving average (ARIMA) model to forecast mean ACEs through 2030. RESULTS Respondents to the ACEs module (n=116,378) represented 63,076,717 adults in the United States, with an average age cohort of 1715 individuals. The mean reported ACEs among individuals 80 years or older (born in or before 1940) was 0.79, while the highest mean ACEs (2.74) were reported among the cohort born in 1998-an average increase of 0.022 ACEs per year. The ARIMA model forecasted that individuals born in 2018 will, on average, surpass a cumulative of three ACEs. CONCLUSIONS Given the connection of ACEs to poor health outcomes and quality of life, this trend is alarming and provides evidence for the necessity of child maltreatment prevention. Multigenerational trauma-informed care and education are warranted for individuals with ACEs and may even prevent the cycle from recurring.
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Affiliation(s)
- Micah Hartwell
- Department of Psychiatry and Behavioural Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA
| | - Amy Hendrix-Dicken
- Department of Paediatrics, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
| | - Rachel Terry
- Oklahoma State University College of Osteopathic Medicine, Office of Medical Student Research, Tulsa, OK, USA
| | - Sadie Schiffmacher
- Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA
| | - Lauren Conway
- Department of Paediatrics, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
| | - Julie M Croff
- Oklahoma State University Centre for Health Sciences, National Centre for Wellness and Recovery, Tulsa, OK, USA
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Dorri AA, Stone AL, Salcido R, Russell ST, Schnarrs PW. Sexual and gender minority adverse childhood experiences (SGM-ACEs), perceived social support, and adult mental health. CHILD ABUSE & NEGLECT 2023; 143:106277. [PMID: 37336087 DOI: 10.1016/j.chiabu.2023.106277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/28/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Building on decades of research into the long-term developmental impacts of adverse childhood experiences (ACEs), researchers have called for expanding the ACEs framework to include experiences specific to minoritized identities. Recent empirical research has led to the development of a measure of sexual and gender minority adverse childhood experiences (SGM-ACEs). Within the SGM-specific ACEs framework, research on the long-term impact to adult mental health and the role of perceived social support are not well studied. OBJECTIVE The purpose of this paper was two-fold. First, examine whether SGM-ACEs adversely impact mental health in SGM adults. Second, examine the role of perceived social support in the association between SGM-ACEs and adult mental health. PARTICIPANTS AND SETTING Data were collected using a multifaceted sampling strategy. In total, 1819 self-identified SGM Texans completed an online survey inquiring about ACEs, SGM-ACEs, mental health, and demographic characteristics. RESULTS We estimated two competing structural equation models (SEM) examining the associations between SGM-ACEs and anxiety and depressive symptoms, and whether perceived social support may moderate or mediate his association. While both models demonstrated that SGM-ACEs were significantly associated with higher anxiety and depressive symptoms. However, we found more support for the mediation model such that SGM-ACEs had direct effects on anxiety and depressive symptoms, and an indirect effect on anxiety symptoms through family support. CONCLUSIONS Our findings confirmed that exposure to SGM-ACE is associated with poorer adult mental health. Additionally, SGM-ACEs exposure undermines SGM individuals' perceptions of family support, which increases symptoms of anxiety.
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Affiliation(s)
- Armin A Dorri
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, United States of America
| | - Amy L Stone
- Department of Sociology and Anthropology, Trinity University, San Antonio, TX, United States of America
| | - Robert Salcido
- The Pride Center San Antonio, San Antonio, TX, United States of America
| | - Stephen T Russell
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, United States of America
| | - Phillip W Schnarrs
- Division of Community Engagement and Health Equity, Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, TX, United States of America.
