Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth

Urban Black adolescents' victimization experiences: The moderating role of family factors on internalizing and academic outcomes

This study investigated the moderating role of family factors on victimization experiences and internalizing and academic outcomes. Data (collected 2017-2019) on 471 Black urban ninth graders (51% male; Mage = 14 years) with elevated externalizing symptoms were analyzed and we explored how the interaction between (self-reported) racial socialization, parent relations, and (teacher-reported) family academic involvement and (self-reported) violence exposure, racial discrimination, and (teacher-reported) bullying potentially influenced (student- and teacher-reported) anxiety and depression, and (student-reported) academic engagement and negative school attitudes. High racial socialization and parent relations were associated with lower internalizing symptoms for youth with discrimination and heard violence, respectively. High academic involvement and parent relations were linked with higher internalizing symptoms for youth with discrimination and high parent relations were linked with higher anxiety for bullied youth. Racial socialization and parent relations may help offset the potential influence of discrimination and heard violence, respectively, for adolescents.

Police killings of unarmed Black persons and suicides among Black youth in the US: A national time-series analysis

INTRODUCTION

Suicide deaths among Black youth in the US have increased rapidly over the past decade. Direct or vicarious racial trauma experienced through exposure to police brutality may underlie these concerning trends.

METHODS

We obtained nationally aggregated monthly counts of suicides for non-Hispanic Black and White youth (age ≤ 24 years) and adults (age > 24 years) from the National Mortality Vital Statistics restricted-use data files provided by the Centers for Disease Control and Prevention, from 2013 to 2019. Monthly counts of Black youth suicides constituted our main outcome. We defined our exposure as the monthly counts of police killings of unarmed Black persons over 84 months (2013 to 2019), retrieved from the Mapping Police Violence database. We used ARIMA (AutoRegressive Integrated Moving Average) time-series analyses to examine whether Black youth suicides increased within 0 to 3 months following police killings of unarmed Black persons, controlling for autocorrelation and corresponding series of White youth suicides.

RESULTS

Suicides among Black youth increase by ∼1 count three months following an increase in police killings of unarmed Black persons (exposure lag 0 coefficient = 0.16, p > 0.05; exposure lag 1 coefficient = -0.70, p > 0.05; exposure lag 2 coefficient = -0.54, p > 0.05; exposure lag 3 coefficient = 0.95, p < 0.05). The observed increase in suicides concentrates among Black male youth (exposure lag 3 coefficient = 0.88, p < 0.05).

Police Harassment and Psychiatric, Sexual, and Substance Use Risk Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort

BACKGROUND

Black sexual minority men and Black transgender women (BSMM/BTW) experience disproportionate levels of HIV/STI-related risk factors as well as police harassment (PH). PH is linked to psychiatric risk and could play a role in substance use, sexual risk behavior, and HIV/STI risk.

METHODS

We used data from the HIV Prevention Trials Network 061(HPTN 061) study to examine associations between PH and HIV/STI-related outcomes. Using PH exposure measured at baseline and 6-month study visits, we examined an ordinal exposure (PH reported at both visits, PH reported at either visit, versus PH reported at neither baseline nor 6 months) and a binary exposure of persistent PH reported at both visits (yes versus no). We estimate risk ratios (RR) for associations between PH and depression, use of alcohol and methamphetamine, multiple partnerships, condomless sex, and syphilis.

RESULTS

Persistent PH (binary) was associated with a 20% or greater increase in the risk of depression (RR, 1.26 (1.07, 1.47)) and multiple partnerships (RR, 1.20 (1.05, 1.39)). There was evidence that ordinal PH was associated with elevated risk of alcohol use (RR, 1.17 (1.00, 1.36)); the point estimate for the association between persistent PH and alcohol use was similar but the imprecision was greater (RR, 1.16 (0.95, 1.42)).

CONCLUSION

PH may influence not only mental health but also behavioral risks that contribute to HIV/STI among BSMM/BTW, highlighting the potential wide-ranging and downstream effects of PH on health. Further research is required to confirm associations and elucidate pathways through which PH may influence HIV/STI among BSMM/BTW.

School Racial Composition as a Moderator of the Effect of Discrimination on Mental Health and Substance use Among American Indian Adolescents

PURPOSE

To examine the relationships between individual-level perceived racial/ethnic discrimination and mental health and substance use outcomes by school-level racial composition among American Indian (AI) adolescents.

METHOD

Self-reported survey data on individual-level variables come from a sample of AI adolescents (n = 510) living in or near the Cherokee Nation during the fall of 2021. School-level data come from publicly available databases. Multilevel linear and logistic regression analyses were performed to test for and examine the interaction between perceived racial/ethnic discrimination and school racial composition in relation to symptoms of anxiety and depression, past 30-day use of alcohol and marijuana, and misuse of prescription opioids.

RESULTS

Adjusted analyses showed a significant interaction effect between discrimination and racial composition on anxiety symptoms, such that the effect of discrimination was more pronounced at lower % AI (10th percentile) than at more equivalently mixed (50th percentile) or higher % AI (90th percentile) school settings. No significant interactions were observed with depressive symptoms or substance use outcomes.

DISCUSSION

School racial compositions of higher percentage AI may buffer the adverse effect of racial/ethnic discrimination on anxiety symptoms among AI adolescents.

The Strong African American Families Program: Disrupting the Negative Consequences of Racial Discrimination Through Culturally Tailored, Family-Based Prevention

Racism continues to be a major source of stress for African Americans and can impair psychological functioning. Adolescents experiencing discrimination may engage in self-soothing, but risky behaviors, which leave them at risk for negative life trajectories. Black pride has been identified as a key factor in explaining the heterogeneity in responses to discrimination. Racial socialization, strategies parents use to promote Black pride and protect youth from discrimination, is an important focus of family-based prevention programs serving African American families. This study tests the efficacy of a culturally tailored preventive intervention for rural African American families to disrupt the negative consequences of discrimination on adolescent psychological functioning. Four waves of data from the Strong African American Families (SAAF) efficacy trial (Murry & Brody in Journal of Marital & Family Therapy 30(3):271-283, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling was used to test study hypotheses. Adolescent experiences with discrimination at age 15 predicted concurrent psychological functioning and multiple risk behaviors at age 16, including sexual risk behavior, substance use problems, academic failure, and juvenile justice involvement. Mediation analyses demonstrated that psychological functioning was a significant mediator of these relations. The SAAF program was associated with increases in racial socialization, which in turn fostered gains in adolescent Black pride. Black pride was indirectly associated with reduced risk behavior through adolescent psychological functioning, but Black pride did not moderate the effect of discrimination on psychological functioning. This study confirms that family-based prevention can support African American adolescent mental health in the context of discrimination. However, more emphasis on reducing exposure to discrimination is needed.

Racial Discrimination and Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Adolescents With Overweight and Obesity: Does Context Matter?

OBJECTIVES

In adolescents at higher risk for chronic disease, the role that context of a discriminatory event may play on cortisol dysregulation is unclear. The purpose of this study was to perform a cross-sectional analysis examining the association between racial discrimination context (peer, educational, institutional, and cumulative) and diurnal cortisol patterning in adolescents with overweight and obesity.

