Racial/ethnic discrimination and well-being during adolescence: A meta-analytic review

Patterns of mental health problems and resilience among immigrant and refugee adolescents: a latent profile analysis

Background: Immigrant and refugee adolescents often face traumatic experiences and are vulnerable to mental health problems, such as post-traumatic stress disorder (PTSD), anxiety and depression. Yet, they also show remarkable resilience in the face of these stressors. Research is still scarce on how both mental health problems and resilience dynamically interplay in immigrant and refugee adolescents' development.Objective: We aimed to identify latent profiles of immigrant and refugee adolescents' wellbeing, consisting of externalizing and internalizing symptoms, PTSD (intrusion and avoidance), and resilience, and analyse the demographic and contextual determinants of these profiles.Method: We employed cross-sectional survey data from the RefugeesWellSchool project for 1607 immigrant and refugee adolescents (mean age 15.3 years, SD 2.15, 42.3% girls) from six European countries: Belgium, Denmark, Finland, Norway, Sweden, and the United Kingdom. Latent profile analysis and three-step procedure with BCH weights were used to identify the wellbeing profiles and their determinants.Results: Results identified four adolescent wellbeing profiles: (1) Low symptoms (49.7%, n = 791); (2) High symptoms with intrusion (10.6%, n = 169); (3) Moderate symptoms (26.9%, n = 428); and (4) Resilient avoidant (12.8%, n = 203). Older participants, those with refugee background, shorter residence in the host country, more experiences of daily stressors or discrimination, or low family support were less likely to belong to the Low symptoms or Resilient avoidant groups (p ≤ .001).Conclusions: The profiles reflected distinct differentiation of intrusive and avoidance dimensions of the PTSD-symptoms. Intrusion clustered with high level of other mental health problems, whereas avoidance co-occurred with high resilience. Experiences related to immigration, stressors, and family support were crucial determinants of the wellbeing profile membership. Future interventions should utilize information obtained by person-centered studies to create better targeted and tailored support for immigrant and refugee adolescents.

Associations Between Acculturation, Discrimination, and Adolescent Relationship Abuse: A Matched Parent-Adolescent Study of Latine Families

Adolescent relationship abuse (ARA) is prevalent among adolescents, including those who identify as Latine. However, there is limited research that has considered the cultural and structural mechanisms that may impact ARA experiences among Latine youth. Further, although parents play a crucial role in ARA prevention, few studies have investigated how adolescent-parent differences in acculturation and discrimination are associated with ARA. The objective of this exploratory study of Latine families was to examine how acculturation, discrimination, and adolescent-parent acculturation/discrimination differences relate to ARA victimization and perpetration. Parent-adolescent dyads recruited from clinic and community-based settings in Pittsburgh and Kansas City completed matched surveys. Parent-adolescent acculturation and discrimination differences were calculated using multilevel linear models. Multivariable logistic regression was used to examine associations among ARA victimization and perpetration and adolescent-reported acculturation, adolescent-reported discrimination, and adolescent-parent acculturation and discrimination differences. One hundred eighty-two adolescents and their parent/caregiver (n = 364) completed a matched survey in English or Spanish from March 2020 to March 2021. Forty-three percent of adolescents reported that they had started dating; of these 35% and 24% reported ARA victimization and perpetration, respectively. Higher levels of adolescent-reported acculturation conflict were associated with lower ARA victimization (adjusted odds ratio [aOR]: 0.24; 95% confidence interval, CI [0.08, 0.75]); conversely, higher adolescent-reported discrimination was associated with ARA victimization (aOR: 2.50 [1.30, 4.60]) and perpetration (aOR: 2.10 [1.10, 3.90]). Wider adolescent-parent acculturation differences in Spanish language (aOR: 3.40 [1.04, 11.30]) and interpersonal discrimination (aOR: 2.40 [1.10, 5.20]) were associated with increased ARA victimization. Results underscore the importance of discrimination in understanding ARA experiences among Latine youth. Future work should consider developing culturally and linguistically affirming ARA prevention programs for Latine adolescents and parents.

Racism and hypothalamic-pituitary-adrenal axis functioning in childhood as risks for health disparities across the lifespan

Racism is a primary social determinant of health and chronic stressor that affects the physical and mental health of People of Color and Indigenous Individuals (POCI) and perpetuates racial and ethnic health disparities. Despite the impact of racism on POCI, the mechanisms through which experiences of racism result in negative health outcomes remain understudied, in particular among children. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is one of the possible mechanisms. Frequent and prolonged exposure to chronic stressors may result in dysregulation of the HPA axis, and in turn cause adverse physical and psychological health outcomes for POCI children. This paper argues for the importance of examining HPA axis dysregulation as a mechanism that links racism during early childhood to negative health outcomes over the lifespan. Several studies have explored the relationship between racism and HPA axis dysregulation during adulthood and adolescence and have found associations between racism and salivary and hair cortisol. Recent studies have identified racial and ethnic differences in cortisol levels during early childhood, but only one study, to our knowledge, explored whether the differences are attributed to racism. In this paper, we conduct a review of the existing literature on the links between racism and HPA axis dysregulation during adulthood and adolescence given the dearth of studies exploring this relationship during early childhood. We also highlight the importance of utilizing an intersectionality framework in the study of racism and health to provide a more comprehensive and nuanced understanding of health disparities among and within racial/ethnic groups. Using this evidence along with consideration of relevant models, we propose how HPA axis dysregulation identified early in life may foreshadow children's increased risk for negative health outcomes from racism and other systems of oppression and signal the need for prevention and intervention.

Family-level moderators of daily associations between discrimination and distress among Mexican-origin youth

The current study evaluated cultural values and family processes that may moderate associations between daily racial-ethnic discrimination and distress among Mexican-origin youth. Integrating micro-time (daily diary) and macro-time (longitudinal survey) research design features, we examined familism, family cohesion, and ethnic-racial socialization from youth-, mother-, and father- reports as potential buffers of daily associations between youth racial-ethnic discrimination and youth distress (negative affect and anger). The analytic sample, drawn from the Seguimos Avanzando study, included 317 Mexican-origin adolescents (Mage = 13.5 years) and their parents, recruited from the Midwestern United States. Results indicated that youth-reported familism and family cohesion significantly buffered daily associations between youth racial-ethnic discrimination and youth distress. In contrast, parent-reported familism and family cohesion and some aspects of ethnic-racial socialization exacerbated the discrimination to distress link. The implications of these results are discussed to inform efforts supporting the healthy development of Mexican-origin youth and their families.

Associations of Racial Discrimination with Depression/Suicidality and Substance Use Among Black Youth: The Moderating Roles of Sexual Identity and School Connectedness

Purpose: The current study examined relations among racial discrimination (RD), depression/suicidality, substance use, and school connectedness among Black youth who identified as lesbian, gay, bisexual, some other way, or not sure (LGBQ) and heterosexual youth. Methods: Data were obtained from the Adolescent Behaviors and Experiences Survey (ABES) conducted by the Centers for Disease Control and Prevention during January-June 2021. ABES was a one-time, online survey given to a nationally representative sample of U.S. high school students. Data for the current study included 1189 Black 9th-12th graders (50.0% female and 18.8% LGBQ). Measures included self-reports of depression/suicidality during the past year, substance use in the past 30 days, current feelings of school connectedness, RD in school across the lifespan, and sexual identity. Structural equation modeling was utilized to examine study aims. Results: Black LGBQ youth reported higher levels of RD, depression/suicidality, and substance use but lower school connectedness compared with heterosexual Black youth. RD was positively associated with depression/suicidality (b = 0.876, standard error = 0.197, p < 0.001) but not with substance use (p = 0.366). Sexual identity and school connectedness did not moderate the relationships between RD and depression/suicidality or RD and substance use. Conclusion: RD's positive association with depression/suicidality and lack of association with substance use was similar for Black heterosexual and LGBQ youth. Future research should expand on the role of intersectionality with other identity groups and protective factors for school-based RD experiences. Educators should explore interventions beyond only school connectedness for reducing school-based RD for Black youth.

Predicting Adolescent Depression and Suicide Risk based on Preadolescent Behavioral Health Screening in Primary Care

OBJECTIVE

To examine the degree to which a broadband behavioral health screener administered in preadolescence in primary care (PC) could serve as an early risk indicator for depression and suicide risk in adolescence.

METHODS

Participants included 9,329 patients who attended well visits at 9 years old and 12 years old in a large pediatric PC network. The sample was 49% female, 64% White, 18% Black, 4% Asian, 14% other races, and 6% Hispanic/Latinx. Caregivers completed the Pediatric Symptom Checklist (PSC-17) about their child at age 9; youth completed the Patient Health Questionnaire-9 Modified for Teens (PHQ-9-M) at age 12.

