Drugs and racial microaggressions: A mediation analysis of racism, mental health, and coping strategies

Substance Use, Parental and Teacher Support, and Mental Health Outcomes Among Latinx Sexual and Gender Minority Youth

Latinx sexual and gender minority youth (LSGMY) experience specific stressors due to intersectional systemic oppression that negatively impact their mental health. Additionally, many LSGMY report engaging in substance use to cope with daily stressors. Furthermore, research shows that parental and teacher support can serve as a buffer against substance use and negative mental health outcomes among these communities. However, there is little research specifically focused on LSGMY and the role that parental and teacher support play in substance use and mental health outcomes. In a sample of 1,338 LSGMY (ages 13-17), we assessed: (a) associations between substance use and mental health outcomes, (b) associations between parental and teacher support and mental health outcomes, and (c) whether parental and teacher support moderated the relationship between substance use and mental health outcomes. Trans and gender diverse (TGD) and plurisexual Latinx youth reported lower self-esteem, higher stress, and higher depressive symptoms compared to their cisgender and/or monosexual counterparts. Parental and teacher support were associated with higher self-esteem, lower stress, and lower depressive symptoms. Alcohol and cigarette use was associated with worse mental health outcomes. Marijuana use was associated with higher depressive symptoms. Finally, teacher support significantly moderated the association between cigarette use and self-esteem at low levels of cigarette use. We discuss clincal implications for working with LSGMY, their parental figures, and their teachers and schools.

"Drug Use with Racism…The Reason I Wanted to Do This Study": Perceptions of Race and Racism's Impact on Drug Use among Black Americans Using Opioids

Background: Several studies link racism with drug use disparities among systemically marginalized populations. However, few invite Black Americans to discuss how they perceive racism's impact on their drug use. Objectives: To examine qualitative accounts from N=40 Black adults reporting non-medical prescription opioid use on their experiences of racism and drug use. Results: A deductive structural tabular thematic analysis informed by Jones's (2000) levels of racism resulted in two themes: (a) Experiences of Racism (subthemes: Denying Experiences of Racism and Endorsing Experiences of Racism) and (b) Race, Racism, and Drug Use (subthemes: Rejecting Race and Racism's Impact on Drugs and Rejecting Race and Racism's Impact on Drugs). Conclusions: Participants provided examples of internalized, personally mediated, and institutionalized racism associated with their drug use. Implications for policy, practice, and research are discussed. Specifically, implications detail how to center Black Americans and demonstrate anti-racism when developing treatment strategies and drug policies.

Histories of violence among clients seeking substance use disorder treatment: a systematic mapping review

Introduction

There is a limited literature base regarding the intersection of drug and alcohol treatment, violence, and trauma. While research substantiates that exposure to violence and trauma impacts the propensity to misuse substances, the conceptualization in clinical trials and practice has largely been narrow and gendered, referring only to intimate partner or domestic violence. Our systematic mapping review explored a more inclusive and expansive review of survivors of and perpetrators of violence and trauma (e.g., intimate partner violence, sexual assault, stalking, child abuse, political and community violence, criminal violence, micro violence, structural violence, and oppression) to establish: 1) the types of treatment settings included in intervention studies, 2) the common indicators of success or common outcomes recorded, and 3) understanding who is seeking treatment for drug and alcohol use with histories of violence.

Methods

A systematic mapping review was conducted to identify any peer-reviewed articles published from 2011 to 2022. The Web of Science database was searched using a broad set of Boolean search terms related to violence, substance use disorders, and treatment. Over 8,800 records were identified from the systematic review with a total of 48 articles meeting inclusion criteria.

Results

Most studies in this review included populations reporting perpetration of violence (n=23, 48%) versus participants reporting survival of trauma/violence (n=17, 35%). Results also indicated female identifying populations (n=19; 40%) were predominantly served, were treated in the US (n=33; 69%) and seen in an outpatient setting (n=24; 50%). Authors also were attentive to studies that included sexual and gender minorities and discovered only three studies (6%) explicitly acknowledging inclusion of transgender participants or participants in relationship with partners of the same sex; three more studies (6%) were focused on participants with histories of or engaging in sex work.

Discussion

This review outlines treatment and research implications directly situated in the gap of service delivery found in this review. Specifically, the results elucidate the impact on minoritized and excluded identities based on gender, sexual preference, criminal legal status and directions for research and treatment to increase inclusion, representation, and equity across research and treatment settings.

Ethnic identity and resilience: a moderated mediation analysis of protective factors for self-blame and racial microaggressions

Introduction

People of Color (PoC) in the United States encounter everyday racial microaggressions, and these commonplace experiences can wear and exhaust PoC's resources. Racial microaggressions have shown detrimental effects on physical and psychological well-being. Consequently, researchers have examined and tested different ways in which PoC cope and protect themselves from these everyday exchanges. Past findings have indicated that PoC might blame themselves for racism-related occurrences to cope with these commonplace discriminatory experiences. Ethnic identity and resilience have emerged in research as protective factors that can moderate and buffer the impact of racism on PoC's well-being. We used a combination of mediation, moderation, and conditional analyses to unpack the relationships between racial microaggression (predictor), psychological distress (outcome), self-blame (mediator), resilience (moderator), and ethnic identity (moderator).

Methods

This study used a cross-sectional design and sampled 696 PoC regarding their experiences and responses to racial microaggressions. We tested the association between psychological distress and racial microaggressions and further examined whether self-blame mediated the relationship. We also tested ethnic identity and resilience as moderators and used a conditional analysis to determine whether these protective factors moderated the mediation model.

Results

Findings from the mediation, moderation, and conditional analyses supported our four hypotheses: (H1) self-blame mediated the relation between racial microaggressions and psychological distress (mediation), (H2) ethnic identity moderated the association between racial microaggressions and self-blame but only at low and average levels (moderation), (H3) resilience moderated the relation between self-blame and psychological distress but only at low and average levels (moderation), and (H4) evidence of moderated mediation were found for all five variables (conditional). While statistically significant, most moderation effects were minimal to small.

Conclusion

PoC may engage in self-blame when experiencing racial microaggressions, which explains why these everyday, commonplace occurrences might lead to psychological distress. There was evidence that ethnic identity and resilience can protect PoC from the negative effects of racial microaggressions. These buffering effects, however, only emerged for PoC endorsing high levels of ethnic identity and resilience, and it should be noted that for most participants, the link between racial microaggressions and psychological distress was still significant. Future studies might need to explore additional individual and interpersonal alongside institutional factors that can protect PoC from racism-related harms.