Microaggressions and marijuana use among college students

Race/ethnic differences in the association of anxiety, depression, and discrimination with subsequent nicotine and cannabis use among young adults: A prospective longitudinal study

INTRODUCTION

The shifting patterns in nicotine and cannabis use among young adults is taking place at a time when there is also increased reports of psychosocial stressors such as anxiety, depression, and everyday discrimination. Although race/ethnicity has been found to moderate the impact of psychosocial stressors, there is limited research examining the association of anxiety, depression, and discrimination with patterns of nicotine and/or cannabis product use among diverse young adults.

METHODS

Data were from a longitudinal study of 2478 US young adults surveyed between 2019 and 2021. General estimating equation models were used to examine associations of self-reported psychological symptoms (depression, anxiety) and social stressors (discrimination) with substance use (any nicotine and cannabis product use; nicotine and cannabis vaping).

RESULTS

Young adults from different racial/ethnic groups differed significantly in their depression and discrimination scores with young adults of color having higher mean scores. Overall, higher depression and everyday discrimination score was associated with increased odds of past 6-month use of any nicotine/tobacco and cannabis products. Higher generalized anxiety score increased odds of any nicotine/tobacco and dual nicotine and cannabis product use. Higher everyday discrimination score was associated with increased odds nicotine and cannabis vaping overall. Stratified models showed variation in associations among different racial/ethnic groups.

CONCLUSIONS

Psychosocial stressors are associated with increased substance use odds among young adults. However, these stressors have a differential impact on substance use odds among young adults from different racial/ethnic contexts.

Microaggressions, perceptions of campus climate, mental health, and alcohol use among first-year college students of color

Depressive and anxiety symptoms are increasingly common, and problematic alcohol use remains prevalent in college. To expand on prior research on mostly white samples, we surveyed first-year students of color from our predominately white university (Southeastern US) to identify risk factors for mental health symptoms and potentially co-occurring problematic alcohol use. Results showed significant associations between microaggressions and poor campus climate (hypothetical predictors) with depressive, anxiety, somatic symptoms (hypothetical outcomes) that were indirectly linked through perceived stress, poor sleep, and academic burnout (hypothetical mediators). Poor campus climate, academic burnout, and using alcohol to cope were the most relevant to alcohol use disorder symptoms. Results support efforts to address and reduce racial microaggressions and promote a positive campus climate for all.

Preliminary Effects of a Guided Self-Change Intervention on Perceived Risk and Self-Efficacy in University Students Engaging in Cannabis or Alcohol Misuse

Guided Self-Change (GSC) is a Motivational Interviewing (MI)-based early intervention program, infused with Cognitive Behavioral Therapy (CBT), for individuals with substance use problems. In this study, we implemented a 4-session GSC program with the innovative addition of mindfulness-based techniques at a minority-serving institution to reduce substance use and negative consequences among self-referred university students. We investigated processes that may be associated with behavior change, including perceived risk of use and self-efficacy ratings among university students who reported their primary substance of choice was cannabis (n = 18) or alcohol (n = 18). The sample of 36 participants (Mage = 24.4, SDage = 5, range 18-37) mostly identified as female (58.3%), then male (41.7%); 52.8% identified as Hispanic/Latine, 22.2% as Black or African American, and 19.5% as a sexual minority. Among cannabis primary using students, results indicated that the perceived risk of weekly cannabis use, confidence to change, and readiness to change showed statistically significant increases from pre- to post-assessment. Among alcohol primary using students, confidence to change and readiness to change showed statistically significant increases from pre- to post-assessments. All results yielded large effect sizes, which may be inflated due to the small sample size. Findings suggest that over the course of participation in a brief, 4-session targeted GSC program, there were significant increases in perceived risk and self-efficacy among minority university students who engage in primary cannabis or primary alcohol use.

Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults

INTRODUCTION

Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders.

METHODS

We used cross-sectional data on adults (18+) from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0-24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity).

RESULTS

Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07-1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12-1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults.

CONCLUSIONS

Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.

Intimate partner violence, substance use, and health comorbidities among women: A narrative review

Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.