RESULTS

After adjusting for demographic covariates, patients scoring above the risk cutoffs on the PSC-17 total scale and subscales (internalizing, externalizing, and attention) at age 9 had significantly greater odds of elevated depression and/or suicide risk on the PHQ-9-M at age 12 (odds ratios: 2.41 to 4.23, ps<.001). Approximately one-third of patients with depression (sensitivity: 37.1%) or suicide (sensitivity: 33.3%) risk at age 12 were identified as at risk on the PSC-17 at age 9.

CONCLUSIONS

Results suggest that the PSC-17, a well-researched screener widely used in pediatrics, has moderate predictive value with respect to depression and suicide risk during adolescence. More research is needed on the feasibility and potential benefits of broadband behavioral health screening in preadolescence to promote early identification and prevention efforts.

Perceived Racism, Brain Development, and Internalizing and Externalizing Symptoms: Findings From the ABCD Study

OBJECTIVE

Racial discrimination drives health disparities among racial/ethnic minority youth, creating chronic stress that affects brain development and contributes to mental and behavioral health issues. This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study to examine the neurobiological mechanisms linking discrimination to mental and behavioral health outcomes.

METHOD

A sample of 3,321 racial/ethnic minority youth was split into training (80%, n=2,674) and testing (20%, n=647) groups. Propensity-score-weighted machine learning was used to assess the effects of perceived discrimination on two-year changes in resting-state functional connectivity between three subcortical regions (nucleus accumbens, amygdala, hippocampus) and large-scale brain networks. Mediation analyses evaluated whether brain changes mediated sex-specific effects on internalizing or externalizing symptoms.

RESULTS

Perceived discrimination was significantly associated with two-year changes in connectivity of the nucleus accumbens, amygdala, and hippocampus in both cross-validation and independent testing. Key findings included decreases in nucleus accumbens connectivity with retrosplenial-temporal and sensorimotor (hand) networks, decreases in amygdala connectivity with the sensorimotor (mouth) network, and increases in hippocampal connectivity with the auditory network. These changes suggest accelerated maturation in these connections among youth reporting higher discrimination levels. Moderated mediation analyses revealed sex differences, with discrimination-related changes in nucleus accumbens connectivity linked to poorer internalizing outcomes in female participants.

CONCLUSIONS

The results indicate perceived racial discrimination experienced in adolescence impact subcortical-cortical brain development, which affect mental and behavioral health outcomes in a sex-specific manner.

Racism in Education among Black Youth in Canada and its Association with Depression, Anxiety, Stress, and Post-Traumatic Stress Disorder

Racial discrimination in educational settings remains a significant barrier to equitable learning environments and is toxic for the mental health of Black youth in Canada. This study employed a mixed-methods multi-study approach to document the rates, dynamics, and mental health impacts of racial discrimination in education experienced by Black youths aged 14 to 24. Quantitative data were collected from two large samples (N = 558 and N = 914) to measure racial discrimination in education, stress, anxiety, depression, and post-traumatic stress disorder (PTSD). Additionally, qualitative data from semi-structured interviews with 32 youths provided deeper insights into their racial discrimination's experiences in educational settings. Over 40% of participants reported racial discrimination in education, which was significantly associated to elevated symptoms of anxiety, depression, stress, and PTSD. In both quantitative datasets, experience of racial discrimination in education moderated the association between resilience and internalized mental health problems (β = .53, p = .037, β = .34, p = .015, respectively). Racial discrimination in education lowers the protective role of resilience against internalized mental health problems. Thematic analysis of qualitative data uncovered key themes, including pervasive assumptions of low academic potential for Black students by authority figures, lack of appropriate intervention by educators and administrators when racial discrimination occurred, and ongoing enablement of a racist environment within schools. These findings underscore a critical need for systemic reform in Canadian schools and universities to prevent racism and address its mental health impacts. Implementing culturally responsive policies and antiracist interventions can foster safer, more inclusive educational environments, supporting well-being and academic success of Black Canadians youth.

A Longitudinal Examination of Children's Friendships Across Racial Status and Gender and Their Intergroup Prosocial Behavior

In this research, we examined (a) the primary effects of intergroup friendships: whether having a friend of a different gender/racial status benefits children's gender/racial status-based prosocial behavior and (b) the secondary transfer of intergroup friendships: whether friendships from one domain (e.g., gender) would extend to improved prosocial behavior toward outgroup members of another domain (e.g., race). Participants were 603 third- to fifth-grade students (Mage = 9.06, SD = .90; 47.9% girls; 52.4% racially minoritized). Peer nominations of prosocial behavior and friendships were collected twice in 1 year. Longitudinal path analyses focused on intergender friendships showed support for both the primary and secondary transfer effects on enhanced intergroup prosocial behavior. Analyses focused on racial status showed the primary effects of these friendships on enhanced interracial prosocial behavior, whereas the secondary transfer effects were less consistent. These findings provide a basis for interventions to promote equity in prosociality toward diverse others.

Change in Health Status Among American Indian/Alaska Native Adolescents Living Outside of Tribal Land in California Before and During the COVID-19 Pandemic

PURPOSE

This article describes change in health status by analyzing key health domains at two time points before and during the COVID-19 pandemic among a sample of American Indian/Alaska Native (AI/AN) adolescents living outside of tribal land (n = 114) throughout California.

METHODS

Data were analyzed from a longitudinal study, Native American Youth Sleep Health and Wellness (NAYSHAW). To test changes in health from baseline (March 2018-March 2020) to follow-up (December 2020-June 2022), we ran a series of linear regression models for continuous measures and repeated measures logistic regression models for dichotomous measures for physical health, behavioral health, and cultural contexts of health and well-being.

RESULTS

For physical health, body mass index percentile significantly decreased (p = 0.02), and both systolic and diastolic blood pressure significantly increased (p < 0.001 for both), although both measures remained within the normal range for adolescents. For behavioral health, depression and anxiety significantly increased (p = 0.005 and 0.008, respectively), although they remained within subclinical levels, and no significant changes were observed with alcohol and cannabis use. For cultural contexts of health and well-being, both cultural identity and sense of historical loss significantly increased (p < 0.001 and p = 0.03, respectively).

DISCUSSION

We observed a mix of positive and negative health changes among AI/AN adolescents living outside of tribal land before and during COVID-19. Findings highlight that enhanced cultural identity during adolescence may have helped foster resilience during this difficult period.

Editorial: The Power of Racial-Ethnic Socialization in Promoting Adolescent Resilience

Adolescence marks a critical period of identity formation, as young people navigate questions about who they are and where they belong in a diverse social landscape. For ethnoracially minoritized youth, this process is often complicated by systemic inequities and racialized stressors, which elevate their risk for mental health challenges such as anxiety and depression.1 Amid these adversities, developing a strong ethnic-racial identity-a sense of pride, belonging, and connection to one's racial or ethnic group-emerges as a crucial foundation for resilience.2.

The recent trends in discrimination and health among ethnic minority adolescents: an integrative review

BACKGROUND

Experiences of racial discrimination during adolescence can negatively affect lifelong health. Although many ethnic minority adolescents face discrimination in common worldwide, there are few updated review studies that explored how discrimination affected health status and behavior among ethnic minority adolescents.

METHODS

Comprehensive searches of the PubMed, Embase, PsycINFO, and CINAHL were conducted, integrating keywords about adolescent, ethnic groups, discrimination, and health. The search encompassed articles published between January 2016 and March 2021, following Whittemore and Knafl's integrative literature review method. Quality appraisal was evaluated by the Risk of Bias Assessment Tool.

RESULTS

After conducting the initial screening of 167 studies, eleven studies met the inclusion criteria and were included in the review. More than 80% of the studies were conducted African-American/Black adolescents in the United States. There were clear associations between group discrimination and mental health problems. Discrimination was also linked to the low overall health, high substance use, high emotional eating, and high behavioral problems, and low ethnic identity. Of the six studies investigating gender differences, two each reported that discrimination was linked to higher substance use in boys and stronger internalizing symptoms in girls.

CONCLUSION

This integrative review provides insights into the discrimination experiences of ethnic minority adolescents, with particular implications for mental health, overall health, substance use, and behavioral problems. This review contributes evidence for need of integrative health promotion programs to mitigate racial discrimination against ethnic minority adolescents for health equity.

