The impact of cultural and institutional race-related stress on mental health outcomes among ethnic/racially minoritized young adults: Ethnic identity as a protective factor.

Racism is multidimensional with three main domains: individual, cultural, and institutional. Much of the research linking racism/race-related stress to negative health outcomes have focused on race-related stress based on full-scale scores or within the individual domain of racism. Far less research has examined the cultural and institutional domains. Thus, the present study examined whether (a) there is a direct positive effect of cultural and institutional race-related stress on anxiety and depressive symptoms among a sample of ethnic/racially minoritized (ERM) young adults and whether (b) ethnic identity affirmation, belongingness, and commitment (EI-ABC), which has been identified as a protective factor of racism, buffers the effect of cultural and institutional race-related stress on symptoms of anxiety and depression. A total of 515 ERM young adults (58.5% females, Mage = 23.94, SD = 5.86) completed an online study examining stress and health outcomes among ERM young adults. A series of multiple regression analyses were used to examine the relationship between race-related stress and anxiety and depressive symptoms and the moderating role of EI-ABC. Cultural and institutional race-related stress were found to significantly predict symptoms of depression and anxiety. Further, EI-ABC significantly buffered the effect of cultural (but not institutional) race-related stress on anxiety symptoms. Interventions for cultural race-related stress among ERMs that target anxiety symptoms should include building high EI-ABC. Additional research should identify factors that may alleviate symptoms of anxiety or depression associated with experiencing cultural and institutional race-related stress among ERM young adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Strengths and challenges among Black and Latinx people living with HIV during COVID-19: A mixed-methods investigation of the translation of self-management across syndemic health crises.

Black and Latinx people are disproportionately impacted by HIV, COVID-19, and other syndemic health crises with similar underlying social determinants of health. Lessons learned from the HIV pandemic and COVID-19 response have been invoked to improve health equity at the systemic level in the face of other emergent health crises. However, few have examined the potential translation of strategies between syndemics at the individual level. The current mixed-methods study examined strategies used to manage HIV during the COVID-19 pandemic and the extent to which they were helpful in managing COVID-19 vulnerability among Black and Latinx people living with HIV. Participants (n = 30) were interviewed by telephone and completed demographic, mental health, alcohol and substance use, health literacy, and clinical measures in October and November 2020 in Los Angeles County. Rapid qualitative analysis, descriptive statistics, and mixed-methods merging were used to analyze the data. Qualitative results demonstrated that participants found HIV self-management strategies translated to aspects of the COVID-19 pandemic including hygiene and social distancing and coping with a health-related stressor. Although telemedicine provided continuity of HIV care for most participants, technology access and literacy posed a potential barrier, particularly to those facing other sociodemographic marginalization (i.e., low education, disability). Findings suggest providers can encourage leveraging individual HIV self-management strategies in response to other public health crises. However, these interventions must be culturally responsive and address intersecting social determinants of health. Future research should examine mechanisms that predict individual translation of HIV management strategies to other health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Differential Role of Perceived Same-Gender and Gender-Neutral Norms in Emerging Adult Risk Behavior.

Background: Normative perceptions are strongly related to risk behaviors among emerging adults but the role of gender-specific normative perceptions remain unclear. Objectives: The current study examined the differential effects of same-gender and gender-neutral normative perceptions on self-reported substance use and sexual risk behavior. College students (n = 389, ages 18-25) reported binge drinking, cannabis use and prescription drug misuse, sexual risk behavior, and the perceived frequency of these behaviors by both the average- and same-gender adult. Results: Binge drinking was positively associated with same-gender norms only, whereas cannabis use and sexual risk behavior were also positively associated with gender-neutral norms perceptions. For binge drinking only, same-gender norms explained more variance in behavior than gender-neutral norms. Conclusions: Findings indicate perceptions of same-gender norms play a particularly important role in binge drinking during this developmental period. Interventions targeting emerging adult risk behavior should include within-group normative perceptions related to demographic and social group characteristics.

Mexican-origin parent and child reported neighborhood factors and youth substance use.

