The Birth and Beyond (BABY) study: protocol for a birth cohort study investigating the social and environmental determinants of pregnancy-related outcomes in Black American families.

INTRODUCTION: In the USA, Black birthing people and infants experience disproportionately worse pregnancy-related health outcomes. The causes for these disparities are unknown, but evidence suggests that they are likely socially and environmentally based. Efforts to identify the determinants of these racial disparities are urgently needed to elucidate the highest priority targets for intervention. The Birth and Beyond (BABY) study evaluates how micro-level (eg, interpersonal and family) and macro-level (eg, neighbourhood and environmental) risk and resiliency factors transact to shape birth person-infant health, and underlying psychobiological mechanisms. METHODS AND ANALYSIS: The BABY study will follow 350 Black families (birthing parents, non-birthing parents and infants) from pregnancy through the first postpartum year, with research visits during pregnancy and at infant ages 6 and 12 months. Research visits comprise a combination of interview about a range of recent and life course stress and resiliency exposures and supports, psychophysiological (sympathetic, parasympathetic and adrenocortical) assessment and behavioural observations of parent-infant coregulatory behaviours. Spatial analyses are completed by mapping parent current and past residential addresses onto archival public data (eg, about neighbourhood quality and racial segregation). Finally, EMRs are abstracted for information about birthing parent relevant medical history, pregnancy conditions and infant birth outcomes. Analyses will evaluate the risk and resiliency mechanisms that contribute to pregnancy and birth-related outcomes for Black birthing people and their infants, and the protective role of individual, familial, cultural, and community supports. ETHICS AND DISSEMINATION: The BABY study has been approved by the Institutional Review Board at Albany Medical Centre. The study team consulted with local organisations and groups comprised of stakeholders and community leaders and continues to do so throughout the study. Research results will be disseminated with the scientific and local community as appropriate.

The relationship between posttraumatic stress disorder and race-based traumatic stress.

OBJECTIVE: This study examined the relationships between race-based traumatic stress symptoms (RBTSS), posttraumatic stress disorder (PTSD) symptoms, and negative affect (NA) in the past year. METHOD: Participants were 185 community-based respondents who completed a paper and pencil survey of the race-based traumatic stress symptoms scale (RBTSSS), diagnostic and statistical manual (DSM)-related PTSD symptoms, and negative emotions. RESULTS: Two canonical correlation analyses were conducted for two participant groups: those with no race-based traumatic stress (RBTS) elevations and those with one or more RBTS elevations. Results showed a significant relationship between RBTS symptoms and PTSD symptoms for the no elevation group, and a significant relationship between RBTS symptoms and NA for the race-based stress/traumatic stress group. Notably, RBTS inclusion was not significantly correlated with NA. CONCLUSIONS: Those with average-level RBTS symptoms appear to endorse more PTSD criteria, while those with elevated RBTS scores do not. The study, therefore, highlights the need for further investigation of how diagnostic measures of trauma may differentiate from trauma symptoms related to race-based experiences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dismantling and eradicating anti-Blackness and systemic racism.

Anti-Blackness and systemic racism are long-standing pressing social issues that have received increasing attention in the counseling psychology literature. However, the past few years have demonstrated what can only be described as an emboldening of anti-Blackness-the brutal individual and systemic threats of emotional and physical violence and loss of life that Black individuals and communities face on a daily basis-and a harsh reminder of the systemic racism that continues to threaten the well-being of Black, Indigenous, and People of Color. In this introduction for the special section on Dismantling and Eradicating Anti-Blackness and Systemic Racism, we provide readers an opportunity to pause and reflect on the ways in which those of us in the field can more intentionally seek to disrupt anti-Blackness and systemic racism. We believe that counseling psychology has an opportunity to increase its real-world relevance as an applied specialty area of psychology to the degree to which it evolves its ways of disrupting anti-Blackness and systemic racism in every content area and domain of the field. In this introduction, we review exemplars of work that helps the field re-envision its approaches to anti-Blackness and systemic racism. We also offer our perspectives on additional ways in which the field of counseling psychology can increase its relevance and real-world impact in 2023 and beyond. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Racial discrimination and trauma symptoms: Further support for the Race-Based Traumatic Stress Symptom Scale.

