Racial Discrimination and Risk for Internalizing and Externalizing Symptoms Among Black Youths.

Importance: Racial discrimination is a psychosocial stressor associated with youths' risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US. Objective: To investigate the association between racial discrimination and risk for psychopathology moderated by neuroaffective processing. Design, Setting, and Participants: This cohort study used longitudinal self-report and functional magnetic resonance imaging (fMRI) data from Black youth participants in the US from the Adolescent Brain Cognitive Development (ABCD) study. Data were analyzed from January 2023 to May 2024. Exposures: At time 1 of the current study (12 months after baseline), youths self-reported on their experiences of interpersonal racial discrimination and their feelings of marginalization. Amygdalar response was measured during an emotionally valenced task that included blocks of faces expressing either neutral or negative emotion. Main Outcomes and Measures: At 24 and 36 months after baseline, youths reported their internalizing (anxiety and depressive symptoms) and externalizing symptoms (aggression and rule-breaking symptoms). Results: A total of 1596 youths were a mean (SD) age of 10.92 (0.63) years, and 803 were female (50.3%). Families in the study had a mean annual income range of $25 000 to $34 999. Two factors were derived from factor analysis: interpersonal racial discrimination and feelings of marginalization (FoM). Using structural equation modeling in a linear regression, standardized ß coefficients were obtained. Neural response to faces expressing negative emotion within the right amygdala significantly moderated the association between FoM and changes in internalizing symptoms (ß = -0.20; 95% CI, -0.32 to -0.07; P < .001). The response to negative facial emotion within the right amygdala significantly moderated the association between FoM and changes in externalizing symptoms (ß = 0.24; 95% CI, 0.04 to 0.43; P = .02). Left amygdala response to negative emotion significantly moderated the association between FoM and changes in externalizing symptoms (ß = -0.16; 95% CI, -0.32 to -0.01; P = .04). Conclusions and Relevance: In this cohort study of Black adolescents in the US, findings suggest that amygdala function in response to emotional stimuli can both protect and intensify the affective outcomes of feeling marginalized on risk for psychopathology, informing preventive interventions aimed at reducing the adverse effects of racism on internalizing and externalizing symptoms among Black youths.

Strengthening through adversity: The hormesis model in developmental psychopathology.

BACKGROUND: Employing a developmental psychopathology framework, we tested the utility of the hormesis model in examining the strengthening of children and youth through limited levels of adversity in relation to internalizing and externalizing outcomes within a brain-by-development context. METHODS: Analyzing data from the Adolescent Brain and Cognitive Development study (N = 11,878), we formed latent factors of threat, deprivation, and unpredictability. We examined linear and nonlinear associations between adversity dimensions and youth psychopathology symptoms and how change of resting-state functional connectivity (rsFC) in the default mode network (DMN) from Time 1 to Time 5 moderates these associations. RESULTS: A cubic association was found between threat and youth internalizing problems; low-to-moderate family conflict levels reduced these problems. Deprivation also displayed a cubic relation with youth externalizing problems, with moderate deprivation levels associated with fewer problems. Unpredictability linearly increased both problem types. Change in DMN rsFC significantly moderated the cubic link between threat levels and internalizing problems, with declining DMN rsFC levels from Time 1 to Time 5 facilitating hormesis. Hormetic effects peaked earlier, emphasizing the importance of sensitive periods and developmental timing of outcomes related to earlier experiences. CONCLUSIONS: Strengthening through limited environmental adversity is crucial for developing human resilience. Understanding this process requires considering both linear and nonlinear adversity-psychopathology associations. Testing individual differences by brain and developmental context will inform preventive intervention programming.

Childhood adversity and racial discrimination forecast suicidal and death ideation among emerging adult Black men: A longitudinal analysis.

