Race-Based Traumatic Stress Research Articles

Literature Review: The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy for Race-Based Traumatic Stress With African Americans

Background:Race-based traumatic stress is defined as psychological and emotional stress induced by race-based offenses in the life span. Examples of this include but are not limited to overt verbal and physical racist encounters, microaggressions, housing discrimination, racist policies, racist policing practices, employment discrimination, and economic disenfranchisement. African Americans are disproportionately affected, and it is not clear if mental health treatment is effective.Objective:The purpose of the study was to examine the effects of race-based traumatic stress on African Americans and examine if eye movement desensitization and reprocessing (EMDR) therapy is an effective treatment modality. The author sought to answer the following question: If African Americans who have been exposed to race-based traumatic stress receive EMDR therapy, will it reduce emotional and psychological distress associated with race-based trauma?Methods:A literature review was conducted between January 22 and April 26 of 2024. The following online databases contributed to the selection of peer-reviewed articles for this literature review: APA PsycArticles, APA PsycInfo, CINAHL Complete, and Educational Resources Information Center. Gray literature such as the National Alliance on Mental Illness’s database was also explored to locate additional statistics and information concerning mental health, race-based traumatic stress, and African Americans. Reference lists of the identified articles were manually reviewed, and additional relevant articles such as primary research articles were included in the literature review.Findings:It could not be concluded that EMDR therapy is an effective modality for treating race-based traumatic stress in African Americans. Thus, the answer appears to be unclear currently.Conclusions:The findings suggest that further research and advocacy are necessary to better understand the effectiveness of specialized modalities and mental health care concerning treatment for African Americans.

Racial Stress and Black Women’s Health in the United States: A Culturally Responsive Prevention and Health Promotion Intervention

Black babies and their mothers are dying at disproportionately high rates. Also, Black women are experiencing higher rates of racial discrimination than other racial-ethnic groups are facing in the United States. An intervention promoting the health of Black women and their unborn babies requires addressing the disproportionate level of racial stress that Black women experience. In this article, the creation of such a program is discussed. To consider individual, community, and systemic factors, three theoretical models were utilized: (a) Race-based traumatic stress injury, (b) stress-health model, and (c) racial identity model. This intervention was co-developed with community stakeholders by using community-based participatory research principles. This process resulted in the development of the Afya Black Women Wellness program, a multidimensional and strength-based intervention grounded in the experiences of Black women. Afya focuses on promoting holistic health through psychoeducation, skills building, and social support. The program is constructed to be implemented twice-a-week for 12 weeks. This will allow pregnant Black women to receive the maximum benefit from the program, improving the quality of life for themselves and their unborn children. Ameliorating health disparities in Black maternal health requires addressing the disproportionate amount of racial stress that Black women experience. Afya is a model intervention that provides practical strategies for addressing racial health inequities in Black maternal health. It does so by promoting the health of Black women at the individual and community levels.

Burnout, racial trauma, and protective experiences of Black psychologists and counselors.

The present study explored rates of burnout and racial trauma among 182 Black mental health professionals (BMHPs) and utilized racial-cultural theory to explore potential protective factors against burnout and racial trauma. We collected data from 182 Black psychologists and counselors who were active mental health professionals during 2020. Descriptive statistics, multivariate analyses of variance, follow-up univariate analyses of variance, bivariate correlations, and multiple regression analyses were used. Both burnout and racial trauma were considerably higher among BMHPs than has been reported across general samples of helping professionals and across a sample of Black participants across the United States. Differences among rates of burnout and racial trauma existed across genders and specialties (i.e., counseling and psychology). Higher levels of social support and an external locus of control significantly predicted lower levels of burnout and racial trauma. In addition, higher levels of resilient coping predicted lower levels of burnout. Last, more frequent meetings with a mentor significantly predicted lower levels of racial trauma. Results from this study suggest that BMHPs may be more susceptible to burnout and race-based traumatic stress as a result of their work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Relationship Between Microaggressions, Race-Based Traumatic Stress, and Posttraumatic Growth: Assessing the Moderating Role of Christian Gratitude for African American Christians

