Emotional impacts of racial discrimination on caregiver-child dyads: Can mentalizing-focused parenting groups buffer against racism-related stress?

Black and Latinx caregivers face high risk for parenting stress and racism-related stress due to experiences of racial discrimination (RD). This study aimed to explore the associations between RD, parenting stress, and psychological distress in caregiver-child dyads, as well as the impact of a mentalizing-focused group intervention on caregivers' experiences of RD distress. Ethnoracially minoritized caregivers of children aged 5-17 years old participated in a non-randomized clinical trial (N = 70). They received either a 12-session mentalizing-focused group parenting intervention or treatment-as-usual in outpatient psychiatry. We assessed self-reported frequency and distress related to RD, parenting stress, and psychological distress at baseline (T1) and post-intervention (T2). Caregiver- and self-reported child psychological distress were also measured. The results showed that greater RD frequency and greater RD distress separately predicted higher overall parenting stress and parental role-related distress. Greater RD distress was linked to increased psychological distress in caregivers. Similarly, greater RD frequency and distress among caregivers were associated with higher caregiver-reported, but not self-reported, child psychological distress. No significant changes in RD distress were observed between T1 and T2 for either of the treatment groups. These findings highlight the exacerbating role of RD on parenting stress and psychological distress among ethnoracially minoritized caregivers and their children.

Racism-Related Experiences and Traumatic Stress Symptoms in Ethnoracially Minoritized Youth: A Systematic Review and Meta-Analysis.

OBJECTIVE: Despite growing evidence demonstrating the association between racial and ethnic discrimination and traumatic stress symptoms in adult populations, the research among youth remains sparse. Drawing upon race-based traumatic stress models, and following the PRISMA-2020 guidelines, this systematic review and meta-analysis aimed to identify the state of the empirical evidence in the association between racism-related experiences and traumatic stress symptoms in ethnoracially minoritized youth. METHOD: Scientific databases were searched to identify articles with ethnoracially minoritized youth participants under age 18 years old that examined the association between racial and/or ethnic discrimination and traumatic stress symptoms. RESULTS: A total of 18 articles comprising 16 studies (N = 4,825 participants) met inclusion criteria. Studies were largely cross-sectional, used nonrandom sampling strategies, focused on Black and Latinx youth, and were conducted in the United States. Furthermore, most studies were theoretically grounded and operationalized racism-related experiences as frequency of direct, personal, everyday discrimination. Few studies examined other dimensions of racism-related experiences. The meta-analysis demonstrated a significant positive association with a medium effect size, rpooled = .356, 95% confidence interval [CI] = 0.27, 0.44, between racism-related experiences and traumatic stress symptoms. No evidence of moderation by age, sex/gender, race/ethnicity, country, or recruitment setting was detected. CONCLUSION: Racism-related experiences may confer risk for traumatic stress symptoms in ethnoracially minoritized youth. Attending to racism-related experiences is critical to improve the cultural responsiveness of trauma-informed services.

Acculturation and suicide-related risk in ethnoracially minoritized youth in the US: a scoping review and content analysis of the empirical evidence.

PURPOSE: Among Asian-American/Pacific Islander, Hispanic/Latinx, and Black youth, the US born have higher risk of suicidal thoughts and behaviors (attempts and death-by-suicide) than first-generation migrants. Research has focused on the role of acculturation, defined as the sociocultural and psychological adaptations from navigating multiple cultural environments. METHODS: Using content analysis, we conducted a scoping review on acculturation-related experiences and suicide-related risk in Asian-American/Pacific Islander, Hispanic/Latinx, and Black youth (henceforth described as "ethnoracially minoritized adolescents"), identifying 27 empirical articles in 2005-2022. RESULTS: Findings were mixed: 19 articles found a positive association between acculturation and higher risk for suicide ideation and attempts, namely when assessed as acculturative stress; 3 articles a negative association; and 5 articles no association. Most of the research, however, was cross-sectional, largely focused on Hispanic/Latinx youth, relied on demographic variables or acculturation-related constructs as proxies for acculturation, used single-item assessments for suicide risk, and employed non-random sampling strategies. Although few articles discussed the role of gender, none discussed the intersections of race, sexual orientation, or other social identities on acculturation. CONCLUSION: Without a more developmental approach and systematic application of an intersectional research framework that accounts for racialized experiences, the mechanisms by which acculturation may influence the risk of suicidal thoughts and behavior remain unclear, resulting in a dearth of culturally responsive suicide-prevention strategies among migrant and ethnoracially minoritized youth.

