Profiles of racial discussions and associations with parent sociocultural factors and internalized racism in Asian American families.

While Asian American parents are key contributors in racially socializing their children, past research indicates that issues of race are not frequently discussed among Asian American families. Moreover, there is limited research on how Asian American parents' sociocultural factors predict the amount and ways they talk about race to their children. We conducted latent profile analyses among 150 Asian American parents' (Mage = 42.36, range = 26-65 years) racial discussions, and the profiles' association with parents' sociocultural factors (i.e., enculturation, acculturation, internalized racism, collectivism, and loss of face) were examined. Four distinct profiles were identified with distinct levels of awareness of discrimination, avoidance of outgroups, minimization of race, and promotion of equality messages. Findings underscore the importance of Asian American parents engaging in nuanced racial discussions with their children, highlighting the need for culturally responsive interventions, educational programs, and policy initiatives to support families in navigating complex racial landscapes and fostering positive youth outcomes.

Internalized racism, racial collective self-esteem, and Asian American adults' disordered eating: Psychological distress as mediator.

Research emphasizes the importance of considering how sociocultural factors affect the disordered eating behaviors of Asian American adults. The present study thus investigated how internalized racism and racial collective self-esteem are associated with disordered eating among Asian American adults, as well as the potential mediating role of psychological distress. A final sample of 796 Asian American adults completed a cross-sectional survey that contained the study's questionnaires. Regression analyses revealed that internalized racism was positively associated with disordered eating, whereas racial collective self-esteem was negatively associated with disordered eating among Asian American adults. Psychological distress mediated both of the aforementioned associations. Researchers and practitioners are encouraged to be cognizant about how Asian American adult clients' experiences of internalized racism and psychological distress may affect their disordered eating. Researchers and practitioners may also strive to increase racial collective self-esteem among this population. Future researchers may consider building upon these findings by conducting longitudinal research or focusing on specific Asian ethnic groups for further studies about disordered eating among Asian Americans.

Examining barriers to dental, medical, mental, and vision healthcare access, attitudes towards seeking healthcare, and internalized racism among Black Americans.

Structural barriers, which impede access to healthcare, are often seen as tangible expressions of structural racism. Those who experience more structural barriers to healthcare access are likely to experience poor health. Expanding on this notion, our research integrated the Internalized Racism Framework (James, 2022) with the Structural Vulnerability Framework (Bourgois et al., 2017; Metzl and Hansen, 2014) to explore how encountering barriers to healthcare access influences healthcare seeking attitudes across four health domains: mental, medical, dental, and vision. Our study included a sample of 780 Black American adults (average age = 37.68) who were recruited to participate in an anonymous web-based cross-sectional survey. Our findings revealed that internalized racism explained the direct effect of healthcare access structural barriers on healthcare attitudes in the mental, medical, and vision health domains, but not in the dental health domain. Specifically, the experience of more structural barriers in accessing healthcare (mental, medical, and vision) correlated with heightened internalized racism, which, in turn, was associated with more negative attitudes towards seeking (mental, medical, and vision) healthcare. Notably, our results also showed variations in the frequency and types of structural barriers encountered across the four health domains, along with differences in participants' positive healthcare seeking attitudes. Our findings underscore an urgent need for targeted interventions addressing both structural and internalized racism. Removing healthcare access barriers is crucial for fostering equitable healthcare access for Black Americans. Future research should explore additional factors influencing healthcare seeking attitudes, as well as strategies that mitigate the negative effects of racism on said attitudes.

Ethnic Identity Protects and Internalized Racism Harms Health and Coping in Asian Americans Following COVID-19 Discrimination: A Mixed-Methods Study.