OBJECTIVES: Disproportionate exposure to childhood adversity and the effects of racial discrimination take a toll on Black American men's mental health. Despite increasing rates of suicidal behaviors and thoughts among young adult, Black American men, few longitudinal studies examine their risk for suicidal and death ideation (SDI). We tested a developmental model linking childhood adversity (experiences of deprivation and threatening experiences) and emerging adult exposure to racial discrimination to increases in SDI and examined a potential mechanism for these effects, negative relational schemas. METHOD: A sample of 504 Black men (Mage = 20.7) from rural Georgia were recruited with respondent-driven sampling and completed a baseline survey. Men participated in two additional follow-up surveys (Mage = 21.9 and Mage = 23.5). Hypotheses were tested using structural equation modeling. RESULTS: Analyses largely supported the proposed model. Childhood adversities were associated directly with reports of SDI. Childhood deprivation indirectly predicted SDI via negative schemas (ß = 0.03, 95% CI [.014, .046]). Racial discrimination also indirectly predicted SDI via negative relational schemas (ß = 0.01, 95% CI [.001, .018]). CONCLUSION: Study results suggest that clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

COVID-19-related stress exacerbates the effect of child maltreatment on negative affect via increased identity confusion during adolescence.

INTRODUCTION: Exposure to childhood maltreatment may undermine the crucial developmental task of identity formation in adolescence, placing them at risk for developing negative affect. The current study investigated whether COVID-19-related stress intensified the indirect link between child maltreatment and adolescents' negative affect through identity confusion. METHOD: Using multidimensional assessments of child maltreatment (threat vs. deprivation), the study included a sample of 124 adolescents (Mage = 12.89, SD = 0.79; 52% female) assessed before (January 2018 to March 2020) and during the pandemic (May to October 2020) in Georgia, United States. The majority of the participants were European American (78.8%), followed by African American (11.5%), Hispanic (3.8%), Asian/Pacific Islander (1.0%), and other (4.8%). We used structural equation modeling to test (a) the mediating role of identity confusion in the link between childhood maltreatment and negative affect and (b) whether COVID-19-related stress moderated these indirect effects. Simple slopes and Johnson-Neyman plots were generated to probe regions of significant interaction effects. RESULTS: Threat and deprivation predicted an increase in adolescent identity confusion. Additionally, childhood threat and deprivation were indirectly linked to adolescents' negative affect through increased levels of identity confusion. COVID-19-related stress significantly exacerbated the link between identity confusion and negative affect. CONCLUSION: Identity confusion is a mechanism underlying the link between child maltreatment and the development of negative affect in adolescence. Our results inform prevention and intervention programs that aim to reduce negative affect among adolescents who experience threatening and depriving rearing environments.

Different Mechanisms Link Internalized Racism to Externalizing Symptomology Among Black American Adolescent Boys and Girls.

OBJECTIVE: Emerging research and theory suggests that the internalization of racist ideas and attitudes, internalized racism, poses a significant threat to Black American adolescents' and increases their risk of externalizing symptomology. Prospective, empirical research linking internalized racism to externalizing symptoms among Black American adolescents and the mechanisms explaining this link is scarce. We hypothesize that internalized racism will forecast externalizing symptoms indirectly, via effects on poor self-regulation and depressive symptoms. We also examine potential sex differences in the pathways linking internalized racism to externalizing symptoms. METHOD: A random sample of 445 Black American adolescents and their primary caregivers were recruited from 8 counties in rural Georgia. Participants provided survey data annually when adolescents were aged 13, 14, 15, and 16 years. Direct, indirect, and multigroup hypotheses were tested with structural equation modeling. RESULTS: Internalized racism assessed at ages 13 and 14 years forecast increased externalizing at age 16, both directly, and indirectly, via increases in poor self-regulation and depressive symptoms. Sex moderated the indirect pathways linking internalized racism and externalizing. Poor self-regulation significantly mediated the path between internalized racism and externalizing symptoms among Black American male youth. Depressive symptoms significantly mediated the pathway between internalized racism and externalizing symptoms among Black American female adolescents. CONCLUSION: Findings suggest behavioral treatment directions for male and female Black American adolescents experiencing depressive symptoms.

Family-Centered Prevention to Reduce Discrimination-Related Depressive Symptoms Among Black Adolescents: Secondary Analysis of a Randomized Clinical Trial.