In the current study, the authors sought to understand the relationships between Christian gratitude (CG) and posttraumatic growth (PTG) following racial and ethnic microaggressions (REMs) and race-based traumatic stress (RBTS) in a sample of Black Christians in the United States ( N = 157). Using a moderated mediation analysis, the researchers explored the mediating role of RBTS in the link between REM and PTG, using CG as a moderator between RBTS and PTG. Findings showed a positive association between REM and PTG (a medium effect). Furthermore, a positive association appeared between REM and RBTS, and RBTS and PTG (both medium effects). Finally, inconsistent with the proposed hypothesis, the index of moderated mediation was not significant. In other words, CG showed no significant interactive relationship with RBTS for moderation between RBTS and PTG. The authors examine the therapeutic implications of the findings as well as potential directions for future research.

Time Spent in Canada and Ethnic Identity Moderate the Relationship Between Race-Based Traumatic Stress Symptoms and Cognitive and Emotional Processes

Time Spent in Canada and Ethnic Identity Moderate the Relationship Between Race-Based Traumatic Stress Symptoms and Cognitive and Emotional Processes

The relationship between posttraumatic stress disorder and race-based traumatic stress.

This study examined the relationships between race-based traumatic stress symptoms (RBTSS), posttraumatic stress disorder (PTSD) symptoms, and negative affect (NA) in the past year. Participants were 185 community-based respondents who completed a paper and pencil survey of the race-based traumatic stress symptoms scale (RBTSSS), diagnostic and statistical manual (DSM)-related PTSD symptoms, and negative emotions. Two canonical correlation analyses were conducted for two participant groups: those with no race-based traumatic stress (RBTS) elevations and those with one or more RBTS elevations. Results showed a significant relationship between RBTS symptoms and PTSD symptoms for the no elevation group, and a significant relationship between RBTS symptoms and NA for the race-based stress/traumatic stress group. Notably, RBTS inclusion was not significantly correlated with NA. Those with average-level RBTS symptoms appear to endorse more PTSD criteria, while those with elevated RBTS scores do not. The study, therefore, highlights the need for further investigation of how diagnostic measures of trauma may differentiate from trauma symptoms related to race-based experiences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Confirmatory factor analysis of the Race-Based Traumatic Stress Symptom Scale in a sample of Asian American adults.

The present study examined the factor structure of the Race-Based Traumatic Stress Symptom Scale (RBTSSS) in a sample of Asian American adults. The sample (n = 403) comprised 78% women, ages 18-72 years, who were administered the RBTSSS in a survey. A first-order and second-order confirmatory factor analysis (CFA) were conducted. The RBTSSS demonstrated good internal consistency in the present study, Cronbach's αs = .78-.94. The first-order CFA revealed mixed model fit indices, χ²(1,253) = 3,431.52, p < .001, root mean square error of approximation (RMSEA) = .066, comparative fit index (CFI) = .875, Tucker-Lewis index (TLI) = .868. The second-order CFA revealed similar mixed findings, χ²(1,267) = 3,559.93, p < .001, RMSEA = .067, CFI = .869, TLI = .863. Findings demonstrated mixed support for the factor structure of the RBTSSS in a sample of Asian American adults. Future research may consider additional testing of the RBTSSS in Asian Americans and further exploring the construct of racial trauma in Asian Americans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Racism-Related Experiences and Traumatic Stress Symptoms in Ethnoracially Minoritized Youth: A Systematic Review and Meta-Analysis

ABSTRACT Objective Despite growing evidence demonstrating the association between racial and ethnic discrimination and traumatic stress symptoms in adult populations, the research among youth remains sparse. Drawing upon race-based traumatic stress models, and following the PRISMA-2020 guidelines, this systematic review and meta-analysis aimed to identify the state of the empirical evidence in the association between racism-related experiences and traumatic stress symptoms in ethnoracially minoritized youth. Method Scientific databases were searched to identify articles with ethnoracially minoritized youth participants under age 18 years old that examined the association between racial and/or ethnic discrimination and traumatic stress symptoms. Results A total of 18 articles comprising 16 studies (N = 4,825 participants) met inclusion criteria. Studies were largely cross-sectional, used nonrandom sampling strategies, focused on Black and Latinx youth, and were conducted in the United States. Furthermore, most studies were theoretically grounded and operationalized racism-related experiences as frequency of direct, personal, everyday discrimination. Few studies examined other dimensions of racism-related experiences. The meta-analysis demonstrated a significant positive association with a medium effect size, rpooled = .356, 95% confidence interval [CI] = 0.27, 0.44, between racism-related experiences and traumatic stress symptoms. No evidence of moderation by age, sex/gender, race/ethnicity, country, or recruitment setting was detected. Conclusion Racism-related experiences may confer risk for traumatic stress symptoms in ethnoracially minoritized youth. Attending to racism-related experiences is critical to improve the cultural responsiveness of trauma-informed services.