Ethnic identity protects against feelings of defeat and entrapment on suicide ideation in African American young adults.

OBJECTIVE: Recent trends in suicide and suicide-related risk suggest that African American youth are particularly vulnerable; however, little is known about the sociocultural context of suicide-related risk in this population. The present study examined ethnic identity as a moderator of the relationship between defeat and entrapment and suicide ideation in African American young adults. METHOD: A sample of African American college students (N = 106; 46.2% female; (Mage = 20.63) completed a battery of surveys online. Using cross-sectional data, a moderation analysis was conducted. RESULTS: As partially hypothesized, ethnic identity, specifically exploration and commitment, weakened the relationship between defeat and entrapment and suicide ideation. CONCLUSION: This study suggests that African Americans who frequently engage in customary traditions and organizations with other African Americans may be protected from the harmful effects of feelings of defeat and entrapment on suicide ideation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association Between Exposure to Suicidal Behaviors and Suicide Attempts Among Adolescents: The Moderating Role of Prior Psychiatric Disorders.

Theories suggest that adolescents exposed to suicide attempts and/or deaths are at higher risk of attempting suicide, themselves. However, research findings have been mixed, with most studies not accounting for psychiatric vulnerability. We examined past psychiatric diagnosis as a moderator of the association between lifetime exposure to suicide attempts and/or deaths and adolescents' suicide attempts. Adolescents (N = 518; 60% female; 45% White), ages 12-21, reported on prior suicide ideation and attempts, and mood, anxiety, and substance use disorders at baseline. Suicide attempts since baseline and exposure to suicidal behaviors were assessed 4-6 years later. Lifetime exposure to family suicide attempts and/or suicide deaths, but not to suicidal behaviors of peers/friends or others, was associated with a suicide attempt at follow-up among those with prior psychiatric disorders. Psychologically vulnerable adolescents may require additional support after exposure to suicidal behaviors of a family member to reduce their risk of attempting suicide.

Emotion expressivity, suicidal ideation, and explanatory factors: Differences by Asian American subgroups compared with White emerging adults.

OBJECTIVE: The relationship between emotion expressivity and psychological symptoms varies by race/ethnicity, and reduced expression of emotions has been implicated in risk for suicidal ideation. The present study examined differences in the relation between emotion expressivity and suicidal ideation through well-documented correlates of suicide risk (i.e., hopelessness, depressive symptoms) among Asian American subgroups compared with White emerging adults. METHOD: A sample of 829 emerging adults, Ages 18 to 28 years, identifying as Asian American (27% East Asian, 18% South Asian, 11% Southeast Asian) or White (44%) completed measures of emotion expressivity, hopelessness, depressive symptoms, and suicidal ideation. RESULTS: Lower emotion expressivity was statistically associated with higher levels of suicidal ideation, via hopelessness and depressive symptoms, among White, East Asian, and South Asian American emerging adults, but not among Southeast Asian Americans, though this difference in mediation was not statistically significant. CONCLUSION: A focus on Asian Americans as a homogenous group occludes important ethnic differences in the relation between emotion expressivity and vulnerability to suicidal ideation. Ethnic differences in the function of emotion expressivity should be considered in suicide prevention and interventions among Asian American emerging adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Racial/Ethnic Discrimination and Suicidal Ideation in Emerging Adults: The Role of Traumatic Stress and Depressive Symptoms Varies by Gender not Race/Ethnicity.

