Trends in Suicidality and Bullying among New York City Adolescents across Race and Sexual Identity: 2009-2019.

Despite evidence showing rising suicidality among lesbian, gay, and bisexual (LGB) and Black adolescents, separately, there is scant research on suicide risk trajectories among youth groups across both racial and sexual identities. Thus, we examined trajectories of self-reported suicidal ideation and attempt and their associations with bullying among New York City-based adolescents. We analyzed 2009-2019 NYC Youth Risk Behavior Survey data. We ran weighted descriptive and logistic regression analyses to test for trends in dichotomous suicidal ideation, suicide attempt, bullying at school, and e-bullying variables among students across both race/ethnicity and sexual identity. We assessed associations between suicidality trends and bullying with logistic regressions. Models controlled for age and sex. Suicidal ideation and attempt were 2 and 5 times more likely among LGB than heterosexual participants, respectively. Bullying at school and e-bullying were 2 times more likely among LGB than heterosexual participants. Black LGB participants were the only LGB group for which both suicidal ideation (AOR = 1.04, SE = .003, p < .001) and attempt (AOR = 1.04, SE = .004, p < .001) increased over time. Both increased at accelerating rates. Conversely, White LGB participants were the only LGB group for which both suicidal ideation (AOR = 0.98, SE = .006, p < .001) and attempt (AOR = 0.92, SE = .008, p < .001) decreased over time. These changes occurred in parallel with significant bullying increases for Black and Latina/o/x LGB adolescents and significant bullying decreases for White LGB adolescents. Bullying was positively associated with suicidal ideation and attempt for all adolescents. Findings suggest resources aimed at curbing rising adolescent suicide should be focused on Black LGB youth.

Methods in HIV-Related Intersectional Stigma Research: Core Elements and Opportunities.

Researchers are increasingly recognizing the importance of studying and addressing intersectional stigma within the field of HIV. Yet, researchers have, arguably, struggled to operationalize intersectional stigma. To ensure that future research and methodological innovation is guided by frameworks from which this area of inquiry has arisen, we propose a series of core elements for future HIV-related intersectional stigma research. These core elements include multidimensional, multilevel, multidirectional, and action-oriented methods that sharpen focus on, and aim to transform, interlocking and reinforcing systems of oppression. We further identify opportunities for advancing HIV-related intersectional stigma research, including reducing barriers to and strengthening investments in resources, building capacity to engage in research and implementation of interventions, and creating meaningful pathways for HIV-related intersectional stigma research to produce structural change. Ultimately, the expected payoff for incorporating these core elements is a body of HIV-related intersectional stigma research that is both better aligned with the transformative potential of intersectionality and better positioned to achieve the goals of Ending the HIV Epidemic in the United States and globally. (Am J Public Health. 2022;112(S4):S413-S419. https://doi.org/10.2105/AJPH.2021.306710).

Intersecting Structural Oppression and Suicidality Among Black Sexual Minority Male Adolescents and Emerging Adults.

This study examined associations between structural racism, anti-LGBTQ policies, and suicide risk among young sexual minority men (SMM). Participants were a 2017-2018 Internet-based U.S. national sample of 497 Black and 1536 White SMM (ages 16-25). Structural equation modeling tested associations from indicators of structural racism, anti-LGBTQ policies, and their interaction to suicide risk factors. For Black participants, structural racism and anti-LGBTQ policies were significantly positively associated with depressive symptoms, heavy drinking, perceived burdensomeness, thwarted belongingness, self-harm, and suicide attempt. There were significant interaction effects: Positive associations between structural racism and several outcomes were stronger for Black participants in high anti-LGBTQ policy states. Structural racism, anti-LGBTQ policies, and their interaction were not significantly associated with suicide risk for White SMM.

Associations between Experiences of Police Contact and Discrimination by the Police and Courts and Health Outcomes in a Representative Sample of Adults in New York City.