Mechanisms underlying the link between COVID-19 anti-Asian racial discrimination and psychological health are underexplored. This mixed-methods study examined the moderating effects of ethnic identity and internalized racism on the relationship between COVID discrimination and behavioral health outcomes among Asian Americans. We hypothesized that individuals with lower ethnic identity and higher internalized racism levels would demonstrate more adverse outcomes, including worsened psychological trauma and identity-avoidant behaviors, post-discrimination. Asian American participants (N = 215) responded to a Qualtrics survey, including qualitative and quantitative questions on COVID-related racism experiences, ethnic identity, internalized racism, trauma, and other subsequent effects. For qualitative analysis, participants were sorted into four subgroups defined by low- and/or high-ethnic identity and internalized racism scores, and we explored themes in participant reports of identity-related coping effects after racism. We additionally used hierarchical multiple regression analyses to quantitatively assess the moderating impact of ethnic identity and internalized racism on the relationship between COVID discrimination and trauma. Analyses revealed no moderating effects from the two identity variables. However, qualitative analyses identified themes of identity-promoting and identity-avoidant behavioral responses, and moderation analyses revealed that ethnic identity had a main effect on mitigating racial trauma, while internalized racism exacerbated both racial trauma and PTSD levels. This study identified ethnic identity and internalized racism as underlying causes to behavioral health outcomes for Asian Americans. Results offer mental health providers serving Asian clients insight into identity-related influences to help optimize culturally appropriate interventions and support initiatives of identity promotion to foster community engagement for this population.

Depression and suicidal ideation among Black individuals in Canada: mediating role of traumatic life events and moderating role of racial microaggressions and internalized racism.

PURPOSE: Although suicidal ideation (SI) is a serious concern in Canada, its prevalence and related factors among Black individuals are poorly documented. Using data from the Mental Health of Black Communities in Canada project (BeCoMHeal), this study aimed to assess the prevalence of SI in Black individuals aged 15-40 years old in Canada, the mediating role of traumatic life events in the association between depression and SI, and the moderating role of racial microaggressions and internalized racism. METHODS: Eight hundred and sixty participants aged between 15 and 40 years (Mage =24.96, SD = 6.29) completed the online questionnaire assessing sociodemographic data, depression symptoms, traumatic life events, racial microaggressions, internalized racism, and SI. RESULTS: Findings showed that 25.7% of the participants reported having experienced SI (26.5% women, 22.7% men, 𝛘2 = 1.08, p = .299). The moderated-mediation model revealed that traumatic life events fully mediated the association between depression and SI (B = 0.12, p = .004; 95% CI, [0.04, 0.20]) and that racial microaggressions (B = - 0.03, p = .042; 95% CI [-0.07, - 0.00]) and internalized racism (B = 0.06, p = .006; 95% CI [0.02, 0.10]) moderated this relationship. CONCLUSION: These findings underscore the importance of addressing racial microaggressions and internalized racism in therapy contexts among Black individuals to mitigate the potential negative impacts on their mental health. They also emphasize the need to develop effective, culturally sensitive, and racially adapted suicide prevention and intervention programs for Black communities in Canada.

Anti-Black discrimination in primary health care: a qualitative study exploring internalized racism in a Canadian context.

OBJECTIVES: A growing body of evidence points to persistent health inequities within racialized minority communities, and the effects of racial discrimination on health outcomes and health care experiences. While much work has considered how anti-Black racism operates at the interpersonal and institutional levels, limited attention has focused on internalized racism and its consequences for health care. This study explores patients' attitudes towards anti-Black racism in a Canadian health care system, with a particular focus on internalized racism in primary health care. DESIGN: This qualitative study employed purposive maximal variation and snowball sampling to recruit and interview self-identified Black persons aged 18 years and older who: (1) lived in Montréal during the COVID-19 pandemic, (2) could speak English or French, and (3) were registered with the Québec health insurance program. Adopting a phenomenological approach, in-depth interviews took place from October 2021 to July 2022. Following transcription, data were analyzed thematically. RESULTS: Thirty-two participants were interviewed spanning an age range from 22 years to 79 years (mean: 42 years). Fifty-nine percent of the sample identified as women, 38% identified as men, and 3% identified as non-binary. Diversity was also reflected in terms of immigration experience, financial situation, and educational attainment. We identified three major themes that describe mechanisms through which internalized racism may manifest in health care to impact experiences: (1) the internalization of anti-Black racism by Black providers and patients, (2) the expression of anti-Black prejudice and discrimination by non-Black racialized minority providers, and (3) an insensitivity towards racial discrimination. CONCLUSION: Our study suggests that multiple levels of racism, including internalized racism, must be addressed in efforts to promote health and health care equity among racialized minority groups, and particularly within Black communities.