Drawing from Race-Based Traumatic Stress theory, the present study examined whether traumatic stress and depressive symptoms differentially help explain the relation between racial/ethnic discrimination and suicidal ideation across gender and racial/ethnic groups. A racially/ethnically diverse group of emerging adults (N = 1344; Mage = 19.88, SD = 2.25; 72% female; 46% Hispanic) completed a battery of self-report measures. A cross-sectional design was employed with a series of hierarchical linear regression models and bootstrapping procedures to examine the direct and indirect relation between racial/ethnic discrimination and suicidal ideation through traumatic stress and depressive symptoms across gender and race/ethnicity. The findings suggest an indirect relation through depressive symptoms, but not traumatic stress, and a serial indirect relation through traumatic stress to depressive symptoms in young women and young men, the latter of which was stronger in young women. The indirect relations did not vary by racial/ethnic group. Cumulative experiences of racial/ethnic discrimination may impact suicide-related risk via increases in psychiatric symptomology (i.e., traumatic stress and depressive symptoms), particularly in young women. Racial/ethnic discrimination experiences should be accounted for as a potential source of psychological distress in the assessment, diagnosis, and treatment of suicidal thoughts and behavior, especially among young women endorsing traumatic stress and depressive symptoms. Further research is warranted to better understand the gender difference in the relation between racial/ethnic discrimination and suicide-related risk.

Emotion Reactivity, Comfort Expressing Emotions, and Future Suicidal Ideation in Emerging Adults.

OBJECTIVE: Emotion reactivity and difficulties in expressing emotions have been implicated in risk for suicidal behavior. This study examined comfort in expressing emotions (positive vs. negative) and depressive symptoms as mediators of the prospective relation between emotion reactivity and suicidal ideation. DESIGN: Emerging adults (N = 143; 72% female; 28% White) completed measures of emotion reactivity, comfort expressing emotions, and suicidal ideation at baseline and of depressive symptoms and suicidal ideation 12 months later. RESULTS: Emotion reactivity predicted suicidal ideation at follow-up through depressive symptoms. Difficulty expressing love-but not happiness, sadness, and anger-partially mediated the relationship between emotion reactivity and suicidal ideation at follow-up before but not after adjusting for baseline ideation. CONCLUSION: The relation between high emotion reactivity and suicidal ideation may be explained by discomfort in the expression of positive emotions and by depressive symptoms. Promotion of comfort in positive emotion expression may reduce vulnerability to suicidal ideation.

Suicidal ideation among racial/ethnic minorities: moderating effects of rumination and depressive symptoms.

Among emerging adults and college students, racial and ethnic minorities experience greater risk for suicidal ideation and behavior than their White counterparts. Research has identified numerous cognitive risk factors for suicidal ideation. However, they have not been well studied among racial and ethnic minorities. The present study examined the association between these factors (brooding rumination, reflective rumination, hopelessness, and depressive symptoms) and suicidal ideation among 690 Black, Latino, and biracial college students. Among all groups, hopelessness was positively associated with suicidal ideation. Brooding was negatively associated with suicidal ideation, after adjusting for reflection and hopelessness, although only at low levels of depressive symptoms. Black race/ethnicity and Latino race/ethnicity, compared with biracial race/ethnicity, each separately interacted with reflection to predict lower levels of suicidal ideation at moderate to high levels of reflection. Furthermore, Latino race/ethnicity, compared with biracial race/ethnicity, interacted with both reflection and depressive symptoms, such that reflection was negatively associated with suicidal ideation among Latino individuals reporting depressive symptoms above the 39th percentile. Biracial race/ethnicity, compared with monoracial race/ethnicity, also interacted with reflection and depressive symptoms, with reflection associated with greater amounts of suicidal ideation at depressive symptom levels above the 39th percentile. Our findings suggest reflective rumination differentially affects racial and ethnic groups and should be considered in conjunction with depressive symptoms among Latino and biracial individuals in suicide risk assessment and treatment.

Ethnic variation in whether dissociation mediates the relation between traumatic life events and attenuated positive psychotic symptoms.