Background: Structural oppression affects health behaviors through residence in suboptimal neighborhoods and exposure to community violence. Youth and parents report perceptions of neighborhood factors that can affect youth substance use behaviors. Given that Latinx youth report higher levels of perceived community violence than other racial and ethnic groups, it is imperative to examine how youth- and parent-perceived neighborhood-level factors may relate to youth substance use. Methods: Data were collected using clinical interviews with family triads (fathers, mothers, and youth) and parent-child dyads (father or mother and youth) enrolled in the Seguimos Avanzando study of 344 Mexican-origin families in Indiana. Neighborhood measures, including perceptions of exposure to violence, neighborhood characteristics, and neighborhood collective efficacy, were included in parent and youth surveys. Self-report measures for past year alcohol and drug use were included in the youth survey only. T-tests were conducted to estimate differences in neighborhood reports among the sample triads. A series of linear regression models were used to estimate the associations between youth-, mother-, and father-reported perceptions of neighborhood factors and youth substance use. Results: Preliminary results indicate that fathers reported higher levels of exposure to violence than mothers [t(163) = 2.33, p = 0.02] and youth [t(173) = 3.61, p < 0.001]. Youth reported lower negative neighborhood characteristics than mothers [t(329) = 6.43, p < 0.001] and fathers [t(169) = 3.73, p < 0.001]. Youth reported significantly better neighborhood collective efficacy than mothers [t(296) = 3.14, p = 0.002], but not statistically different from fathers. Results from the primary analysis showed that youth exposure to violence was positively associated with youth substance use (b = 0.24, SE = 0.06, p < 0.0001), but the youth's neighborhood characteristics and collective efficacy were not significantly associated with youth substance use. None of the parent-reported neighborhood variables were associated with youth substance use. Conclusion: The discrepant findings between parent and youth reports of perceived neighborhood characteristics and substance use have important implications for researchers and community stakeholders, and for developing targeted interventions and prevention strategies. Our study highlights the need to address youth experience of community violence and to prioritize creating safe and inclusive neighborhood environments. Potential strategies include improving community resources, strengthening social support networks, promoting open communication about neighborhood risks, and fostering collaborative efforts to address substance use behaviors.

Self-Identified Stage in Recovery and Substance-Use Behaviors among Pregnant and Postpartum Women and People with Opioid Use Disorder.

Opioid use among pregnant and postpartum women and people (PPWP) has significant health repercussions. This study explores how substance-use behaviors may vary by stage in recovery among PPWP with opioid use disorder (OUD). We recruited 29 PPWP with OUD. "High-risk" participants self-identified as "not being engaged in treatment" or "new or early in their recovery" (n = 11); "low-risk" participants self-identified as being "well-established" or "in long-term recovery" (n = 18). Participants were queried regarding sociodemographic, mental health, and drug-misuse factors; urine drug screens were collected at baseline. Univariate group comparisons between high-risk and low-risk PPWP were conducted. High-risk PPWP were more likely to self-identify as non-Hispanic African American and more likely to report current opioid use, other illicit drugs, and tobacco. High-risk PPWP had higher opioid cravings versus low-risk PPWP. High-risk PPWP were more likely to screen positive on urine tests for non-opioid drugs and on concurrent use of both non-opioid drugs and opioids versus low-risk participants. PPWP earlier in recovery are at higher-risk for opioid and other illicit drug misuse but are willing to disclose aspects of their recent use. PPWP early in recovery are an ideal population for interventions that can help facilitate recovery during the perinatal period and beyond.

Attitudes Toward Medication for Opioid Use Disorder Among Pregnant and Postpartum Women and People Seeking Treatment.

OBJECTIVES: Pregnant and postpartum women and people (PPWP) who use opioids experience higher rates of morbidity, preterm labor, and stillbirth than those who do not. Although medication for opioid use disorder (MOUD) is the standard of treatment, utilization among PPWP has remained low because of MOUD stigma and misconceptions. The current report examined general and pregnancy-related MOUD attitudes, norms, and self-efficacy among PPWP seeking treatment. METHODS: Participants (n = 33) receiving MOUD at a Midwestern clinic reported beliefs about MOUD in general using the Attitudes toward Methadone Questionnaire (modified to include all MOUD) and during pregnancy/postpartum using an investigator-generated scale based on previous research. Participants responded using a 5-point scale from "strongly agree" to "strongly disagree" with higher scores indicating more positive attitudes. Analyses examined the bivariate association of attitudes with MOUD subjective norms and self-efficacy, also measured via investigator-generated scales. RESULTS: Respondents reported positive attitudes toward MOUD use during pregnancy, with most agreeing it was safe. However, up-to-half of participants reported uncertainty regarding the appropriate dosage of MOUD and its impact on the fetus and/or neonate. Both general and pregnancy/postpartum-related MOUD attitudes were positively associated with subjective norms toward MOUD. CONCLUSIONS: Pregnant and postpartum women and people reported high uncertainty about MOUD use despite currently using it, emphasizing the need for strategies that assess and mitigate MOUD-related stigma. Findings suggest that familial support and stigma impact attitudes toward MOUD and highlight the importance of accurate psychoeducation and social supports for patients and their families to improve the acceptance and utilization of MOUD among PPWP.