Associations between discrimination and substance use among college students in the United States from 2015 to 2019

Discrimination has been associated with adverse health behaviors and outcomes, including substance use. Higher rates of substance use are reported among some marginalized groups, such as lesbian, gay, and bisexual populations, and have been partially attributed to discrimination. This study uses 2015-2019 National College Health Assessment data to determine whether college students reporting discrimination due to sexual orientation, race/ethnicity, gender, or age report greater substance use than their peers who do not report such experiences. Additionally, we assess exploratory questions regarding whether substance choices differ among students who reported facing discrimination. Over time, about 8.0% of students reported experiencing discrimination in the past year. After applying inverse probability treatment weights (IPTWs), exposure to discrimination was associated with an excess of 44 cases of marijuana use per 1000 students, an excess of 39 cases of alcohol use per 1000 students, and an excess of 11 cases of prescription painkiller use per 1000 students. Multivariable logistic regression models with IPTW demonstrated that students who experienced discrimination were more than twice as likely to use inhalants and methamphetamine. These students were also significantly more likely to use other drugs, including opiates, non-prescribed painkillers, marijuana, alcohol, hallucinogens, cocaine, and cigarettes; however, the differences with peers were smaller in magnitude. Students who experienced discrimination did not differ from peers who reported non-prescribed antidepressants use and were significantly less likely to use e-cigarettes and smokeless tobacco. Associations between discrimination and substance use vary by race, gender, sexual orientation, and age. These findings indicate that discrimination has significant associations with many kinds of substance use; however, the magnitude varies by substance type. More institutional efforts to address sources of discrimination affecting college students are needed.

After Pierce and Sue: A Revised Racial Microaggressions Taxonomy

Harvard psychiatrist Chester Pierce's conception of "subtle and stunning" daily racial offenses, or microaggressions, remains salient even 50 years after it was introduced. Microaggressions were defined further by Sue and colleagues in 2007, and this construct has found growing utility as the deleterious effects of microaggressions on the health of people of color continues to mount. Many studies seek to frame microaggressions in terms of a taxonomic analysis of offender behavior to inform the assessment of and interventions for the reduction of racial microaggressions. This article proposes an expansion and refinement of Sue et al.'s taxonomy to better inform such efforts. We conducted a review of published articles that focused on qualitative and quantitative findings of microaggressions taxonomies (N = 32). Sixteen categories of racial microaggressions were identified, largely consistent with the original taxonomy of Sue et al. but expanded in several notable ways. Building on our prior research, other researchers supported such new categories as tokenism, connecting via stereotypes, exoticization and eroticization, and avoidance and distancing. The least studied categories included the denial of individual racism from Sue et al., and newer categories included reverse-racism hostility, connecting via stereotypes, and environmental attacks. A unified language of microaggressions may improve understanding and measurement of this important construct.

Reviewing Racial Microaggressions Research: Documenting Targets' Experiences, Harmful Sequelae, and Resistance Strategies

In this article, we review the theoretical and empirical literature on racial microaggressions from 2007 to 2020 (N = 138 articles). First, we refine racial microaggressions theory and update the definition to address mischaracterizations in the literature and clarify the term (i.e., "micro" refers to microlevel interactions rather than degree of harm). Next, we used four superordinate categories (i.e., pathologizing differences, denigrating and pigeonholing, excluding or rendering invisible, and perpetuating color-blind racial attitudes) in which to situate racial microaggression themes from the extant literature. Moreover, we consolidated and renamed existing themes to privilege targets' perspectives (e.g., facing assumptions of inferior status and enduring exoticization). We then synthesized qualitative and quantitative research that shows harmful sequelae of racial microaggressions (i.e., psychological and physiological symptoms). Extending prior research on coping with gendered racial microaggressions, we describe empirical findings on collective, resistance, and self-protective strategies to mitigate the harmful impact of racial microaggressions. We conclude with directions for future research.

Examining the role of ethnic microaggressions and ethnicity on cortisol responses to an acute stressor among young adults

Objective: This study examined whether the frequency of experiences of ethnic microaggressions and the sensitivity to such experiences were associated with cortisol responses to an acute social stressor (Trier Social Stress Test; TSST) among an ethnically diverse sample of young adults (N = 109, Mage = 18.82 years, SD = 1.40 years, 74% female, 44% Latinx). Method: Self-reported experiences of and sensitivity to microaggressions were assessed using the Everyday Microaggressions Scale. Participants' salivary cortisol was collected before, immediately after, and at three 15-min intervals after the TSST (for a total of 5 salivary samples) to assess their cortisol responses to an acute social stressor. Results: Mixed model analyses revealed that experiencing a higher frequency of microaggressions (p = .005) and being more sensitive to those experiences (p = .001) were associated with a more blunted cortisol response (i.e., lower cortisol reactivity and recovery) to the TSST, relative to experiencing a lower frequency of microaggressions and being less sensitive to them. Furthermore, this blunted cortisol response to the TSST was more prominent among young adults of Latinx and other ethnic backgrounds (i.e., biracial, African American, and Native American) compared to their Asian American and non-Hispanic White peers (p = .034). Conclusion: Findings provide insight into the different ways in which experiences of ethnic microaggressions can be associated with biological markers of stress. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A qualitative study of microaggressions against African Americans on predominantly White campuses