METHODS

One hundred adolescents (13-19 years; 49% non-Hispanic Black; 65% female; body mass index percentile = 93.9% [4.14%]) were included in this analysis. Racial discrimination context was measured using the self-reported Adolescent Discrimination Distress Index. Salivary cortisol, collected across 3 days at five time points during the day, was used to calculate Δ 0-30 minutes, diurnal slope, and average total diurnal cortisol area under the curve. Sixteen separate multivariable linear regression models were performed to analyze the relationship between racial discrimination and diurnal cortisol patterns.

RESULTS

Primary findings show that cumulative racial discrimination and peer discrimination were associated with a greater diurnal slope (cumulative: β = 0.010 ± 0.004, p = .03; peer: β = 0.023 ± 0.010, p = .026).

CONCLUSIONS

Findings from this study identified cross-sectional associations between racial discrimination experienced among peers and diurnal cortisol patterns in adolescents with overweight/obesity. If our findings were to be confirmed in longitudinal analyses, evidence-based programs should be considered to buffer the effects of discrimination on adolescent health, and more importantly, policy makers should work to eliminate discrimination exposure.

Intersectionality and adolescent medicine: an overview

PURPOSE OF REVIEW

This review defines intersectionality, discusses recent studies that use an intersectional framework in adolescent health research, and outlines ways where clinicians can use intersectionality to address health disparities in youth of color through clinical practice, research, and advocacy.

RECENT FINDINGS

Research using an intersectional framework can identify populations at risk for certain disorders or behaviors. Recent studies in adolescent health research using an intersectional lens identified lesbian girls of color as an at-risk population for e-cigarette use, demonstrated lower skin color satisfaction among Black girls of all ages predicted greater binge-eating disorder symptoms, and showed that two-thirds of Latine (gender-neutral term that refers to people with Latin American roots) youth who recently immigrated to the United States experienced at least one traumatic event during their migration journey, putting them at risk for PTSD and other mental health disorders.

SUMMARY

Intersectionality refers to how multiple social identities intersect to produce a specific experience that reflects overlapping systems of oppression. Diverse youth contain multiple identities that intersect to produce unique experiences and health inequities. Using an intersectional framework acknowledges that youth of color are not homogenous. Intersectionality becomes an important tool to care for marginalized youth and advance health equity.

Perceived discrimination and mental health in college students: A serial indirect effects model of mentoring support and academic self-concept

OBJECTIVE

Examine the direct and indirect effects of perceived discrimination, mentoring support, and academic self-concept on college student mental health.

PARTICIPANTS

Three hundred fifteen undergraduates of minorized gender (72%), ethnic (57%), and sexual (37%) identities.

METHODS

An online survey assessed perceived discrimination, mentoring support, academic self-concept, and mental health.

RESULTS

Perceived discrimination was associated with mentoring support (B=-0.11, p=.019), academic self-concept (B=-0.13, p<.001), and mental health (B=-0.15, p<.001). Additionally, mentoring support (B = 0.29, p<.001) and academic self-concept (B = 0.53, p<.001) were associated with mental health, and each other (B = 0.25, p<.001). Significant indirect effects were observed such that mentoring support and academic self-concept, individually and collectively, contributed to the association between perceived discrimination and mental health.

CONCLUSIONS

Addressing discrimination, creating supportive relationships, and facilitating academic growth may reduce mental health concerns in undergraduate populations, thereby having implications for college transition and retention strategies.

A Psychometric Investigation of the Hate-Motivated Behavior Checklist

Hate-motivated behavior (HMB) comprises a continuum ranging from microaggressions to criminal acts. The measurement of HMB is limited primarily to one or two minoritized groups in any given instrument. Current HMB research also lacks a way to assess the full range of acts and motivations for bias-based behavior. The present study fills gaps in HMB measurement by conducting a psychometric study of the Hate-Motivated Behavior Checklist (HMBC). The HMBC is a self-report instrument of HMB perpetration; the instrument also has sections capturing victim target group (e.g. race, sexual orientation, disability) and perpetrator motivation for HMB commission (e.g., perceived threat, impulsivity). We conducted an online cross-sectional survey of community-dwelling adults and college students (N = 463). Measures assessed demographic information, HMB, and social-political characteristics. Confirmatory factor analysis, item response theory analyses, between-groups analyses (e.g., Analysis of Variance), and descriptive statistics were used to examine HMBC properties. Primary findings included (1) poor model fit of the HMBC behaviors score; (2) good model fit with high reliability for an HMBC behaviors score adapted to binary (no/yes) scoring; (3) men reported meaningfully higher HMB scores compared to women; (4) the most common target classification for HMB was based on political affiliation; and (5) perceived intrusion was the most cited reason for committing HMB. Our findings are an important step in refining the HMBC. The instrument represents a potentially useful tool for HMB research, surveillance, and intervention evaluation. Future directions in HMBC research include application to extremist and criminal samples, replication and extension of the binary scoring to include cut-score derivation, and validation against behavioral outcomes.

The influence of racial violence in neighborhoods and schools on the psycho-behavioral outcomes in adolescence

Racism in all its manifestations is violence. This study examines the effect of discrimination-based racial violence in neighborhoods and schools on adolescent psychological and behavioral outcomes, while also testing the moderating influence of civic engagement. Researchers used a cross-sectional survey design to measure neighborhood and school-based racial discrimination, civic engagement, racial identity development, racism-based stress, and aggressive behaviors in a sample of 167, 13 to 23 year old adolescents and emerging adults. Participants were recruited through a cluster randomized trial to test the impact of blight remediation in preventing youth violence. Study researchers hypothesized a direct effect of racial discrimination on adolescents' racism-based stress and aggressive behaviors and a buffering effect of civic engagement on these relationships. Researchers also examined these relationships in participants with higher-than-average racial identity development scores. Multivariate regression models revealed a significant direct effect of both neighborhood and school discrimination on adolescents' aggressive behaviors. Civic engagement had a positive buffering effect in the relationship between neighborhood discrimination and aggressive behaviors. Similar relationships were observed among adolescents with a high racial identity with stronger effect. Study findings have implications for understanding the behavioral impact of racial violence and investing in civic engagement to mitigate its impact in adolescence and emerging adulthood.

Perceptions of Social-Emotional Learning Among K-12 Teachers in the USA During the COVID-19 Pandemic

Social-emotional learning (SEL) is the process of acquiring and applying knowledge, skills, and attitudes to achieve long-term relational and emotional goals. Teachers often implement SEL strategies in the classroom; however, shifting to online schooling during the COVID-19 pandemic may have impacted teachers' perceptions of their abilities to implement SEL. This study was designed to identify whether and how teachers' perceptions of SEL changed since the onset of the COVID-19 pandemic. Teachers (N = 637) in the USA completed a demographic questionnaire, the Depression, Anxiety, and Stress Scale (DASS-21), and rated their beliefs about SEL during the pandemic on a modified version of the Comfort and Culture subscales of the Teacher SEL Beliefs Scale. Data were collected between September 2020 and March 2021. Teachers indicated that they felt neutral to comfortable with SEL and that they felt neutral to supported by their school culture for SEL during the pandemic. Lower depression symptoms, greater school poverty, and perceived general support (not specific to SEL) from the administration were associated with higher teacher comfort with SEL. Further, greater general support from the district and colleagues was associated with greater school culture supporting SEL during COVID-19. Results suggest that addressing teachers' internalizing symptoms and fostering a supportive work environment is important in aiding teachers in SEL implementation.