"We have to lie low that sort of poisons me more and more": A qualitative study of violent political rhetoric and health implications for Spanish and Chinese speaking immigrants.

BACKGROUND: In recent years, the historical legacy of anti-immigrant sentiment in the US has resurfaced, fueled by a new wave of anti-immigrant political rhetoric. Violent political rhetoric, defined as either explicit or metaphorically targeted language to dehumanize targeted groups, can incite discriminatory treatment of immigrants at both interpersonal and institutional levels, shaping their health and healthcare experiences. This qualitative study explores and compares how Spanish- and Chinese-speaking immigrant populations in Chicago make sense of violent political rhetoric against their racial and ethnic identities, utilize coping strategies to maintain their sense of belonging, and experience downstream health consequences. METHODS: In 2019, 14 semi-structured focus groups were conducted among immigrants to the U.S. (n = 79). Participants were recruited from four community sites in either Hispanic/Latino or Chinese neighborhoods in Chicago. Focus groups were conducted by racially- and linguistically concordant interviewers in Spanish, Mandarin, or Cantonese. The research team developed a codebook iteratively and analyzed transcripts using grounded theory and the constant comparison method. RESULTS: Participants included Chinese (61%) and Spanish-speaking immigrants (39%), with an average age of 61.4 years (sd = 13); the majority were female (62%), unemployed (68%), and attained less than a high school diploma (53%). Self-reported stress due to political rhetoric was more pronounced among Spanish-speaking participants (93%) than Chinese participants (39.6%). Immigrants responded to manifestations of violent political rhetoric in numerous ways including mobilizing the model minority myth with internalized racism, anticipatory stress, and "high effort" coping mechanisms (John Henryism), all with downstream health effects. CONCLUSION: Violent political rhetoric is one of the mechanisms by which racism and xenophobia exacerbate a toll on the health of racialized immigrant groups. These processes have implications for both interpersonal and institutional experiences, as well as health and healthcare interactions. We propose a conceptual model that outlines these mechanisms and points to potential areas of intervention to ameliorate immigrant health inequities.

Different Mechanisms Link Internalized Racism to Externalizing Symptomology Among Black American Adolescent Boys and Girls.

OBJECTIVE: Emerging research and theory suggests that the internalization of racist ideas and attitudes, internalized racism, poses a significant threat to Black American adolescents' and increases their risk of externalizing symptomology. Prospective, empirical research linking internalized racism to externalizing symptoms among Black American adolescents and the mechanisms explaining this link is scarce. We hypothesize that internalized racism will forecast externalizing symptoms indirectly, via effects on poor self-regulation and depressive symptoms. We also examine potential sex differences in the pathways linking internalized racism to externalizing symptoms. METHOD: A random sample of 445 Black American adolescents and their primary caregivers were recruited from 8 counties in rural Georgia. Participants provided survey data annually when adolescents were aged 13, 14, 15, and 16 years. Direct, indirect, and multigroup hypotheses were tested with structural equation modeling. RESULTS: Internalized racism assessed at ages 13 and 14 years forecast increased externalizing at age 16, both directly, and indirectly, via increases in poor self-regulation and depressive symptoms. Sex moderated the indirect pathways linking internalized racism and externalizing. Poor self-regulation significantly mediated the path between internalized racism and externalizing symptoms among Black American male youth. Depressive symptoms significantly mediated the pathway between internalized racism and externalizing symptoms among Black American female adolescents. CONCLUSION: Findings suggest behavioral treatment directions for male and female Black American adolescents experiencing depressive symptoms. PLAIN LANGUAGE SUMMARY: Little is known about the influence of internalization of racist ideas and attitudes, often referred to as internalized racism, on Black youths' development of externalizing symptoms. In this study, the authors surveyed 445 Black youths annually at ages 13, 14, 15, and 16 years. Internalized racism at ages 13 and 14 predicted increased externalizing symptoms at age 16. Among boys, depressive symptoms mediated the path between internalized racism and externalizing symptoms. Among girls, struggles with self-regulation mediated the path between internalized racism and externalizing symptoms.