White coats, Black lives–racial trauma in Black pharmacists

BackgroundRace-based traumatic stress, or racial trauma, can negatively impact the health and wellbeing of Black health professionals. However, the effects of racial trauma among Black pharmacists have not been thoroughly explored. ObjectiveThe purpose of this study is to explore Black pharmacist experiences of race-based traumatic stress and its effects in the workplace. MethodsThis qualitative study utilized focus groups among a convenience sample of Black pharmacist attendees of a national convention for an organization dedicated to serving underserved communities and minoritized pharmacy professionals. The data were analyzed with inductive coding and thematic analysis as proposed by Braun and Clark. ResultsThree focus groups were conducted with a total of 22 participants. The majority of participants were female (77%), and the average age of the participants was 48.3 years old. Three themes related to racial trauma were identified. The participants described racial trauma as an ever-present phenomenon, tension with coworkers and institutions, and internal and external structures of support. The Black pharmacists in this study provided context and recommendations for employers to support their wellbeing. ConclusionsAn awareness of the hidden wounds that Black pharmacists carry with them to work every day is an important factor in creating diverse and inclusive workplaces. The results of this study give Black pharmacists a voice and a chance to share with colleagues their distinct realities. Employers and institutions should assess individual needs and implement strategies to support Black pharmacists in creating more inclusive work and professional environments.

Examination of race-based traumatic stress symptom networks in Black adults in the United States: A network analysis.

In the United States, racism is theorized to exert its negative effects on Black individuals' mental health by triggering a response known as "race-based traumatic stress" (RBTS), a multidimensional construct comprising seven clusters of symptoms that can occur following exposure to race-based traumatic events (e.g., racial discrimination, racist incidents): depression, intrusion, anger, hypervigilance, physical symptoms, (low) self-esteem, and avoidance. However, little is known about which symptoms and clusters are strongest and most influential in the maintenance of RBTS. Network analysis is a powerful tool for understanding the etiology of traumatic stress, but it has not yet been applied to the examination of this construct. The present study aimed to identify the symptoms most central to RBTS and examine associations between symptoms and symptom clusters. Participants (N = 1,037) identified as Black, and lived in the United States (Mage = 45.12 years, range: 18-82 years) and completed the Race-Based Traumatic Stress Symptom Scale-Short Form (RBTSSS-SF). Regularized partial correlation networks were estimated using R/RStudio. The cluster- and item-level networks demonstrated adequate centrality stability, CS = .44. The depression and physical symptoms clusters were the most central nodes in the cluster network. Feelings of meaninglessness, experiencing mental images of the event, and physical trembling were the most central items within the item-level network. These findings offer insights and implications for assessing and treating symptoms of RBTS in Black adults in the United States who are exposed to race-based traumatic events.

Racial discrimination and trauma symptoms: Further support for the Race-Based Traumatic Stress Symptom Scale.

This study provides further validity for scores produced by the Race-Based Traumatic Stress Symptom Scale (RBTSSS), through examining the relationship between perceived discrimination, trauma symptoms, and mental health symptoms with the RBTSSS. Participants consisted of 148 people of color (54% women) with an average age of 33.38 years. Study hypotheses were tested using correlational and regression analyses. Validity was supported by strong relations with established symptom scores and perceived discrimination. Regression analysis found RBTSSS to be a significant predictor of trauma symptoms, controlling for general stress. Finally, multivariate analysis found perceived discrimination to be a stronger predictor of RBTSSS symptoms than general stress. The RBTSSS demonstrates strong relations with other symptom measures and perceived discrimination, supporting the validity of the RBTSSS scores. Both researchers and practitioners may benefit from use of the instrument which captures emotional outcomes specific to racial trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Asians and Asian Americans’ social media use for coping with discrimination: A mixed-methods study of well-being implications