Racial Discrimination and Conduct Problems Among Black American Youth: The Moderating Effect of Ethnic Racial Socialization

PURPOSE

Experiencing racial discrimination in everyday life can have lasting detrimental effects on Black American youth. Conduct problems are one of the consequences of discriminatory experiences. The present study examined whether the effects of discrimination on conduct problems vary by the levels of ethnic-racial socialization youth experience.

METHODS

A sample of 472 Black American youth provided five waves of survey data from ages 11-15 (June 2013 - December 2017). We tested the moderating effect of different types of ethnic-racial socialization (preparation for bias, cultural socialization, promotion of mistrust) on the association between discrimination and conduct problems using logistic regression analyses.

RESULTS

We found that cultural socialization significantly moderates the effects of racial discrimination on conduct problems. Promotion of mistrust was directly associated with increased risk for conduct problems.

DISCUSSION

Findings suggest that high levels of cultural socialization are beneficial to mitigate the effect of discrimination on conduct problems. Promotion of mistrust needs to be avoided but future research is warranted to investigate if promotion of mistrust can be helpful to youth in certain contexts.

Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

How Ethnic Minority Context Alters the Risk for Developing Mental Health Disorders and Psychological Distress for Latinx Young Adults

Policy Points In low-income communities in the South Bronx and Puerto Rico, Puerto Rican youth are exposed to many of the same risk and protective factors for developing depression, anxiety, or psychological distress; yet it is unclear how the ethnic minority context of the South Bronx and ethnic majority context of Puerto Rico influence risk. Results from our quasi-experimental, longitudinal study demonstrate the importance of addressing social factors (parent-child relationships, youth peer relationships) for youth living in the majority context, and neighborhood and cultural factors (residential mobility, perceived discrimination, perceived social position in the neighborhood) for youth living in the minority context. Our findings support the need for tailoring programs specific to the needs of youth who reside in an ethnic majority or a minority context, since some of the risk factors might operate differently depending on context. Housing and neighborhood environment policies that address discrimination and eliminate structural inequities for ethnic minority groups may protect against the harm of minoritization on young people's mental health.

CONTEXT

Puerto Rican youth growing up in low-income communities in the South Bronx and Puerto Rico are exposed to many of the same risk factors for major depressive disorder, generalized anxiety disorder, and psychological distress. One potentially powerful factor differs: Puerto Ricans have been socially marginalized as an ethnic minority group in the South Bronx, but are the ethnic majority of the population in Puerto Rico. A growing body of literature demonstrates the influence of neighborhood, cultural, and social factors and parental psychopathology in the development of mental health problems. An important unanswered question is whether these risk and protective factors have the same impact for youth raised as members of an ethnic majority versus minority group.

METHODS

Using a population-based cohort study, with four waves of assessment from early childhood into young adulthood, we investigated whether ethnic minority context alters risk and protective factors for depression, anxiety, and psychological distress. Our longitudinal data set includes 2,491 young children at baseline (82.8% retained at wave 4). Using a quasi-experimental design, we examine how ethnic minority context can alter the development of mental health disorders as Latinx children transition to late adolescence and young adulthood.

FINDINGS

Some risk and protective factors operated differently across minority and majority contexts. Higher discrimination and social position were more powerful risk and protective factors, respectively, in the minority context, whereas positive peer relationships mattered more in the majority context. Children of mothers with depression were significantly more likely to develop anxiety in late adolescence and young adulthood in the majority context (60.0%) compared to the minority context (4.5%).

CONCLUSIONS

Preventing depression and anxiety disorders in Latinx young adults may require targeting different childhood factors depending on whether they reside within the ethnic majority or minority context. People in the ethnic minority context may benefit more from policies aimed at reducing discrimination and improving economic opportunity, while people in the majority context may benefit more from opportunities for strengthening family and peer relationships.

An Integrative Model for the Development of Anti-Racist Behavior in White Adolescents

We propose an integrative model for the development of anti-racism in white adolescents that unpacks and combines critical consciousness, color consciousness, anti-racism, and Critical Race Theory frameworks. Black and Brown youth in the U.S. face increasing rates of peer-directed racism, which contribute to long-term negative physical, psychological, academic, and behavioral outcomes. Despite increased focus on how critical consciousness and anti-racism develop uniquely in adolescence, there are no existing theories that provide an integrated, comprehensive model of anti-racist development in white adolescents. Our model unpacks and reorganizes the core features of four prominent theories into cognitive, psychological, and behavioral components of anti-racism development in white adolescents based on existing research to support a next-generation of hypotheses for future research. In doing so, we aim to provide a contemporary theoretical foundation for research that will elucidate anti-racism development among white youth, and help to dismantle structural racism against Black and Brown people in the U.S.

Discrimination in Context: Examining Neighborhood-Level Variation in the Incidence and Adverse Effects of Perceived Racial and Ethnic Discrimination Among Chicago Youth

A growing body of research links interpersonal racial and ethnic discrimination to adverse youth outcomes. Yet, studies examining the relevance of neighborhood context for discrimination are sparse. This study examines neighborhood-level variation in the incidence and impact of perceived racial and ethnic discrimination on depressive symptoms, suicidal behavior, violent behavior, and substance use. Hierarchical regression models on a sample of 1333 African American and Hispanic youth (52.44% female; x̄ = 13.03 years, SD = 3.25 at wave 1) residing in 238 Chicago neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated little to no neighborhood-level variation in the incidence and impact of discrimination. Findings suggest that the experience of discrimination among youth of color is ubiquitous.

Adolescent Neglect and Health Risk

This study examined relationships between adolescent neglect and abuse and later health risk in a sample of 1050 youth (53% female, 56% Black, and 24% White) from the Longitudinal Studies of Child Abuse and Neglect. At age 16, the youth reported any adolescent exposure to neglect and physical, sexual, and emotional abuse. At age 18, they reported risk behaviors (delinquency, substance use, and sexual behavior) and emotional and behavioral problems (externalizing and internalizing problems, suicidality). Control variables were childhood maltreatment (self-reports and early childhood child protective services reports), risk behaviors and emotional and behavioral problems at age 16, and demographics. Analysis confirmed a 5-factor model of adolescent neglect (Exposure to Risk, Inadequate Monitoring, Inattention to Basic Needs, Permitting Misbehavior, and Inadequate Support). Inadequate Support and Exposure to Risk were associated with more substances used; Exposure to Risk was also associated with delinquency and suicidality. Adolescent emotional abuse was associated with not using a condom use and internalizing and externalizing problems. Findings underscore the importance of preventing or addressing neglect during adolescence.