The present study sought to determine whether dissociative experiences mediated the relationship between traumatic life events and attenuated positive psychotic symptoms in a non-treatment-seeking sample of racial and ethnic minority young adults. Participants (n = 549) completed a self-report inventory for psychosis risk (i.e., the Prodromal Questionnaire; R. L. Loewy, C. E. Bearden, J. K. Johnson, A. Raine, & T. D. Cannon, 2005), from which a total number of attenuated positive psychotic symptoms was assessed. Participants also completed a checklist of potentially traumatic life events and a traumatic dissociation scale. Hierarchical linear regression models and bootstrapping results indicated that dissociation mediated the relationship between traumatic life events and attenuated positive psychotic symptoms. Stratified analyses of Black, Asian, and Hispanic subgroups revealed that full mediation was only evident in the Black subgroup of young adults. Partial mediation was found among the Hispanic group, and no mediation occurred in the Asian subgroup. For the latter, traumatic life events were not significantly associated with dissociative experiences. A dissociative response style may be particularly relevant to trauma-exposed Black young adults exhibiting subclinical psychotic experiences and less so for Asian young adults. Trauma-induced dissociative experiences should be assessed further in clinical high-risk studies, especially among Black traumatized youth.

Toward an understanding of intergenerational trauma and storytelling in Black families.

OBJECTIVE: Despite growing attention to the intergenerational effects of trauma, including racial trauma, within Black communities, little empirical evidence exists. This qualitative study explored intergenerational trauma and storytelling within Black families in the United States, with two key aims: (1) explore if and how family members talk about their trauma experiences with one another, and (2) explore if and how sharing stories may impact family members' mental health and well-being. METHOD: Semistructured interviews were conducted with 17 adults across eight self-identifying Black families, examining the stories they share. Interviews were analyzed using reflexive thematic analysis. RESULTS: Four primary themes were identified: (1) Sharing is Caring …, (2) Family Ties, (3) The Reality of Racism, and (4) Safety in Silence. These themes underscore the direct effects of the traumas on those who experience and talk about them, and the meaning and impact that these traumas and stories carry across generations. CONCLUSION: Parents who shared stories of their trauma with their adult children described that doing so had a positive impact on their well-being. Adult children endorsed feeling similarly in some instances. However, they also experienced an internal conflict, feeling connected to yet burdened by these stories. Silence and protection also played a significant role. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self- and collective care as radical acts: A mixed-method study on racism-based traumatic stress among emerging adults.

Racism has been declared a public health threat. With increased direct and vicarious exposure to racism-based violence through social media, we explored the associations between racism-based events and traumatic stress symptomatology, as well as self- and collective care (inclusive of coping, activism, and ethnic and racial identity) through a mixed-methods approach. A total of 104 racism-based events were reported across 43 Black and/or Latine/x emerging adults in the sample, with a majority endorsing racism-based stress or traumatic stress (i.e., the symptomatology associated with a racism-based event). Individuals who reported higher racism-based traumatic stress symptoms immediately following a racism-based event also reported higher ethnic identity resolution scores. Further, 19%-42% of participants reported racism-based traumatic stress and racism-based stress more recently (respectively), showing that racism-based events may be traumatic stressors with long-term mental health consequences. Participants provided thick descriptions of how they defined and engaged in self- and collective care as wellness and activism and reported engaging in cultural, ancestral, spiritual, and religious practices in an attempt to heal. The findings of this study underscore the importance of radical hope and radical healing for Black and Latine/x communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Historical trauma and polysubstance use in Black young adults: The role of contemporary racism.

OBJECTIVES: The legacy of slavery renders Black individuals vulnerable to the harmful effects of historical trauma which may interact with contemporary racism-related experiences to increase substance use. We examined the associations between historical and contemporary racism-related experiences (i.e., historical loss thinking, major racial discrimination events, racial microaggressions, and internalized racism) and polysubstance use in a group of Black young adults. METHOD: Black young adults (N = 163; 60% female) aged 18-35 years (M = 25.7, SD = 3.27) completed surveys online. RESULTS: Historical loss thinking (b = 0.03, 95% CI [0.01, 0.05], p = .003), racial microaggressions (b = 0.03, 95% CI [0.02, 0.04], p < .001), major racial discrimination events (b = 0.42, 95% CI [0.30, 0.53], p < .001), and internalized racism (b = 0.49, 95% CI [0.33, 0.65], p < .001) were independently associated with past 12-month polysubstance use. Major racial discrimination events showed the largest association with polysubstance use (ß = 0.26, 95% CI [0.08, 0.45], p = .006). No significant interactions between historical loss thinking and contemporary racism-related experiences were observed. CONCLUSIONS: Findings suggest an association between substance use and historical and contemporary-related experiences among Black young adults. This may suggest that experiences with racism contextualized within historical and contemporary manifestations may impact risk for polysubstance use among Black young adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reduced attentional control in individuals with a history of suicide attempts compared to those with suicidal ideation: Results from a systematic review and meta-analysis.

