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

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

Perceived racial/ethnic discrimination, posttraumatic stress symptoms, and health risk behaviors among Mexican American adolescents

Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact.     

Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.     

The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel

This study examines the role of acculturation, perceived discrimination, and self-esteem in predicting the mental health symptoms and risk behaviors among 1.5 and second generation non-Jewish adolescents born to migrant families compared with native-born Jewish Israeli adolescents in Israel. Participants included n = 65 1.5 migrant adolescents, n = 60 second generation migrant adolescents, and n = 146 age, gender, and socioeconomic matched sample of native-born Jewish Israelis. Participants completed measures of acculturation pattern, perceived discrimination, and self-esteem as well as measures of mental health symptoms and risk behaviors. Results show that migrant adolescents across generations reported worse mental health symptoms compared with native-born Jewish Israelis. However, only the 1.5 generation migrants reported higher engagement in risk behaviors compared with second generation migrants and native-born Jewish Israelis. Our findings further showed that acculturation plays an important role in predicting the mental health status of migrant youth, with those characterized with integrated acculturative pattern reporting lower mental health symptoms compared with assimilated acculturation pattern. Importantly, contextual factors, such as higher perception of discrimination in the receiving culture as well as individual factors such as lower self-esteem and female gender were strongly associated with worse mental health symptoms. The findings manifest the complex relationship between contextual factors and individual level variables in the acculturative process of migrants as well as the importance of examining the effect of migration generation on mental health outcomes.     

Perceived COVID-induced racism and contextual predictors of fear and psychological distress among Black men

The present study examined if Black men's perceptions of COVID-induced racism (i.e., the extent to which racism increased during the beginning months of the COVID-19 pandemic) were associated with their reported fear of COVID-19 and psychological distress. Self-report COVID-related variables and psychological distress data from 231 Black men in the U.S. were analyzed alongside archival percentages of confirmed cases and deaths by participants' county at the time of participation. Hierarchical regressions identified perceptions of COVID-induced racism as a significant predictor of Black men's psychological distress over and above contextual (e.g., county-level COVID-19 case %) and individual-level predictors (i.e., perceived race-related infection risk and self-reported COVID-related stressful life events). This work contributes to the growing literature on health inequities during the COVID-19 pandemic with a snapshot of Black men's experiences during the COVID-19 and racism pandemics of 2020 in the U.S.     

Perceived self-other differences in life events and mental health among Mexicans and Americans

The social context of reported stressful life events was examined as a determinant of psychiatric symptoms in four cultural groups: Anglo-Americans (n = 132), Mexican-Americans (n = 108), Mexicans in El Paso (n = 90), and Mexican nationals (n = 133). The perceived difference between life events experienced by the self and spouse or by the self and significant others constituted preliminary operational definitions of the social context of life events. Ten Psychiatric Epidemiology Research Interview (PERI) psychiatric symptom scales as well as a suicidal tendency scale and a hopelessness index constituted the measures of the dependent variables. The potential predictive value of the social contextual measures of life-event stress for mental health variables was generally supported by the findings. Results indicated a rank ordering of predicted effects, with Mexican nationals most susceptible to the psychological effects of the social context of life events and Anglo-Americans least susceptible.     

HIV prevention with persons with mental health problems

The HIV seroprevalence rate among persons with mental health problems (PMHP) is substantially higher than that of the general population in the United States. This study examines the efficacy over 12 months of an HIV prevention program with 99 individuals attending outpatient mental health clinics who were randomly assigned to receive either: (a) a seven-session, small-group intervention of Project LIGHT (Living in Good Health Together); or (b) a one-session video intervention. Regression analyses of data from 87% of the sample interviewed at 1-year follow-up revealed that intervention group membership was associated with significantly fewer sexual risk acts. A significant intervention effect for condom use was found for 72% of the sample who were African American, but not for Latino or Caucasian participants. Results from this study suggest that HIV risk reduction groups such as Project LIGHT may have utility in public mental health care settings.     

Perceived discrimination is associated with poorer health and well‐being outcomes among Pacific peoples in New Zealand

Our study investigated the association between perceived discrimination and outcomes related to health and well‐being for Pacific adults in New Zealand. We examined personal and group discrimination from the 2013 wave of the New Zealand Attitudes and Values Study (n = 429 women and 196 men). Personal discrimination was associated with poorer health and well‐being outcomes (higher psychological distress and lower self‐esteem, subjective evaluation of health, satisfaction with life and personal well‐being). Group discrimination, in contrast, was associated with poorer well‐being but not health outcomes (lower subjective evaluation of health and personal well‐being). These findings corroborate previous research and highlight the corrosive effect of discrimination towards health and well‐being among Pacific communities in New Zealand.     