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Zhen-Duan J, Colombo D, Alvarez K. Inclusion of Expanded Adverse Childhood Experiences in Research About Racial/Ethnic Substance Use Disparities. Am J Public Health 2023; 113:S129-S132. [PMID: 37339415 PMCID: PMC10282858 DOI: 10.2105/ajph.2023.307220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2022] [Indexed: 06/22/2023]
Affiliation(s)
- Jenny Zhen-Duan
- Jenny Zhen-Duan is with the Departments of Psychiatry and Medicine, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. Daniella Colombo is with Rutgers New Jersey Medical School, Newark, NJ. Kiara Alvarez is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Daniella Colombo
- Jenny Zhen-Duan is with the Departments of Psychiatry and Medicine, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. Daniella Colombo is with Rutgers New Jersey Medical School, Newark, NJ. Kiara Alvarez is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kiara Alvarez
- Jenny Zhen-Duan is with the Departments of Psychiatry and Medicine, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. Daniella Colombo is with Rutgers New Jersey Medical School, Newark, NJ. Kiara Alvarez is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Bernard DL. Toward a Socioecological Model of Training and Mentoring to Reduce Disparities in Mental Health Service Use Among Black Youths. Am J Public Health 2023; 113:S133-S135. [PMID: 37339411 PMCID: PMC10282857 DOI: 10.2105/ajph.2023.307250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Donte L Bernard
- Donte L. Bernard is with the Department of Psychological Sciences, University of Missouri, Columbia
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Zak-Hunter L, Carr CP, Tate A, Brustad A, Mulhern K, Berge JM. Associations Between Adverse Childhood Experiences and Stressful Life Events and Health Outcomes in Pregnant and Breastfeeding Women from Diverse Racial and Ethnic Groups. J Womens Health (Larchmt) 2023; 32:702-714. [PMID: 37140441 PMCID: PMC10277999 DOI: 10.1089/jwh.2022.0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Background: This study sought to understand the characteristics of racially/ethnically diverse pregnant and breastfeeding women who have experienced adverse childhood experiences (ACEs) and stressful life events (SLEs) and the relationship among ACEs, SLEs, and health outcomes in this population. Materials and Methods: This was a secondary analysis of cross-sectional data from the Family Matters study. The participants in this study were families with children ages 5-9 (N = 1,307) recruited from Minneapolis-St. Paul primary care clinics representing six racial/ethnic backgrounds (White, Black, Native American, Hmong, Somali, Latino). Primary caregivers completed surveys about personal health, parenting styles, resilience, ACEs, and SLEs. Linear and logistic regression models were used to examine the associations between ACEs and SLEs with health outcomes of pregnant and breastfeeding women at the individual level. Results: A total of 123 racially/ethnically diverse women in this study reported being pregnant or currently breastfeeding. Eighty-eight (72%) reported a history of ACEs or SLEs. Those with both ACEs/SLEs reported more depression, economic strain, and a shorter duration of living in the United States. An increase in one reported ACE or SLE was positively associated with self-reported stress, number of reported medical conditions, substance use, self-efficacy, and permissive parenting (all β coefficients p < 0.05). SLEs independently demonstrated increased predictive probability of severe mental health distress (6.7 percentage points, confidence interval [95% CI: 0.02-0.11; p < 0.01]) and moderate or severe anxiety (7.5 percentage points [95% CI: 0.04-0.11; p < 0.001]). Conclusion: Exposure to ACEs and SLEs appear to have significant impacts on physical health, mental health, and substance use in pregnant racially/ethnically diverse women.
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Affiliation(s)
- Lisa Zak-Hunter
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
| | - Christopher P. Carr
- Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens, Georgia, USA
| | - Allan Tate
- Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens, Georgia, USA
| | - Abby Brustad
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
| | - Kaitlyn Mulhern
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
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Tan K, Mahoney J, Campbell J, Laursen T, Kemp D, Kim BKE. The Promise of Racial Healing to Achieve Health Equity Through School-Based Prevention. Am J Public Health 2023; 113:S119-S123. [PMID: 37339421 PMCID: PMC10282854 DOI: 10.2105/ajph.2023.307288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Kevin Tan
