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Exploring Intersections Between Trauma and Discrimination in Youth of Color Seeking Mental Health Services - 28/07/25

Doi : 10.1016/j.jaac.2024.10.018 
Lauren Alvis, PhD a, , Camisha D.M. Kibble, PsyD b, Robyn D. Douglas, MS c, Christopher Giang, BS d, Tamara Johns, LCSW a, Benjamin Oosterhoff, PhD a, Julie B. Kaplow, PhD, ABPP a, e
a Trauma and Grief Center at Meadows Mental Health Policy Institute, Houston, Texas 
b University of Texas at Dallas, Dallas, Texas 
c Texas A&M University, College Station, Texas 
d University of Michigan School of Public Health, Ann Arbor, Michigan 
e Tulane University School of Medicine, New Orleans, Louisiana 

Correspondence to Lauren Alvis, PhD, P.O. Box 130059, Houston, TX 77219-0059P.O. Box 130059HoustonTX77219-0059

Abstract

Objective

The purpose of this study is to explore the intersection between trauma and discrimination among Black and Latino/a/x youth seeking treatment. Specifically, we examine the following: (1) the frequency of various everyday discrimination experiences, averaged across the sample and disaggregated by demographic characteristics; (2) unique associations between exposure to potentially traumatic events (PTEs) and everyday discrimination experiences; and (3) unique associations between everyday discrimination experiences and specific posttraumatic stress symptoms while accounting for demographic characteristics and PTEs.

Method

Participants were 573 Black (54.8%) and non-Black Latino/a/x youth (10-18 years of age, 55.8% female, 25.7% first- or second-generation immigrant) who were treatment-seeking and had exposure at least one traumatic event.

Results

Two-thirds of trauma-exposed youth reported having experienced discrimination, with the most common experience being treated as not smart (46%), followed by being treated with less courtesy or respect (40%). Rates of discrimination varied by intersecting demographic characteristics in nuanced ways. Among 11 PTEs, exposure to a natural disaster, experiencing community violence, and witnessing community violence were each positively associated with overall everyday discrimination scores and specific discriminatory encounters. Everyday discrimination experiences were positively associated with posttraumatic stress symptoms after accounting for demographic characteristics and exposure to PTEs.

Conclusion

Findings provide important context for understanding experiences of everyday discrimination in Black and Latino/a/x youth seeking mental health services for trauma. Findings further highlight variability in the types of discrimination youth with different intersecting identities experience, the high rates of co-occurrence between discrimination and other traumatic events, and unique associations between specific discrimination experiences and posttraumatic stress reactions.

Plain language summary

This study examines links between discrimination and trauma, using data from 573 ten to 18-year-old Black and non-Black Latino/a/x youth seeking trauma and/or grief related mental health services. Results show that 66% of these youth face discrimination alongside other traumatic events, particularly community violence and natural disasters. Importantly, both obvious and subtle forms of discrimination were positively associated with posttraumatic stress symptoms. Results highlight the importance of assessing everyday discrimination experiences when providing trauma-informed care for youth of color.

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 that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. 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 self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. 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 sex and gender balance in our reference list. 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. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper received support from a program designed to increase minority representation in science.

Le texte complet de cet article est disponible en PDF.

Key words : trauma, discrimination, posttraumatic stress disorder, adolescent, youth of color


Plan


 This project was funded by the Powell Foundation (JBK), the Humana Foundation (JBK), the Brown Foundation (JBK), and the Boone Family Foundation (JBK).
 This article is part of a special series devoted to addressing bias, bigotry, racism, and mental health disparities through research, practice, and policy. The 2024 Antiracism Team includes Deputy Editor Lisa R. Fortuna, MD, MPH, MDiv, Consulting Editor Andres J. Pumariega, MD, PhD, Diversity, Equity, and Inclusion Emerging Leaders Fellows Tara Thompson-Felix, MD, and Nina Bihani, MD, Assistant Editor Eraka Bath, MD, Deputy Editor Wanjikũ F.M. Njoroge, Associate Editor Robert R. Althoff, MD, PhD, and Editor-in-Chief Douglas K. Novins, MD.
 The research was performed with permission from the TriWest Institutional Review Board.
 During the preparation of this work, the authors used ChatGPT to reduce word count. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.
 Consent has been provided for descriptions of specific patient information.
 Data Sharing: Data can be made available upon request to the senior author.
 Benjamin Oosterhoff, PhD, served as the statistical expert for this research.
 The authors wish to thank the youth and clinicians who participated in the study.
 Disclosure: Lauren Alvis, Camisha D.M. Kibble, Robyn D. Douglas, Christopher Giang, Tamara Johns, Ben Oosterhoff, and Julie B. Kaplow have reported no biomedical financial interests or potential conflicts of interest.


© 2025  American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 64 - N° 8

P. 921-933 - août 2025 Retour au numéro
Article précédent Article précédent
  • Trends in Mental Disorders in Children and Adolescents Receiving Treatment in the State Mental Health System
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| Article suivant Article suivant
  • Does State-Level Structural Racism Impact Risk for Suicide Ideation and Attempts Among US Adolescents Across Race and Ethnicity?
  • Lillian Polanco-Roman, Sharifa Z. Williams, Ana Ortin-Peralta

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