BACKGROUND: Neurocognitive profiles may be especially useful to identify factors that facilitate transitioning from contemplating suicide to attempting suicide. Generally, those who attempt suicide show greater disruptions in neurocognitive ability compared to those who think about suicide but do not proceed to attempt. The goal of this systematic review and meta-analysis is to test whether this pattern is observed with attentional control. METHODS: We systematically searched PubMed, PsychINFO, CINAHL, and Google Scholar to find pertinent studies. All included studies compared attentional functioning using neutral stimuli. Each sample featured adults with a history of suicidal ideation (SI) and no history of suicide attempts (SA) compared to those with a history of SA. RESULTS: We identified 15 studies with 32 effect sizes (N = 931; n = 506 with SI only; n = 425 with SA). SA groups, compared to SI groups, exhibited worse accuracy yet similar reaction time, suggesting a comparatively blunted speed-accuracy tradeoff. Relative to SI, SA groups performed worse on Stroop-like and Go/NoGo tasks. SA performed better than SI on Trail Making Test B, but not A. LIMITATIONS: There were few available studies. Most samples were small. We did not differentiate current vs. past SI or high vs. low lethality SA. Only English and Spanish language articles were included. CONCLUSIONS: Disrupted attentional control may convey risk for transitioning to SA from SI. More work is needed to determine which components of attention are most associated with suicide risk.

Perceived discrimination, ruminative subtypes, and risk for depressive symptoms in emerging adulthood.

Perceived discrimination has been found to increase risk for depression in emerging adulthood, but explanatory cognitive mechanisms have not been well studied. We examined whether the brooding and reflective subtypes of rumination would mediate the relation between perceived discrimination and depressive symptoms among racial/ethnic minority, versus White, emerging adults, and whether a strong ethnic identity would buffer against this effect. Emerging adults (N = 709; 70% female; 68% racial/ethnic minority), ages 18-25, completed measures of perceived discrimination, rumination, depressive symptoms, and ethnic identity. Perceived discrimination was positively associated with depressive symptoms among racial/ethnic minority and White participants. Brooding--but not reflection--mediated this relation only among racial/ethnic minorities. Ethnic identity, though negatively associated with depressive symptoms, did not buffer against the mediating effect of brooding on the discrimination-depression relation. Interventions for depression among racial/ethnic minority emerging adults should address maladaptive cognitive responses, such as brooding, associated with perceived discrimination.

Study Preregistration: Does State-level Structural Racism Impact Risk for Suicidal Thoughts and Behaviors Among US Adolescents Across Race and Ethnicity?

In the United States, suicide deaths have disproportionately increased among Black and Hispanic youth over the past 2 decades.1 Despite the critical need for more culturally responsive suicide prevention strategies, there has been only sparse research into unique risk factors commonly experienced among ethnoracially minoritized youth, such as racism-related experiences. Experiences of racial and ethnic discrimination (ie, a behavioral manifestation of racism via unfair treatment predicated on an individual's racial and/or ethnic group affiliation) have been associated with higher rates of suicidal thoughts and behaviors (STBs) in Black and Hispanic adolescents.2,3 This research has largely focused on individual-level racism (ie, interpersonal exchanges) assessed via subjective self-report surveys. Thus, less is known about the impact of structural racism, which is enacted at the system level.

Racial/ethnic discrimination and suicide-related risk in a treatment-seeking group of ethnoracially minoritized adolescents.