Perceived Racism and Demographic, Mental Health, and Behavioral Characteristics Among High School Students During the COVID-19 Pandemic - Adolescent Behaviors and Experiences Survey, United States, January-June 2021

Perceived racism in school (i.e., a student’s report of being treated badly or unfairly because of their race or ethnicity) is an important yet understudied determinant of adolescent health and well-being. Knowing how perceived racism influences adolescent health can help reduce health inequities. CDC’s 2021 Adolescent Behaviors and Experiences Survey (ABES), an online survey of a probability-based, nationally representative sample of U.S. public- and private-school students in grades 9–12 (N = 7,705), was conducted during January–June 2021 to assess student behaviors during the COVID-19 pandemic. CDC analyzed data from ABES to measure perceived racism and the extent to which perceptions of racism are associated with demographic, mental health, and behavioral characteristics. Mental health and behavioral characteristics analyzed included mental health status; virtual connection with others outside of school; serious difficulty concentrating, remembering, or making decisions; and feeling close to persons at school. Demographic characteristics analyzed included sex, race and ethnicity, and grade. Prevalence of perceived racism and associations between perceived racism and demographic, mental health, and behavioral characteristics are reported overall and stratified by race and ethnicity. Approximately one third (35.6%) of U.S. high school students reported perceived racism. Perceived racism was highest among Asian (63.9%), Black (55.2%), and multiracial students (54.5%). Students who reported perceived racism had higher prevalences of poor mental health (38.1%); difficulty concentrating, remembering, or making decisions (44.1%); and not feeling close to persons at school (40.7%). Perceived racism was higher among those students who reported poor mental health than those who did not report poor mental health during the pandemic among Asian (67.9% versus 40.5%), Black (62.1% versus 38.5%), Hispanic (45.7% and 22.9%), and White students (24.5% versus 12.7%). A better understanding of how negative health outcomes are associated with student experiences of racism can guide training for staff and students to promote cultural awareness and antiracist and inclusivity interventions, which are critical for promoting safe school environments for all students.

Mental health needs in a large urban school district: Findings from a web-based survey

OBJECTIVE

To explore the mental health needs of students, and the professional development and support needs of teachers and school health professionals, as a way to foster community engagement and help set priorities for a comprehensive school mental health system in the Detroit Public Schools Community District (DPSCD).

SETTING

The study team surveyed all DPSCD staff in June 2019 and all students in grades 8-12 between October and December 2019.

STUDY DESIGN

A descriptive study based on anonymous, web-based surveys focused on student trauma exposure and mental health symptoms, student mental health resource utilization, staff burnout, and professional development needs.

DATA COLLECTION

All students (grades 8-12) and district staff were eligible to participate; the student survey was made available in six languages. Parents/guardians could opt children out; schools could exclude children unable to complete the survey independently. Student surveys were administered in school; staff surveys were sent via email.

PRINCIPAL FINDINGS

Thirty-four percent of DPSCD students reported moderate/severe depression symptoms; 22% had seriously considered suicide in the past year. Rates exceed national averages; 37% of students with severe depression and 34% of those with suicidal ideation had not accessed mental health supports. Staff indicated high levels of burnout and substantial interest in learning about self-care strategies or coping with vicarious trauma. Over 75% of teachers and school mental health professionals expressed interest in learning about best practices for supporting students impacted by trauma or mental illness.

CONCLUSIONS

A large number of DPSCD students are experiencing symptoms of depression and anxiety, and many students who need care are not accessing it. Addressing the mental health needs of students is a high priority for staff, but they need more training and support, as well as support for their own vicarious trauma and high levels of burnout.

High Fear of Discriminatory Violence among Racial, Gender, and Sexual Minority College Students and Its Association with Anxiety and Depression

Minority students experience more discrimination on college campuses, yet little is known about fear of discrimination. This paper (a) establishes a new measure, fear of discriminatory violence, (b) assesses sociodemographic correlates of fear of discriminatory violence, and (c) estimates the effect of fear of discriminatory violence on anxiety and depression. A cross-sectional study using online surveys was undertaken among college students. A zero-inflated negative binomial model estimated the association between sociodemographics and fear of discriminatory violence. Multiple logistic regression models estimated the association between fear of discriminatory violence and anxiety/depression. Fear of discriminatory violence was higher among Black (ME: 11.9, p < 0.0001), Hispanic (ME: 5.9, p < 0.0001), Middle Eastern (ME: 5.4, p = 0.03), Asian (ME: 4.9, p < 0.0001), and multiracial (ME: 2.9, p < 0.0001) students compared with White students; transgender/gender non-conforming (ME: 7.2, p = 0.01) and female (ME: 3.4, p < 0.0001) students compared with male students; and gay (ME: 10.7, p < 0.0001), lesbian (ME: 9.0, p = 0.01), and bisexual students (ME: 3.4, p = 0.001) as well as those with a sexual orientation not included (ME: 5.5, p = 0.001), compared with heterosexual students. Increasing fear of discriminatory violence was associated with increased odds of anxiety (AOR: 1.04; 95% CI: 1.02, 1.06) and depression (AOR: 1.03; 95% CI: 1.02, 1.05). This understudied public health issue should be addressed to prevent fear of discriminatory violence and the resulting mental health consequences among college populations.

Discrimination and PTSD among Latinx immigrant youth: The moderating effects of gender

OBJECTIVE

Discrimination is a minority-related stressor that contributes to mental health disparities between Latinx youth and their racial/ethnic peers. Discrimination activates the body's stress response system, resulting in a higher allostatic load that can cause mental health problems such as PTSD. We explored 1) the relation between perceived discrimination and PTSD symptoms among Latinx immigrant youth, and 2) how gender moderates this relation.

METHODS

We conducted surveys with 306 Latinx first- and second-generation immigrant youth during the 2018-19 school year in Harris County, Texas and Rhode Island.

RESULTS

We found that youth who perceived more discrimination were more likely to report PTSD symptoms. Female participants reported higher levels of PTSD symptoms than males, including higher levels of avoidance and reexperiencing symptoms. Perceived discrimination was associated with increased PTSD symptoms, including hypervigilance and avoidance symptoms, for female participants but not males. These interactions did not differ by location.

CONCLUSION

These results further provide support for research into discrimination as a potentially traumatic experience linked to PTSD and underscore the importance of including discrimination in assessments of trauma and adverse childhood outcomes among Latinx immigrant youth. Results further suggest the importance of an intersectional approach to understanding how discrimination relates to PTSD among Latinx immigrant youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The impact of anticipated, vicarious, and experienced racial and ethnic discrimination on depression and suicidal behavior among Chicago youth

There is a growing body of research linking racial and ethnic discrimination to adverse youth outcomes. Beyond experienced racial and ethnic discrimination, this study considers the relevance of anticipated and vicarious racial and ethnic discrimination for depression and suicidal behavior. Hierarchical regression models on a diverse sample of 1147 youth (50.31 % female) within 79 neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated that experienced, anticipated, and vicarious racial and ethnic discrimination were associated with an increased risk of depression and suicidal behavior. Additionally, African American and Hispanic youth were disproportionately exposed to-but not differentially impacted by-racial and ethnic discrimination. Findings suggest that developmental research should account for experienced, anticipated, and vicarious racial and ethnic discrimination.

Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults

BACKGROUND

Nonmedical use of prescription opioids (defined as taking opioid medications for hedonic effects or in a manner other than prescribed) and the use of heroin have emerged in recent years as major public health concerns in the United States. Of particular concern is the prevalence of opioid use among emerging adults (ages 18-25), as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development. Data from 2015 show that American Indian/Alaska Native (AI/AN) people have the highest rates of diagnosis for opioid use disorders (OUDs). One recent study found that the overdose death rate among urban-dwelling AI/AN individuals was 1.4 times higher compared to those living in rural areas. To date, there are no evidence-based prevention programs addressing opioid use among urban AI/AN emerging adults that integrate culturally-appropriate strategies with evidence-based treatment. Traditions and Connections for Urban Native Americans (TACUNA) builds on our prior work with AI/AN communities across California to develop and evaluate culturally appropriate programming to address opioid, alcohol, and cannabis use among urban AI/AN emerging adults.

METHODS/DESIGN

In a randomized controlled trial, 18-25 year old urban AI/AN emerging adults will receive either TACUNA (n = 185), which comprises three virtual workshops utilizing motivational interviewing, social network visualization, and integrating traditional practices and a wellness circle, or one virtual culturally sensitive opioid education workshop (n = 185). We will evaluate intervention effects on primary outcomes of frequency of opioid, alcohol, and cannabis use, as well as secondary outcomes of social network characteristics and cultural connectedness, over a 12-month period.

DISCUSSION

This project has the potential to expand the range and effectiveness of opioid, alcohol, and cannabis services for urban AI/AN emerging adults by addressing the opioid epidemic and use of other substances at both the community and individual level. In addition, it provides important culturally grounded conceptual and practical information to advance the field of substance use interventions and enhance resiliency among this population.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04617938. Registered October 26, 2020 https://clinicaltrials.gov/ct2/show/record/NCT04617938 .

The Association Between Racism and Suicidality Among Young Minority Groups: A Systematic Review

INTRODUCTION

The World Health Organization states that suicide is the second leading cause of death among youngs, and racism has been proven to have detrimental effects on both physical and mental health. These two plagues represent a public health priority, especially for susceptible minorities.

METHOD

This systematic review analyzed 23 studies from multiple database searches, to understand the relationship between racism and suicidality in young minority groups.

RESULTS

The review demonstrated the correlation between racism and suicidality with the consequent development of mental disorders. There is strong evidence that the main suicide risk factor is acculturation, interpreted as the assimilation of the dominant culture with the loss of values from one's cultural background.

DISCUSSION

Health care professionals should not underestimate the risk of suicidality associated with racism. Prevention is crucial and it should be implemented from a young age, in schools, through a joint intervention with children and their families, aiming toward integration without acculturation.

Interrupting the Pathway From Discrimination to Black Adolescents' Psychosocial Outcomes: The Contribution of Parental Racial Worries and Racial Socialization Competency

Racial discrimination can lead to psychosocial problems for Black adolescents, including internalization (e.g., depression) and externalization (e.g., conduct problems). Black parents (N = 186; M_age  = 42.9) of adolescents (ages 10-18) were assessed to investigate how parental worries and racial socialization competency (i.e., confidence, skills, and stress) contribute to the association between parental discrimination experiences and their adolescents' psychosocial problems. Mediation analyses indicated that the total direct models with discrimination, worries, and problems had good fit, and that the addition of worry mediated the discrimination-problems association. Furthermore, racial socialization competency moderated the association between worry and problems, wherein greater competency was associated with less impact of worry on problems. Findings illuminate potential intervention targets for buffering discrimination's influence on adolescents' psychosocial functioning.

Discrimination and Internalizing Symptoms in Rural Latinx Adolescents: The Protective Role of Family Resilience

Objective: There is a well-documented relationship between discrimination and increases in internalizing symptoms among rural Latinx youth. Among numerous assets in these adolescents' lives, family resilience emerges as a culturally relevant and robust protective factor. However, it is still unclear whether family resilience is equally protective across different internalizing symptom clusters and whether this buffering effect is independent of other interconnected resilience sources.Method: Latinx adolescents from an underserved rural community (n = 444; M_age = 15.74, SD_age = 1.22; 51% male) reported on their internalizing symptoms, experiences of discrimination, and sources of resilience. We examined whether perceived family resilience moderated the association between perceived discrimination and self-reported depressive, somatic, and anxiety symptoms over and above adolescents' sex, self-reported level of acculturation, as well as perceived individual and contextual resilience.Results: Analyses showed that perceived discrimination experiences were robustly associated with higher levels of self-reported internalizing symptoms, while perceived family resilience was related to lower self-reported symptomatology. Closer examination revealed that perceived family resilience buffered the negative effects of perceived discrimination on self-reported depression and somatic symptoms, but not anxiety symptoms.Conclusions: This study addresses a gap in the literature by identifying differential protective effects of family resilience that might be explained by cultural values and practices in rural Latinx families. Findings suggest that interventions that incorporate family members and promote supportive family environments may benefit rural Latinx youth with a broad range of internalizing symptoms.

Delay discounting and neurocognitive correlates among inner city adolescents with and without family history of substance use disorder

Adolescents with a family history (FH+) of substance use disorder (SUD) are at a greater risk for SUD, suggested to be partly due to the transmission of behavioral impulsivity. We used a delay discounting task to compare impulsivity in decision-making and its associated brain functioning among FH+ and FH - minority adolescents. Participants chose between Smaller Sooner (SS) and Larger Later (LL) rewards. The SS was available immediately (Now trials) or in the future (Not-Now trials), allowing for greater differentiation between impulsive decisions. The FH+ group showed greater impatience by responding SS more frequently than the FH - group, only on the Now trials, and even when the relative reward differences (RRD) increased. Surprisingly, there were no differences in brain activity between the groups. Combined, the groups showed greater reward activity during the Now vs. Not-Now trials in medial prefrontal/anterior cingulate, posterior cingulate, precuneus, and inferior frontal gyrus (i.e., an immediacy effect). As the RRD increased activation in the reward network decreased, including the striatum, possibly reflecting easy decision-making. These results indicate that risk for SUD, seen behaviorally among FH+ adolescents, may not yet be associated with discernable brain changes, suggesting that early intervention has the potential to reduce this risk.

Ambient Discrimination, Victimization, and Suicidality in a Non-Probability U.S. Sample of LGBTQ Adults

Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at a higher risk for suicidality compared to the general population. A growing body of research has investigated this risk, particularly with attention to systemic factors such as discrimination and harassment. Unfortunately, research has only examined the impact of direct discrimination on suicidality and has neglected to examine how ambient discrimination (i.e., witnessing or being made aware of discriminatory behaviors directed at someone other than yourself in your group) relates to suicidality. Additionally, although some links exist between discrimination and suicidality, the mechanisms by which these are related are understudied. This study aimed to address these gaps by exploring the effect of ambient discrimination on suicidal ideation and examining psychological pain as a mediator in this relationship. Data were collected from a sample of 200 LGBTQ-identified individuals (M age = 35 years; 53.5% female; 86% White). Results of independent t tests and a one-way multivariate ANOVA revealed greater vulnerability for ambient/direct discrimination and psychache among individuals identifying as transgender, queer, and other. Regression and mediation analyses revealed that while both ambient and direct discrimination predicted suicidal ideation, only direct discrimination accounted for unique variance in the outcome; however, both ambient and direct discrimination contributed unique variance to psychological pain, which fully mediated their relationships to suicidal ideation. Results of this study may begin to provide insight into the pathways of risk and points of intervention for suicidality in the LGBTQ community.