Examining psychological distress among youth in Singapore: Insights from the National Youth Mental Health Study

Youth is a period of transition associated with immense biological, physical, and social changes, which increases the vulnerability to mental illnesses. The study aimed to establish the prevalence of severe and extremely severe levels of depression and anxiety symptoms among the youths in Singapore and identify the psycho-social factors associated with them. The National Youth Mental Health Study was a cross-sectional epidemiological study of Singapore Residents aged 15-35 years. The youths self-administered the survey on tablets containing the programmed questionnaires. The Depression Anxiety Stress Scales Short Form (DASS-21) was used to assess youths' mental health. Multiple logistic regressions were conducted to examine the socio-demographic correlates and to identify factors associated with psychological distress. The prevalence of severe and extremely severe symptoms of depression was 14.9 % among youths in Singapore. Severe and extremely severe levels of depression symptoms were highest among those in the age group of 20-24 years (20.9 %). The prevalence of severe and extremely severe levels of anxiety symptoms among youths in Singapore was 27.0 %. The prevalence was significantly higher among females (28.9 %) than males (25.0 %). Severe and extremely severe symptoms of anxiety were highest among those in the age group of 20-24 years (34.1 %). Body shape concerns, daily smoking, and self-esteem were significantly associated with severe and extremely severe symptoms of depression and anxiety. The high prevalence of severe and extremely severe levels of depression and anxiety highlights the need for comprehensive and accessible mental health services tailored to the unique challenges faced by youths.

A framework for understanding adverse adolescent experiences

Adolescence (ages 10-24) is characterized by cognitive, behavioural and social development. Childhood environments are typically centred on home and care settings, whereas adolescents increasingly engage with peer and community environments. These changing environments confer risks of experiencing specific adversities at different ages. Despite the unique characteristics of adversities in adolescence and potential associations with lifespan outcomes, few frameworks exist to systematize adversities in adolescents. Here we review current research and propose an approach specific to this developmental period: the adverse adolescent experiences (AAEs) framework. Building on existing models (for example, the adverse childhood experiences framework), the AAEs focus on potentially traumatizing experiences during adolescence. The framework builds on Bronfenbrenner's ecological systems theory to conceptualize adversities at intrapersonal, interpersonal, community and societal levels. We argue that this approach can enhance our understanding of adolescent adversity, facilitate the study of its potential effects, and guide prevention and intervention efforts.

Profiles of negative and positive risk-taking behavior among Asian and non-Asian American emerging adults

Risk-taking includes both negative and positive risky behaviors, but little is known about how negative and positive risk-taking occur simultaneously. This study examined negative and positive risk-taking profiles of Asian American and Non-Asian American emerging adults (N = 401; Mage = 20.68; 68.30% women) and their demographic and cultural factor correlates. Three profiles emerged: Moderate Negative and Positive, Low Negative and Positive, and High Negative/Average Positive. Asian Americans were most likely to belong in the Low Negative and Positive. The High Negative/Average Positive profile was associated with stronger emotion control values, whereas the Low Negative and Positive profile was higher in humility values. These findings underscore the role of cultural beliefs in shaping distinct risk-taking patterns among emerging adults.

Racial Discrimination as a Traumatic Bedrock of Healthcare Avoidance: A Pathway Through Healthcare Institutional Betrayal and Mistrust

Objectives: Experiences of racial discrimination within the healthcare system are potentially traumatic events (PTEs) that have been associated with lowered perceived trust in healthcare providers, ongoing symptoms of PTSD and depression, and anticipated healthcare avoidance. Based on the BITTEN trauma impact model, we test a pathway such that greater past healthcare discrimination would be associated with anticipated future healthcare avoidance among BIPOC college students. We posited that this direct relationship would be sequentially mediated by healthcare institutional betrayal (HIB) during one's worst healthcare event and subsequently reduced trust in healthcare. Methods: Our model was tested in a subsample of undergraduate students, all of whom self-identified with at least one minoritized racial or ethnic identity (n = 472). Participants reported on their past experiences with racial discrimination in healthcare. Each then chose and described their worst and/or most traumatic previous healthcare experience. Subsequently, they indicated if this experience included acts of HIB and/or led to medical mistrust. Finally, they reported on the degree to which they anticipated engaging in future healthcare avoidance. Results: Our model explained 31% of the variance in anticipated healthcare avoidance. As hypothesized via BITTEN, greater HIB during one's worst or most traumatic healthcare experience and resulting mistrust in healthcare sequentially mediated the relationship between past experiences of healthcare racial discrimination and anticipated future healthcare avoidance. However, a direct relationship between racial discrimination in healthcare and anticipated healthcare avoidance was retained. Conclusions: Racial discrimination is a potentially traumatic experience associated with deleterious health outcomes. Current results suggest that healthcare discrimination may drive BIPOC college students' future healthcare avoidance both directly and through experiencing increased healthcare institutional betrayal during one's worst healthcare experience and resultant mistrust in healthcare. Due to the crucial role both discrimination and HIB experiences may play in healthcare outcomes, greater organizational adoption of anti-racist trauma-informed healthcare and the enactment of deliberate system-level repair strategies post discrimination and/or HIB is critical. Understanding the interplay of racial discrimination, HIB, and medical mistrust is also likely to help us address and repair system-level factors leading to anticipated healthcare avoidance behavior among BIPOC emerging adults.

Exploring the Role of Ethnic Identity, Attachment, and Family Prosocial Opportunities on BIPOC Adolescents' Anxiety and Depression

Black, Indigenous, and People of Color (BIPOC) adolescents experience oppressive mental health stressors and barriers to receiving treatment. Ethnic identity development, attachment to parents, and family prosocial opportunities have been associated with improved mental health outcomes in BIPOC adolescents, yet there is a dearth of literature examining the intersections of these variables on anxiety and depressive outcomes for this population. The purpose of this study was to examine the associations between ethnic identity development, attachment to parents, family prosocial opportunities, and anxiety and depressive symptoms in a sample of BIPOC adolescents (N = 1424) in the Northeastern United States. Attachment to father (B =  - 0.14, p < 0.01), family prosocial opportunities (B =  - 0.51, p < 0.001), and ethnic identity development (B =  - 0.20, p < 0.001) emerged as significant protective factors of anxiety. Similarly, attachment to father (B =  - 0.14, p < 0.01), attachment to mother (B =  - 0.19, p < 0.05), family prosocial opportunities (B =  - 0.55, p < 0.001), and ethnic identity development (B =  - 0.14, p < 0.01) were significantly associated with decreased depressive symptoms. These findings suggest implications related to culturally responsive mental health prevention and intervention efforts for practitioners who serve BIPOC adolescents.

Out of the Mouths of Babes: Black Children's Experiences of Emotion-Focused Racial-Ethnic Socialization, Coping, and Antiracist Resistance

Black children in the U.S. learn from scaffolded parental teachings to help manage racial discrimination. Middle childhood is an understudied developmental period for this research. This paper builds upon research on culturally informed practices Black caregivers use to rear their young with a healthy identity and socio-emotional skills to navigate racism Guided by a phenomenological qualitative approach, we conducted focus groups with 39 Black children (Meanage = 7.67, 54% girls, 46% boys). Children reported that their parents imparted a sense of positive identity in terms of their cultural heritage, skin, and hair-areas in which they experienced frequent bullying. A uniqueness of our study is that Black children also reported learning emotion-centered coping strategies that focus on their inner strengths and private speech. They adopted a range of adaptive coping mechanisms such as kindness, ignoring perpetrators, centering their positive identity, identity framing, and fighting back. Through children's voices, we build upon previous research integrating racial-ethnic socialization (RES) with socio-emotional competencies in response to discrimination. We underscore the importance of exploring racial-ethnic identity development and socialization in childhood, a developmental period in which these processes are understudied.

Racial-Ethnic Discrimination and Early Adolescents' Behavioral Problems: The Protective Role of Parental Warmth

OBJECTIVE

The purpose of the study was to investigate the association between discrimination by multiple sources (ie, teachers, students, and other adults) and early adolescents' behavioral problems (ie, internalizing, externalizing, and attention problems), also considering the protective role of parental warmth in the association.

METHOD

Cross-sectional analyses were conducted with 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development Study (ABCD Study) at year 1 follow-up (Y1), a large and diverse sample of children (mean age = 9.48 years) in the United States. Racially-ethnically minoritized adolescents reported sources of discrimination, parental warmth, and symptoms of psychopathology. Regression with interaction terms was conducted to investigate the associations among sources of discrimination, parental warmth, and behavioral problems among racially-ethnically minority adolescents. Sensitivity analyses were conducted to examine (1) race/ethnicity and sex/gender variations; (2) whether the associations between different sources of discrimination and behavioral problems were reliably different; and (3) effects of discrimination, parental warmth, and their interplay at Y1 in predicting adolescents' behavioral problems at year 2 follow-up.