Communities marginalized because of racism, heterosexism, and other systems of oppression have a history of being aggressively policed, and in those contexts, researchers have observed associations between a range of negative experiences with police and poor physical, mental, and behavioral health outcomes. However, past studies have been limited in that experiences of police contacts were aggregated at the neighborhood level and, if police contacts were self-reported, the sample was not representative. To address these limitations, we employed NYC Department of Health and Mental Hygiene 2017 Social Determinants of Health Survey (n = 2335) data to examine the associations of self-reported police contacts and discrimination by police and the courts with measures of physical (poor physical health), mental (poor mental health, serious psychological distress), and behavioral health (binge drinking). Residents marginalized because of racial, ethnic, and sexual minority status were more likely to be stopped, searched, or questioned by the police; threatened or abused by the police; and discriminated against by the police or in the courts; those experiences were associated with poor physical, mental, and behavioral health outcomes. The associations between experiences with police and poor health outcomes were strongest among Black residents and residents aged 25-44. Our findings suggest that the health of NYC residents who have had exposure to police and experienced discrimination by the police and courts is poorer than those who have not, and build on a growing body of evidence that aggressive policing practices have implications for public health.

Racial Discrimination, Sexual Partner Race/Ethnicity, and Depressive Symptoms Among Black Sexual Minority Men.

Although racial sexual exclusivity among Black gay, bisexual, and other sexual minority men (SMM) is frequently framed as a cause of HIV inequities, little research has examined how these sexual relationships may be driven by and protective against racism. This study examined associations between general racial discrimination, Black sexual exclusivity, sexual racial discrimination, and depressive symptoms among Black SMM. We conducted analyses on cross-sectional self-report data from 312 cisgender Black SMM in the U.S. Deep South who participated in the MARI study. Measures included general racial and sexual identity discrimination, race/ethnicity of sexual partners, sexual racial discrimination, and depressive symptoms. We estimated a moderated-mediation model with associations from discrimination to Black sexual exclusivity, moderated by discrimination target, from Black sexual exclusivity to sexual racial discrimination, and from sexual racial discrimination to depressive symptoms. We tested an indirect effect from racial discrimination to depressive symptoms to examine whether Black sexual exclusivity functioned as an intervening variable in the associations between racial discrimination and depressive symptoms. Results indicated that participants who experienced racial discrimination were more likely to exclusively have sex with Black men. Men with higher Black sexual exclusivity were less likely to experience sexual racial discrimination and, in turn, reported lower depressive symptoms. The indirect pathway from racial discrimination to depressive symptoms through Black sexual exclusivity and sexual racial discrimination was significant. Our results suggest that one of the drivers of sexual exclusivity among Black SMM may be that it helps to protect against the caustic psychological effects of racial discrimination.

Trajectories of Online Racial Discrimination and Psychological Functioning Among African American and Latino Adolescents.

This study investigated trajectories of individual and vicarious online racial discrimination (ORD) and their associations with psychological outcomes for African American and Latinx adolescents in 6th-12th grade (N = 522; Mgrade  = 9th) across three waves. Data were analyzed using growth mixture modeling to estimate trajectories for ORD and to determine the effects of each trajectory on Wave 3 depressive symptoms, anxiety, and self-esteem. Results showed four individual and three vicarious ORD trajectories, with the majority of participants starting out with low experiences and increasing over time. Older African American adolescents and people who spend more time online are at greatest risk for poor psychological functioning.

The Roles of Gender Affirmation and Discrimination in the Resilience of Transgender Individuals in the US.

Transgender individuals face severe stigma-driven health inequities structurally, institutionally, and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one's gender identity, expression, and/or role, may be considered a manifestation of resilience. To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey. Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation and psychological distress, and higher odds of substance use, and past-year healthcare use and HIV-testing. Discrimination was associated with higher odds of suicidal ideation, psychological distress, substance use, and past-year HIV-testing. Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation, with affirmation having a significant moderating protective effect against discrimination. Gender affirmation is paramount in upholding transgender health. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.

Daily multidimensional racial discrimination among Black U.S. American adolescents.

This study examined frequencies and psychological effects of daily racial discrimination experienced individually, vicariously, online, offline, and through teasing. Participants were 101 Black U.S. American adolescents for this ecological momentary assessment study that measured daily racial discrimination and 14-day depressive symptoms slopes. Confirmatory factor analyses specified subscales, t-test analyses compared subscale means, and hierarchical linear analyses tested associations between subscales and depressive symptoms slopes. Results showed that six subscales fit the data well: individual general, vicarious general, individual online, vicarious online, individual teasing, and vicarious teasing. Participants reported 5606 experiences of racial discrimination during the study and averaged 5.21 experiences per day across the six subscales. The two online subscales were more frequent than the offline subscales. Aside from online vicarious experiences, all subscales were positively associated with depressive symptoms slopes. Findings underscore the multidimensional, quotidian, and impactful nature of racial discrimination in the lives of Black adolescents in the U.S.