Examining Increasing Racial Inequities in Opioid Overdose Deaths: a Spatiotemporal Analysis of Black and White Decedents in St. Louis, Missouri, 2011-2021.

The third wave of the opioid overdose crisis-defined by the proliferation of illicit fentanyl and its analogs-has not only led to record numbers of overdose deaths but also to unprecedented racial inequities in overdose deaths impacting Black Americans. Despite this racialized shift in opioid availability, little research has examined how the spatial epidemiology of opioid overdose death has also shifted. The current study examines the differential geography of OOD by race and time (i.e., pre-fentanyl versus fentanyl era) in St. Louis, Missouri. Data included decedent records from the local medical examiners suspected to involve opioid overdose (N = 4420). Analyses included calculating spatial descriptive analyses and conducting hotspot analyses (i.e., Gettis-Ord Gi*) stratified by race (Black versus White) and time (2011-2015 versus 2016-2021). Results indicated that fentanyl era overdose deaths were more densely clustered than pre-fentanyl era deaths, particularly those among Black decedents. Although hotspots of overdose death were racially distinct pre-fentanyl, they substantially overlapped in the fentanyl era, with both Black and White deaths clustering in predominantly Black neighborhoods. Racial differences were observed in substances involved in cause of death and other overdose characteristics. The third wave of the opioid crisis appears to involve a geographic shift from areas where White individuals live to those where Black individuals live. Findings demonstrate racial differences in the epidemiology of overdose deaths that point to built environment determinants for future examination. Policy interventions targeting high-deprivation communities are needed to reduce the burden of opioid overdose on Black communities.

Developmental differences in the impact of racial discrimination on depression and anxiety among Black youth: Examining rumination as a mechanism.

Experiences of racial discrimination are pervasive among Black youth, resulting in psychosocial problems such as depression and anxiety. Rumination plays a key role in linking racial discrimination and internalizing concerns. Developmental age has also been shown to influence the extent to which racial discrimination and rumination impact mental health; however, studies have yet to explore the interplay between these factors. This study examined the association between racial discrimination and internalizing concerns among Black youth, whether racial discrimination was indirectly associated with internalizing concerns through rumination, and whether developmental age moderated these direct and indirect effects. Participants included 158 pre- and early-adolescent youth recruited from a community sample (Mage = 11.56 years; 53% female). Data were from baseline questionnaire responses from a larger longitudinal study conducted in the Southeastern United States examining the effects of interpersonal stressors on youth mental health outcomes. Racial discrimination was directly and indirectly associated with internalizing concerns through rumination. Developmental age moderated the indirect link between racial discrimination and depressive symptoms via rumination with the association being stronger as participant age increased. The impact of racial discrimination on mental health among Black youth is informed by maladaptive coping strategies such as rumination and developmental age. Such factors help to identify who is most at risk for the impact of racial discrimination and potential intervening targets. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Identifying drivers of increasing opioid overdose deaths among black individuals: a qualitative model drawing on experience of peers and community health workers.

BACKGROUND: Black individuals in the USA face disproportionate increases in rates of fatal opioid overdose despite federal efforts to mitigate the opioid crisis. The aim of this study was to examine what drives increases in opioid overdose death among Black Americans based on the experience of key stakeholders. METHODS: Focus groups were conducted with stakeholders providing substance use prevention services in Black communities in St. Louis, MO (n = 14). One focus group included peer advocates and volunteers conducting outreach-based services and one included active community health workers. Focus groups were held at community partner organizations familiar to participants. Data collection was facilitated by an interview guide with open-ended prompts. Focus groups were audio recorded and professionally transcribed. Transcripts were analyzed using grounded theory to abstract line-by-line codes into higher order themes and interpret their associations. RESULTS: A core theme was identified from participants' narratives suggesting that opioid overdose death among Black individuals is driven by unmet needs for safety, security, stability, and survival (The 4Ss). A lack of The 4Ss was reflective of structural disinvestment and healthcare and social service barriers perpetuated by systemic racism. Participants unmet 4S needs are associated with health and social consequences that perpetuate overdose and detrimentally impact recovery efforts. Participants identified cultural and relationship-based strategies that may address The 4Ss and mitigate overdose in Black communities. CONCLUSIONS: Key stakeholders working in local communities to address racial inequities in opioid overdose highlighted the importance of upstream interventions that promote basic socioeconomic needs. Local outreach efforts utilizing peer services can provide culturally congruent interventions and promote harm reduction in Black communities traditionally underserved by US health and social systems.

