Racism in Australia: a protocol for a systematic review and meta-analysis

BACKGROUND

Racism has been identified as a major source of injustice and a health burden in Australia and across the world. Despite the surge in Australian quantitative research on the topic, and the increasing recognition of the prevalence and impact of racism in Australian society, the collective evidence base has yet to be comprehensively reviewed or meta-analysed. This protocol describes the first systematic review and meta-analysis of racism in Australia at the national level, focussing on quantitative studies. The current study will considerably improve our understanding of racism, including its manifestations and fluctuation over time, variation across settings and between groups, and associations with health and socio-economic outcomes.

METHODS

The research will consist of a systematic literature review and meta-analysis. Searches for relevant studies will focus on the social and health science databases CINAHL, PsycINFO, PubMed and Scopus. Two reviewers will independently screen eligible papers for inclusion and extract data from included studies. Studies will be included in the review and meta-analysis where they meet the following criteria: (1) report quantitative empirical research on self-reported racism in Australia, (2) report data on the prevalence of racism, or its association with health (e.g. mental health, physical health, health behaviours) or socio-economic outcomes (e.g. education, employment, income), and (3) report Australian data. Measures of racism will focus on study participants' self-reports, with a separate analysis dedicated to researcher-reported measures, such as segregation and differential outcomes across racial/ethnic groups. Measures of health and socio-economic outcomes will include both self-reports and researcher-reported measures, such as physiological measurements. Existing reviews will be manually searched for additional studies. Study characteristics will be summarised, and a meta-analysis of the prevalence of racism and its associations will be conducted using random effects models and mean weighted effect sizes. Moderation and subgroup analyses will be conducted as well. All analyses will use the software CMA 3.0.

DISCUSSION

This study will provide a novel and comprehensive synthesis of the quantitative evidence base on racism in Australia. It will answer questions about the fluctuation of racism over time, its variation across settings and groups, and its relationship with health and socio-economic outcomes. Findings will be discussed in relation to broader debates in this growing field of research and will be widely disseminated to inform anti-racism research, action and policy nationally.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021265115 .

Unpacking stigma: Meta-analyses of correlates and moderators of personal stigma in psychosis

Personal stigma entails perceived, experienced and internalised stigmatisation. Mental Health stigma has been widely researched across a range of countries and a meta-analysis of their associations and moderators in psychosis is timely. Meta-analyses were conducted examining the correlates and moderators of personal stigma in terms of: (1) demographic variables (2) illness related variables (3) symptoms/negative outcomes, and (4) aspects of wellbeing. Associations were obtained from a total of 216 records. Several demographic factors including age, economic status, employment, and rural residence had small associations with aspects of personal stigma (r's = 0.12 to -0.13). Personal stigma aspects were inversely related to medication adherence (r's = -0.20, -0.21), and positively associated with insight and number of hospitalisations (r's = 0.09-0.19). Most symptoms were positively associated with personal stigma (r's = 0.10-0.43), whereas inverse relations with wellbeing variables were identified (r's = -0.13 to -0.54). Moderator effects emerged including that of cultural setting and sex, age and education level, highlighting the role of cultural and demographic factors in shaping personal stigma aspects in psychosis. The present study also highlights the importance of recognizing the negative effect of actual stigma and discrimination experiences; particularly its detrimental impact on self-image and its complex role in shaping the internalisation of societal stigma.

A Meta-Analysis of the Relationship Between Internalized Racial Oppression and Health-Related Outcomes

Internalized racism represents a critical component of the system of racial oppression wherein People of Color adopt the negative beliefs about their race held by members of the White majority group. In this meta-analysis, the authors reviewed 29 studies (32 effect sizes) on the relationships between internalized racism and negative physical and mental health outcomes published between 1999 and 2015 and tested for literature-driven moderator effects using subgroup analyses. Results suggested that the direct overall relation between internalized racism and health was strongest for negative mental health outcomes ( r = .26), followed by negative physical health outcomes ( r = .11). Significant moderator effects were found for scale of measurement, country of sample (United States vs. international), and sampling method. Moderator effects of gender, publication type, year, and sample setting were not statistically significant. These findings are discussed and their implications for practice, advocacy, education/training, and research are described.

Board Attributes and Corporate Social Responsibility Disclosure: A Meta-Analysis

Many studies have examined the relationships between board attributes (board independence, CEO duality, board size, and women on boards) and corporate social responsibility disclosure (CSRD) as a means to improve a firm’s reputation. This research was performed in various international settings and uneven outcomes were obtained. We therefore meta-analyzed 88 studies to summarize scattered evidence and found that CEO duality had a significantly negative relationship with CSRD, while board independence, board size and women representation had a significantly positive relationship with CSRD. These relationships were more significant in countries with low levels of commitment to sustainable goals. Thus, our study revealed differences in the relationship between board attributes and CSRD, and that these differences were conditioned by the institutional contexts in which firms operate. Our research has practical implications for practitioners and policy makers alike as we offer guidelines on the most suitable corporate governance mechanisms to achieve lower capital costs and better access to finance.