Measuring Black men's police-based discrimination experiences: Development and validation of the Police and Law Enforcement (PLE) Scale.

OBJECTIVES: Although social science research has examined police and law enforcement-perpetrated discrimination against Black men using policing statistics and implicit bias studies, there is little quantitative evidence detailing this phenomenon from the perspective of Black men. Consequently, there is a dearth of research detailing how Black men's perspectives on police and law enforcement-related stress predict negative physiological and psychological health outcomes. This study addresses these gaps with the qualitative development and quantitative test of the Police and Law Enforcement (PLE) Scale. METHOD: In Study 1, we used thematic analysis on transcripts of individual qualitative interviews with 90 Black men to assess key themes and concepts and develop quantitative items. In Study 2, we used 2 focus groups comprised of 5 Black men each (n = 10), intensive cognitive interviewing with a separate sample of Black men (n = 15), and piloting with another sample of Black men (n = 13) to assess the ecological validity of the quantitative items. For Study 3, we analyzed data from a sample of 633 Black men between the ages of 18 and 65 to test the factor structure of the PLE, as we all as its concurrent validity and convergent/discriminant validity. RESULTS: Qualitative analyses and confirmatory factor analyses suggested that a 5-item, 1-factor measure appropriately represented respondents' experiences of police/law enforcement discrimination. As hypothesized, the PLE was positively associated with measures of racial discrimination and depressive symptoms. CONCLUSIONS: Preliminary evidence suggests that the PLE is a reliable and valid measure of Black men's experiences of discrimination with police/law enforcement. (PsycINFO Database Record

Observed Racial Socialization and Maternal Positive Emotions in African American Mother-Adolescent Discussions About Racial Discrimination.

This study examined patterns of (a) observed racial socialization messages in dyadic discussions between 111 African American mothers and adolescents (Mage  = 15.50) and (b) mothers' positive emotions displayed during the discussion. Mothers displayed more advocacy on behalf of their adolescents in response to discrimination by a White teacher than to discrimination by a White salesperson. Mothers displayed consistent emotional support of adolescents' problem solving across both dilemmas but lower warmth in response to the salesperson dilemma. Findings illustrate evidence of the transactional nature of racial socialization when presented with adolescents' racial dilemmas. The role of adolescent gender in mothers' observed racial socialization responses is also discussed. A framework for a process-oriented approach to racial socialization is presented.

"They were just making jokes": Ethnic/racial teasing and discrimination among adolescents.

OBJECTIVES: The effects of peer-based discrimination are especially harmful for adolescents given the heightened role of social feedback during this period. The current study aimed to understand the unique expressions of discrimination that adolescents experience between close peers and friends, as well as the daily influence of such experiences. METHOD: Study 1 included semistructured interviews (10 interviews, 2 focus groups; Mage = 17.3) with an ethnic/racially diverse sample of adolescence. Study 2 (n = 79; Mage = 15.72) used a 21-day daily diary study with a different sample of ethnic/racially diverse adolescents. RESULTS: Study 1 found that, among close peers and friends, adolescents experienced "ethnic/racial teasing," a unique form of discrimination characterized by humor. Additionally, adolescents consistently dismissed the negative messages as innocuous based on the supposedly humorous nature of such interactions. Study 2 found that when adolescents were targeted for ethnic/racial teasing, individuals who were already anxious experienced increased daily anxiety, and that increases in social anxiety persisted across days. CONCLUSIONS: The current study suggests that among peers, ethnic/racial teasing is a common way that adolescents interact around ethnicity/race. Further, this study points to the complexity of these experiences; though they were largely considered normative and harmless, they also had negative psychological effects for some adolescents. Implications for our conceptual understanding of discrimination and teasing during adolescence are discussed.

Measuring the Pros and Cons of What It Means to Be a Black Man: Development and Validation of the Black Men's Experiences Scale (BMES).