Feasibility and acceptability of texting school-aged adolescents to assess daily substance use among community-based black and white youth.

BACKGROUND: Ecological momentary assessment (EMA) is well-suited to measure adolescent substance use. Previous research with adolescents, particularly racially minoritized adolescents, has predominantly provided mobile devices to participants as a strategy to reduce structural barriers to technology access. This report examined feasibility and acceptability of a text-message-delivered EMA protocol to adolescents' personal phones. METHODS: Non-Hispanic Black and White adolescents aged 14-18 years with mobile phone access and past-30-day substance use were recruited from community settings. Respondents (n = 36; 55.5 % female; 55.5 % White) completed a 14-day diary assessing substance use. RESULTS: Respondents completed M = 13.8 (SD = 1.36) diaries for a compliance rate of 93.5 %. Black respondents completed significantly fewer diaries (87.9 %) than White respondents (97.9 %) although compliance rates were high among both groups. Adolescents reported high acceptability of the protocol, with 97.1 % willing to participate again. CONCLUSION: Findings suggest text-message-based EMA delivered to personal phones is acceptable and feasible for assessing substance use among adolescents. As the sociodemographic "digital divide" narrows among adolescents, this cost-effective and equitable method becomes more feasible.

Opioid Use Disorder and COVID-19: Treatment and Recovery Factors among Vulnerable Populations at the Intersection of Two U.S. Epidemics.

Social inequities made some sociodemographic groups - including those of older age, minoritized race/ethnicity, and low socioeconomic status - disproportionately vulnerable to morbidity and mortality associated with the opioid epidemic and COVID-19 pandemic. Given shared vulnerability to these public health crises, it is critical to understand how COVID-19 impacts substance use disorder (SUD) treatment and recovery among people with these characteristics. The current study examined COVID-19's perceived impact on treatment factors and psychosocial outcomes by sociodemographic vulnerability. Patients receiving SUD treatment with a history of opioid misuse were recruited. Participants completed self-report questionnaires regarding the impact of COVID-19 on treatment indicators and mood and substance use symptoms. Most participants reported that COVID-19 decreased their treatment access and quality. There were no sociodemographic differences in treatment factors. Those with high sociodemographic vulnerability reported greater pandemic-related increases in depression and demonstrated greater mood symptoms. Post-hoc analyses demonstrated that unmet basic needs were significantly associated with lower treatment access and quality, greater mood symptoms, and higher substance use. Findings suggest pandemic-related stressors and barriers affected those across the sociodemographic spectrum. Treatment systems must address socioeconomic barriers to care exacerbated by the pandemic and bolster integrated treatment options for opioid use and mood disorders.

Racial discrimination and substance use among African American youth: Personal and collective self-esteem as mechanisms.

Little is known about the mechanisms of the relationship between racial discrimination and substance use among Black youth. The current study examined the role of collective self-esteem and personal self-esteem in this relationship among Black adolescents in grades 5 through 12 (N = 1514; 57% female). Regression analyses estimated direct effects of perceived racial discrimination on substance use and indirect effects of discrimination on substance use through personal and collective self-esteem. Controlling for grade and sex, results revealed significant indirect effects such that experiences of discrimination were positively associated with substance use through lower reports of collective and personal self-esteem. Findings suggest that bolstering personal and race-related esteem may mitigate the deleterious influence of discrimination among Black youth.

Sexual Risk Behavior among Adolescents Seeking Treatment for Posttraumatic Stress Disorder: Exploring Psychosocial & Symptom Correlates.

Adolescents exposed to trauma experience disproportionate rates of HIV/STI. However, integrated treatment for trauma and sexual risk behavior is rare. To inform integrated prevention efforts, the current study describes prevalence and correlates of sexual risk behavior among adolescents seeking treatment for symptoms of posttraumatic stress and substance use disorders. Adolescents aged 13-18 years (N = 135; 88% female) with histories of interpersonal violence exposure completed pre-treatment questionnaires in a randomized controlled trial of an integrated psychotherapy for trauma and substance use symptomology. Adolescents reported high rates of sexual risk behaviors relative to national estimates and general mental health treatment samples. Symptoms of reexperiencing, substance use, and peer deviance were related to sexual risk behavior beyond the influence of other trauma symptoms. Individual and contextual psychosocial factors may be stronger predictors of sexual risk behavior than posttraumatic stress disorder symptoms among adolescents with trauma symptomology. Integrated interventions targeting traumatic stress, substance use, and sexual risk behavior concurrently may prevent revictimization and HIV/STI incidence among trauma-exposed youth.