Racism and health service utilisation: A systematic review and meta-analysis

Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field.

A Meta-Analysis of the Correlates of Educational and Vocational Goals for Latina/o Students

Among Latina/o Americans, the fastest growing segment of the U.S. population, disparities exist in educational and career attainment. The emergence of research on Latina/o students has resulted in varied findings that make it difficult to draw conclusions as to which predictors are most closely associated with goal outcomes for this population. Using meta-analytic techniques, the current study examined the magnitude, direction, and heterogeneity of effect sizes across multiple educational and vocational goal outcomes for Latina/o students (i.e., educational/vocational aspirations, expectations, goals/plans, and persistence). Across 34 independent samples from 33 studies, career-related self-efficacy, peer support, adult support, barriers, and Anglo acculturation had moderate effects on at least one of the outcomes, with career-related self-efficacy and peer support being moderately related to two or more outcomes. If replicated, this research suggests that interventions focused on career-related self-efficacy and peer support could enhance the development of educational and career goals for Latina/o students.

Construct Validation in Counseling Psychology Research

Counseling psychology researchers devote little attention to theory-based measurement validation, as evidenced by cursory mention of validity issues in the method and discussion sections of published research reports. Especially, many researchers appear unaware of the limitations of correlations between pairs of self-report measures as evidence of construct validity. The authors provide an overview of the process of construct validation via user-friendly terminology and examples, with special attention to aspects often neglected in counseling psychology research, including specific recommendations for design and interpretation of multimethod validity investigations.

Advanced Applications of Structural Equation Modeling in Counseling Psychology Research

Structural equation modeling (SEM) is a data-analytic technique that allows researchers to test complex theoretical models. Most published applications of SEM involve analyses of cross-sectional recursive (i.e., unidirectional) models, but it is possible for researchers to test more complex designs that involve variables observed at multiple points in time or variables implicated in reciprocal feedback loops (i.e., bidirectional models). Given SEM’s popularity among counseling psychology researchers, this article aims to introduce three SEM designs not often seen in the counseling psychology literature: cross-lagged panel analyses, latent growth curve modeling, and nonrecursive mediated model analysis. For each design, the authors provide a brief rationale regarding its purpose, procedures for specifying a model to test the design, and a worked illustration.

Scale Development Research

The authors conducted a content analysis on new scale development articles appearing in the Journal of Counseling Psychology during 10 years (1995 to 2004). The authors analyze and discuss characteristics of the exploratory and confirmatory factor analysis procedures in these scale development studies with respect to sample characteristics, factorability, extraction methods, rotation methods, item deletion or retention, factor retention, and model fit indexes. The authors uncovered a variety of specific practices that were at variance with the current literature on factor analysis or structural equation modeling. They make recommendations for best practices in scale development research in counseling psychology using exploratory and confirmatory factor analysis.

Paradigms, Purpose, and the Role of the Literature

The authors have identified three areas that are central to the rationale for conducting a qualitative research project, yet which produce confusion and uncertainty for some psychologists trained in traditional research methods. In this article, they consider how philosophy of science paradigms relate to the foundational rationale for qualitative inquiry and present suggestions for how researchers can formulate a statement of purpose and research questions that are congruent with an identified paradigm. They examine the role of scholarly literature in two areas: those of developing a rationale and in enhancing the impact of qualitative research. Examples from contemporary counseling psychology research are used to illustrate core concepts.

Qualitative Research in Counseling Psychology

Beginning with calls for methodological diversity in counseling psychology, this article addresses the history and current state of qualitative research in counseling psychology. It identifies the historical and disciplinary origins as well as basic assumptions and underpinnings of qualitative research in general, as well as within counseling psychology. It identifies the foundational elements of qualitative research, including its purposes and goals, paradigmatic bases, and underlying characteristics. Finally, it locates qualitative research in counseling psychology in the research genre and explores the promise that this form of research holds for counseling and psychotherapy research as well as counseling psychology's multicultural and social justice agenda.

Racism as a Determinant of Health: A Systematic Review and Meta-Analysis

Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.

Depression, Alcohol Abuse, and Alcoholism in One versus Two Parents and the Implications for Child Attachment and Self-Regulation in Infancy through Adolescence

This study's purpose was to determine whether the influence of combined parental disorders can cause greater frequency in the occurrence of insecure child attachment and dysfunctions in self-regulation as opposed to the influence of one parent having a disorder. The research design is a quantitative meta-analysis that combined effects from 10 studies to establish differences in the frequency of occurrence for insecure child attachment and dysfunctions in self-regulation through an examination of Cohen's d. Global analysis of Cohen's effect (d) indicated that children being reared by two disordered parents had higher frequency in occurrence of insecure attachment and self-regulation dysfunction than those children reared by only one disordered parent. By addressing the issues surrounding the child population where both parents are disordered, children would have a better chance at healthy development by way of interventions that minimize the occurrence of child psychopathology and foster improvements in the social and overall human condition.