- Kevin Tan is with the School of Social Work, University of Illinois, Urbana-Champaign. Jenna Mahoney, Jeanna Campbell, and Tiffany Laursen are doctoral students at the School of Social Work, University of Illinois, Urbana-Champaign. Durriyyah Kemp is with the Illinois Extension, University of Illinois, Urbana-Champaign. Bo-Kyung Elizabeth Kim is with the School of Social Work, University of Southern California, Los Angeles
| | - Jenna Mahoney
- Kevin Tan is with the School of Social Work, University of Illinois, Urbana-Champaign. Jenna Mahoney, Jeanna Campbell, and Tiffany Laursen are doctoral students at the School of Social Work, University of Illinois, Urbana-Champaign. Durriyyah Kemp is with the Illinois Extension, University of Illinois, Urbana-Champaign. Bo-Kyung Elizabeth Kim is with the School of Social Work, University of Southern California, Los Angeles
| | - Jeanna Campbell
- Kevin Tan is with the School of Social Work, University of Illinois, Urbana-Champaign. Jenna Mahoney, Jeanna Campbell, and Tiffany Laursen are doctoral students at the School of Social Work, University of Illinois, Urbana-Champaign. Durriyyah Kemp is with the Illinois Extension, University of Illinois, Urbana-Champaign. Bo-Kyung Elizabeth Kim is with the School of Social Work, University of Southern California, Los Angeles
| | - Tiffany Laursen
- Kevin Tan is with the School of Social Work, University of Illinois, Urbana-Champaign. Jenna Mahoney, Jeanna Campbell, and Tiffany Laursen are doctoral students at the School of Social Work, University of Illinois, Urbana-Champaign. Durriyyah Kemp is with the Illinois Extension, University of Illinois, Urbana-Champaign. Bo-Kyung Elizabeth Kim is with the School of Social Work, University of Southern California, Los Angeles
| | - Durriyyah Kemp
- Kevin Tan is with the School of Social Work, University of Illinois, Urbana-Champaign. Jenna Mahoney, Jeanna Campbell, and Tiffany Laursen are doctoral students at the School of Social Work, University of Illinois, Urbana-Champaign. Durriyyah Kemp is with the Illinois Extension, University of Illinois, Urbana-Champaign. Bo-Kyung Elizabeth Kim is with the School of Social Work, University of Southern California, Los Angeles
| | - Bo-Kyung Elizabeth Kim
- Kevin Tan is with the School of Social Work, University of Illinois, Urbana-Champaign. Jenna Mahoney, Jeanna Campbell, and Tiffany Laursen are doctoral students at the School of Social Work, University of Illinois, Urbana-Champaign. Durriyyah Kemp is with the Illinois Extension, University of Illinois, Urbana-Champaign. Bo-Kyung Elizabeth Kim is with the School of Social Work, University of Southern California, Los Angeles
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Kerig PK. Introduction to the Special Section: Developmental Perspectives on Trauma Exposure and Posttraumatic Stress. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:381-390. [PMID: 37234830 PMCID: PMC10205950 DOI: 10.1007/s40653-023-00557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
This article provides an introduction and overview of the current special section devoted to developmental perspectives on trauma exposure and posttraumatic stress reactions. Although there have been many revisions to the posttraumatic stress disorder (PTSD) diagnosis in the four decades that have ensued since its inclusion in our diagnostic systems, and many decades of empirical and clinical work investigating the differential effects of traumatic stress on children and adolescents, a truly developmental perspective is still lacking in the diagnosis. In a call to address this gap, this article outlines principles of developmental psychopathology as applied to the phenomenology of trauma and points to potential developmental transformations in the expression of posttraumatic stress across developmental epochs. The introduction then goes on to describe the valuable contributions to the literature represented by the six teams of contributing authors to this present special section, in which they discuss stability and change in posttraumatic symptom expression across development, the current state of validation research on the proposed diagnosis of Developmental Trauma Disorder, complex symptom arrays in children who have been complexly traumatized, distinctions between Complex PTSD and emerging personality pathology, developmental perspectives on prolonged grief, and developmental considerations for understanding the intersection between trauma and moral injury. It is hoped that this collection of articles will serve to stimulate new research and inform effective interventions for young persons affected by traumatic stress.