Change in subjective social status following HIV diagnosis and associated effects on mental and physical health among HIV-positive gay men in Australia

Objective: This study investigates the impact of HIV diagnosis on subjective social status and if changes are linked to health outcomes.

Design: Two measures of subjective social status, socio-economic and standing in the community were examined in 342 Australian HIV-positive gay men in 2014. Participants recalled ratings at diagnosis were compared with current ratings.

Main outcome measures: Self-reported mental (psychological distress, self-esteem, positive mental health and satisfaction with life) and physical health (self-rated health, CD4 count, viral load).

Results: Half of the participants reported improvements in subjective socio-economic status (59%) or standing in the community (52%) since diagnosis, yet one quarter reported socio-economic status (25%) or standing in the community had decreased (23%). Increases in either measure of subjective social status were linked to higher self-esteem, positive mental health, satisfaction with life and better self-rated health. Decreases in subjective social status, however, were strongly linked to poorer outcomes on all mental health measures. Decreases in standing in the community were also associated with poorer physical self-rated health.

Conclusion: Most participants reported their subjective social status were the same or better since diagnosis. Changes in subjective social status following diagnosis were strongly linked to mental health outcomes. Those who reported a decrease in subjective social status were particularly vulnerable to mental health problems.     

Social factors and mental health symptoms among women who have experienced involuntary job loss

The growing proportion of women in the labor force and the current economic crisis has made women a target population for job loss. In that situation, they are likely to experience recurrent layoffs, which force them to cope with multiple job loss and with unemployment. The present study aimed to examine sociodemographic factors that help women succeed in coping with single or multiple experiences of job loss, and that even enhance their self-efficacy in returning to work. The population of participants consisted of 134 Israeli women aged 30-45 who had been laid off. The findings indicate that the women who had experienced multiple job loss expressed a stronger desire to return to work than did those who had been laid off only once. Married women showed a greater tendency to become accustomed to stress after being laid off than did never-married women. However, even though multiple job loss might be a forced solution to home-work conflict, never-married women were found to be at risk for distress responses after being laid off. There is a need to develop responses for women who are at risk for multiple job loss, and to enhance employers' awareness of the situation faced by women who are laid off.     

Religion and mental health among blacks

The positive role of religion in the mental health of black Americans is a much neglected theme in the literature. This paper considers religion as one of the important retained black cultural traits, which continues to play a vital role in the mental health and survival strategies of black Americans. The paper examines Grier and Cobbs's appraisal of the religion-mental health connection in black communities and identifies different ways for mental health practitioners to think about religious phenomena and the primal partnership between religion and mental health. The paper concludes with a challenge to keep awareness of the religion-mental health partnership together in the treatment of black Americans.This paper was originally presented at a two-day conference on Some Dynamics and Psychotherapeutic Methods in Rendering Treatment to Blacks, March 15 and 16, 1980, in Oakland, California. This particular paper discussed religion as one of the important retained black cultural trains.     

Perceived discrimination and educational attainment for U.S. Black adults: the influence of Black racial identity

Social Psychology of Education - Few studies have examined the role of Black racial identity as a moderator of the relation between perceived discrimination and educational attainment among Black...     

Social context,sexual practices,and risks for HIV transmission among men who have sex with men: The south beach health survey

In a population-based sample of 193 men who had sex with men in South Beach, Miami-Dade County, Florida, two indicators of social context—choice of sexual relationships and perceived HIV-infection status—were used to analyze residents who engaged in certain sexual practices with their partners. The vast majority (88.6%) of respondents reported engagement in anal sex during the previous 12 months; 20.2% reported unprotected anal intercourse (UAI) with ejaculation with any partner and 12.4% reported UAI with ejaculation with one or more casual partners. Findings supported the hypothesis that primary partner relationships and perceived HIV status are important variables for understanding engagement in UAI with ejaculation. Men who engaged in such behaviors with casual partners were more likely to have negative attitudes towards condoms, report difficulty communicating desires for safer sex, disagree with the belief that AIDS is fatal, and be intoxicated during anal intercourse. Men who reported engaging in anal intercourse, but who never shared unprotected ejaculations, were most likely to be unknowingly infected with HIV, suggesting that many men may become infected while following what they believe to be “safer sex practices.” In designing effective interventions, public health authorities need to take into account socially embedded risk-negotiating practices.     