Metaanalyse–praktische Schritte und Entscheidungen im Umsetzungsprozess

In diesem Beitrag wird der Durchführungsprozess metaanalytischer Techniken nach Hunter und Schmidt (2004) Schritt für Schritt beschrieben. In Form eines Tutoriums geben wir evidenzbasierte Empfehlungen, verweisen auf relevante Quellen und Hilfsmittel und bewerten alternative Vorgehensweisen in Bezug auf ihre Güte und Akzeptanz. Wir wenden uns an Forschende, die eine Metaanalyse mit der Besonderheit der Artefaktkorrekturen nach Hunter und Schmidt durchführen wollen und geben Anregungen für die Verbreitung metaanalytischer Ergebnisse sowohl im Wissenschaftskontext als auch im Austausch mit Praktikern.

Comment: Why Meta-Analyses Rarely Resolve Ideological Debates

In their meta-analysis Wood, Kressel, Joshi, and Louie (2014) argue little evidence supports shifts in mating preferences across the menstrual cycle. They imply this may represent a critical weakness of evolutionary psychology theories of mating preferences more generally. This report represents a fairly common use of meta-analysis: to assemble data to support or reject a particular proposition over which there is debate. Yet, rarely do meta-analyses succeed at resolving ideological debates. Multiple decision points related to the selection, coding, effect size extraction, and interpretation of studies leaves considerable room for meta-analytic authors to interject their own beliefs. Meta-analyses are typically hailed by those who agreed a priori with their conclusion, and rejected as fatally flawed by those in disagreement. As such, meta-analyses have failed in replacing narrative reviews as more objective.

Neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis

BACKGROUND

It is assumed within the accumulated literature that children born of pregnant opioid dependent mothers have impaired neurobehavioral function as a consequence of chronic intrauterine opioid use.

METHODS

Quantitative and systematic review of the literature on the consequences of chronic maternal opioid use during pregnancy on neurobehavioral function of children was conducted using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We searched Cinahl, EMBASE, PsychINFO and MEDLINE between the periods of January 1995 to January 2012.

RESULTS

There were only 5 studies out of the 200 identified that quantitatively reported on neurobehavioral function of children after maternal opioid use during pregnancy. All 5 were case control studies with the number of exposed subjects within the studies ranging from 33-143 and 45-85 for the controls. This meta-analysis showed no significant impairments, at a non-conservative significance level of p < 0.05, for cognitive, psychomotor or observed behavioural outcomes for chronic intra-uterine exposed infants and pre-school children compared to non-exposed infants and children. However, all domains suggested a trend to poor outcomes in infants/children of opioid using mothers. The magnitude of all possible effects was small according to Cohen's benchmark criteria.

CONCLUSIONS

Chronic intra-uterine opioid exposed infants and pre-school children experienced no significant impairment in neurobehavioral outcomes when compared to non-exposed peers, although in all domains there was a trend to poorer outcomes. The findings of this review are limited by the small number of studies analysed, the heterogenous populations and small numbers within the individual studies. Longitudinal studies are needed to determine if any neuropsychological impairments appear after the age of 5 years and to help investigate further the role of environmental risk factors on the effect of 'core' phenotypes.

A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people

Racial discrimination is increasingly recognised as a determinant of racial and ethnic health inequalities, with growing evidence of strong associations between racial discrimination and adult health outcomes. There is a growing body of literature that considers the effects of racial discrimination on child and youth health. The aim of this paper is to provide a systematic review of studies that examine relationships between reported racial discrimination and child and youth health. We describe the characteristics of 121 studies identified by a comprehensive search strategy, including definitions and measurements of racial discrimination and the nature of reported associations. Most studies were published in the last seven years, used cross-sectional designs and were conducted in the United States with young people aged 12-18 years. African American, Latino/a, and Asian populations were most frequently included in these studies. Of the 461 associations examined in these studies, mental health outcomes (e.g. depression, anxiety) were most commonly reported, with statistically significant associations with racial discrimination found in 76% of outcomes examined. Statistically significant associations were also found for over 50% of associations between racial discrimination and positive mental health (e.g. self esteem, resilience), behaviour problems, wellbeing, and pregnancy/birth outcomes. The field is currently limited by a lack of longitudinal studies, limited psychometrically validated exposure instruments and poor conceptualisation and definition of racial discrimination. There is also a need to investigate the complex and varying pathways by which reported racial discrimination affect child and youth health. Ensuring study quality in this field will allow future research to reveal the complex role that racial discrimination plays as a determinant of child and youth health.

