Experience of Racism as a Correlate of Developmental and Health Outcomes Among Urban Adolescent Mental Health Clients

Summary

Correlates of race/ethnicity and perceived racism among 760 urban, predominantly Hispanic/Latino and African-American, adolescent mental health clients were investigated using an exploratory, clinical data-mining approach. All racial/ethnic groups reported substantial rates of racism, ranging from 80.0% for Asian/Pacific Islanders to 32.4% for Hispanic/Latinos. Racism was associated with significantly elevated environmental risk (e.g., violence, sexual abuse or assault, exposure to drug use), behavioral risk (e.g., drug use) and worry (e.g., worry about hurting self or others, worry about doing dangerous things). Overall, racism was significantly associated with more negative health and well-being outcomes than ability to get a gun, sexual orientation, and being enrolled in school. The authors conclude that experience of racism should be routinely assessed at intake to mental health services along with traumatic experiences such as physical or sexual abuse.     

Critical race theory speaks to the sociology of mental health: mental health problems produced by racial stratification

The sociology of mental health focuses on the epidemiology, etiology, correlates, and consequences of mental health (i.e., psychiatric disorder and symptoms, psychological distress, and subjective well-being) in an attempt to describe and explain how social structure influences an individual's psychological health. Critical race theory describes and explains iterative ways in which race is socially constructed across micro- and macro-levels, and how it determines life chances implicating the mundane and extraordinary in the continuance of racial stratification (i.e., racism). This paper invoked critical race theory to inform the sociology of mental health's approach to studying race and mental health by conceptualizing five hypothetical mental health problems that could exist because of racial stratification. These problems were: (1) nihilistic tendencies, (2) anti-self issues, (3) suppressed anger expression, (4) delusional denial tendencies, and (5) extreme racial paranoia. Mental health problems such as these and undocumented others can only be recognized given awareness of the social and personal implications of racial stratification.     

Exposure to Client Trauma,Secondary Traumatic Stress,and the Health of Clinical Social Workers: A Mediation Analysis

While it is widely acknowledged that providing services to traumatized populations may negatively impact the mental health of clinicians, little is known about the impact of exposure to traumatized clients and secondary traumatic stress on the physical health status of clinicians. As such, the twofold purpose of this study was to: (1) document the prevalence of STS in a national (US) sample of clinical social workers, and (2) to examine the relationships between exposure to client trauma, STS, and perceived health of clinical social workers. Specifically, we sought to determine if STS mediates the relationship between exposure to client traumas and perceived health. Results indicate clinicians experience intrusion symptoms most frequently, and a significant portion report arousal and avoidance symptoms. Mediation analyses revealed that exposure to traumatized client populations indirectly influenced clinical social workers’ physical health perceptions by way of secondary traumatic stress. Findings call for increased attention toward prevention and amelioration of secondary traumatic stress symptomology among direct service providers, given both its prevalence and potential impact on physical health. Directions for future research are discussed.     

The prevalence, distribution, and mental health correlates of perceived discrimination in the United States.

The survey data presented here are on the national prevalences of major life-time perceived discrimination and day-to-day perceived discrimination; the associations between perceived discrimination and mental health; and the extent to which differential exposure and differential emotional reactivity to perceived discrimination account for the well-known associations between disadvantaged social status and mental health. Although more prevalent among people with disadvantaged social status, results show that perceived discrimination is common in the total population, with 33.5 percent of respondents in the total sample reporting exposure to major lifetime discrimination and 60.9 percent reporting exposure to day-to-day discrimination. The associations of perceived discrimination with mental health are comparable in magnitude to those of other more commonly studied stressors, and these associations do not vary consistently across subsamples defined on the basis of social status. Even though perceived discrimination explains only a small part of the observed associations between disadvantaged social status and mental health, given its high prevalence, wide distribution, and strong associations with mental health, perceived discrimination needs to be treated much more seriously than in the past in future studies of stress and mental health.     

Racial Discrimination, Post Traumatic Stress, and Gambling Problems among Urban Aboriginal Adults in Canada

Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events.     

The Injurious Relationship Between Racial Microaggressions and Physical Health: Implications for Social Work

ABSTRACT

In recent years, the study of racial microaggressions (or subtle forms of racial discrimination) has increased significantly in the social sciences, particularly highlighting the negative impact of racial microaggressions on individuals’ mental health. Despite this, there is a dearth of literature that has examined the relationship between racial microaggressions and physical and psychological health. Using two self-reported measures—the Racial and Ethnic Microaggressions Scale (REMS) and the RAND 36-Item Short Form Health Survey—with a diverse group of participants (N = 277), results suggest that racial microaggressions are significantly correlated with poorer health conditions. Furthermore, racial microaggressions were found to predict various types of physical health conditions, such as general health problems, pain, lower energy levels, and fatigue. Finally, different types of microaggressions (e.g., microaggressions in school or the workplace, environmental microaggressions) were found to be predictors of specific health issues. Implications for social work are discussed.     