Rumination as a Mediator of the Association Between Racial Discrimination and Depression Among Black Youth.

BACKGROUND: Racial discrimination constitutes a significant risk factor for depressive symptoms among Black youth. Rumination, a maladaptive self-regulatory stress response, is a notable pathway by which racial discrimination contributes to depressive symptoms among racial/ethnic minority adults. Yet, examinations of the mechanistic nature of rumination in the context of racial discrimination among racial/ethnic minority youth remain limited. The present study investigated rumination as a mediator of the association between racial discrimination and depressive symptoms among Black youth. METHODS: Data for the current study were drawn from baseline questionnaire responses of community recruited Black pre-and-early adolescents (N = 158, 53% female, Mage = 11.50) in the southeast USA participating in an ongoing longitudinal study examining the effects of interpersonal stressors on youth mental health outcomes. RESULTS: After adjusting for age and gender, mediation analyses revealed a significant indirect effect of racial discrimination on depressive symptoms through rumination, estimate = 0.29, 95% confidence interval [0.12, 0.47]. Racial discrimination was positively associated with rumination (b = .74, SE = .23, p = .001), and rumination, in turn, was positively associated with depressive symptoms (b = .40, SE = .06, p < .001). CONCLUSION: Consistent with previous research, we found racial discrimination to be directly and indirectly associated with depressive symptoms among Black youth. Findings provide evidence of the cognitive burden of discriminatory experiences and suggest that rumination represents a potential pathway that can be targeted at early developmental stages to reduce the deleterious impact of racism-related stressors.

Examining the effects of implicit and explicit racial identity on psychological distress and substance use among Black young adults.

Racial identity is an aspect of self-concept that is important to the mental and behavioral health of Black individuals. Yet, much of the current research on racial identity is based on self-report measures which may impact findings due to reporting biases. One way to alleviate some of the measurement concerns is to use implicit measures to assess racial identity. The purpose of the present study was to examine whether an implicit assessment of racial identity, specifically racial centrality, provided a unique contribution to the understanding of risk for psychological distress and substance use among Black young adults above potential effects observed from an explicit measurement of racial identity. Additionally, the potential moderating effect of implicit racial identity, controlling for explicit racial identity, on the association between racial discrimination and these health outcomes was also examined. One hundred and forty-seven Black young adults participated in this study. Contrary to our hypothesis, there was no significant main effect of implicit racial centrality on depressive symptoms or substance use after accounting for explicit racial centrality. However, after controlling for explicit racial centrality, a significant moderating effect of implicit racial centrality on the relationship between racial discrimination and substance use was observed. Although support for all of our hypotheses was not definitively found, our findings can be added to this emerging area of study. Additionally, potential explanations for the findings are provided that can be used to inform future research in this area to better understand the utility of assessing for implicit racial identity among Black young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Traditional risk and cultural protection: Correlates of alcohol and cannabis co-use among African-American adolescents.

OBJECTIVE: Previous work indicates that African-American adolescents are at high risk for concurrent alcohol and cannabis use. The present study examines the associations of traditional ecological predictors of substance use with concurrent alcohol and cannabis use among African-American adolescents. It also examines whether racial identity, a culturally relevant factor, is associated with concurrent use beyond the influence of traditional factors. METHOD: Secondary analyses were conducted based on a large survey of high school adolescents. Responses on self-report measures of substance use and psychosocial determinants of health were examined for those respondents in grades 9-12 who identified as African American (N = 465; 59.8% female). RESULTS: Findings demonstrated that traditional risk and resilience factors, including externalizing symptoms and substance use beliefs, were related to alcohol and cannabis co-use relative to other patterns of use among African-American adolescents. Racial identity dimensions were also associated with alcohol and cannabis co-use beyond the influence of traditional factors. However, the direction of these associations varied by dimension. CONCLUSIONS: Findings from the present study assist in advancing the current knowledge base by identifying potential risk and protective factors for alcohol and cannabis co-use among African-American youth, who face increasing rates of this substance use pattern. They also underscore the importance of accounting for cultural variability in models of adolescent substance use among this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Anhedonia in tobacco withdrawal among African-American smokers.