RESULTS

Early adolescents experiencing interpersonal racial-ethnic discrimination by multiple sources, including teachers, students, and other adults, reported higher levels of attention, internalizing, and externalizing problems. Parental warmth was protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems.

CONCLUSION

Experiencing interpersonal racial-ethnic discrimination from teachers, peers, and other adults is related to heightened attention, internalizing, and externalizing problems among racially-ethnically minoritized early adolescents. Parental warmth may reduce the risk of developing behavioral problems among early adolescents who experience interpersonal racial-ethnic discrimination from students, teachers, and other adults outside of school.

PLAIN LANGUAGE SUMMARY

In this cross sectional analysis of 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development (ABCD) Study, the authors found that early adolescents experiencing interpersonal racial-ethnic discrimination from multiple sources, including teachers, students, and other adults, reported higher levels of behavioral problems (ie, internalizing, externalizing, and attention problems). Parental warmth was found to be protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems. These findings emphasize the importance of assessing experiences of interpersonal racial-ethnic discrimination among racially-ethnically minoritized early adolescents and contribute to the understanding of parental warmth as a protective factor for early adolescents to cope with such experiences.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Examining the integrated model of the interpersonal-psychological theory of suicide and intersectionality theory among Black male adolescents

INTRODUCTION

Guided by Opara et al.'s (2022), Integrated Model of the Interpersonal Psychological Theory of Suicide and Intersectionality Theory, the current study examined contextual stressors experienced disparately by Black youth (racial discrimination, poverty, and community violence) as moderators of the association between individual motivating factors for suicidal thoughts and behaviors (perceived burdensomeness, thwarted belongingness, and hopelessness) and active suicidal ideation.

METHOD

Participants were 457 Black adolescent boys (mean age = 15.31, SD = 1.26) who completed self-report surveys.

RESULTS

As predicted, the association between perceived burdensomeness and active suicidal ideation was significantly moderated by economic stress. In addition, the association between peer belongingness and suicidal ideation was significantly moderated by racial discrimination, but there were no moderating effects for school belongingness. Finally, the association between hopelessness and suicidal ideation was significantly moderated by both racial discrimination and witnessing community violence.

CONCLUSION

These findings highlight the need for research, interventions, and policy work devoted to using integrated approaches of individual and socioeconomically relevant patterns of suicidal thoughts and behaviors to support Black youth exposed to various forms of structural oppression.

How Racism and Discrimination Impacts Black Young Women's Sexual Health: The Influence of Racial and Sexual Stereotypes on Educational Access

PURPOSE

Structural racism and racial discrimination may increase adverse sexual health outcomes in Black adolescent girls. However, the influence of racism on sexual health has not been well-described in qualitative studies. The purpose of this study was to explore definitions of structural racism and determine how experiences of racial discrimination impact sexual health and decision-making in a sample of adolescent Black girls.

METHODS

Black girls aged 13-19 years were recruited from an ongoing longitudinal study. Virtual focus groups and individual interviews were facilitated, inquiring about understandings of structural racism, experiences with discrimination, and factors that influence sexual health decision-making and healthcare-seeking. Transcripts were professionally transcribed and coded by two independent, blinded team members. Thematic content analysis was used to identify emergent themes.

RESULTS

Four themes emerged as follows: (1) slavery and medical racism in the United States impact the sexual and reproductive health (SRH) choices of Black girls; (2) stereotypes and oversexualization of Black girls are considered a barrier to SRH education; (3) adults serve as both barriers and facilitators to SRH and resource utilization; and (4) Black girls often seek information from friends or social media outlets to make SRH decisions.

DISCUSSION

Reproductive health education for Black girls should integrate historical influences of systemic oppression. Practitioners should include reproductive justice to build trust in clinical and community spaces. Engaging caregivers in health education may reduce barriers for youth to engage in care.

Associations Between Adolescents' Exposure to Online Racism and Substance Use

With recent increases in adolescents' use of the Internet and social media, exposure to online racism and race-based violence has emerged as a critical public health concern. Recent studies have found that 45% to 94% of adolescents report exposure to online racism,1,2 which includes being a direct target of race-based discrimination or being exposed to others' experiences of racism (ie, vicarious exposure3). Exposure to online racism among adolescents is associated with greater symptoms of depression and anxiety and lower academic self-efficacy.4 Theory and prior research indicates that Black adolescents in particular experience higher levels of distress and mental health symptoms from exposure to anti-Black racism compared with White adolescents.1,5 Although prior research has found that exposure to racism is associated with substance use,6 gaps persist in the literature regarding the associations between online racism and substance use in adolescents.

"It Would Ruin My Life": Pacific Islander Male Adolescents' Perceptions of Mental Health Help-Seeking-An Interpretative Phenomenological Analysis Focus Group Study

Given rising mental health concerns among Pacific Islander (PI) adolescents, this population remains underserved by available mental health resources. This interpretative phenomenological analysis with focus groups (IPA-FG) examined the lived experiences and perceptions of 19 male PI adolescents (ages 14-16) from Native Hawaiian, Maori, Samoan, and Tongan backgrounds regarding mental health help-seeking behaviors. Four overarching themes emerged: stigma and judgment, cultural misalignment in professional services, impact of disclosure and perceived punitive consequences, and a complex ecosystem of trusted relationships as mental health support. Notably, participants expressed belief that disclosing mental health challenges would "ruin their lives" and held misconceptions about adults' ability to address mental health concerns. These findings are particularly significant given high suicidality rates among PI adolescents. This study provides insights for developing culturally responsive mental health interventions and highlights the urgent need to address mental health stigma within PI communities. Implications for practice are discussed.

Racial and nonracial discrimination and tobacco use among high school students in California

BACKGROUND

The public health literature has established a relationship between discrimination, health outcomes, and health and well-being in adolescence. The objective of this study is to add vaping to the existing studies on discrimination and tobacco use among youth. To achieve this objective, the analysis examined the relationship between discrimination, type of discrimination, and current tobacco use, including current vape use, among adolescents in California.

METHODS

This study uses data from the 2023 California Youth Tobacco Survey, which was administered to a representative sample of middle and high school students (8th, 10th, and 12th graders) attending public and private schools in California. The analysis focused on high school students in public schools. Outcome variables were current use of any tobacco product and current vape use. Predictor variables were any, racial, and nonracial discrimination. Covariates included race/ethnicity, gender identity and sexual orientation, and age. Separate logistic regression models examined the relationship between any discrimination or racial and nonracial discrimination and current tobacco use or current vape use, adjusting for covariates. Analyses were adjusted by sampling weights and stratification variables to account for complex sampling techniques.

RESULTS

Any, racial, and nonracial discrimination were associated with significantly higher odds of current tobacco use. Any discrimination was also associated with significantly higher odds of current vape use. Nonracial, but not racial, discrimination was significantly associated with significantly higher odds of current vape use.

CONCLUSION

The results of this analysis are consistent with other analyses demonstrating a significant positive relationship between experiences of discrimination and tobacco use. These results contribute to existing knowledge by revealing that this relationship also exists for vaping among youth. Discrimination remains a public health crisis, including for youth in California. Increased use of supportive, rather than punitive, tobacco control approaches and cessation resources should be considered for schools in California.

Emotional Health of Immigrant Adolescents by a Cross-Lagged Panel Network Analysis: Self-Esteem and Depression

Background/Objectives: The study investigated the dynamic interrelations of both positive and negative self-esteem with depression among immigrant adolescents. Methods: Longitudinal data from the Children of Immigrants Longitudinal Study (CILS) were analyzed using a Cross-Lagged Panel Network (CLPN) model. Results: The results showed strong autoregressive effects; both the positive and negative dimensions of self-esteem and symptoms of depression were fairly stable across the two measurement times. Cross-lagged effects indicated that higher levels of positive self-esteem predicted reduced depressive symptoms; for example, higher self-worth at Time 1 was associated with a lower lack of motivation at Time 2. However, some components, for instance, positive self-attitude, predicted in greater sadness from Time 1 to Time 2. On the other hand, certain dimensions of negative self-esteem, such as feeling useless at Time 1, were related to decreases in depressive symptoms at Time 2, which points to complex and bidirectional effects that challenge traditional hypotheses on how self-esteem may affect mental health. Conclusions: The current study teases apart sub-components of self-esteem and, in doing so, demonstrates how different facets uniquely predict depression over time and inform nuanced mental health trajectories among immigrant youth. The findings indicate that selective self-esteem interventions should be carried out to enhance resilience and mental well-being in adolescents from diverse backgrounds.