Racial/Ethnic Differences in the Relationship Between Stressful Life Events and Quality of Life in Adolescents

PURPOSE

Stressful life events (SLEs) increase allostatic load and require adaptation. Experiencing SLEs has been associated with decreased health-related quality of life (HRQOL) among adolescents. This study examined racial/ethnic and developmental differences in the relationship between SLEs and HRQOL from preadolescence to midadolescence.

METHODS

Data were from 4,824 participants in the Healthy Passages project, a population-based prospective longitudinal survey of fifth, seventh, and 10th grade adolescents in the U.S. HRQOL was measured with Pediatric Quality of Life Inventory and SLEs with items addressing family-related SLEs (e.g., the parent's death, separation, and divorce; family member's injury/illness; residential change; new child in the household).

RESULTS

Adolescents, regardless of race/ethnicity, reported the highest SLEs and the lowest HRQOL in early adolescence. Analysis of an autoregressive model with cross-lagged effects showed that the concurrent relationships between SLEs and HRQOL were significantly negative across preadolescence, early adolescence, and midadolescence in African-American, Latinx, and white groups. Furthermore, adolescents had a negative cross-lagged association from SLEs in early adolescence to HRQOL in pre adolescence, but this was not the case among the other racial/ethnic groups.

CONCLUSIONS

Because the negative relationship between family-related SLEs and HRQOL persisted throughout stages of adolescent development, health services targeting adolescents should provide comprehensive family-centered care to alleviate the impact of family-related life stress. Relationships between family life stress and HRQOL varied by racial/ethnic groups, which should be considered by health professionals, teachers, and parents, and in prevention efforts. Latinx adolescents may be particularly vulnerable to time-lagged effects of such family-related stress.

Sensing everyday activity: Parent perceptions and feasibility

Mobile and wearable sensors provide a unique opportunity to capture the daily activities and interactions that shape developmental trajectories, with potential to revolutionize the study of development (de Barbaro, 2019). However, developmental research employing sensors is still in its infancy, and parents' comfort using these devices is uncertain. This exploratory report assesses parent willingness to participate in sensor studies via a nationally representative survey (N = 210) and live recruitment of a low-income, minority population for an ongoing study (N = 359). The survey allowed us to assess how protocol design influences acceptability, including various options for devices and datastream resolution, conditions of data sharing, and feedback. By contrast, our recruitment data provided insight into parents' true willingness to participate in a sensor study, with a protocol including 72 h of continuous audio, motion, and physiological data. Our results indicate that parents are relatively conservative when considering participation in sensing studies. However, nearly 41 % of surveyed parents reported that they would be at least somewhat willing to participate in studies with audio or video recordings, 26 % were willing or extremely willing, and 14 % reported being extremely willing. These results roughly paralleled our recruitment results, where 58 % of parents indicated interest, 29 % of parents scheduled to participate, and 10 % ultimately participated. Additionally, 70 % of caregivers stated their reason for not participating in the study was due to barriers unrelated to sensing while about 25 % noted barriers due to either privacy concerns or the physical sensors themselves. Parents' willingness to collect sensitive datastreams increased if data stayed within the household for individual use only, are shared anonymously with researchers, or if parents receive feedback from devices. Overall, our findings suggest that given the correct circumstances, mobile sensors are a feasible and promising tool for characterizing children's daily interactions and their role in development.

Buffering Effects of Racial Discrimination on School Engagement: The Role of Culturally Responsive Teachers and Caring School Police

BACKGROUND

Urban black adolescents' wellbeing in the early high school years can be negatively impacted by exposure to racial discrimination. These impacts may be buffered by supportive relationships with adults at school. We considered both the protective and promotive effects of culturally responsive teachers and caring school police on school engagement for students exposed to racial discrimination across settings.

METHOD

This study leveraged baseline student report from a sample of urban, predominantly black high school students with elevated teacher-rated levels of aggressive behavior (N = 397 9th graders; 91.2% black; 50.4% male; J = 10 schools). Using a path model with full-information maximum likelihood estimation, we examined the associations of racial discrimination, teacher cultural responsiveness, and school police caring in relation to school engagement and school disconnection, adjusting for covariates, including family racial socialization.

RESULTS

Frequency of racial discrimination was significantly associated with lower school engagement and greater school disconnection. Teacher cultural responsiveness was significantly, favorably associated with all outcomes. Police caring had no significant direct associations; however, there were moderation effects. When police caring was below average, increased racial discrimination was associated with significantly poorer attitudes toward school.

CONCLUSIONS

Findings suggested that students' perceptions of school police caring may buffer links between racial discrimination experiences and school disconnection. Moreover, students who perceive that their teachers are culturally responsive may feel more engaged at school. Interventions to promote teachers' and school police officers' cultural responsiveness and caring may improve engagement among at-risk urban youth who experience racial discrimination.

The Healthy Young Men's Cohort: Health, Stress, and Risk Profile of Black and Latino Young Men Who Have Sex with Men (YMSM)

Young men who have sex with men (YMSM), especially YMSM of color, are at increased risk for a wide range of threats to their health and well-being. In this study, we recruited and surveyed an urban sample of 448 young African American/Black (Black), Hispanic/Latino (Latino), and multi-racial/ethnic YMSM, ages 16-24 years (mean = 22.3 years), about stressful life events, their health and mental health, their access to and utilization of care, and their involvement in risk-related behaviors. We found that the majority reported experiences of racism (87%) and homophobia (76%). A high percentage reported food insecurity/hunger (36%), residential instability (15%), financial hardship (63%), and conflict with family/friends (62%). The prevalence of risk behaviors was also high, including recent use of tobacco (46%), alcohol (88%), and marijuana (72%), and 41% tested positive for 1+ drugs. Furthermore, 26% tested positive for 1+ sexually transmitted infections (STIs). Over half (56%) reported being worried about their health, 33% reported having a chronic health condition and 31% a mental health condition, and 45% had wanted/needed mental health services during the past year. Further, 17% reported suicidal ideation/had planned a suicide attempt and 26% had ever engaged in self-injurious behaviors. Significant differences by race/ethnicity and HIV status included residential status/food insecurity, type of racism/homophobia, drug use, and STIs. These findings demonstrate how vulnerable this population is with respect to a wide range of structural and social determinants of health that may be important drivers of behavioral, health, mental health outcomes, and potentially long-term health disparities.

Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model

Heterosexual African American youth face substantial disparities in sexual health consequences such as HIV and STI. Based on the social ecological framework, the current paper provides a comprehensive, narrative review of the past 14 years of literature examining HIV/STI risk, including risky sexual behavior, among heterosexual African American youth and a conceptual model of risk among this population. The review found that individual psychological and biological factors are insufficient to explain the sexual health disparities faced by this group; instead, structural disadvantage, interpersonal risk, and community dysfunction contribute to the disparity in HIV/STI outcomes directly and indirectly through individual psychological factors. The conceptual model presented suggests that for African American youth, (1) HIV/STI risk commonly begins at the structural level and trickles down to the community, social, and individual levels, (2) risk works in a positive feedback system such that downstream effects compound the influence of structural risks, and (3) contextual and individual risk factors must be considered within the advanced stage of the epidemic facing this population. Despite advanced HIV and STI epidemics among heterosexual African American youth, multisystemic interventions that target structural risk factors and their downstream effects are posited to reduce the disparity among this high-risk population.