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Affiliation(s)
- Patricia K. Kerig
- Department of Psychology, University of Utah, Salt Lake City, UT 84112 USA
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Andrews AR, Walker J, Bernard DL, Adams Z, de Arellano M, Danielson CK. Clinical diversity in a randomized trial that explicitly sought racial/ethnic diversity in its sample: Baseline comparisons in a treatment of youth substance use and posttraumatic stress. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:S183-S191. [PMID: 36862478 PMCID: PMC10259880 DOI: 10.1037/tra0001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE For more than two decades, federal agencies have sought to address a persistent lack of inclusion of Black, Latinx, Asian, and indigenous peoples in randomized controlled trials (RCTs), often with an underlying hypothesis that such efforts will increase diversity across clinically-relevant dimensions. We examined racial/ethnic and clinical diversity, including racial/ethnic differences in prior service access and symptom dimensions, in an RCT focusing on trauma-related mental health and substance use among adolescents. METHOD Participants were 140 adolescents in an RCT of Reducing Risk through Family Therapy. Recruitment followed several recommendations for enhancing diversity. Structured interviews examined trauma exposure, posttraumatic stress disorder (PTSD) and depression symptoms, substance use, service utilization, and demographics. RESULTS Non-Latinx (NL) Black youth were more likely to receive mental health services for the first time and have greater trauma exposure, but less likely to report symptoms of depression (ps < .05) relative to NL White youth. Relevant caregiver differences included that NL Black caregivers were more likely to be unemployed and looking for work (p < .05) despite having similar levels of education relative to NL White caregivers (p > .05). CONCLUSION Results suggest that efforts to expand racial/ethnic diversity in an RCT of combined substance use and trauma-focused mental health may also expand other clinical dimensions. Many of these differences reflect multiple dimensions of racism experienced by NL Black families that clinicians must attend to. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Arthur R Andrews
- Department of Psychology, Institute for Ethnic Studies, University of Nebraska-Lincoln
| | | | - Donte L Bernard
- Department of Psychological Sciences, University of Missouri
| | - Zachary Adams
- Department of Psychiatry, Indiana University School of Medicine
| | - Michael de Arellano
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
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Hurd NM, Young AS. Introduction to the Special Issue: Advancing Racial Justice in Clinical Child and Adolescent Psychology. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:311-327. [PMID: 37141558 PMCID: PMC10213141 DOI: 10.1080/15374416.2023.2202255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Relative to White youth, racially and ethnically marginalized youth in the U.S. are less likely to initiate treatment, stay in treatment, and receive adequate care. This special issue attends to racial injustice in clinical child and adolescent psychology. While numerous factors drive these racial disparities, this special issue focuses specifically on opportunities and responsibilities we have as mental health providers, teachers, mentors, researchers, and gatekeepers to make our field more racially just. In this introduction to the special issue, we review barriers and solutions across multiple contexts including structural, institutional, and practice-based. We also discuss challenges and opportunities to diversify our field and increase the representation of racially and ethnically marginalized practitioners and scholars in clinical child and adolescent psychology. We then briefly review the special issue articles and make final recommendations for how to move the field forward.
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Affiliation(s)
| | - Andrea S Young
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
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Lazaridou FB, Heinz A, Schulze D, Bhugra D. Racialised identity, racism and the mental health of children and adolescents. Int Rev Psychiatry 2023; 35:277-288. [PMID: 37267023 DOI: 10.1080/09540261.2023.2181059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 06/03/2023]
Abstract
As a social justice issue, it is suggested that racialised identity may represent a critical moderator in the association between racism and adverse mental health. We performed a meta-moderation analysis of studies on racialised identity, racism and adverse mental health in children and adolescents. We searched Pubmed, Web of Science, SocINDEX, PsychInfo, Medline, CINAHL and EBSCO Academic Search Ultimate for peer-reviewed articles published between January 2013 and December 2022. Nine studies, encompassing 2146 Black, Moroccan, Turkish, Indigenous, South Korean, Latinx and Multi-heritage children and adolescents between the ages of 7 and 16, were included, covering depressive symptoms, substance use, internalising symptoms and externalising symptoms. A random effect meta-analysis reported a medium size positive correlation of 0.26 (95% CI = 0.20-0.32) between racism and adverse mental health. A comparison between internalising and externalising symptoms revealed a smaller positive correlation of 0.25 (95% CI = 0.09-0.41) for internalising symptoms and a slightly larger positive correlation of 0.30 (95% CI = 0.19-0.41) for externalising symptoms. A small negative moderation of -0.07 (95% CI = -0.17 to 0.02) was found for racialised identity in the association between racism and internalising symptoms, whilst no moderation was found between racism and externalising symptoms. Overall, a negligible moderation of -0.02 (95% CI = -0.08-0.05) was found for racialised identity in the association of racism to adverse mental health. These findings suggest that the effect of racism on internalising symptoms is slightly stronger for children and adolescents with lower racialised identities and slightly weaker for those with higher racialised identities.