INTRODUCTION AND AIMS: Despite growing evidence demonstrating the negative mental health effects of racism-related experiences, racial/ethnic discrimination is seldom examined in youth suicide risk. The present study tested the association between racial/ethnic discrimination and well-supported correlates of suicide-related risk including emotion reactivity and dysregulation, and severity of psychiatric symptoms in a sample of ethnoracially minoritized adolescents receiving outpatient psychiatric services. METHODS: Participants were adolescents (N = 46; 80.4% female; 65.2% Latinx) who ranged in age from 13-20 years old (M=15.42; SD=1.83) recruited from a child outpatient psychiatry clinic in a low-resourced community in Northeast US. Youth completed a clinical interview and a battery of surveys. RESULTS: Findings from separate linear regression models show that increases in frequency of racial/ethnic discrimination were associated with increases in severity of suicidal ideation (SI), independent of emotion reactivity and dysregulation, and symptoms of PTSD and depression. Discriminatory experiences involving personal insults, witnessing family being discriminated, and school-based contexts were uniquely associated with SI. DISCUSSION AND CONCLUSION: Preliminary findings support the association between racial/ethnic discrimination and increased severity of suicide-related risk in ethnoracially minoritized adolescents. Accounting for racial/ethnic discrimination may improve the cultural responsiveness of youth suicide prevention strategies within outpatient psychiatric care.

Culturally responsive assessment of suicidal thoughts and behaviors in youth of color.

The significance of youth suicide as a public health concern is underscored by the fact that it is the second-leading cause of death for youth globally. While suicide rates for White groups have declined, there has been a precipitous rise in suicide deaths and suicide-related phenomena in Black youth; rates remain high among Native American/Indigenous youth. Despite these alarming trends, there are very few culturally tailored suicide risk assessment measures or procedures for youth from communities of color. This article attempts to address this gap in the literature by examining the cultural relevancy of currently widely used suicide risk assessment instruments, research on suicide risk factors, and approaches to risk assessment for youth from communities of color. It also notes that researchers and clinicians should consider other, nontraditional but important factors in suicide risk assessment, including stigma, acculturation, and racial socialization, as well as environmental factors like health care infrastructure and exposure to racism and community violence. The article concludes with recommendations for factors that should be considered in suicide risk assessment for youth from communities of color. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A cycle of exclusion that impedes suicide research among racial and ethnic minority youth.

In the United States, suicide risk for Black, Indigenous, and People of Color (BIPOC) is most concentrated before age 30, which contrasts with non-Hispanic White groups, for whom the highest risk period is during ages 50-65. The need for a better understanding of the underlying causes of suicidal behavior among BIPOC youth is critical. Cultural considerations were recommended over a decade ago to advance the study of youth suicide prevention and research. Without addressing the barriers to implementing these recommendations in limited-resourced settings, however, the mental health needs of BIPOC youth at risk for suicide will continue to go unmet. In this commentary, we outline structural barriers in research that perpetuate a cycle of exclusion wherein an understudied, though timely, research area faces undue burdens across the research cycle, which impedes the study of suicide risk among BIPOC youth.

Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems.

Suicide rates among ethnoracially minoritized youth (i.e., youth of color) peak before the age of 30, and striking disparities in access to mental health services have been identified in this age group. However, suicide prevention strategies have yet to fully address structural racism as a mechanism in producing disparities in risk, protective factors, and access to quality effective intervention for youth of color. Such an approach is critical to provide more culturally responsive mental health care. Through an adapted socio-ecological model, the authors propose the Structural Racism and Suicide Prevention Systems Framework and illustrate pathways through which structural racism impacts suicide prevention and intervention for youth of color in the United States. The authors contextualize the impact of structural racism in three key settings where youth suicide prevention occurs: mental health services, schools, and the interface between crisis care and law enforcement. The authors posit that critical attention must be paid to the intersection of mutually reinforcing, interdependent systems rather than to systems in isolation. The authors then propose recommendations to address structural racism in suicide prevention, including macro-level interventions to improve societal conditions, research strategies to inform structural solutions, training approaches to address institutional racism, and clinical approaches to address the impact of racism and racial trauma on youths and families.