Alex L. Pieterse

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

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

Racism as a Determinant of Health: A Systematic Review and Meta-Analysis

Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.

An examination of the relationship between general life stress, racism-related stress, and psychological health among black men.

This study explored the relationship among general life stress, racism-related stress, and psychological health in a sample of 220 Black men. Participants completed a personal data form, the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983), a modified version of the Schedule of Racist Events (H. Landrine & E. A. Klonoff, 1996), and the Mental Health Inventory (C. T. Veit & J. E. Ware, 1983). Results of hierarchical regressions indicated that when general stress was controlled, racism-related stress predicted an additional 4% of variance in psychological distress for working class men and an additional 7% for middle-upper class men. Racism-related stress also predicted an additional 5% of variance in psychological well-being for middle-upper class men; however, it was not predictive of psychological well-being for working class men. Implications for counseling practice and future research are discussed.

An exploratory examination of the associations among racial and ethnic discrimination, racial climate, and trauma-related symptoms in a college student population

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Racial Climate Scale. Results of a multivariate analysis of variance (MANOVA) indicated that Asian and Black students reported more frequent experiences of discrimination than did White students. Additionally, the MANOVA indicated that Black students perceived the campus racial climate as being more negative than did White and Asian students. A hierarchical regression analysis showed that when controlling for generic life stress, perceptions of discrimination contributed an additional 10% of variance in trauma-related symptoms for Black students, and racial climate contributed an additional 7% of variance in trauma symptoms for Asian students.

An Exploratory Investigation of the Relationship between Racism, Racial Identity, Perceptions of Health, and Health Locus of Control among Black American Women

This exploratory investigation examined the relationship between racial identity and perceived racism as predictor variables and perceptions of health status and health locus of control as criterion variables in a sample of 90 Black American women. Results of a canonical correlational analysis indicated a shared variance of 37% between these two sets of variables. This finding highlights the need to focus on perceived racism and racial identity attitudes as potentially important factors for consideration when seeking to understand health disparities in the United States.

Construct, Predictive Validity, and Measurement Equivalence of the Race-Based Traumatic Stress Symptom Scale for Black Americans.

The current study was designed to determine the construct and predictive validity of the Race-Based Traumatic Stress Symptom Scale (RBTSSS) using structural equation modeling (SEM) and confirmatory factor analysis (CFA) with Black adults. The study involved 527 Black American adults who completed the RBTSSS and various measures of psychological functioning. Analyses included CFA, test of measurement invariance across gender and socioeconomic status, and test of predictive validity employing canonical correlation analysis (CCA). Two separate CCAs were conducted: one for the total sample of participants completing both measures and one with a subset of the sample identified as meeting criteria for race-based stress–trauma. The structure of the RBTSSS was confirmed through tests of the first order model and construct invariance using CFA. A second order SEM supported the RBTS construct. Canonical correlation analyses indicated that the RBTSS scales were significantly associated with psychological outcomes, including anxiety, depression, and loss of emotional and behavioral control. The analyses found support for the construct and predictive validity for the RBTSSS for Blacks.

Development and initial validation of the anti-racism behavioral inventory (ARBI)

This investigation reports on the development and initial validation of the anti-racism behavioral inventory, a measure designed to assess anti-racism awareness and behavior among students in counseling and counseling psychology programs within the United States (US). Data from 513 participants were collected over three related studies. Factor analyses suggested that the 21-item scale was best represented as a bifactor model with one general anti-racism behavior factor and three domain-specific factors, namely individual advocacy, awareness of racism, and institutional advocacy. Additional validity was supported through inverse associations with measures of symbolic racism and color-blind racial attitudes, as well as positive associations with scores on the Quick Discrimination Index. Potential utility of the measure and future directions for ongoing development is discussed.

Examining the factor structure of the perceived ethnic discrimination questionnaire in a sample of Australian university students

ABSTRACT The current study examines the factor structure of a modified version of the Perceived Ethnic Discrimination Questionnaire (PEDQ). Data was collected on a sample of 189 Australian university students and two items measuring online experiences of ethnic discrimination were added to the PEDQ. Results of an exploratory factor analysis supported the initial four-factor structure, suggesting that the revised Perceived Ethnic Discrimination Questionnaire-Australia (PEDQ-A) is a valid measure for use across Australian ethnic groups. Implications for cross-cultural assessment of ethnic discrimination are provided.

Attending to racial trauma in clinical supervision: Enhancing client and supervisee outcomes

ABSTRACT This article is focused on racial trauma as a psychological outcome associated with experiences of racism. Guidelines for clinical intervention are presented and the role of the clinical supervisor is discussed, both as it relates to the therapy treatment and the process of supervision.

Racism, racial discrimination, and trauma: a systematic review of the social science literature

OBJECTIVE The aim of this paper is to provide a systematic review of studies that examine relationships between racial discrimination and trauma in order to further understand the relationship between racial oppression and psychological functioning. DESIGN In this review, we describe the characteristics of 28 studies, identified by a comprehensive search strategy, including measurements of racial discrimination and trauma, as well as the nature of the reported associations. RESULTS Half of studies included in this review were published in the last 6 years. The majority of studies used cross-sectional designs and were conducted in the United States with adults ≥18 years old. African American, White, Latinx, and Asian populations were most frequently included in these studies. Of the 44 associations examined in these studies, 70% of the trauma symptomology outcomes were statistically significantly associated with racial discrimination. Significant positive associations ranged in strength, with the strongest relationships between racial discrimination and trauma occurring in studies examining veteran populations and moderate relationships among these variables in non-veteran, student populations. CONCLUSIONS Our findings reveal that current research on race-based trauma seems to be limited by a lack of measures that capture the stress/intensity associated with race-related events, an inability to account for vicarious/collective/intergenerational experiences of trauma, and failure to control for non-race-based trauma.