Although social media has the potential to serve as a coping tool, it is unclear how Asians and Asian Americans use social media to cope with discrimination, and how social media coping is associated with these users’ psycho-emotional well-being. Drawing on the Multidimensional Model of Social Media Use, this mixed-methods study examined the well-being implications of three social media coping activities among Asians and Asian Americans. A total of 931 Asians and Asian Americans in the U.S. between the ages of 18 and 93 (M = 46.49, SD = 16.58; 49.2% female) completed an anonymous online survey. Twenty-three participants (12 females) between the ages of 19 and 70 joined seven focus group interviews. Survey results showed that messaging was related to greater race-based traumatic stress (RBTS), although it also had a weak indirect relationship with positive emotions through social support. Posting and commenting had an indirect relationship with both lower RBTS and greater positive emotions via social support. Reading and browsing was associated with greater RBTS (directly) and positive emotions (both directly and indirectly through social support). Focus group data revealed how the three activities contributed to perceived social support and why these activities were associated with promising and/or concerning well-being outcomes.

Racial trauma as a risk factor for risky alcohol use in diverse college students

Exposure to potentially traumatic race-based experiences poses a risk factor for risky drinking among college students from historically marginalized racial/ethnic backgrounds. Objective: The current study examined the relationship between both the level (severity) and pattern of race-based traumatic stress (RBTS) reactions and risky drinking. Participants: The current study sample was made up of 62 male (23.5%) and 202 female (76.5%) Latino/a/x, Black, and Asian college students attending a minority-serving institution. Methods: Study participants were asked to participate in an anonymous online survey. Results: A criterion profile analysis revealed that higher scores on RBTS reactions overall, and elevated scores on RBTS – avoidance, low self-esteem, and anger, specifically, were indicative of more risky drinking. Conclusions: These findings highlight a distinct pattern of RBTS scores that may predict a vulnerability to risky drinking and underscore the importance of racial trauma healing in alcohol use prevention and intervention efforts.

Supplemental Material for Confirmatory Factor Analysis of the Race-Based Traumatic Stress Symptom Scale in a Sample of Asian American Adults

Supplemental Material for Confirmatory Factor Analysis of the Race-Based Traumatic Stress Symptom Scale in a Sample of Asian American Adults

Race-based Traumatic Stress Predicts Risky Drinking, Over and Above Negative Affect, and Non-race-related Trauma Symptoms in Racial/Ethnic Minority Female College Students.

Alcohol misuse remains a major concern in college student populations and rates of risky and problematic drinking are specifically on the rise for women. One important factor that has been shown to be positively associated with substance use/misuse for women from historically marginalized or minoritized racial/ethnic backgrounds is exposure to racial discrimination and possible resulting traumatic stress reactions. Questions remain about the relationship between race-based traumatic stress and risky drinking particularly among diverse female college students who are at greater risk due to their marginalized status in their racial/ethnic and gender groups. The current study examined race-based traumatic stress as a unique predictor of risky drinking when controlling for negative affectivity and general trauma symptoms, additional risk factors for risky drinking in women. Hierarchical linear regressions revealed that race-based traumatic stress made a significant and unique contribution to the amount of variance in risky drinking, above negative affectivity, and general trauma symptoms. These findings highlight the importance of considering experiences of racism as risk factors in substance use prevention and intervention, specifically for female college students from marginalized or minoritized racial/ethnic backgrounds.

Intersections of gendered racial trauma and childbirth trauma: Clinical interventions for Black women.