OBJECTIVES: This study provides further validity for scores produced by the Race-Based Traumatic Stress Symptom Scale (RBTSSS), through examining the relationship between perceived discrimination, trauma symptoms, and mental health symptoms with the RBTSSS. METHOD: Participants consisted of 148 people of color (54% women) with an average age of 33.38 years. Study hypotheses were tested using correlational and regression analyses. RESULTS: Validity was supported by strong relations with established symptom scores and perceived discrimination. Regression analysis found RBTSSS to be a significant predictor of trauma symptoms, controlling for general stress. Finally, multivariate analysis found perceived discrimination to be a stronger predictor of RBTSSS symptoms than general stress. CONCLUSIONS: The RBTSSS demonstrates strong relations with other symptom measures and perceived discrimination, supporting the validity of the RBTSSS scores. Both researchers and practitioners may benefit from use of the instrument which captures emotional outcomes specific to racial trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The psychophysiological salience of past experiences of discrimination.

OBJECTIVES: This study sought to test whether a discrimination recall task would elicit a significant parasympathetic response in multiracial undergraduate women. The study also investigated whether parasympathetic responsivity to the discrimination recall would be similar or different from that elicited by a widely used stress paradigm-the Trier Social Stress Test (TSST), and whether responses would differ for Black and White women. METHOD: Multiracial undergraduate women (n = 67; Mage = 19.4 years; 32% White, 22% Black) completed the TSST and a discrimination recall task. Parasympathetic activity was assessed using high-frequency heart rate variability (HF-HRV). RESULTS: Women exhibited significant HF-HRV responsivity to the discrimination recall and showed smaller average decreases in HF-HRV to the discrimination recall than the TSST. However, whereas White women exhibited decreased HF-HRV in response to both tasks, Black women showed increased HF-HRV for the discrimination recall but decreased HF-HRV for the TSST. CONCLUSIONS: Findings complement a growing body of research suggestive that experiences of discrimination are psychophysiologically salient. Additionally, discriminatory experiences may elicit distinctive patterns of HF-HRV responsivity compared to generic social stressors. Efforts to elucidate the unique role of discrimination-specific HF-HRV responsivity may be critical for delineating discrimination-health linkages. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining how lesbian, gay, and bisexual Christian clients' perceptions of therapists' cultural humility contribute to psychotherapy outcomes.

Understanding the intersection between sexual and religious identity has important implications for mental health. The lesbian, gay, and bisexual (LGB) community is at high risk for a wide range of psychopathologies, and religious culture can further these risks when it creates homophobic environments (Sherry et al., 2010). The present study examined lesbian, gay, and bisexual (LGB) Christian clients' religious commitment and perceptions of their therapists' cultural humility in relation to the working alliance and therapeutic outcomes. A sample of 158 LGB Christians who were currently or had been in psychotherapy within the last year participated in the study. Perceptions of their therapists' cultural humility positively predicted therapeutic outcomes, and the working alliance partially mediated the relation between cultural humility and therapeutic outcomes. Contrary to predictions, religious commitment did not moderate the relation between cultural humility and working alliance. Implications are discussed, namely, that the results of this study join existing literature to potentially suggest a systemic shift in psychotherapy training that includes cultural humility. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Internalized racism and self-esteem: Do depressive symptoms matter?

OBJECTIVES: This study examines the relation between internalized racism and self-esteem in a sample of students of Color while controlling for depressive symptoms. Internalized racism has been demonstrated to contribute to negative mental health outcomes in people of Color, however the nuanced relations between these interrelated outcomes and internalized racism are unclear. METHODS: Participants were 140 students of Color (83% female; mean age = 26.11, SD = 7.21) who self-identified as African American (45.7%), Asian (18.6%), Latino (16.4%), Multiracial (16.4%), Native American (1.4%), and Middle Eastern (1.4%). Data were analyzed using hierarchical linear regression. RESULTS: Internalized racism was inversely related to self-esteem when controlling for depressive symptoms, with devaluation of one's racial group being the largest contributor to this relation. CONCLUSIONS: Psychological responses to internalized racism can include non-pathological states such as lowered self-esteem. Given the strong contribution of devaluation, for students of Color, the promotion of racial pride could be an important intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Racism, racial discrimination, and trauma: a systematic review of the social science literature.