Social Maltreatment and Symptomatology: Validating the Social Discrimination and Maltreatment Scale-Short Form in a Diverse Online Sample

There are few psychometrically valid measures of exposure to social maltreatment that simultaneously assess sexism, racism, and anti-LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and other nonheteronormative) behavior, despite the commonness of these phenomena. The Social Discrimination and Maltreatment Scale (SDMS) meets this requirement but is, as a result, somewhat lengthy (36 items). This article introduces a short form of the SDMS containing only half the number of items but generally retaining the psychometric qualities of the original measure. The 18-item Social Discrimination and Maltreatment Scale-Short Form (SDMS-SF) consists of six SDMS stem items (e.g., I have been disrespected, People made cruel or demeaning jokes about me) each of which is rated according to how often it had happened "because of my sex," "because of my race," and "because of my sexual orientation or gender identity." In the SDMS online sample (N = 528), SDMS-SF Sexism, Racism, and Cisheterosexism subscales were validated by confirmatory factor analysis and were internally consistent (α = .91-.95) and highly correlated with the original SDMS subscales (r = .94 in all cases). All SDMS-SF subscales correlated with self-reported anxiety, depression, and posttraumatic stress (mean r = .29), corresponding to a medium effect size. In all but one instance, related SDMS and SDMS-SF subscales did not differ significantly in the strength of their association with symptomatology. Together, these results suggest that the SDMS-SF is a reliable and valid measure of social discrimination, generally equivalent to the SDMS despite containing only half as many items.

Discrimination, critical consciousness, and mental health in American youth of color

To resist and cope with oppression, youth of color may use the process of critical consciousness which involves understanding racial injustices (critical reflection), developing motivation to fight these injustices (critical motivation), and taking action to enact sociopolitical change (critical action). However, little is known about how each dimension of critical consciousness affects mental health in adolescents of color. In a sample of 367 ethnically and racially diverse American adolescents of color (age range = 13-17; 68.9% girls, 28.6% boys, and 2.5% gender minority; 84.4% US-born), we conducted multivariate regressions in Mplus to examine the cross-sectional links between each critical consciousness dimension (reflection, motivation, and action) and mental health outcomes (anxiety, depression, and stress) over and above the impact of everyday discrimination. We also investigated the interaction between critical consciousness and discrimination in predicting mental health outcomes. Controlling for age, gender, nativity, and social class, we found that discrimination and critical action were both positively associated with anxiety, depression, and stress. For our covariates, girls and gender minority adolescents reported worse outcomes. No interactions were significant. Overall, critical action, while necessary to enact societal change, may have a complex relationship with youth's depression, anxiety, and psychological stress symptoms and warrants careful exploration. Future research should focus on understanding the longitudinal mechanisms of critical action and how we can maximize the benefits by protecting youth from those negative effects.

The Relationship Between Perceived Discrimination and Social Adaptation of Migrant Workers' Children: The Role of Alienation and Psychological Capital

This study explores the relationship between perceived discrimination and social adaptation of migrant workers' children, as well as the mediating role of sense of alienation and the moderating role of psychological capital. A multi-stage-multi-source longitudinal study design was adopted. A total of 423 Chinese migrant workers' children (Mage = 13.36, Female ratio = 39.48%) were recruited, and sample data were collected at three time points for 6 months. The results indicated that the interpersonal alienation played a mediating role between discriminatory perception and social adaptation. Psychological capital moderated the relationship between perceived discrimination and interpersonal alienation. Compared to participants with high psychological capital, interpersonal alienation played a stronger mediating role between perceived discrimination and social adaptation among those with low psychological capital. Perceived discrimination could reduce the level of social adaptation of migrant workers' children through interpersonal alienation. The social adaptation of migrant workers' children could be improved by improving the level of psychological capital.

Longitudinal Changes in Epigenetic Age Acceleration Across Childhood and Adolescence

Importance

Individuals exposed to discrimination may exhibit greater epigenetic age acceleration (ie, cellular indicators of premature aging) over time, but few studies have examined longitudinal changes in epigenetic age acceleration, the heterogeneity in these changes for diverse groups of youths, and contextual explanations (ie, discrimination) for differences by ethnicity or race.

Objective

To provide a descriptive illustration of changes in epigenetic age acceleration across childhood and adolescence among an ethnically and racially diverse sample of youths.

Design, Setting, and Participants

This cohort study leveraged longitudinal data on a large sample of youths from low-income households in 20 large urban US cities who provided repeated assessments of saliva tissue samples at ages 9 and 15 years for DNA methylation analysis. Of 4898 youths from the Future of Families and Child Well-Being study, an ongoing study that oversampled children born to unmarried parents from 1998 to 2000, 2039 were included in the present analysis, as these youths had salivary DNA methylation data assayed and publicly available. Analyses were conducted from March 2023 to June 2024.

Exposures

Racialized intrusive encounters with police (eg, stop and frisk and racial slurs).

Main Outcomes and Measures

Analyses were conducted to examine longitudinal changes in salivary epigenetic age acceleration over time, whether such changes varied across ethnically and racially diverse groups of youths, and whether police intrusion was associated with variation across ethnic and racial groups.

Results

Among 2039 youths (mean [SD] age at baseline, 9.27 [0.38] years; 1023 [50%] male and 1016 [50%] female; 917 [45%] Black, 430 [21%] Hispanic or Latino, 351 [17%] White, and 341 [17%] other, including multiple races and self-identified other) with salivary epigenetic clocks at 9 and 15 years of age, longitudinal results showed that White youths exhibited less accelerated epigenetic aging over time than did Black and Hispanic or Latino youths and those reporting other or multiple races or ethnicities from ages 9 to 15 years, particularly in the Hannum (B, 1.54; 95% CI, 0.36-2.18), GrimAge (B, 1.31; 95% CI, 0.68-1.97), and DunedinPACE epigenetic clocks (B, 0.27; 95% CI, 0.11-0.44). Across these clocks and the PhenoAge clock, police intrusion was associated with Black youths' more accelerated epigenetic aging (Hannum: B, 0.11; 95% CI, 0.03-0.23; GrimAge: B, 0.09; 95% CI, 0.03-0.18; PhenoAge: B, 0.08; 95% CI, 0.02-0.18; DunedinPACE: B, 0.01; 95% CI, 0.01-0.03).

Conclusions and Relevance

The transition from childhood to adolescence may represent a sensitive developmental period when racism can have long-term deleterious impacts on healthy human development across the life span. Future research should build on the present study and interrogate which social regularities and policies may be perpetuating discrimination against ethnically and racially minoritized adolescents.

Discrimination Exposure, Neural Reactivity to Stress, and Psychological Distress

OBJECTIVE

Discrimination exposure has a detrimental impact on mental health, increasing the risk of depression, anxiety, and posttraumatic stress. The impact discrimination exposure has on mental health is likely mediated by neural processes associated with emotion expression and regulation. However, the specific neural processes that mediate the relationship between discrimination exposure and mental health remain to be determined. The present study investigated the relationship adolescent discrimination exposure has with stress-elicited brain activity and mental health symptoms in young adulthood.

METHODS

A total of 301 participants completed the Montreal Imaging Stress Task while functional MRI data were collected. Discrimination exposure was measured four times from ages 11 to 19, and stress-elicited brain activity and psychological distress (depression, anxiety, posttraumatic stress) were assessed in young adulthood (age 20).

RESULTS

Stress-elicited dorsolateral and dorsomedial prefrontal cortex (PFC), inferior parietal lobule (IPL), and hippocampal activity varied with discrimination exposure. Activity within these brain regions varied with the cumulative amount and trajectory of discrimination exposure across adolescence (initial exposure, change in exposure, and acceleration of exposure). Depression, anxiety, and posttraumatic stress symptoms varied with discrimination exposure. Stress-elicited activity within the dorsolateral PFC and the IPL statistically mediated the relationship between discrimination exposure and psychological distress.

CONCLUSIONS

The findings suggest that adolescent discrimination exposure may alter the neural response to future stressors (i.e., within regions associated with emotion expression and regulation), which may in turn modify susceptibility and resilience to psychological distress. Thus, differences in stress-elicited neural reactivity may represent an important neurobiological mechanism underlying discrimination-related mental health disparities.