Discrimination Against Latina/os

This meta-analysis synthesizes the findings of 60 independent samples from 51 studies examining racial/ethnic discrimination against Latina/os in the United States. The purpose was to identify individual-level resources and outcomes that most strongly relate to discrimination. Discrimination against Latina/os significantly results in outcomes pertaining to health, mental health, education, and employment. Mental health indicators have the strongest correlations with discrimination. Among the individual resources resulting from this meta-analysis—personal constructs and strengths, social support, acculturation, enculturation, acculturative stress, and active coping skills—personal constructs and strengths (e.g., self-esteem and self-efficacy) have the strongest correlations with discrimination and outcomes. These findings are significantly moderated by sample age, ethnicity, and regionality. Implications of these findings are discussed.

Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis

BACKGROUND

Dose-effect relationship data suggest that short-term psychotherapy is insufficient for many patients with chronic distress or personality disorders (complex mental disorders).

AIMS

To examine the comparative efficacy of long-term psychodynamic psychotherapy (LTPP) in complex mental disorders.

METHOD

We conducted a meta-analysis of controlled trials of LTPP fulfilling the following inclusion criteria: therapy lasting for at least a year or 50 sessions; active comparison conditions; prospective design; reliable and valid outcome measures; treatments terminated. Ten studies with 971 patients were included.

RESULTS

Between-group effect sizes in favour of LTPP compared with less intensive (lower dose) forms of psychotherapy ranged between 0.44 and 0.68.

CONCLUSIONS

Results suggest that LTPP is superior to less intensive forms of psychotherapy in complex mental disorders. Further research on long-term psychotherapy is needed, not only for psychodynamic psychotherapy, but also for other therapies.

Racial Discrimination and Asian Mental Health: A Meta-Analysis

Although research on racial discrimination and mental health has proliferated, findings are varied and dispersed. This study explored the critical question of how Asians, in particular, deal with discrimination and how this relates to Asian mental health. With 99 correlations from 23 independent studies, the overall relationship between racial discrimination and mental health was statistically significant ( r = .23). Individual resources (i.e., personal constructs and strengths, social support, cultural identity, and coping strategies) were also found to be significantly related to racial discrimination ( r = -.19, -.15, -.10, .22, respectively) and to mental health with the exception of coping strategies ( r = -.48, -.27, -.21, respectively). Recommendations regarding future research and clinical implications of these findings are discussed.

Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis

An expansive body of research has investigated the experiences and adverse consequences of internalized stigma for people with mental illness. This article provides a systematic review and meta-analysis of the extant research regarding the empirical relationship between internalized stigma and a range of sociodemographic, psychosocial, and psychiatric variables for people who live with mental illness. An exhaustive review of the research literature was performed on all articles published in English that assessed a statistical relationship between internalized stigma and at least one other variable for adults who live with mental illness. In total, 127 articles met the inclusion criteria for systematic review, of which, data from 45 articles were extracted for meta-analyses. None of the sociodemographic variables that were included in the study were consistently or strongly correlated with levels of internalized stigma. The review uncovered a striking and robust negative relationship between internalized stigma and a range of psychosocial variables (e.g., hope, self-esteem, and empowerment). Regarding psychiatric variables, internalized stigma was positively associated with psychiatric symptom severity and negatively associated with treatment adherence. The review draws attention to the lack of longitudinal research in this area of study which has inhibited the clinical relevance of findings related to internalized stigma. The study also highlights the need for greater attention on disentangling the true nature of the relationship between internalized stigma and other psychosocial variables.

Efficacy of Counseling and Psychotherapy in Schools: A Meta-Analytic Review of Treatment Outcome Studies 1Ψ7

This study investigated the efficacy of counseling and psychotherapy interventions for youth in schools. Data were examined for 107 studies that included 132 treatment interventions. Overall efficacy was d = 0.45 and was significantly different from zero. Interventions for adolescents outperformed those of children, treatment groups that were predominately female or male did better than mixed-gender groups, and licensed professional therapists outperformed paraprofessionals, who outperformed graduate students. Implications for supporting the mental health needs of youth in schools are discussed.

The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: a meta-analysis of direct comparisons

Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.

Evidence-based practice in psychology: Implications for research and research training

In this article, the author discusses the implications of evidence-based practice (EBP) for research and research training in clinical psychology. It is argued that EBP provides a useful framework for addressing some heretofore ignored problems in clinical research. Advancing evidence-based psychological practice will require educators to inject significant new content into research, design, and methodology courses and to further integrate research and practicum training. The author believes this to be an exciting opportunity for the field, not only because it will further psychologists' integration into the interdisciplinary health care and research environment, but also because it will provide new tools to educate students for capable, not just competent professional activity.