Divorce Disclosures and Adolescents' Physical and Mental Health and Parental Relationship Quality

Two studies were constructed to examine the associations between custodial parents' negative disclosures about the other parent after a divorce and parent–adolescent relational quality (closeness and satisfaction) and adolescents' physical and mental health. In general, the results suggested that even though negative disclosures about the other parent might be associated with more cohesive relationships between custodial parents and adolescents, it does not mean that adolescents are immune to the physical and psychological effects of such disclosures. In Study 2, negative disclosures about the other parent were associated with adolescents' increased reports of physical and mental health symptoms. The results revealed a similar effect for general divorce information and adolescents' mental health. However, there was no association for catharsis and adolescents' physical and mental health. The results from both studies also revealed that adolescents perceived that their custodial parents disclosed more negative information about the other parent than the parents perceived that they disclosed.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

Everyday Racial Discrimination,Everyday Non-Racial Discrimination,and Physical Health Among African-Americans

ABSTRACT

Past research has identified a link between discrimination and health outcomes among people of color. Perceptions of the cause of discrimination (racial versus other) seem to be important for mental health; however, this relationship has not been fully examined for physical health. Using data from the National Survey of American Life, we find that, among African-Americans, racial discrimination and overall discrimination regardless of attribution are associated with negative health outcomes while non-racial discrimination is not. The results suggest that racial discrimination has a unique adverse effect on physical health for African-Americans that practitioners need to better understand.     

Perceived Discrimination and Its Associations With Mental Health and Substance Use Among Asian American and Pacific Islander Undergraduate and Graduate Students

Abstract

Objectives: Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. Participants: A total of 113 API students aged 18–35 completed the study during February–June, 2011. Methods: The authors conducted a cross-sectional, anonymous survey online. Dependent variables included mental health (depressive, anxiety, and somatic symptoms) and substance use (alcohol problems, use of tobacco, marijuana or hashish, and other illegal drugs). Results: Students’ perceived discrimination were significantly, positively associated with depressive, anxiety, and somatic symptoms, but not with substance use. Ethnic identity moderated the relationship between perceived discrimination and somatic symptoms, but not depressive or anxiety symptoms. Conclusions: These findings suggested the negative effect of racial discrimination on API students’ mental health. The buffering effect of ethnic identity may increase resilience in these students when they face racial discrimination.     

Is Ethnic Identity a Buffer? Exploring the Relations Between Racial Microaggressions and Depressive Symptoms Among Asian-American Individuals

ABSTRACT

This study explores the moderating role of ethnic identity in the relations between racial microaggressions and depressive symptoms. Using survey data from 353 Asian-American college students, we found that racial microaggressions significantly predicted depressive symptoms and accounted for 24% of the variance in a hierarchical multiple regression analysis. In addition, ethnic identity moderated the relations between racial microaggressions and depressive symptoms. Thus, ethnic identity buffers Asian-Americans against the negative mental health effects of racial microaggressions. Implications for research and practice in the field of social work are discussed.     

The Effect of Gender Identity on Perceptions of Authority Figures’ Racial Comments

Social identity affects perceptions of leaders and subordinates in organizations. This investigation examined gender identity an aspect of social identity. Utilizing quantitative and qualitative survey methods, we theorized that gender identity affects perceptions of racism by authority figures. The quantitative results indicated that white women participants with a low gender identity were more likely to perceive racism by a low-status authority figure (e.g., a black individual) who made a derogatory racial comment toward white students than when a high-status group member authority figure (i.e., a white individual) made similar comments. This suggests that women have low feelings of solidarity with oppressed racial groups when they have a low gender identity. However, the qualitative results indicated that, overall, more women than men perceived racism in negative racial comments by the authority figure, no matter the authority figure’s social status.     

‘Racism’, intersectionality and migration studies: framing some theoretical reflections

The concept of ‘racism’ has faced many difficulties in migration studies. Depending on definitions, islamophobia is a form either of religious discrimination or of racism. The same is true in contemporary debates in Europe about xenophobia against immigrants from the Global South. This article provides an alternative way of thinking about racism and its relationship with questions of intersectionality and discusses the relationship of these issues to migration theory. In the first part, we discuss intersectionality in relation to Fanon’s definition of racism. Then, we establish a dialogue between the work of de Sousa Santos and Fanon that could enrich our understanding of intersectionality in the framework of modernity and the capitalist/imperial/patriarchal/racial colonial world-system. Finally, we analyse this discussion’s implications for migration theory, highlighting how migration studies tend to reproduce a northern-centric social science view of the world that comes from the experience of others in the zone of being.     

Participatory action research with asylum seekers and refugees experiencing stigma and discrimination: the experience from Scotland

Using evidence from a participatory action research process with over 100 asylum seekers and refugees in Scotland, this study explores participants’ views on mental health problems, stigma and discrimination. The study found that migration can have adverse effects on mental health and well-being, due to racism and the asylum process, and this is worsened by stigma and discrimination. This stigma is influenced by both social and cultural causal factors, including fear, past trauma, isolation, racism and the stress of the asylum process coupled with negative cultural beliefs about mental health problems. The paper considers the international relevance of this approach and the value of a model grounded in principles of community development and grassroots action.     