Different contexts - different stories: Adolescents' experiences of how ethnicity is addressed in schools and sports and on social media in Sweden

Ethnicity plays a significant role in adolescents' everyday lives, but there is a limited understanding of adolescents' own experiences with how ethnicity is addressed in different contexts. Three contexts of importance during adolescence are investigated in the present study: schools, social media, and sports. A closer contextual examination has the potential to provide insights into how multiple contexts shape experiences with ethnicity. The aim of the study was to understand more about adolescents' experiences of how ethnicity is addressed in schools, on social media, and in sports. Six focus groups with a total of 21 adolescents (Mage = 14.5, SDage = 0.5, female = 76%) discussed their experiences. Data were transcribed verbatim and analyzed using a close-to-data, inductive thematic analysis. The analysis resulted in three main themes and seven subthemes, indicating that ethnicity was addressed differently in the three studied contexts. For the main theme of how ethnicity was addressed in schools, the subthemes were: Addressing ethnicity is important; Ethnicity is addressed through stereotypes and Everyday racism. The main theme of ethnicity on social media consisted of two subthemes: Sharing ethnic and cultural narratives and Hateful remarks. The main theme of ethnicity in sports also consisted of two subthemes: On equal terms and Clear consequences for racist behaviors. To better understand the multiple contexts, the results are discussed guided by the ecological systems theory. The adolescents highlighted that there are many benefits of addressing ethnicity and that it is important to do so in multiple contexts of adolescent life, just not in the same way. When ethnicity was addressed carelessly, such as through stereotypes or via racism masked as jokes, it had the potential to cause harm. When ethnicity was addressed with reflection, it instead had the potential to build understanding, lead to positive experiences, and provide learning opportunities.

Ethnic-racial discrimination and socialization: Short-term longitudinal effects on Black and Latinx young adults' ethnic-racial identity

Short-term longitudinal data were used to examine how racial discrimination, cultural socialization (CS), and preparation for bias (PB) related to Black and Latinx young adults' public and private regard. Black (n = 90) and Latinx (n = 54) young adults (Mage = 20 years) were assessed at two time points, 6 weeks apart. Racial discrimination predicted lower levels of public regard 6 week later; whereas PB predicted greater levels of private regard. CS moderated the relations between racial discrimination and private regard suggesting that at low levels of CS, discrimination related to lower private regard 6 weeks later. Findings demonstrate the short-term effects of racial discrimination and suggest that ethnic-racial socialization is a salient cultural resource for young adults.

The association between experiences of unfair treatment in school and adolescent adjustment over 5 years

This study investigates how high-school experiences of unfair treatment connect to adolescents' higher education enrollment and life satisfaction 5 years later. We utilized four waves of data at ages 14 years (T1), 16 (T2), 18 (T3) and 19 (T4) in the UK (N = 13,065; 51% Male, 49% Female, 70% White, 11% Black, 19% South-Asian). Perceived teacher unfairness at T1 predicted lower university aspirations (T2) and subsequently lower enrollment in higher education (at T3 and T4) and life satisfaction (T4). Experiences with T1 teacher ethnic discrimination also predicted lower life satisfaction. The effects were similar across historically minoritized and majority-background pupils, but historically minoritized adolescents experienced more ethnic discrimination in school. Our findings highlight the importance of fair treatment for all pupils.

Disentangling the directionality among cultural stressors and psychosocial outcomes in recently immigrated Hispanic families: A random intercept cross-lagged panel model approach

Research shows the impact of cultural stressors (e.g. perceived discrimination, bicultural stressors, negative context of reception) on adolescents' psychosocial outcomes. Given the presence of multiple cultural stressors in many Hispanic adolescents' lives, it is essential to examine the (a) developmental sequencing of cultural stressors among recent immigrant youth and (b) predictive effects of cultural stressors on adolescents' psychosocial outcomes. We employed a random intercept cross-lagged panel model to examine the longitudinal interplay among cultural stressors and their effects on youth outcomes using longitudinal data with six waves among 302 recently immigrated Hispanic adolescents (47% girls, Mage = 14.51, SD = .88). We observed bidirectional within-person relations and between-person associations among cultural stressors. At the within-person level, bidirectional cross-lagged effects emerged between perceived discrimination and bicultural stress, between perceived discrimination and negative context of reception, and between negative context of reception and bicultural stress. At the between-person level, bidirectional cross-lagged effects emerged only between perceived discrimination and bicultural stressors. Our findings indicate that cultural stressors explain heterogeneity in psychosocial outcomes: self-esteem was inversely predicted by all cultural stressors, whereas depressive symptoms were predicted only by perceived discrimination. In addition, optimism was predicted only by bicultural stressors, and externalizing behavior was predicted by both bicultural stressors and perceived discrimination. These results suggest that the longitudinal relationships among cultural stressors are (partly) bidirectional. Additionally, cultural stressors demonstrated differential predictive effects on psychosocial outcomes, indicating the added value of considering multiple cultural stressors and their longitudinal effects on adolescents' psychosocial outcomes.

Coping with ethnic-racial discrimination: Protective-reactive effects of shift-and-persist coping on internalizing symptoms among Black American adolescents

Ethnic-racial discrimination has pervasive negative effects on Black youth's mental health; therefore, it is crucial to identify factors that provide resilience against discrimination. Two promising factors to help youth cope are ethnic-racial identity (how one feels about their ethnicity/race) and shift-and-persist coping (reappraising and accepting an uncontrollable stressor while remaining optimistic about the future). While there is existing scholarship on ethnic-racial identity among Black youth, this work has not yet assessed the impacts of shift-and-persist in this population. Using a sample of 155 Black youth (ages 13-17), the current study examined the interplay between discrimination, ethnic-racial identity, shift-and-persist coping, and internalizing symptoms. Symptoms of depression and anxiety were positively associated with discrimination and negatively associated with shift-and-persist. Significant interactions between discrimination and shift-and-persist predicting both depressive and anxiety symptoms revealed significant negative associations between shift-and-persist and internalizing symptoms at low and average, but not high discrimination levels. Effects are, thus, protective-reactive; the protective effects of shift-and-persist are not significant for youth facing high levels of discrimination. Ethnic-racial identity, surprisingly, was not significantly associated with either depressive or anxiety symptoms, nor did it interact with shift-and-persist as it has in studies of Latinx youth. By understanding the protective benefits of shift-and-persist and ethnic-racial identity in Black youth, during a pivotal period for mental health, we can provide this growing population with tools to lessen the maladaptive outcomes associated with discrimination.

Parental support in adolescence: A potential moderator of the relationship between racial discrimination and adult suicidality

OBJECTIVES

It is critical to understand supportive factors that may help mitigate the negative effects of racial discrimination on mental health. Supportive family environments positively impact adolescent health, yet less is known about the impact of family support on adult health outcomes as a consequence of experiences of racial discrimination. The primary objective of this study was to evaluate parental support in adolescence as a potential moderator of the relationship between racial discrimination and mental health, specifically stress and suicidality, in adulthood.

STUDY DESIGN

Secondary data analysis.

METHODS

We performed a secondary data analysis using data from waves I (grades 7-12), IV (ages 24-32), and V (ages 32-42) of the National Longitudinal Study of Adolescent to Adult Health (N = 1523).

RESULTS

Univariate logistic regression models showed that racial discrimination was significantly associated with an increased likelihood of suicidality in adulthood (Odds Ratio = 12.94, 95 % Confidence Interval = [4.69, 35.73]). Multivariate models showed similar findings. Racial discrimination was also significantly associated with increased stress scores in adulthood, though with a small effect. Maternal, paternal, and overall parental support in adolescence did not moderate these relationships. This remained true in racial and ethnic subgroup analyses.

CONCLUSIONS

Parental support includes a variety of behaviors that may not have been fully captured in the measures used in this study. Potential moderating effects should be evaluated using alternative measures of parental support that may better capture these behaviors.

Exploring the educational journey: perspectives of ethnic minority GP-trainees in Dutch GP-specialty training - a qualitative interview study

BACKGROUND

Previous research highlights persistent differential attainment by ethnicity in medical education, wherein the perceived inclusiveness significantly influences ethnic minority students' and trainees' outcomes. Biased organizational practices and microaggressions exacerbate the challenges faced by ethnic minorities, leading to lower academic performance and higher dropout rates. Consequently, understanding ethnic minority GP-trainees' experiences and perspectives regarding relevant educational aspects is crucial for addressing these disparities and cultivating a more inclusive environment within medical education.

RESEARCH QUESTION

We aimed to investigate the experiences of minority GP-trainees throughout their educational journey in Dutch GP-specialty training, emphasizing their challenges, sources of support, and suggestions for enhancing their learning environment.

METHOD

We conducted semi-structured, in-depth interviews with minority GP trainees, employing purposive convenience sampling to ensure diversity across multiple dimensions. These included gender, age, ethnicity, social background, migration generation, educational stage, encountered challenges, sources of support, and the GP training institute attended. The analysis involved iterative, open and axial coding, followed by generating, reviewing, and defining themes. For a structured analysis of encountered microaggressions, we adopted Sue's Taxonomy of Microaggressions.