Although extensive research documents that Black people in the U.S. frequently experience social discrimination, most of this research aggregates these experiences primarily or exclusively by race. Consequently, empirical gaps exist about the psychosocial costs and benefits of Black men's experiences at the intersection of race and gender. Informed by intersectionality, a theoretical framework that highlights how multiple social identities intersect to reflect interlocking social-structural inequality, this study addresses these gaps with the qualitative development and quantitative test of the Black Men's Experiences Scale (BMES). The BMES assesses Black men's negative experiences with overt discrimination and microaggressions, as well their positive evaluations of what it means to be Black men. First, we conducted focus groups and individual interviews with Black men to develop the BMES. Next, we tested the BMES with 578 predominantly low-income urban Black men between the ages of 18 and 44. Exploratory factor analysis suggested a 12-item, 3-factor solution that explained 63.7% of the variance. We labeled the subscales: Overt Discrimination, Microaggressions, and Positives: Black Men. Confirmatory factor analysis supported the three-factor solution. As hypothesized, the BMES's subscales correlated with measures of racial discrimination, depression, resilience, and social class at the neighborhood-level. Preliminary evidence suggests that the BMES is a reliable and valid measure of Black men's experiences at the intersection of race and gender.

The Impact of African American Parents' Racial Discrimination Experiences and Perceived Neighborhood Cohesion on their Racial Socialization Practices.

Parental racial socialization is a parenting tool used to prepare African American adolescents for managing racial stressors. While it is known that parents' racial discrimination experiences affect the racial socialization messages they provide, little is known about the influence of factors that promote supportive and communal parenting, such as perceived neighborhood cohesion. In cohesive neighborhoods, neighbors may help parents address racial discrimination by monitoring youth and conveying racial socialization messages; additionally, the effect of neighborhood cohesion on parents' racial socialization may differ for boys and girls because parents socialize adolescents about race differently based on expected encounters with racial discrimination. Therefore, the current study examines how parents' perception of neighborhood cohesion and adolescents' gender moderate associations between parents' racial discrimination experiences and the racial socialization messages they deliver to their adolescents. Participants were a community sample of 608 African American adolescents (54 % girls; mean age = 15.5) and their primary caregivers (86 % biological mothers; mean age = 42.0). Structural equation modeling indicated that parental racial discrimination was associated with more promotion of mistrust messages for boys and girls in communities with low neighborhood cohesion. In addition, parental racial discrimination was associated with more cultural socialization messages about racial pride and history for boys in neighborhoods with low neighborhood cohesion. The findings suggest that parents' racial socialization messages are influenced by their own racial discrimination experiences and the cohesiveness of the neighborhood; furthermore, the content of parental messages delivered varies based on adolescents' gender.

Perceived sex discrimination amplifies the effect of antagonism on cigarette smoking.

INTRODUCTION: Compared to men, the decline in smoking during the past few decades has been slower for women, and smoking-related morbidity and mortality has increased substantially. Identifying sex-specific risk factors will inform more targeted intervention/prevention efforts. The purpose of this research is to examine the interactive effect of psychological (trait antagonism) and social (perceived sex discrimination) factors on current cigarette smoking and whether these effects differ by sex. METHODS: Participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study (HANDLS; N = 454) and participants in the Health and Retirement Study (HRS; N = 8,155) completed measures of antagonism, perceived sex discrimination, and reported whether they smoked currently. Logistic regressions were used to predict smoking from antagonism, discrimination, and their interaction. RESULTS: Antagonism was associated with an increased risk of smoking. For women, there was an interaction between antagonism and discrimination: among women who perceived sex discrimination, every standard deviation increase in antagonism was associated with a 2.5 increased risk of current smoking in HANDLS (odds ratio [OR] = 2.54, 95% confidence interval [CI] = 1.46-4.39) and an almost 1.5 increased risk in HRS (OR = 1.43, 95% CI = 1.18-1.73). This interaction was not significant for men in either sample. CONCLUSION: In 2 independent samples, perceived sex discrimination amplified the effect of antagonism on cigarette smoking for women but not men. A hostile disposition and a perceived hostile social environment have a synergistic effect on current cigarette smoking for women.

Associations between trajectories of perceived racial discrimination and psychological symptoms among African American adolescents.