Anhedonia-diminished interest and pleasure in response to rewards-may be a symptom of tobacco withdrawal that is understudied in priority populations. This experiment investigated the magnitude and correlates of various dimensions of anhedonia during tobacco withdrawal among African-American (AA) smokers-a population subject to health disparities. AA smokers (N = 607; ≥ 10 cigarettes/day, 37.8% female, M[SD] age = 50.0[10.6] years) completed self-report measures assessing expected pleasure from (i.e., consummatory anhedonia) and desire to engage in (i.e., anticipatory anhedonia) various types of hypothetically experienced rewards at counterbalanced 16-hr tobacco deprived and nondeprived lab visits. Other tobacco withdrawal symptom measures (e.g., craving, negative affect, hunger) were also assessed. Tobacco deprivation most robustly increased scores on a composite measure of consummatory anhedonia directed toward various reward domains (i.e., hobbies, sensory experiences, social activities; d = .32, p < .001). Deprivation modestly increased consummatory and anticipatory anhedonia directed toward sexual rewards (ds = .09-.12, ps < .02), did not significantly change anhedonia toward food rewards, and decreased anhedonia directed toward psychoactive drug rewards (i.e., increased desire for and pleasure from drugs; ds = -.21 to -.19, ps < .001). Deprivation-induced changes in anhedonia were modestly correlated with other withdrawal symptoms (average |r|s = .04-.23) and were amplified among participants with higher nicotine dependence and lower positive affect-related traits (|ß|s = .10-.12, ps < .01). Some dimensions of anhedonia may be genuine expressions of acute tobacco withdrawal in AA smokers. Applying multi-dimensional anhedonia conceptualizations might advance basic knowledge and treatment of tobacco use disorder, improve smoking cessation outcomes, and address tobacco-related health disparities facing AA smokers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Making the "C-ACE" for a Culturally-Informed Adverse Childhood Experiences Framework to Understand the Pervasive Mental Health Impact of Racism on Black Youth.

The high prevalence and psychological impact of childhood exposure to potentially traumatic events (PTE) is a major public health concern in the United States. Considerable evidence has demonstrated the significant racial disparities that exist with respect to PTE exposure, indicating that Black youth are particularly burdened by these harmful experiences. Racism may serve a unique role in explaining why Black youth are disproportionately exposed to PTEs, and why mental health disparities are more likely to occur following such experiences. Despite clear evidence acknowledging racism as a major life stressor for Black youth, theoretical models of early childhood adversity have largely neglected the multifaceted influence of racism on mental health outcomes. Inspired by bourgeoning literature highlighting the potentially traumatic nature of racism-related experiences for Black youth, we present a culturally-informed Adverse Childhood Experiences (ACEs) model, or "C-ACE", to understand the pervasive and deleterious mental health impact of racism on Black youth. This model extends the ACE framework by noting the significance of racism as an ACE exposure risk factor, a distinct ACE category, and a determinant of post-ACE mental health outcomes among Black youth. The model acknowledges and supports the advancement of ACEs research that takes a culturally informed approach to understanding the intergenerational and multilevel impact of racism on the mental health of Black youth. Future research utilizing the proposed C-ACE model is essential for informing clinical and public health initiatives centered on reducing the mental health impact of racism-related experiences and health disparities in the United States.

Racial identity, discrimination, and polysubstance use: Examining culturally relevant correlates of substance use profiles among Black young adults.

OBJECTIVES: Among Black Americans, young adulthood marks an important developmental period for the initiation of problematic substance use and related health disparities. Unique cultural factors, such as discrimination and racial identity, influence substance use during this period, but it is unknown whether they influence more severe patterns such as polysubstance use. The current study identifies prototypical patterns of substance use among Black young adults and examines whether cultural factors are associated with those patterns. DESIGN: The current study used latent class analysis to characterize prototypical substance use among a community-based sample of Black young adults (N = 147). Culturally relevant correlates of substance use classes (i.e., perceived discrimination and racial identity) were examined in univariate and multivariate models. RESULTS: Five profiles of substance use emerged, including three characterized by polysubstance use. In univariate models only, racial identity was differentially associated with membership in classes characterized by co-use of alcohol and cannabis. In both models, discrimination was significantly associated with membership in a class characterized by polysubstance use. CONCLUSION: Findings suggest a need to integrate cultural resilience factors into substance use interventions for Black young adults. Helping Black youth build coping skills for discrimination may also confer resilience against polysubstance use and associated health disparities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).