Risk and Resilience in Minority Youth Populations

This review presents current theory and empirical research that address the interplay between risk and resilience processes among minority youth in the United States. To move the clinical sciences forward in their research and treatment approaches to solving minority–majority health and well-being disparities, ecological, intersectional, and emic (within-group) approaches must be adopted. We discuss the consequences of systematic oppression and marginalization for children in the United States, focusing primarily on research regarding xenophobia, discrimination, and racism. Lastly, we provide examples of recent interventions that take emic approaches to closing minority–majority gaps in developmental outcomes.

Effects of sexual/gender minority- and race-based enacted stigma on mental health and substance use in female assigned at birth sexual minority youth

OBJECTIVE

People of color who are also sexual and gender minorities (SGM) experience forms of enacted stigma based on both their racial/ethnic identity and their SGM status. We set out to test the effects of enacted stigma specific to race/ethnicity and SGM identity on mental health and substance use problems among female assigned at birth (FAB) SGM of color.

METHOD

Data come from a community-based sample of FAB SGM who also identified as racial/ethnic minorities (N = 352). The effects of racial discrimination, SGM victimization, and sexual orientation microaggressions on depression symptoms, anxiety symptoms, alcohol-related problems, and marijuana-related problems were tested using linear regression and negative binomial models.

RESULTS

Enacted stigma based on both race/ethnicity and SGM status were significant predictors of mental health outcomes and alcohol-related problems within the same model, which suggested that both uniquely contributed to poorer health. There was little support for interactive effects between the multiple forms of enacted stigma. Marijuana-related problems were best explained by enacted stigma based on race/ethnicity only.

CONCLUSIONS

Racially diverse FAB SGM are at unique risk of experiencing multiple forms of discrimination and aggression based on their minority identities that each contribute negatively to their wellbeing. Consideration of the multiple forms of enacted stigma they face is necessary for understanding health disparities in these populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Motivational interviewing and culture for urban Native American youth (MICUNAY): A randomized controlled trial

To date, few programs that integrate traditional practices with evidence-based practices have been developed, implemented, and evaluated with urban American Indians/Alaska Natives (AI/ANs) using a strong research design. The current study recruited urban AI/AN teens across northern, central, and southern California during 2014-2017 to participate in a randomized controlled trial testing two cultural interventions that addressed alcohol and other drug (AOD) use. Adolescents were 14-18 years old (inclusive), and either verbally self-identified as AI/AN or were identified as AI/AN by a parent or community member. We tested the added benefit of MICUNAY (Motivational Interviewing and Culture for Urban Native American Youth) to a CWG (Community Wellness Gathering). MICUNAY was a group intervention with three workshops that integrated traditional practices with motivational interviewing. CWGs were cultural events held monthly in each city. AI/AN urban adolescents (N = 185) completed a baseline survey, were randomized to MICUNAY + CWG or CWG only, and then completed a three- and six-month follow-up. We compared outcomes on AOD use, spirituality, and cultural identification. Overall, AOD use remained stable over the course of the study, and we did not find significant differences between these two groups over time. It may be that connecting urban AI/AN adolescents to culturally centered activities and resources is protective, which has been shown in other work with this population. Given that little work has been conducted in this area, longer term studies of AOD interventions with urban AI/AN youth throughout the U.S. are suggested to test the potential benefits of culturally centered interventions.

Adolescent Adjustment Problems Mediate the Association Between Racial Discrimination and School Connectedness

BACKGROUND

Whereas previous research suggests a positive association between racial discrimination and early adolescent adjustment problems, few studies examine the relationship between discrimination and school connectedness as it relates to adjustment problems among Hispanic early adolescents. In this study, we examined if depressive symptoms and conduct problems would mediate the concurrent association between perceived racial discrimination and school connectedness among Hispanic early adolescents.

METHODS

Participants for this study were 192 11-15-year-old (M = 12.1; SD = .95) Hispanic middle school students. Using multigroup path analyses, we examined the indirect association between racial discrimination and school connectedness through adjustment problems, and the equivalence of the associations across girls and boys.

RESULTS

Racial discrimination was positively associated with depressive symptoms and conduct problems for both girls and boys. In turn, depressive symptoms were negatively associated with school connectedness for girls only, whereas conduct problems were negatively associated with school connectedness for boys only.

CONCLUSIONS

In consideration of study findings, school personnel should be mindful of Hispanic adolescents who display depressive symptoms or conduct problems, as they may be highly vulnerable to lower levels of school connectedness when experiencing racial discrimination.

Trends of Suicidal Behaviors Among High School Students in the United States: 1991-2017

OBJECTIVES

To determine if racial and ethnic subgroups of adolescents are at high risk for engagement in suicidal behaviors.

METHODS

Using the nationally representative school-based Youth Risk Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses to examine trends by different racial and ethnic groups, with each suicide indicator serving as a dichotomous outcome. Participants included 198 540 high school students.

RESULTS

Across all sex and race and ethnic groups, there were significant linear decreases in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents (odds ratio [OR], 0.98; P < .001) had significant decreases in attempts over time. Black adolescents had positive linear trends for suicide attempts among both boys (OR, 1.04; P < .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR, 1.04; P = .048) had a significant linear increase in injury by attempt.

CONCLUSIONS

The results suggest that, over time, black youth have experienced an increase in suicide attempts, which is troubling because attempts are the most prominent risk factor associated with suicide death. For black boys, a significant increase in injury by attempt occurred, which suggests that black boys may be engaging in increasingly lethal means when attempting suicide. Examining trends of suicidal thoughts and behaviors over time by sex and race and ethnicity allow us to determine where to focus prevention and intervention efforts. Future research should examine the underlying reasons for these changes observed in US high school students.

Perceived Needs for Adolescent Mental Health in an Urban Community

INTRODUCTION

Stressors in urban communities are detrimental to adolescents' psychological health. Key factors for success are a community-academic partnership in which researchers and stakeholders in the community work together on program development and research practices. This study elicited students', parents', and teachers' perceived needs for psychological well-being in urban-dwelling adolescents.

METHODS

Focus groups were conducted with teachers, family members, and students in an urban middle school. Individuals who did not speak English were excluded. Focus group interviews were recorded and transcribed and underwent content analysis to identify key themes. Two investigators independently reviewed and coded the data, with a third expert available if there was disagreement.

RESULTS

Six focus groups, two from each stakeholder group, were conducted with a total of 29 participants. Approximately 70% of participants were female, ranging in age from 11 to 68 years. Participants were primarily African American (n = 22), and the remainder were multiracial (n = 4), White (n = 2), and Latino (n = 1). Emergent themes were educational support, social skills, and community landscape.

DISCUSSION

Participants identified gaps and approaches to education and clinical care, strengthening social skills, and changing the community landscape as possible effective targets for future interventions.

