What is the Power of Identity? Examining the Moderating Role of Racial Identity Latent Profiles on the Relationship between Race-Related Stress and Trauma Symptomatology among African American Women (original) (raw)
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To understand the impact racial experiences have on people of color, it is important to consider both whether there are any race-based traumatic stress symptoms (RBTS) and within-group psychological differences as reflected in one's racial identity status attitudes (RISA). Moreover, if the combination of RBTS reactions and racial identity status attitudes are related to their psychological functioning? The current study explored the relationships between a person's reactions to memorable racial encounters as assessed by the Race-Based Traumatic Stress Symptoms Scale, their racial identity status attitudes measured by the People of Color Racial Identity Attitude Scale, and psychological functioning (i.e., distress and well-being). Data from 282 adult community-based participants were used to examine the combined associations between RBTS, racial identity status attitudes, psychological well-being and psychological distress. A hierarchical cluster analysis was conducted to examine the relationships between race-based traumatic stress reactions and racial identity status attitudes. A two-cluster group solution was found that showed associations between externally defined or less mature racial identity status attitudes and higher RBTS symptoms and psychological distress. Internally defined or more mature or differentiated racial identity statuses were related to decreased psychological distress and RBTS symptoms. The findings were not expected in that lower racial identity statues were associated with higher levels of RBTS. Clinical implications and future research directions are discussed.
Psychological Medicine
Background The prevalence of mental disorders among Black, Latino, and Asian adults is lower than among Whites. Factors that explain these differences are largely unknown. We examined whether racial/ethnic differences in exposure to traumatic events (TEs) or vulnerability to trauma-related psychopathology explained the lower rates of psychopathology among racial/ethnic minorities. Methods We estimated the prevalence of TE exposure and associations with onset of DSM-IV depression, anxiety and substance disorders and with lifetime post-traumatic stress disorder (PTSD) in the Collaborative Psychiatric Epidemiology Surveys, a national sample (N = 13 775) with substantial proportions of Black (35.9%), Latino (18.9%), and Asian Americans (14.9%). Results TE exposure varied across racial/ethnic groups. Asians were most likely to experience organized violence – particularly being a refugee – but had the lowest exposure to all other TEs. Blacks had the greatest exposure to participation in o...
Psychological trauma : theory, research, practice and policy, 2015
This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Althou...
Journal of racial and ethnic health disparities, 2018
Sociodemographic group-specific strategies for stress management may contribute to racial and gender disparities in health outcomes in the United States. We aimed to systematically review theoretical and empirical investigations of factors influencing variation in response to and management of identity-related stress among black and white Americans. OvidPsychInfo and PubMed databases were searched to identify eligible studies. Criteria were participant age of ≥ 18 years, conducted in the US sampling black or white participants, and published in English in a peer-reviewed journal. The final sample included 167 articles. Theories suggesting social status inequities as the primary contributor to disparate strategies employed by black and white women and men to manage social identity-related stress were most frequently tested and supported. Studies disproportionally focused on how women and black persons cope as targets of prejudice and discrimination rather than on how management strategies of men or white persons are affected as perpetrators. Finally, there was theoretical support for an interactive effect of race and gender on stress management, but empirical evidence was lacking, particularly among black men, white women, and white men. The literature could be strengthened through the use of prospective cohorts and nationally-representative samples, as well as study designs accounting for potential within-race and within-gender variation in the effects of social-identity related stressors on coping. With greater consistency in methodology, future empirical studies may yield additional information regarding group differences in stress management pertinent to clarifying mechanisms for the health consequences of exposure to social inequity among black and white women and men.