Importance: Racial discrimination undermines the mental health of Black adolescents. Preventive interventions that can attenuate the effects of exposure to racial discrimination are needed. Objective: To investigate whether participation in the Strong African American Families (SAAF) program moderates Black adolescents' depressive symptoms associated with experience of racial discrimination. Design, Setting, and Participants: This secondary analysis used data from a community-based randomized clinical trial of SAAF (SAAF vs no treatment control). Participants were followed up at 10, 22, and 34 months after the baseline assessment. Assessment staff were blind to participant condition. Participants in this trial lived in 7 rural counties in Georgia. SAAF was delivered at local community centers. Eligible families had a child aged 11 to 12 years who self-identified as African American or Black. The joint influence of random assignment to SAAF and exposure to racial discrimination was investigated. Data were analyzed from September 2022 to March 2023. Intervention: SAAF is a 7-session (14 hours) family skills training intervention that occurs over 7 weeks. Small groups of caregivers and their adolescents participate in a structured curriculum targeting effective parenting behavior, adolescent self-regulation, and Black pride. Main Outcomes and Measures: The main outcome was adolescent-reported depressive symptoms, assessed at 34 months via the 20-item Center for Epidemiologic Studies Depression Scale for Children. Results: Of 825 families screened randomly from public school lists, 472 adolescents (mean [SD] age, 11.6 years; 240 [50.8%] female) were enrolled and randomized to SAAF (252 participants) or a no treatment control (220 participants). Exposure to racial discrimination at age 13 years was associated with increased depressive symptoms at age 14 years (ß = 0.23; 95% CI, 0.13 to 0.34; P < .001). Interaction analyses indicated that the experimental condition significantly moderated the association of racial discrimination with depressive symptoms: (ß = -0.27; 95% CI, -0.47 to -0.08; P = .005). Probing the interaction with simple slopes at ±SD revealed that for the control group, racial discrimination was significantly associated with depressive symptoms (ß = 0.39; 95% CI, 0.23 to 0.54; P < .001), while for the SAAF group, there was no association between racial discrimination and depressive symptoms (ß = 0.12; P = .09). Conclusions and Relevance: This randomized clinical trial found that the SAAF intervention reduced the incidence of racism-associated mental health symptoms among Black adolescents. SAAF is recommended for dissemination to health care practitioners working with rural Black adolescents. Trial Registration: ClinicalTrials.gov Identifier: NCT03590132.

Trajectories of Depressive Symptoms Among Black American Adolescents: Sociocultural, Racism and Familial Predictors.

OBJECTIVE: The development of depressive symptoms often increases in adolescence, and for Black American youth, can result in disproportionately long-lasting and deleterious outcomes. Despite the epidemiological trend, scant research has examined the longitudinal development of heterogeneous patterns of depressive symptoms among Black American youth. Moreover, less is known on the impact of contextual covariates on depressive symptom trajectories among Black American youth. The investigation into within-group differences of depressive symptoms is crucial for culturally informed interventions. METHODS: The sample consisted of 472 Black American youth and their primary caregivers from eight counties in Georgia who provided data at five time points (i.e., youth ages 11 to 15). Hypotheses were tested with latent class growth analysis to investigate multiple trajectories of depressive symptoms, and examine sociocultural and familial covariates of trajectory group, including caregiver depressive symptoms, involved vigilant parenting, racial discrimination experiences, Black pride, and internalized racism. RESULTS: Four-classes of depressive symptoms were identified including stable low (58.4%); high start, decreasing (20%); later onset (13%); and high and increasing (8.5%). Family and race-related predictors differentiated youth's depressive symptom trajectories class and identified warning signs for high-symptomology trajectories. CONCLUSIONS: Findings provide novel insights into developmental patterns of depressive symptoms and the role of contextual and sociocultural factors within a sample of Black American youth. Implications include treatment and prevention recommendations.

The Transition to Fatherhood, Contextual Stress, and Substance Abuse: A Prospective Analysis of Rural, Emerging Adult Black American Men.

Background: Among Black American emerging adult men (∼aged 18-25), the early transition to fatherhood is often marred by numerous contextual stressors related to racial discrimination and socioeconomic instability. The strain of transitioning to fatherhood while experiencing high levels of contextual stress may evidence escalations in substance misuse over time as men may turn to substances to cope with the stress of complex life transitions. However, research examining these associations are scarce. Objective: This study aimed to investigate the influence of contextual stress on the association between fatherhood and substance misuse. Hypotheses were tested using multiple linear regression with 3 waves of data from 476 Black American men aged 19 to 22 at baseline living in resource-poor communities in the rural South. Results: Results demonstrated that fatherhood status was associated, prospectively, with Black American fathers' substance misuse when exposure to contextual stress was high but not low. Conclusions: Findings underscore the need for substance misuse prevention programs to (a) support Black American fathers in coping with race-related stress and (b) integrate robust socioeconomic stability services in order in disrupt patterns of future substance misuse by improving Black American men's experience of the transition to fatherhood.