Black sexual minority women's Internalized stigma and coping motivated alcohol use: the role of emotional suppression.

Black sexual minority women have an increased risk for excessive alcohol use, which has been attributed to their use of alcohol to cope with oppression. Internalized stigma is suggested to be one of the most insidious byproducts of systemic oppression whereby people internalize ideologies of self-hatred. Still, research has yet to examine the association between internalized stigma and alcohol use among sexual minorities of color. This survey-based study investigated the associations between internalized homonegativity and internalized racism with coping motivated alcohol use among 330 Black sexual minority women. Additionally, we explored the role of emotional suppression within these associations. Internalized homonegativity was significantly positively associated with coping motivated alcohol use. The significant positive association between internalized racism and coping motivated alcohol use was strongest at higher levels of emotional suppression. Given the majority of our sample identified as having a masculine gender expression, we recommend research exploring whether the identity-based experiences of masculine Black sexual minority women impact their substance use behaviors. Implications for culturally sensitive and emotion-centered practice with Black sexual minority women are discussed.

Gendered racial microaggressions, internalized racism, and suicidal ideation among emerging adult Asian American women.

BACKGROUND: Despite suicide being the leading cause of death among emerging adult Asian American women (AAW), little is known about the risk factors. AIM: We tested whether gendered racial microaggressions stress (GRMS) would be associated with AAW's suicidal ideation, and whether internalized racism (self-negativity, IRSN; weakness stereotypes, IRWS; and appearance bias, IRAB) would exacerbate this link based on self-devaluating implications of internalized racism. METHOD: Using a sample of 309 AAW (Mage = 20.00, SD = 6.26), we conducted a moderated logistic regression with GRMS predicting suicidal ideation (endorsement or no endorsement) and the three internalized racism factors (IRSN, IRWS, and IRAB) as moderators. RESULTS: GRMS significantly predicted suicidal ideation with a threefold increase in the odds of suicidal ideation. Only IRSN significantly exacerbated this link at low to mean levels. CONCLUSION: Gendered racial microaggressions is likely a risk factor for suicidal ideation among AAW, particularly for those who internalize negative images of themselves as Asian individuals.

Congruence and discrepancy in Asian American women's perception and stress appraisal of gendered racial microaggressions: Relationships with depressive symptoms and internalized racism.

Prior research demonstrates significant links between discrimination and mental health by assessing either encounters with or stress appraisal of discrimination. However, research has yet to examine the dynamic interplay between frequency and stress appraisal (e.g., high frequency-low stress appraisal) and their linkage to depressive symptoms. Using a sample of 309 Asian American women (M age = 22.81, SD = 0.26), we used a polynomial regression and response surface analysis to model the congruence and discrepancy between frequency and stress appraisal of gendered racial microaggressions experienced by Asian American women and how they are related to depressive symptoms and internalized racism. The dynamics between frequency and stress in relation to depressive symptoms were further probed at low, mean, and high levels of internalized racism. Greater congruence between frequency and stress was significantly associated with depressive symptoms (medium to large effect) and internalized racism (small effect). A discrepancy between higher frequency and lower stress was significantly associated with greater internalized racism. Further, when looking across levels of internalized racism, greater congruence between frequency and stress was significantly associated with greater depressive symptoms at low and mean levels of internalized racism but not at high levels. Gendered racial microaggressions are associated with adverse mental health outcomes among Asian American women, contributing to greater depressive symptoms and internalized racism. Further consideration should be given toward how internalized racism shapes differences in the perceptions and stress appraisal of gendered racial microaggressions, and subsequent mental health outcomes among Asian American women.