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Affiliation(s)
- Felicia Boma Lazaridou
- Department of Psychiatry and Neurosciences, Campus Mitte, Charité Universitätsmedizin Berlin, Germany
- The National Discrimination and Racism Monitor, German Institute for Integration and Migration Research - DeZIM, Germany
- Department of Migration, Mental and Physical Health Promotion, Berlin Institute of Integration and Migration Research - BIM, Humboldt-Universität zu Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Campus Mitte, Charité Universitätsmedizin Berlin, Germany
- Department of Migration, Mental and Physical Health Promotion, Berlin Institute of Integration and Migration Research - BIM, Humboldt-Universität zu Berlin, Germany
- Psychiatric University Clinic of Charité Universitätsmedizin at Alexianer St Hedwig Hospital Berlin, Germany
| | - Daniel Schulze
- Institute of Biometry and Clinical Epidemiology, Campus Mitte Charité Universitätsmedizin Berlin, Germany
| | - Dinesh Bhugra
- The Institute of Psychiatry, Psychology and Neuroscience - IoPPN, King's College London, UK
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Alvis L, Douglas RD, Oosterhoff B, Gaylord-Harden NK, Kaplow JB. Identity-based bullying and mental health among Black and Latino youth: The moderating role of emotional suppression. J Trauma Stress 2023; 36:409-420. [PMID: 36989065 DOI: 10.1002/jts.22927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/05/2022] [Accepted: 01/11/2023] [Indexed: 03/30/2023]
Abstract
The current study examined the prevalence of identity-based bullying, the unique links between identity-based bullying and mental health (i.e., depressive and posttraumatic stress symptoms [PTSS]), and emotional suppression as a potential moderator of these links. Participants were 899 clinic-referred Black and Latino youth aged 7-18 years (M = 13.37 years, SD = 2.75, 60.8% female). Regression analyses indicated youth who experienced identity-based bullying victimization reported worse depressive symptoms and PTSS, controlling for co-occurring trauma exposure and demographic characteristics. We did not find evidence that emotional suppression moderated these associations. The findings highlight the potentially traumatic nature of identity-based bullying victimization in treatment-seeking Black and Latino youth and speak to the need for identity-based bullying risk screening.
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Affiliation(s)
- Lauren Alvis
- The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, Texas, USA
| | - Robyn D Douglas
- Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | | | | | - Julie B Kaplow
- The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, Texas, USA
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Sissoko DRG, Baker S, Caron EH. Into and Through the School-to-Prison Pipeline: The Impact of Colorism on the Criminalization of Black Girls. JOURNAL OF BLACK PSYCHOLOGY 2023. [DOI: 10.1177/00957984231161900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Colorism is a social construct privileging lighter-skinned people of color with proximity to European features over their darker-skinned counterparts. Despite the significant role in the lives of Black women and girls, colorism is an overlooked and understudied phenomenon, particularly regarding how it shapes their punishment and criminalization in schools. We conceptualize colorism as a social determinant of Black girls’ psychological well-being and outcomes. Darker-skinned Black girls face disproportionately severe school discipline, negative evaluation by teachers and peers, and are inundated with stereotypical messages that influence their sense of self—which increase vulnerability to trauma and psychological distress. Once inside the legal system, colorism plays a role in moving dark-skinned Black girls further into and through the pipeline at every stage of legal processing. The goal of the paper is to (1) highlight the role of colorism in the criminalization of Black girls, (2) identify school, forensic, and counseling/clinical psychology’s role in reducing the impact of colorism on Black girls’ lived experience as it relates to mental health and criminalization, and (3) identify psychological research and policy needs to mitigate the impact of colorism on Black girls’ life outcomes.
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Affiliation(s)
- D. R. Gina Sissoko
- The Graduate Center, City University of New York, New York, NY, USA
- John Jay College of Criminal Justice, New York, NY, USA
| | - Sydney Baker
- The Graduate Center, City University of New York, New York, NY, USA
- John Jay College of Criminal Justice, New York, NY, USA
| | - Emily Haney Caron
- The Graduate Center, City University of New York, New York, NY, USA
- John Jay College of Criminal Justice, New York, NY, USA
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