A Framework for Race-Related Trauma in the Public Education System and Implications on Health for Black Youth

BACKGROUND

A combination of increased suicide in the past decade, documented high rates of anxiety and depression, and the preponderance of other behavioral and emotional regulation challenges place black youth at risk for school suspension and involvement in the juvenile justice system. Pointing to deficits in black youth and their families negates how forces of racism, whether unconscious or conscious, can disrupt well-being.

METHODS

A framework for race-related trauma in the public education system illustrates the interplay between macro-level forces, such as institutional and symbolic racism, and micro level forces of racism such as racial discrimination and violence. Identifying causal links between these forces and adverse academic and health outcomes for black youth can inform interventions and strategies to reduce race-related trauma.

RESULTS

The framework for race-related trauma is a multi-level analysis of racism and recognizes school districts facing economic restraints and school personnel turnover may face significant challenges in designing intervening strategies.

CONCLUSION

The framework guides change effort towards improving school climate and culture through preparing school professionals to meet the diverse needs of youth, strengthening family and community collaboration, and tackling those policies and behaviors that exclude and disconnect black youth.

School-Based Interventions for Reducing Youths’ Racial and Ethnic Prejudice

Minoritized youth encounter racial and ethnic prejudice and discrimination in a variety of settings, including schools. Prejudice refers to harboring negative attitudes and beliefs toward targeted social groups; discrimination reflects translating those attitudes into actions that marginalize targeted groups. Exposure to racial and ethnic discrimination has been associated with numerous detrimental outcomes for youth, including poorer mental health outcomes and lower levels of academic performance. This article describes the nature of racial and ethnic discrimination encountered by minoritized youth as well as its impact on these populations. It also reviews research on prejudice reduction interventions for youth, with a focus on those interventions designed for school settings. In light of existing research, several policy recommendations support high-quality, evidence-based programming in schools.

The Paradox of Positive Self-Concept and Low Achievement Among Black and Latinx Youth: A Test of Psychological Explanations

Previous studies often document that Black and Latino adolescents demonstrate considerable positive self-concept despite their low academic achievement. We critically reviewed two common psychological explanations for this paradoxical phenomenon: selective devaluation hypothesis (lower value placed in schoolwork protects their self-concept) and external attribution hypothesis (external attribution of poor achievement protects their self-concept). For a deeper understanding of Black and Latino youth's development of self-concept as racially or ethnically influenced process, we revisited these hypotheses with consideration of explanatory mediator (i.e., academic value) and moderator (i.e., perceived school fairness), based on nationally representative longitudinal data of Black, Latino, and White 10th graders (n ~= 12,920, 50.5% female). Contrary to the selective devaluation hypothesis, we found that Black and Latino youth placed greater value in schoolwork than White adolescents. Contrary to the external attribution hypothesis, self-concept was similarly related to previous achievement between Black and White adolescents and more closely related among Latino adolescents. Based on the results, we proposed three alternative hypotheses that might better explain the process of developing academic self-concept among Black and Latino youth.

Racial/Ethnic Discrimination and Suicidal Ideation in Emerging Adults: The Role of Traumatic Stress and Depressive Symptoms Varies by Gender not Race/Ethnicity

Drawing from Race-Based Traumatic Stress theory, the present study examined whether traumatic stress and depressive symptoms differentially help explain the relation between racial/ethnic discrimination and suicidal ideation across gender and racial/ethnic groups. A racially/ethnically diverse group of emerging adults (N = 1344; M_age = 19.88, SD = 2.25; 72% female; 46% Hispanic) completed a battery of self-report measures. A cross-sectional design was employed with a series of hierarchical linear regression models and bootstrapping procedures to examine the direct and indirect relation between racial/ethnic discrimination and suicidal ideation through traumatic stress and depressive symptoms across gender and race/ethnicity. The findings suggest an indirect relation through depressive symptoms, but not traumatic stress, and a serial indirect relation through traumatic stress to depressive symptoms in young women and young men, the latter of which was stronger in young women. The indirect relations did not vary by racial/ethnic group. Cumulative experiences of racial/ethnic discrimination may impact suicide-related risk via increases in psychiatric symptomology (i.e., traumatic stress and depressive symptoms), particularly in young women. Racial/ethnic discrimination experiences should be accounted for as a potential source of psychological distress in the assessment, diagnosis, and treatment of suicidal thoughts and behavior, especially among young women endorsing traumatic stress and depressive symptoms. Further research is warranted to better understand the gender difference in the relation between racial/ethnic discrimination and suicide-related risk.

Overt Perceived Discrimination and Racial Microaggressions and their Association with Health Risk Behaviors among a Sample of Urban American Indian/Alaska Native Adolescents

BACKGROUND

Urban American Indian/Alaska Native (AI/AN) adolescents are an understudied population in the USA who are at risk for a variety of health problems. Perceived discrimination (PD), including both overt PD and racial microaggressions (RMA), is known to adversely affect health. However, studies analyzing associations between overt PD and RMA and various health behaviors are limited.

METHODS

This study measured past-year alcohol use, heavy drinking, marijuana use, commercialized tobacco use, consequences experienced from alcohol and marijuana use in the past 3 months, mental and physical health status, AI/AN traditional activity participation, and overt PD and RMA among 182 urban AI/AN adolescents in California. To assess the association between overt PD and RMAs and health outcomes, we conducted either logistic regression (for dichotomous outcomes: past-year alcohol use, past-year heavy drinking, past-year marijuana use, consequences of alcohol and marijuana use, commercialized tobacco use) or linear regression (for continuous outcomes: mental and physical health, AI/AN traditional practices).

RESULTS

In contrast to our hypotheses, overt PD and RMA were not significantly associated with substance use or mental or physical health among this sample of urban AI/AN adolescents. After adjusting for age and gender, overt PD and RMA were only correlated with past-year cigarette use and alcohol-related consequences experienced in the past 3 months.

CONCLUSION

Potential factors that may play a role in decreasing effects of overt PD and RMA among urban AI/AN adolescents are discussed, including participation in AI/AN traditional practices and community engagement.

Navigating double marginalisation: migrant Chinese sexual and gender minority young people's views on mental health challenges and supports

Sexual and/or gender minority young people who are also members of an ethnic minority can experience unique challenges. Limited research draws directly on the mental health experiences of these 'double minority' youth. This study focused on Chinese sexual/gender minority youth in New Zealand. It sought to explore features they found challenging for, or supportive of, their mental health and wellbeing. Semi-structured interviews were conducted with 11 Chinese sexual/gender minority participants aged between 19 and 29 years old and residing in Auckland, New Zealand. An inductive approach to qualitative data analysis was used. Two major domains of findings emerged. Firstly, participants described mental health challenges linked to racism, sexism, cis-heteronormativity and challenges in relation to intersecting identities. Secondly, Chinese culture and community connections, family and peer support and role models seemed to facilitate resiliency. However, the fear of 'losing face', unwillingness to disclose distress when unwell and mental health service providers' lack of cultural and linguistic competency were described as barriers to effective mental health support. In conclusion, Chinese and sexual/gender minority identities were integral parts of participants' sense of self, and this was associated with their mental health and wellbeing. Further research is required to explore ways to reduce barriers and promote resiliency.