"Who is our real enemy?" internalized racism in the Puerto Rican diaspora and the role of political education within community health intervention.

RATIONALE: Puerto Ricans experience disproportionately high levels of emotional distress and co-occurring adverse health outcomes. Our study sought to elicit Puerto Rican men's perceptions of health disparities while centering dialogue on stressors, coping mechanisms, and general well-being. This paper focuses on one pronounced finding in our study, that of internalized racism and the effect it has on both individual well-being and intra-group cohesion. A significant gap within racial health disparity work is the role of internalized racism and its connection to psychological distress, ruptures in social unity, and resulting ill-health of racial and ethnic populations. Based on this, we probed this particular finding to further understand internalized racism within this Puerto Rican population. METHODS: Using a hybrid thematic analysis approach, this study presents qualitative findings from in-depth interviews with Latino (92.5% Puerto Rican) men living in Springfield, Massachusetts and conducted between October 2019 and January 2020. RESULTS: Our findings reveal a duality throughout: The acceptance and propagation of negative Latinx stereotypes and consequent intragroup division exists alongside expressions of community pride and desire for Latinx unity. This duality is analyzed by using W.E.B. Du Bois's theory of double consciousness. Double consciousness not only explains the self-disparagement toward oneself and one's own racial and ethnic group, but also elucidates a liberatory pathway toward political consciousness and well-being. The concept of "second sight" within double consciousness is particularly germane, speaking to one's awakening to the learned self-subjugation imposed by White supremacy. CONCLUSIONS: Internalized racism contributes to the persistent propagation of disparate health burdens in minoritized communities. Remediation can and should include community-led frameworks for the development of efficacious multilevel health interventions. The Young Lords community health activism provides such a model. These findings provide viable evidence-based examples of how the academy can synergize with community-led efforts to achieve collective agency.

Perceived Everyday Discrimination Explains Internalized Racism during the COVID-19 Pandemic among Asians.

The current study examined the impact of the COVID-19 pandemic on perceived everyday discrimination and internalized racism among Asians compared to Latinxs. Recently, researchers have attempted to tackle institutional and interpersonal racism during this pandemic outbreak, however, few studies have addressed the internalized component of the racism. We launched this survey study during the critical months of the national pandemic lockdown (April 2020 to April 2021) with a sample (N = 360) of 170 Asians and 190 Latinxs college students self-reporting their experiences related to everyday discrimination and internalized racism. Findings indicated that Asians experienced more internalized racism and perceived a change in everyday discrimination during the COVID-19 pandemic compared to Latinxs. Furthermore, the perceived everyday discrimination during the COVID-19 pandemic emerged as a mediator for the race effect on internalized racism. That is, Asians perceived a significant change in everyday discrimination frequency during the COVID-19 pandemic compared to Latinxs and this change was related to higher levels of internalized racism. According to our findings, Asians perceived more daily discriminatory and inferiorizing messages, compared to Latinxs, which also explained the reasons for higher levels of internalized racism during the COVID-19 pandemic. Our findings suggest that Asians might be rationalizing their encounters with discrimination and even believing their communities deserve these daily attacks during the COVID-19 pandemic outbreak.

Does race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literature.