RESULTS

All fourteen ethnic minority interviewees had faced educational barriers stemming from misunderstandings and stereotyping in a predominantly 'white' organization. These barriers impacted various aspects of their education, including professional identity formation, application, admission, assessment procedures, social networks, course content, and expert guidance. Microaggressions permeated throughout their educational journey, hindering their full expression and potential. Their ideal GP-specialty training emphasized uniqueness of all trainees, comprehensive staff engagement in inclusivity, robust diversity, equity, and inclusion (DEI)-policies, individual mentorship, transparent standards, concise language usage in test questions, and bias elimination through mandatory DEI staff training.

CONCLUSION

Ethnic minority GP-trainees in the Netherlands face significant challenges like biased assessment and admission, stereotyped course content, inadequate support networks, and microaggressions, putting them at risk for underperformance outcomes. They emphasize the need for inclusive training with robust DEI-policies to eliminate bias.

Associations of stressful life events with stress symptoms and well-being of adolescent refugees: mediation by post-migration stressors and protective resources?

OBJECTIVE

This paper focuses on the relationship between stressful life events experienced by young refugees and their reports of psychological and somatic stress symptoms and well-being. It examines whether this relationship is mediated by personal and social resources and by acculturation hassles experienced in the host country.

METHODS

Path analyses were calculated based on data from 147 adolescents aged 11 to 18 years from the Middle East after their flight to Germany to test the proposed mediation model.

RESULTS

The number of experienced stressful life event types was directly linked to current psychological and somatic stress symptoms. The association with psychological stress symptoms was partially mediated by acculturation hassles experienced in the host culture. Well-being was not related to stressful life events but showed significant associations with available social resources. A closer inspection of the mediation by acculturation hassles showed that discrimination hassles and socio-cultural adaptation hassles are important mediators in the relationship between stressful life events and the included outcome variables.

CONCLUSION

The results indicate that stressful life events as well as resources and acculturation hassles should be considered in measures to improve the adjustment of young refugees.

Parent and Peer Racial-Ethnic Socialization Facilitates Psychological Well-Being Via Proactive Coping: A Daily Diary Study

OBJECTIVE

The aim of this study was to assess the promotive and protective effects of parental and peer racial-ethnic socialization (RES) on adolescents' psychological well-being in the context of racial-ethnic discrimination. We hypothesized that RES would buffer the pernicious effects of discrimination on well-being by promoting more proactive coping (problem solving, seeking social support) and less avoidant coping responses.

METHOD

Participants were a nationally representative sample of 371 ethnoracially minoritized adolescents who were recruited through a research survey panel (51.75% assigned female sex at birth; 46.90% Black, 24.80% Latine, 20.22% Asian/Asian American; mean age = 14.47 years, SD age = 1.46 years, range = 10-19 years). Participants completed daily surveys of exposure to racial-ethnic discrimination, RES, coping, and psychological well-being across 30 days.

RESULTS

Results indicated parental cultural socialization promoted more positive next-day well-being via increased problem-solving coping (unstandardized B = 0.01, SE = 0.01, p < .05). The same pattern of findings emerged when examining cultural socialization messages from peers (unstandardized B = 0.02, SE = 0.01, p < .01) and preparation for bias messages from parents (unstandardized B = 0.02, SE = 0.01, p < .01). RES significantly moderated the effects of racial-ethnic discrimination on avoidance coping.

CONCLUSION

Findings suggest that RES from parents and peers may promote more positive psychological well-being in adolescents by facilitating proactive coping processes on days when they experience racial-ethnic discrimination. Overall, the study points to the need for continued efforts to develop, test, and disseminate evidence-based approaches to strengthening RES competency, as doing so may be a critical avenue for cultivating resilience among ethnoracially minoritized youth.

Racism and health and wellbeing among children and youth-An updated systematic review and meta-analysis

BACKGROUND

Evidence of racism's health harms among children and youth is rapidly increasing, though attention to impacts on physical health and biomarker outcomes is more emergent. We performed a systematic review of recent publications to examine the association between racism and health among children and youth, with a meta-analysis of the specific relationships between racism and physical health and biomarkers.

METHODS

We conducted a systematic literature search using four databases: Medline, PsycINFO, PubMed, and ERIC. Four inclusion criteria were used to identify eligible studies: (1) exposure was experiences of racism, (2) outcome was health and wellbeing, (3) quantitative methods were used to estimate the association between racism and health outcomes, and (4) the effect size of associations between racism and health and wellbeing was reported for participants aged 0-24 years. Correlation coefficients were used to report the pooled effect size for each outcome indicator.

RESULTS

There were 463 eligible studies included in the screening process, with 42 studies focusing on physical health or biomarker outcomes. Random-effects meta-analysis found minimal to moderate positive associations between racism and C-reactive protein, Interleukin 6, body mass index (BMI), obesity, systolic blood pressure, salivary cortisol, asthma, and somatic symptoms. There were marginal positive associations between racism and Tumour Necrosis Factor-α, cortisol collected via saliva, urine and hair, BMI-z score, and diastolic blood pressure, with imprecise estimates and wide confidence intervals.

CONCLUSIONS

Racism is associated with negative physical health and biomarker outcomes that relate to multiple physiological systems and biological processes in childhood and adolescence. This has implications for health and wellbeing during childhood and adolescence and future chronic disease risk. Collective and structural changes to eliminate racism and create a healthy and equitable future for all children and youth are urgently required.

Trajectories of ethnic discrimination and school adjustment of ethnically minoritized adolescents: The role of school diversity climate

This study investigated trajectories of ethnic discrimination experiences in school, diversity climates as contextual antecedents, and school adjustment as outcome. Latent-Growth-Mixture-Models of repeated self-reported discrimination over 3 years (2012-2015) by 1445 ethnically-minoritized adolescents of Turkish and Moroccan background in 70 Belgian schools (52.6% boys, M age = 15.07) revealed four trajectories: low (72.5%), moderate (16.6%), initially-high (6.5%), or increasingly high discrimination (4.4%). Adolescents who attended schools with more minoritized peers, or schools that valued cultural diversity and equality, were more often in low-discrimination trajectories, which predicted better academic outcomes. Overall, school diversity climates can protect minoritized adolescents from experiencing persistent or initially high discrimination over time. Moreover, high discrimination at any point in schooling-initially or later-is harmful to adolescents' school adjustment.

Racial and ethnic socioenvironmental inequity and neuroimaging in psychiatry: a brief review of the past and recommendations for the future

Neuroimaging is a major tool that holds immense translational potential for understanding psychiatric disorder phenomenology and treatment. However, although epidemiological and social research highlights the many ways inequity and representativeness influences mental health, there is a lack of consideration of how such issues may impact neuroimaging features in psychiatric research. More specifically, the potential extent to which racialized inequities may affect underlying neurobiology and impact the generalizability of neural models of disorders is unclear. The present review synthesizes research focused on understanding the potential consequences of racial/ethnic inequities relevant to neuroimaging in psychiatry. We first discuss historical and contemporary drivers of inequities that persist today. We then discuss the neurobiological consequences of these inequities as revealed through current research, and note emergent research demonstrating the impact such inequities have on our ability to use neuroimaging to understand psychiatric disease. We end with a set of recommendations and practices to move the field towards more equitable approaches that will advance our abilities to develop truly generalizable neurobiological models of psychiatric disorders.

Being as Having, Loving, and Doing: A Theory of Human Well-Being

ACADEMIC ABSTRACT

Stronger theory on the nature of human well-being is needed, especially as well-being indicators are increasingly utilized in policy contexts. Building on Erik Allardt, who argued that a theory of well-being is, in essence, a theory of human nature, I propose four modes of existence each capturing one dimension central to human well-being: Having recognizes humans as biological creatures requiring certain material resources for survival. Loving captures human social nature and our dependence on others for well-being. Doing highlights the active and agentic nature of human existence. Being acknowledges humans as experiencing their existence. Each mode of existence gives rise to a few more specific needs, and a full assessment of human well-being requires both subjective and objective indicators tapping into these needs. The proposed theory integrates psychological well-being research with sociological and philosophical traditions and contributes to debates about how the progress of nations and sustainability should be measured.

PUBLIC ABSTRACT

Well-being is something we all value individually, and it is also a key political goal. Accordingly, how we define and measure well-being influences what physicians, managers, policy-makers, politicians, and international organizations aim to improve through their work. Better theories of well-being make better measurement of well-being possible, which makes possible more effective and evidence-based advancement of human well-being. In this spirit, the present article argues that there are four fundamental dimensions to human well-being: Having highlights that as biological creatures, we have physical needs, loving highlights human social needs, doing highlights that we are active and agentic beings with goals and strivings, and being highlights that we feel and evaluate our lives. To assess well-being, we need measures tapping into all four of these dimensions. And to assess the sustainability of well-being, we need to examine how to provide well-being for all humanity while remaining within planetary boundaries.