Association between Depressive Symptoms,Perceived Partner Emotional Expression,and Marital Quality

Previous studies have explored the direct association between mental health and marital quality; however, the processes moderating that association are not yet well understood. The present study examined associations between depressive symptoms, perceived partner emotional expression, and marital quality among 462 married individuals. Findings suggest that (a) low commitment, low satisfaction, and marital instability may be symptomatic of mental well-being; (b) individuals experiencing depressive symptoms are more inclined to have negative views of their relationships; and (c) perceptions of their partners’ expressions of gratitude and understanding serve as a buffer against the negative association between depressive symptoms and marital quality. Thus, perceptions of positive emotional expressiveness may serve as a resource facilitating marital quality when individuals are experiencing depressive symptoms.     

Stress, negative social exchange, and health symptoms in university students

Although social support has been studied extensively in terms of its role in the relationship between stress and health, less attention has been devoted to the impact of negative social interactions. In this investigation, the authors examined the unique contributions of positive social support and negative social exchange in the relationship between stress and health symptoms, using data from 206 undergraduates at a large state university. Negative social exchange accounted for more variance in physical health symptoms than did life-event stress, daily hassles, or social support. The relationship between negative social interaction and physical symptoms was not the result of variance shared with psychological well-being. The importance of attending to negative aspects of social interaction among university students in terms of their health and well-being is discussed.     

The relationship between financial strain,perceived stress,psychological symptoms,and academic and social integration in undergraduate students

ABSTRACT

Objective: Financial strain may directly or indirectly (i.e., through perceived stress) impact students’ psychological symptoms and academic and social integration, yet few studies have tested these relationships. The authors explored the mediating effect of perceived stress on the relationship between financial strain and 2 important outcomes: psychological symptomology and academic and social integration. Participants: Participants were 157 undergraduate students. Data were collected from December 2013 to March 2014. Methods: Cross-sectional data collection conducted using online survey software. Results: It was found that perceived stress mediated the relationship between financial strain and (a) psychological symptomology and (b) academic and social integration. Both models included first-generation status as a covariate. Conclusions: Results suggest that perceived stress is an important intervention target for reducing psychological symptoms and improving academic and social integration for undergraduate students. Implications for university health centers and mental health professionals include incorporating a public health model to minimize stress risk.     

Racial differences in depression trajectories among older women: socioeconomic, family, and health influences

Despite recent increases in life course research on mental illness, important questions remain about the social patterning of, and explanations for, depression trajectories among women in later life. The authors investigate competing theoretical frameworks for the age patterning of depressive symptoms and the physical health, socioeconomic, and family mechanisms differentiating black and white women. Using data from the National Longitudinal Survey of Mature Women, the authors use linear mixed (growth curve) models to estimate trajectories of distress for women aged 52 to 81 years (N = 3,182). The results demonstrate that: (1) there are persistently higher levels of depressive symptoms among black women relative to white women throughout later life; (2) physical health and socioeconomic status account for much of the racial gap in depressive symptoms; and (3) marital status moderates race differences in distress. The findings highlight the importance of physical health, family, and socioeconomic status in racial disparities in mental health.     

Associations Between Social Support Network Characteristics and Receipt of Emotional and Material Support Among a Sample of Male Sexual Minority Youths

Few studies have examined how social support network characteristics are related to perceived receipt of social support among male sexual minority youths. Using egocentric network data collected from a study of male sexual minority youths (N = 592), multivariable logistic regression analyses examined distinct associations between individual and social network characteristics with receipt of (1) emotional and (2) material support. In multivariable models, frequent communication and having friends in one's network yielded a twofold increase in the likelihood of receiving emotional support whereas frequent communication was associated with an almost threefold higher likelihood of perceived material support. Finally, greater internalized homophobia and personal experiences of gay-related stigma were inversely associated with perceived receipt of emotional and material support, respectively. Understanding the evolving social context and social interactions of this new generation of male sexual minority youths is warranted in order to understand the broader, contextual factors associated with their overall health and well-being.     

Perceived discrimination,socioeconomic status,and mental health among Latino adolescents in US immigrant families

The association between interpersonal discrimination and mental health among Latino adolescents has been relatively well studied. Less is known about perceived societal discrimination or how discrimination may differentially impact Latino adolescents with recent immigration histories. Further, while personal and family characteristics have often been posited to influence the association between discrimination and health outcomes, little attention has been paid to potentially moderating influences of social status. Using data from the first two rounds of the Children of Immigrants Longitudinal Study (CILS) study, we estimate a series of logit regression models to investigate the association between discrimination (societal and interpersonal) and mental health (depressive symptoms and self-esteem) among Latino adolescents with recent immigration histories, and test how this association differs by parental socioeconomic status (SES). Results show a negative association between perceived societal and interpersonal discrimination and mental health, inconsistent associations between SES and mental health, and some evidence of a moderating role of parental SES. Specifically, higher SES appears to attenuate the detrimental effect of discrimination on depressive symptoms, particularly in contexts of interpersonal discrimination. Our findings support increased attention to measuring the impact of perceived societal discrimination on mental health outcomes as well as further examination of the intervening role of social status.