Background

Pierce’s (The Black seventies: an extending horizon book, 1970) conception of “subtle and stunning” daily racial offenses, or microaggressions, remains salient even 50 years after it was introduced. Microaggressions were defined further by Sue and colleagues (Am Psychol 62:271, 2007), and this construct has found growing utility as the deleterious effects of microaggressions on the health of people of color continues to mount. Microaggressions are common on campuses and contribute to negative social, academic, and mental health outcomes.

Method

This paper explores how Black college students’ experiences correspond to or differ from the microaggression types originally proposed by Sue et al. (Am Psychol 62:271, 2007). Themes were identified from focus group data of students of color (N = 36) from predominately White institutions (PWIs) of higher learning (N = 3) using interpretative phenomenological analysis.

Results

We identified 15 categories of racial microaggressions, largely consistent with the original taxonomy of Sue et al. but expanded in several notable ways. New categories in our data and observed by other researchers, included categories termed Connecting via Stereotypes, Exoticization and Eroticization, and Avoidance and Distancing. Lesser studied categories identified included Sue et al.’s Denial of Individual Racism, and new categories termed Reverse Racism Hostility, Connecting via Stereotypes, and Environmental Attacks.

Discussion

While previous literature has either embraced the taxonomy developed by Sue and colleagues or proposed a novel taxonomy, this study synthesized the Sue framework in concert with our own focus group findings and the contributions of other researchers. Improving our understanding of microaggressions as they impact people of color may better allow for improved understanding and measurement of this important construct.

Perceived Discrimination and Risk Behaviors in African American Students: the Potential Moderating Roles of Emotion Regulation and Ethnic Socialization

Prior research has identified perceived discrimination as being a contributing factor in health and mental health disparities. However, there is little research on the relationship between perceived discrimination and behaviors such as hazardous alcohol and illicit substance use and risky sexual behaviors that put people at risk for negative health consequences including HIV. The current research explores the role that cultural factors may play in a tendency for individuals to engage in unhealthy behaviors or an ability to avoid them. A total of 266 college students who self-identified as Black or African American were surveyed on measures of familial ethnic socialization, perceived discrimination, emotion regulation, substance use, and risky sexual behaviors. Findings indicate that perceived discrimination and emotion regulation-suppression were associated with higher levels of hazardous alcohol use, and that emotion regulation-cognitive reappraisal was associated with lower levels of illicit substance use. Implications for intervention and prevention in African American college students are discussed.

Racial discrimination and alcohol problems among African American young adults: Examining the moderating effects of racial socialization by parents and friends

OBJECTIVE

Racial discrimination is a stressor that may put African Americans at risk for alcohol use and related problems. We examined whether experiences of blatant (racist events) and subtle (racial microaggressions) forms of racial discrimination were associated with alcohol consumption and alcohol problems among African American young adults, and whether childhood/adolescence racial socialization by parents and friends moderated these associations.

METHOD

The sample included 383 African American young adults (Mage = 20.65, SD = 2.28; 81% female) who completed an electronic survey in Fall, 2017. Hierarchical linear regression analyses were conducted in Mplus.

RESULTS

Experiences of racist events and racial microaggressions were associated with higher levels of alcohol consumption and more alcohol problems. Racial socialization by friends, but not parents, moderated these associations. Specifically, cultural socialization by friends buffered the effect of racist events on alcohol consumption and alcohol problems, whereas promotion of mistrust by friends exacerbated the effect of racial microaggressions on alcohol problems.

CONCLUSIONS

Both blatant and subtle forms of racial discrimination were associated with higher risk for alcohol use or problems among African American young adults. Racial socialization by friends while growing up may play an important role in alcohol use outcomes during young adulthood. Findings highlight the importance of considering different forms of racial discrimination and emphasize the unique roles of racial socialization across different social contexts (i.e., parent and peers or friends) in relation to psychosocial outcomes among African American individuals. (PsycInfo Database Record (c) 2020 APA, all rights reserved).