The relationship between racial identity status attitudes, racism-related coping, and mental health among Black Americans

To date, few studies have examined how different strategies for coping with racism affect the mental health of Black Americans, and none have explored how racial identity status attitudes and racism-related coping affect mental health. This study sought to examine the relationship between racial identity status attitudes, the specific strategies used by Black Americans to cope with racism, and mental health outcomes. Participants were 233 Black adults, and cluster analysis identified four cluster groups that differed significantly with respect to the patterns of racial identity attitudes and racism-related coping strategies employed. Although the groups did not differ significantly in well-being, the group with predominantly high Internalization status attitudes and that used primarily Empowered Resistance racism-related coping strategies had the least psychological symptoms. Implications for mental health and research are discussed.     

HIV infection and mental health: suicidal behaviour--systematic review

Suicide has long been associated with serious illness generally and HIV specifically. New treatments have affected prognosis in HIV positively, but it is unclear how they impact on suicidal burden (thoughts, self-harm and completions). This review examines all published suicide and HIV data for a definitive account of (1) prevalence of HIV-related suicidality, (2) measurement within studies and (3) effectiveness of interventions. Standard systematic research methods were used to gather quality published papers on HIV and suicide, searching published databases according to quality inclusion criteria. From the search, 332 papers were generated and hand searched resulting in 66 studies for analysis. Of these, 75% were American/European, but there was representation from developing countries. The breakdown of papers provided 12, which measured completed suicides (death records), five reporting suicide as a cause of attrition. Deliberate self-harm was measured in 21, using 22 instruments; 16 studies measured suicidal ideation using 14 instruments, suicidal thoughts were measured in 17, using 15 instruments. Navigating the diverse range of studies clearly points to a high-suicidal burden among people with HIV. The overview shows that autopsy studies reveal 9.4% of deceased HIV+?individuals had committed suicide; 2.4% HIV+?study participants commit suicide; approximately 20% of HIV+?people studied had deliberately harmed themselves; 26.9% reported suicidal ideation, 28.5% during the past week and 6.5% reported ideation as a side effect to medication; 22.2% had a suicide plan; 19.7% were generally "suicidal" (11.7% of people with AIDS, 15.3% at other stages of HIV); 23.1% reported thoughts of ending their own life; and 14.4% expressed a desire for death. Only three studies recruited over 70% female participants (39 studies recruited over 70% men), and six focussed on injecting drug users. Only three studies looked at interventions - predominantly indirect. Our detailed data suggest that all aspects of suicide are elevated and urgently require routine monitoring and tracking as a standard component of clinical care. There is scant evidence of direct interventions to reduce any aspect of suicidality, which needs urgent redress.     

Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure

Abstract

Evidence across a multitude of contexts indicates that social support is associated with reduced risk for mental health symptoms. More information is needed on the effectiveness of different sources of support, as well as sex differences in support. Associations between social support from two sources – the military unit and friends and family – and mental health symptoms were examined in a study of 1571 Marine recruits assessed at the beginning and end of a highly stressful 13-week training program. Military social support buffered the stressor exposure–posttraumatic stress symptomatology (PTSS) relationship, whereas the relationship between stressor exposure and PTSS was highest when civilian social support was high. Further inspection of the interactions revealed that military support was most important at high levels of stressor exposure. Sex differences in the relationship between social support and symptoms were found, such that support from military peers was associated with lower levels of PTSS for men, whereas civilian support was associated with lower PTSS for women. While civilian social support was associated with lower levels of depression symptom severity in both women and men, the relationship was stronger for women. Reviewed implications focus on the importance of considering the recipient, source, and context of social support.     

The prevalence of perceived discrimination among African American and Caribbean Black youth

The present study examined ethnic, gender, and age differences in perceived discrimination and the association between perceived discrimination and psychological well-being in a nationally representative sample of Black adolescents. Data are from the National Survey of African Life (NSAL), which includes 810 African American and 360 Caribbean Black youth. Results indicate that the majority of Black youth perceived at least 1 discriminatory incident in the previous year. Adolescents at later stages of development perceived more discrimination than those at earlier stages, and African American and Caribbean Black males perceived more discrimination than their female counterparts. Perceptions of discrimination were positively linked to depressive symptoms and were negatively linked to self-esteem and life satisfaction, regardless of ethnicity. However, Caribbean Black youth appear to be more vulnerable when they perceive high levels of discrimination.     

Examining mental health symptoms in male and female incarcerated juveniles

Varying risk factors for both incarceration and mental health diagnoses have been identified for female juveniles, highlighting the need for gender-specific assessments and treatment protocols. The purpose of this study is to determine how the prevalence rates of mental health symptoms differ in male and female juvenile offenders. It was hypothesized that the prevalence rates would be greater for females than males. This study found significant differences between males and females on several clinical scales. These findings are consistent with past studies that have identified differences in mental health symptoms between genders.