The burden of preeclampsia, a substantial contributor to perinatal morbidity and mortality, is not born equally across the population. Although the prevalence of preeclampsia has been reported to be 3% to 5%, racial and ethnic minority groups such as non-Hispanic Black women and American Indian or Alaskan Native women are widely reported to be disproportionately affected by preeclampsia. However, studies that add clarity to the causes of the racial and ethnic differences in preeclampsia are limited. Race is a social construct, is often self-assigned, is variable across settings, and fails to account for subgroups. Studies of the genetic structure of human populations continue to find more variations within racial groups than among them. Efforts to examine the role of race and ethnicity in biomedical research should consider these limitations and not use it as a biological construct. Furthermore, the use of race in decision making in clinical settings may worsen the disparity in health outcomes. Most of the existing data on disparities examine the differences between White and non-Hispanic Black women. Fewer studies have enough sample size to evaluate the outcomes in the Asian, American Indian or Alaskan Native, or mixed-race women. Racial differences are noted in the occurrence, presentation, and short-term and long-term outcomes of preeclampsia. Well-established clinical risk factors for preeclampsia such as obesity, diabetes, and chronic hypertension disproportionately affect non-Hispanic Black, American Indian or Alaskan Native, and Hispanic populations. However, with comparable clinical risk factors for preeclampsia among women of different race or ethnic groups, addressing modifiable risk factors has not been found to have the same protective effect for all women. Abnormalities of placental formation and development, immunologic factors, vascular changes, and inflammation have all been identified as contributing to the pathophysiology of preeclampsia. Few studies have examined race and the pathophysiology of preeclampsia. Despite attempts, a genetic basis for the disease has not been identified. A number of genetic variants, including apolipoprotein L1, have been identified as possible risk modifiers. Few studies have examined race and prevention of preeclampsia. Although low-dose aspirin for the prevention of preeclampsia is recommended by the US Preventive Service Task Force, a population-based study found racial and ethnic differences in preeclampsia recurrence after the implementation of low-dose aspirin supplementation. After implementation, recurrent preeclampsia reduced among Hispanic women (76.4% vs 49.6%; P<.001), but there was no difference in the recurrent preeclampsia in non-Hispanic Black women (13.7 vs 18.1; P=.252). Future research incorporating the National Institute on Minority Health and Health Disparities multilevel framework, specifically examining the role of racism on the burden of the disease, may help in the quest for effective strategies to reduce the disproportionate burden of preeclampsia on a minority population. In this model, a multilevel framework provides a more comprehensive approach and takes into account the influence of behavioral factors, environmental factors, and healthcare systems, not just on the individual.

Igniting Collective Freedom: An Integrative Behavioral Model of Acceptance and Commitment Toward Black Liberation.

Racism continues to reveal disastrous effects on the Black community. There exists no behavior-analytic literature with a specific focus on ending Black psychological suffering due to continual acts of violence perpetrated against the community. I present a behavioral model to promote Black psychological liberation, infusing preestablished frameworks of Black psychology and cultural healing practices with acceptance and commitment therapy. The model addresses behaviors observed within systemic and internalized racism.

The Associations Between Internalized Racism, Racial Identity, and Psychological Distress.

Internalized racism, or the acceptance of negative stereotypes about one's own racial group, is associated with psychological distress; yet, few studies have explored the longitudinal impact of internalized racism on the psychological well-being of African American emerging adults. Furthermore, racial identity's role as a protective factor in the context of internalized racism remains unclear. This study examined the longitudinal impact of internalized racism on psychological distress (depressive and anxiety symptoms) and the moderating role of racial identity beliefs among 171 African American emerging adults. Full cross-lagged panel models revealed no main effects of internalized racism beliefs on psychological distress. However, several racial identity beliefs moderated the relationship between internalized racism beliefs and changes in psychological distress over a year later. Initial levels of alteration of physical appearance, internalization of negative stereotypes, and hair change internalized racism beliefs were related to subsequent psychological distress, but only for those with certain levels of racial centrality, private regard, public regard, and assimilationist, humanist, and nationalist ideology beliefs. These findings suggest that, over time, internalized racism and racial identity beliefs can combine to influence the psychological well-being of African American emerging adults.