Profiles of Suicidal Ideation Among Black Male Adolescents: Examination of Individual and Socioecological Predictors

OBJECTIVE

The current study utilized latent profile analysis to identify distinct profiles of suicidal ideation among Black male adolescents and compared profiles on socioecological determinants of suicide and psychological symptoms.

METHOD

A sample of 457 Black male adolescents (mean age = 15.31, SD = 1.26) completed self-report measures of suicidal ideation, racial discrimination, community violence exposure, anxiety symptoms, depressive symptoms, and posttraumatic stress symptoms.

RESULTS

Results of the latent profile analysis revealed a three-profile model: a low ideation profile, with low levels of all forms of suicidal ideation; a general death ideation profile with elevated general thoughts of death and dying; and a high, concealed ideation profile with high levels on all suicidal ideation items, except communicating the ideation to others. ANOVAs revealed that levels of psychological symptoms were significantly different for each profile, with the high, concealed ideation profile showing the highest levels. The low ideation profile had significantly lower scores than the two other profiles on community violence exposure, but the other two profiles did not differ significantly from one another. Further, the general death ideation profile had significantly higher scores on racial discrimination than the other two profiles, but the other two profiles did not differ significantly from one another.

CONCLUSIONS

The current study supports recent socio-cultural theories of suicidal ideation and behavior in Black youth and highlights the need for increased access to care and services for Black boys who are exposed to socioecological factors that heighten suicidal ideation.

Yearly and Daily Discrimination-Related Stressors and Mexican Youth's Mental Health and Sleep: Insights From the First Wave of a Three-Wave Family Study

OBJECTIVE

Research is needed to examine discrimination-related stressors and their social and psychological shaping of mental health and sleep outcomes of Latinx youth. The background, design, and methodology of a longitudinal study of Mexican families in Indiana and the initial findings of associations between discrimination-related stressors and youth mental health and sleep outcomes are presented.

METHOD

Initiating wave 1 of a 3-wave (yearly) longitudinal study, investigators surveyed an ethnically homogeneous sample of 344 Mexican-origin adolescents (ages 12-15) and their primary caregivers, assessing risks and protective factors for mental health and sleep outcomes. Youth also completed a one-time 21-day daily diary after wave 1. Self-reported measures of youth mental health, sleep, and discrimination across wave 1 and the daily diary were evaluated to compare the cross-sectional (wave 1) and daily associations between discrimination and youth mental health and sleep outcomes.

RESULTS

Of youth, 88.1% reported at least one incident of lifetime discrimination. Almost one-third had elevated depressive symptoms, 44.5% had probable generalized anxiety disorder, and 50.9% had poor sleep quality. Between-youth correlations at wave 1 and in the daily diary were consistent in that perceived racial discrimination was positively correlated with worse mental health and poorer sleep quality. Smaller within-youth correlations were observed in the daily diary, but there was striking variability in the effect of discrimination across youth.

CONCLUSION

The present results illustrate the powerful methods of combining yearly and daily time data to investigate how and for whom discrimination-related stressors lead to adverse outcomes.

PLAIN LANGUAGE SUMMARY

Latinx youth are the largest and fastest growing minoritized youth group in the United States. This study surveyed 344 Mexican-origin adolescents and their primary caregivers to assess risk and protective factors for mental health and sleep outcomes. The authors found that 88.1% of youth reported at least one incident of lifetime discrimination, 29.7% reported elevated depressive symptoms, 44.5% reported elevated anxiety symptoms, and 50.9% reported poor sleep quality. Youth who experienced racial discrimination were more likely to have worse mental health and lower sleep quality than those who did not experience racial discrimination.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

CLINICAL TRIAL REGISTRATION INFORMATION

Seguimos Avanzando - Latino Youth Coping With Discrimination; https://clinicaltrials.gov/; NCT04875208.

The effect of social withdrawal on life satisfaction among multicultural adolescents: The mediating and moderating effects of parental support

Background

The number of multicultural adolescents is continuously increasing, and they tend to experience more psychological difficulties than their non-multicultural peers.

Objective

This study investigates the mediating and moderating effects of parental support on the relationship between social withdrawal and life satisfaction among multicultural adolescents.

Methods

This secondary data analysis utilized the Multicultural Children & Adolescents Panel Survey conducted by the National Youth Policy Institute. The analysis included data from 2018 and involved 1197 multicultural adolescents. The data were analyzed using the R-Statistics 4.1.1 program.

Results

Social withdrawal and parental support had a detrimental impact on life satisfaction among multicultural adolescents. Parental support also played a partial mediating role in the connection between social support and life satisfaction. Furthermore, parental support was a moderating factor capable of mitigating the negative influence of social withdrawal on life satisfaction.

Conclusion

Measures to reduce social withdrawal and increase parental support are very effective in improving the life satisfaction of multicultural adolescents. More focused professional intervention measures for social withdrawal and parental support must be considered when seeking and preparing support measures to improve the life satisfaction of multicultural adolescents.

Experiences of Racism in School and Associations with Mental Health, Suicide Risk, and Substance Use Among High School Students - Youth Risk Behavior Survey, United States, 2023

Racism is a fundamental determinant of health inequities among racial and ethnic groups and is understudied among adolescents. In 2023, the national Youth Risk Behavior Survey questionnaire included an item assessing experiences of racism in the school setting among students in grades 9-12 in the United States. This report estimates the prevalence of students who reported ever having experienced racism in school and compares prevalence by racial and ethnic groups. For each racial and ethnic group, prevalence differences and prevalence ratios were estimated comparing the prevalence of indicators of poor mental health, suicide risk, and substance use among students who reported that they have ever versus never experienced racism in school. In 2023, approximately one in three high school students (31.5%) said that they had ever experienced racism in school. Reported experiences of racism were most prevalent among Asian (56.9%), multiracial (48.8%), and Black or African American (Black) (45.9%) students and least prevalent among White students (17.3%). Black and Hispanic or Latino (Hispanic) students who reported experiencing racism had a higher prevalence of all health risk behaviors and experiences investigated, including indicators of poor mental health, suicide risk, and substance use compared with students of their racial and ethnic group who reported never experiencing racism. Many of these associations were also found among multiracial and White students. Student reports of racism were associated with indicators of mental health and suicide risk among American Indian or Alaska Native (AI/AN) and Asian students. Among students of color, including AI/AN, Asian, Black, Hispanic, and multiracial students, the prevalence of seriously considering and attempting suicide was more than two times higher among students who ever compared with never experienced racism. These findings demonstrate that racism in the school setting is experienced by high school students attending public and private schools and continues to disproportionately affect students of color. Students who reported experiencing racism had a higher prevalence of indicators of poor mental health, suicide risk, and substance use. Schools can incorporate policies and practices to prevent unfair treatment on the basis of race and ethnicity and offer resources to help students cope with these experiences.

Beyond the stereotypes: Artificial Intelligence image generation and diversity in anesthesiology

Introduction

Artificial Intelligence (AI) is increasingly being integrated into anesthesiology to enhance patient safety, improve efficiency, and streamline various aspects of practice.

Objective

This study aims to evaluate whether AI-generated images accurately depict the demographic racial and ethnic diversity observed in the Anesthesia workforce and to identify inherent social biases in these images.

Methods

This cross-sectional analysis was conducted from January to February 2024. Demographic data were collected from the American Society of Anesthesiologists (ASA) and the European Society of Anesthesiology and Intensive Care (ESAIC). Two AI text-to-image models, ChatGPT DALL-E 2 and Midjourney, generated images of anesthesiologists across various subspecialties. Three independent reviewers assessed and categorized each image based on sex, race/ethnicity, age, and emotional traits.

Results

A total of 1,200 images were analyzed. We found significant discrepancies between AI-generated images and actual demographic data. The models predominantly portrayed anesthesiologists as White, with ChatGPT DALL-E2 at 64.2% and Midjourney at 83.0%. Moreover, male gender was highly associated with White ethnicity by ChatGPT DALL-E2 (79.1%) and with non-White ethnicity by Midjourney (87%). Age distribution also varied significantly, with younger anesthesiologists underrepresented. The analysis also revealed predominant traits such as "masculine, ""attractive, "and "trustworthy" across various subspecialties.

Conclusion

AI models exhibited notable biases in gender, race/ethnicity, and age representation, failing to reflect the actual diversity within the anesthesiologist workforce. These biases highlight the need for more diverse training datasets and strategies to mitigate bias in AI-generated images to ensure accurate and inclusive representations in the medical field.