Planful Self-Control, Metabolic Risk, and Psychosocial Outcomes Among Young, Black Men: A Test of Skin-Deep Resilience Theory.

Research on skin-deep resilience suggests that for youth and young adults from disadvantaged backgrounds, high levels of planful self-control may promote positive psychosocial outcomes while simultaneously conferring vulnerabilities to chronic diseases related to aging. In this study, we investigated the divergent effects of planful self-control on young Black American men's psychosocial well-being and their metabolic risk. We expected that high levels of planful self-control in emerging adulthood would predict positive outcomes in young adulthood (educational attainment, low depressive symptoms, job satisfaction); however, the combination of high levels of planful self-control and the experience of contextual adversity either in emerging adulthood or in childhood would forecast poor metabolic health. Hypotheses were tested with prospective data from 504 Black American men followed from age 20 to age 26. Planful self-control in emerging adulthood directly forecasted low levels of depressive symptoms, one's likelihood of obtaining a bachelor's degree, increased job satisfaction, and increases in metabolic risk. Exposure to childhood deprivation moderated the influence of planful self-control on metabolic risk. Men with high levels of deprivation and high levels of planful self-control exhibited the worst metabolic profiles in the sample. In contrast, men with high levels of childhood deprivation and low levels of planful self-control exhibited the best metabolic profiles. Documenting the health consequences associated with planful self-control provides a foundation from which to identify modifiable psychosocial factors that affect the course of psychosocial problems and health.

Predicting Receipt of an Effective Dose of a Family-Centered Preventive Intervention for African American Youth.

Research reveals a linear association between prevention program dose and outcomes; that is, families receive the most benefits when they attend a sufficient number of program sessions. Ensuring participants receive an effective dose of prevention is a persistent challenge for the widespread implementation of family-centered prevention programs. We investigated factors associated with an effective dose of the Strong African American Families (SAAF) substance use prevention program. Dose-related factors included socioeconomic disadvantage, caregiver depression, family disorganization, youth risk for problem behavior, and community risk. Notably, SAAF includes an ecologically appropriate curriculum and a comprehensive set of engagement procedures, which decrease the influence of these factors on attendance. The sample consisted of 252 African American youth and their caregivers from eight rural counties in South Georgia who had been randomly assigned to receive the SAAF substance use prevention program, a seven-session family skills training program. We operationalized an effective dose of SAAF, per recent research, as attendance in at least 5 of 7 sessions. Logistic structural equation modeling revealed no evidence of the tested factors reducing dose. Family disorganization, however, was associated positively with an effective dose, controlling for all other factors. Families with more disorganization were more likely to receive an effective dose of the program. Findings suggest that ecologically sensitive engagement protocols and curricula may obviate the influence of common risk factors and foster participation among those who most perceive a need for the program.

Family Stress and Rural African-American Adolescents' Depressive Symptoms.

PURPOSE: Limited longitudinal research investigates the effects of family stress on the development of depressive symptoms among African-American adolescents. This study tests a developmental model of the family and intrapersonal processes linking family stress to depressive symptoms from the ages of 11 to 15 years. We hypothesized that family stress would predict increases in caregiver-youth conflict, which in turn would predict decreases in adolescents' self-control, a proximal predictor of increases in depressive symptoms. METHODS: The sample consisted of 472 African-American youths and their primary caregivers from eight rural counties in southern Georgia who provided data at four time points (youth of ages 11-15 years). Hypotheses were tested with structural equation modeling. RESULTS: Results were consistent with study hypotheses. Family stress significantly predicted depressive symptoms via intermediate effects on caregiver-youth conflict and adolescent self-control. The indirect influence of family stress via these intermediate processes was significant. CONCLUSIONS: Findings suggest tha, when families experience stress, caregiver-youth conflict increases, which may lead to the development of poor self-control in youth, a proximal predictor of increases in depressive symptoms. Findings have implications for the development of prevention programs for rural African-American adolescents.