The Relationship Between Social Anxiety and Internalized Racism in Black Young Adults.

The study examined the relationships between social anxiety (SA), generalized anxiety (GA), and depression with racial microaggressions and internalized racism (IR) among Black young adults. Given SA's core features, we expected it to have a unique association with IR, and to moderate the connection between racial microaggressions and IR. Participants were 182 Black university students who completed measures of SA, GA, depressive symptoms, racial microaggressions, and IR. Linear regression models indicated that IR was a significant predictor of SA, but not GA or depression. Racial microaggressions were only positively associated with depressive symptoms. SA and racial microaggressions each predicted IR, but no interaction was found. Black young adults with elevated concerns of others' evaluation may be more prone to accepting negative stereotypes about one's racial group.

Does internalized racism matter in HIV risk? Correlates of biomedical HIV prevention interventions among Black men who have sex with men in the United States.

Black men who have sex with men (MSM) account for 26% of all new HIV infections in the United States. Biomedical HIV interventions have proven to reduce HIV infections however the use of these interventions by Black MSM is inconsistent. Research suggests that internalized racism may contribute to inconsistent biomedical HIV interventions (condom use and PrEP use) among Black MSM. Using a national sample of 432 Black MSM, we examined the relationship between condom and PrEP use and internalized racism. The results suggest there is some evidence for an association between internalized racism and PrEP use. In addition, internalized racism was not associated with condom use for both insertive and receptive anal sex among Black MSM. These finding suggest the relationship between internalized racism and HIV prevention strategies is not facile and more attention is needed to understand the true impact of racism, both internal and societal, on HIV prevention strategies among Black MSM. These findings underscore the nature of racism in the daily lives of Black MSM and how it impacts HIV prevention strategies adopted by these men.

Health and Health-Related Correlates of Internalized Racism Among Racial/Ethnic Minorities: a Review of the Literature.

Internalized racism (IR) is a form of racism that leads people to internalize beliefs and stereotypes about their racial/ethnic (RE) group and/or about themselves because of their RE group membership. However, relative to other forms of racism research investigating the relationship IR and health is lacking. Thus, in an attempt to promote research on IR, this paper reviews and summarizes 112 empirical quantitative studies-representing nearly three decades of research published between January 1990 to December 2018-that examine the health and health-related correlates of IR among racial/ethnic minorities. Collectively, evidence from this review suggests that (1) IR is negatively associated with health via decrements in positive core self-evaluation; (2) IR exacerbates the relationship between other stressors and ill health; (3) IR mediates the relationship between discrimination and health; and (4) IR is a self-protective strategy that protects against ill health. Using the accumulated evidence, this review presents new conceptualizations of IR, along with specific recommendations on how to improve the scientific study of IR among racial/ethnic minorities.

"That Guy is Gay and Black. That's a Red Flag." How HIV Stigma and Racism Affect Perception of Risk Among Young Black Men Who Have Sex with Men.

Young Black men who have sex with men's (YBMSM) attitudes and personal beliefs about themselves and their risk for HIV can be modified as a result of experiences with racism and HIV stigma. In-depth qualitative interviews were conducted with 25 HIV-negative YBMSM, aged 18-24, in North Carolina and Maryland. Data were thematically analyzed to capture participants' experiences and thoughts related to stigmatizing experiences and their perception of risk for HIV. Participants reported experiencing HIV stigmatizing and blatant racist commentary related to their identities as YBMSM. Participants described diverse strategies to distance themselves from these negative stereotypes and decrease their sexual risk for HIV. The findings highlight that HIV stigma and racial stereotypes are one of the many types of discrimination that YBMSM experience within the Black and gay communities and in society; leading to psychological distress and an altered perception of self and sexual risk.