European Journal of Psychotraumatology
Background: African Americans experience more severe and chronic posttraumatic stress disorder (PTSD) symptoms compared to other racial groups, and thus it is important to examine factors that are relevant for the aetiology of PTSD in this population. Although racial discrimination has been implicated as an exacerbating factor in the development and maintenance of PTSD, relatively less is known about mechanisms through which this process may occur. Objective: The purpose of this study was to examine one such mechanism, emotion dysregulation, in two independent samples of African American adults. Method: Trauma-exposed participants were recruited in a large, urban community hospital setting (initial sample n = 1,841; replication sample n = 294). In the initial sample, participants completed a unidimensional measure of emotion dysregulation and self-reported PTSD symptoms based on the DSM-IV. In the replication sample, participants completed a multidimensional measure of emotion dysregulation and a diagnostic interview of PTSD symptoms based on the DSM-5. Mediation analyses were used to test our hypotheses. Results: Across both samples, results indicated that racial discrimination was indirectly associated with PTSD symptoms through emotion dysregulation (even when trauma load was added as a covariate). Conclusions: Taken together, these results provide strong evidence that the association between racial discrimination and PTSD symptoms may be partially explained by the association between racial discrimination and worse emotion dysregulation. These findings elucidate the impact of racist incidents on mental health and identify modifiable emotion regulatory processes that can be intervened upon to enhance the psychological and social wellbeing of African Americans. Discriminación racial y estrés postraumático: examinando la desregulación emocional como mediador en una muestra de la comunidad afroamericana Antecedentes: Los afroamericanos experimentan síntomas de trastorno de estrés postraumático (TEPT) en forma más severa y crónica en comparación con otros grupos raciales y, por lo tanto, es importante examinar los factores que son relevantes para la etiología del TEPT en esta población. Aunque la discriminación racial ha sido implicada como un factor agravante en el desarrollo y mantenimiento del TEPT, se sabe relativamente poco acerca de los mecanismos por los cuales este proceso puede ocurrir. Objetivo: El propósito de este estudio fue examinar uno de tales mecanismos, la desregulación emocional, en dos muestras independientes de adultos afroamericanos. Método: Los participantes expuestos a trauma fueron reclutados en un gran hospital comunitario urbano (Muestra 1 n= 1.841; Muestra 2 n= 294).Todos los participantes completaron una medida de discriminación racial, pero para la muestra 1, los participantes completaron una medida unidimensional de desregulación emocional y síntomas de TEPT auto-informados y para la Muestra 2, los participantes completaron una medida multidimensional de desregulación emocional y una entrevista diagnostica de síntomas de TEPT. Para probar nuestra hipótesis se utilizaron análisis de mediación. Resultados: En ambas muestras, los resultados indicaron que la discriminación racial estuvo asociada indirectamente con síntomas de TEPT a través de la desregulación emocional (incluso cuando la carga del trauma se agregó como una covariable). Conclusiones: En conjunto, estos resultados proveen una fuerte evidencia que la asociación entre discriminación racial y síntomas de TEPT puede explicarse en parte por la asociación entre discriminación racial y una peor desregulación emocional. Estos hallazgos dilucidan el impacto de los incidentes racistas en la salud mental e identifican procesos reguladores de emociones modificables que pueden intervenirse para mejorar el bienestar psicológico y social de los afroamericanos.
Response of African American and Caucasian women to cognitive behavioral therapy for PTSD
Behavior Therapy, 1999
The present study examined the influence of ethnicity on the effectiveness of cognitive behavioral treatment for PTSD in female victims of sexual and nonsexual assault. Ninety-five women with chronic PTSD (60 Caucasian and 35 African American) were randomly assigned to either active cognitive behavioral treatment or wait list control. Active treatment consisted of nine, twice-weekly, individual sessions of prolonged exposure, stress inoculation training, or a combination. Independent evaluations were conducted at pretreatment, posttreatment, and 12-month follow-up. African Americans and Caucasians did not differ in terms of pretreatment psychopathology or general functioning, dropout rates from treatment, or overall treatment efficacy. These results are discussed within the context of the need for future exploration of ethnocultural factors in the treatment of PTSD.
Psychological Trauma: Theory, Research, Practice, and Policy, 2013
The paper describes the development of the Race-Based Traumatic Stress Symptom Scale (RBTSSS), a measure designed to assess the psychological and emotional stress reactions to racism and racial discrimination. Scale items were derived from existing measures of race-related stress and models of trauma, and were tested on a 330 racially heterogeneous (e.g., Blacks, White, Asian, and Hispanic) adult sample. Exploratory Factor Analyses with oblique rotations revealed a 52-item measure consisting of seven scales; Depression, Anger, Physical Reactions, Avoidance, Intrusion, Hypervigilance/Arousal, and Low Self-Esteem. The findings are consistent with symptom clusters associated with the conceptual model of race-based traumatic stress. The RBTSSS adds a tool to counseling assessment by providing mental health professionals a way to assess the emotional reactions of racism and racial discrimination. Implications for counseling and future research are discussed.
American Psychologist, 2019
Research has suggested that African American and Latino adults may develop posttraumatic stress disorder (PTSD) at higher rates than White adults, and that the clinical course of PTSD in these minority groups is poor. One factor that may contribute to higher prevalence and poorer outcome in these groups are sociocultural factors and racial stressors, such as experiences with discrimination. To date, however, no research has explored the relationship between experiences with discrimination and risk for PTSD, and very little research has examined the course of illness for PTSD in African Americans and Latino samples. The present study examined these variables in the only longitudinal clinical sample of 139 Latino and 152 African American adults with anxiety disorders, the Harvard/Brown Anxiety Research Project-Phase II (HARP-II). Over 5 years of follow-up, remission rates for African Americans and Latinos with PTSD in this sample were 0.35 and 0.15 respectively, and reported frequency of experiences with discrimination significantly predicted PTSD diagnostic status in this sample, but did not predict any other anxiety or mood disorder. These findings demonstrate the chronic course of PTSD in African American and Latino adults, and highlight the important role that racial and ethnic discrimination may play in the development of PTSD among these populations. Implications for an increased focus on these sociocultural stressors in the assessment and treatment of PTSD in African American and Latino individuals are discussed.