Many African American adolescents experience racial discrimination, with adverse consequences; however, stability and change in these experiences over time have not been examined. We examined longitudinal patterns of perceived racial discrimination assessed in Grades 7-10 and how these discrimination trajectories related to patterns of change in depressive and anxious symptoms and aggressive behaviors assessed over the same 4-year period. Growth mixture modeling performed on a community epidemiologically defined sample of urban African American adolescents (n = 504) revealed three trajectories of discrimination: increasing, decreasing, and stable low. As predicted, African American boys were more frequent targets for racial discrimination as they aged, and they were more likely to be in the increasing group. The results of parallel process growth mixture modeling revealed that youth in the increasing racial discrimination group were four times more likely to be in an increasing depression trajectory than were youth in the low stable discrimination trajectory. Though youth in the increasing racial discrimination group were nearly twice as likely to be in the high aggression trajectory, results were not statistically significant. These results indicate an association between variation in the growth of perceived racial discrimination and youth behavior and psychological well-being over the adolescent years.

Neighborhood racial composition, racial discrimination, and depressive symptoms in African Americans.

While evidence indicates that experienced racial discrimination is associated with increased depressive symptoms for African Americans, there is little research investigating predictors of experienced racial discrimination. This paper examines neighborhood racial composition and sociodemographic factors as antecedents to experienced racial discrimination and resultant levels of depressive symptoms among African American adults. The sample included 505 socioeconomically-diverse African American adults from Baltimore, MD. Study data were obtained via self-report and geocoding of participant addresses based on 2010 census data. Study hypotheses were tested using multiple pathways within a longitudinal Structural Equation Model. Experienced racial discrimination was positively associated with age and sex such that older individuals and males experienced increased levels of racial discrimination. In addition, the percentage of White individuals residing in a neighborhood was positively associated with levels of experienced racial discrimination for African American neighborhood residents. Experienced racial discrimination was positively associated with later depressive symptoms. Neighborhood-level contextual factors such as neighborhood racial composition and individual differences in sociodemographic characteristics appear to play an important role in the experience of racial discrimination and the etiology of depression in African American adults.

Online Racial Discrimination, Suicidal Ideation, and Traumatic Stress in a National Sample of Black Adolescents.

Importance: Because of increased suicide rates among Black youth in the past 2 decades, there is a dire need for research on suicidal ideation and risk factors in this population. Objective: To examine the direct and indirect associations between online racial discrimination and suicidal ideation through posttraumatic stress disorder symptoms among Black adolescents living in the US, with consideration of potential differential associations by gender and age. Design, Setting, and Participants: This cross-sectional study used data drawn from the first wave of the National Survey of Critical Digital Literacy. Black adolescents aged 11 to 19 years were selected from a nationally representative probability-based sample. Data were collected from October 2020 to December 2020 and analyzed from August 2021 to October 2021. Main Outcomes and Measures: Hypotheses of the current study were formulated during research design and grounded in empirical literature. The individual online racial discrimination subscale (Online Victimization Scale), the UCLA Child/Adolescent posttraumatic stress disorder Reaction Index for DSM-5, and an item from the second edition of the Children's Depression Inventory were used to assess constructs. Mediation was assessed through mediation models with path analyses using structural equation modeling. Results: Among a total 525 participants, 265 were girls (50.5%) and 251 were boys (47.8%); the mean (SD) age was 14.8 (2.5) years. Findings from structural equation modeling analysis indicated that individual online racial discrimination was associated with posttraumatic stress disorder symptoms (ß = 0.49, SE = 0.06, P < .001), and posttraumatic stress disorder symptoms were associated with suicidal ideation (ß = 0.51, SE = 0.06, P < .001). Posttraumatic stress disorder was identified as a full mediator between online racial discrimination and suicide (ß = 0.25, SE = 0.04, P < .001). No differences by gender or age were found. Furthermore, no significant direct association between online racial discrimination and suicidal ideation was found. Conclusions and Relevance: This study found an association between individual online racial discrimination and posttraumatic stress disorder symptoms and between posttraumatic stress disorder symptoms and suicidal ideation. These risk factors are important to consider in continuing studies of the cause of suicidal ideation for Black adolescents in the US.