Objective: The aim of this paper is to provide a systematic review of studies that examine relationships between racial discrimination and trauma in order to further understand the relationship between racial oppression and psychological functioning.Design: In this review, we describe the characteristics of 28 studies, identified by a comprehensive search strategy, including measurements of racial discrimination and trauma, as well as the nature of the reported associations.Results: Half of studies included in this review were published in the last 6 years. The majority of studies used cross-sectional designs and were conducted in the United States with adults ≥18 years old. African American, White, Latinx, and Asian populations were most frequently included in these studies. Of the 44 associations examined in these studies, 70% of the trauma symptomology outcomes were statistically significantly associated with racial discrimination. Significant positive associations ranged in strength, with the strongest relationships between racial discrimination and trauma occurring in studies examining veteran populations and moderate relationships among these variables in non-veteran, student populations.Conclusions: Our findings reveal that current research on race-based trauma seems to be limited by a lack of measures that capture the stress/intensity associated with race-related events, an inability to account for vicarious/collective/intergenerational experiences of trauma, and failure to control for non-race-based trauma.

Contributions of acculturation, enculturation, discrimination, and personality traits to social anxiety among Chinese immigrants: A context-specific assessment.

Based on the diathesis-stress model of anxiety, this study examined the contributions of cultural processes, perceived racial discrimination, and personality traits to social anxiety among Chinese immigrants. Further guided by the theory of intergroup anxiety, this study also adopted a context-specific approach to distinguish between participants' experience of social anxiety when interacting with European Americans versus with other Chinese in the United States. This quantitative and ex post facto study used a convenience sample of 140 first-generation Chinese immigrants. Participants were recruited through e-mails from different university and community groups across the United States. The sample includes 55 men and 82 women (3 did not specify) with an average age of 36 years old. Results showed that more social anxiety was reported in the European American context than in the Chinese ethnic context. The full models accounted for almost half the variance in anxiety in each context. Although personality accounted for the most variance, the cultural variables and discrimination contributed 14% of the unique variance in the European American context. Notably, low acculturation, high neuroticism, and low extraversion were unique contributors to social anxiety with European Americans, whereas in the Chinese ethnic context only low extraversion was a unique contributor; more discrimination was uniquely significant in both contexts. The findings suggest a need to contextualize the research and clinical assessment of social anxiety, and have implications for culturally sensitive counseling with immigrants.

Perceived racism and mental health among Black American adults: a meta-analytic review.

The literature indicates that perceived racism tends to be associated with adverse psychological and physiological outcomes; however, findings in this area are not yet conclusive. In this meta-analysis, we systematically reviewed 66 studies (total sample size of 18,140 across studies), published between January 1996 and April 2011, on the associations between racism and mental health among Black Americans. Using a random-effects model, we found a positive association between perceived racism and psychological distress (r = .20). We found a moderation effect for psychological outcomes, with anxiety, depression, and other psychiatric symptoms having a significantly stronger association than quality of life indicators. We did not detect moderation effects for type of racism scale, measurement precision, sample type, or type of publication. Implications for research and practice are discussed.

An exploratory examination of the associations among racial and ethnic discrimination, racial climate, and trauma-related symptoms in a college student population.

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Racial Climate Scale. Results of a multivariate analysis of variance (MANOVA) indicated that Asian and Black students reported more frequent experiences of discrimination than did White students. Additionally, the MANOVA indicated that Black students perceived the campus racial climate as being more negative than did White and Asian students. A hierarchical regression analysis showed that when controlling for generic life stress, perceptions of discrimination contributed an additional 10% of variance in trauma-related symptoms for Black students, and racial climate contributed an additional 7% of variance in trauma symptoms for Asian students.

An exploratory investigation of the relationship between racism, racial identity, perceptions of health, and health locus of control among black American women.

This exploratory investigation examined the relationship between racial identity and perceived racism as predictor variables and perceptions of health status and health locus of control as criterion variables in a sample of 90 Black American women. Results of a canonical correlational analysis indicated a shared variance of 37% between these two sets of variables. This finding highlights the need to focus on perceived racism and racial identity attitudes as potentially important factors for consideration when seeking to understand health disparities in the United States.