Studies suggest that racism affects the type and quality of health care that patients who are Black receive, perhaps in part because poorer patient-provider communication and less provider encouragement of patient involvement have been consistently reported for patients of color. In particular, Black women are 3-4 times more likely to experience dangerous and even life-threatening complications, and more likely to report mistreatment and neglect from medical providers and staff, during childbirth. Experiences with gendered racism during childbirth, which in itself is a vulnerable, intense, and potentially traumatic experience when proper support is absent, may lead to posttraumatic stress reactions. Psychotherapy can help affected clients to process gendered racial and childbirth traumas through: (a) the establishment of a safe, trusting, and collaborative therapeutic relationship, in which careful attention is paid to repairing alliance ruptures caused by cultural misunderstandings or gendered racial microaggressions, and (b) framing experiences and "symptoms" as understandable reactions to gendered race-based traumatic stress during childbirth. In addition to direct therapeutic intervention, therapists should collaborate with doulas and/or medical providers on patient care, and, separately, advocate for systemic-level change, supporting clients' lived experiences outside of the therapy room. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Campus Racial Climate, Psychological Well-being, and Race-Based Traumatic Stress Symptoms Among Monoracial Black and Biracial Black Students Following Heightened Exposure to Police Brutality.

The spring of 2020 was characterized by highly visible acts of police brutality and a heightened attention to systemic racism that created a macro-stressor for Black-identifying individuals. The current study aimed to capture college students' perceptions of campus racial climate, subjective well-being, and race-based trauma symptoms during this time. Results indicated that racial identity was associated with students' mental well-being, perceptions of campus racial climate, and experiences of traumatic stress symptoms. Monoracial Black and biracial Black students differed from non-Black students in their perceptions of campus racial climate and their traumatic stress symptoms. Monoracial Black and biracial Black students differed from one another on reports of subjective well-being. A unique pattern of correlations among the study variables emerged for each group. Our findings document the race-based trauma symptoms experienced by monoracial Black and biracial Black students in the spring of 2020 and provide a foundation for future research to examine factors that uniquely contribute to the well-being of monoracial Black and biracial Black students.

The Experience of BIPOC Living with Chronic Pain in the USA: Biopsychosocial Factors that Underlie Racial Disparities in Pain Outcomes, Comorbidities, Inequities, and Barriers to Treatment.

This review synthesizes recent findings related to the biopsychosocial processes that underlie racial disparities in chronic pain, while highlighting opportunities for interventions to reduce disparities in pain treatment among BIPOC. Chronic pain is a prevalent and costly public health concern that disproportionately burdens Black, Indigenous, and people of color (BIPOC). This unequal burden arises from an interplay among biological, psychological, and social factors. Social determinants of health (e.g., income, education level, and lack of access or inability to utilize healthcare services) are known to affect overall health, including chronic pain, and disproportionately affect BIPOC communities. This burden is exacerbated by exposure to psychosocial stressors (i.e., perceived injustice, discrimination, and race-based traumatic stress) and can affect biological systems that modulate pain (i.e., inflammation and pain epigenetics). Further, there are racial/ethnic disparities in pain treatment, perpetuating the cycle of undermanaged chronic pain among BIPOC.

Multiracial discrimination, religious struggles, and race-based stress among biracial Black–White and Asian-White Christians in the early 2020s: a mediation model

ABSTRACT Using a community-based sample of Black-White (N = 177) and Asian-White (N = 87) biracial Christian adults, we explored associations between multiracial discrimination (discrimination due to being mixed race), religious/spiritual (r/s) struggles, and race-based traumatic stress during the two year period of 2020–2021. We assessed whether r/s struggles mediated the association between multiracial discrimination and race-based stress for the two groups. The two mediation analyses revealed a positive indirect effect of multiracial discrimination on race-based traumatic stress through r/s struggles for both groups. In addition, the two groups showed significant differences in their reports of discrimination during the two-year period, with Black-White biracial individuals reporting more multiracial discrimination (including lack of family acceptance) than Asian-White biracials. However, no differences were found in their reports of race-based stress or r/s struggles. Implications for assessment and intervention and directions for future research are provided.

A Social Work Model of Historical Trauma

Abstract This article introduces a Social Work Model of Historical Trauma. The model draws from social work perspectives (ecosystems theory and the life model, human rights philosophy, race-based traumatic stress injury theory and attachment theory), disparities research, social work issues and policy statements, social work ethics and epigenetics. Assessment and intervention in micro, mezzo and macro domains are discussed. The article concludes with a case vignette and model application.