Racial Stress and Trauma and the Development of Adolescent Depression: A Review of the Role of Vigilance Evoked by Racism-Related Threat

Abstract

There are known disparities in the burden of illness and access/quality of care for African, Latino/a, Asian, and Native American (ALANA) patients diagnosed with depressive disorders, which may occur because of health inequities. Racial stress and trauma (RST), or the significant fear and distress that can be imparted from exposure to racism, is one such inequity linked to the development of depression. The current review summarizes past research examining the association between racism, RST, and depression, as well as avenues in which RST becomes biologically embedded in ALANA individuals. We describe multimodal research that supports vigilance as a potential mediator of the association between RST and depression and consider the nuanced role that vigilance plays during experiences with racism. Finally, we describe methodological advances in the assessment of vigilance evoked by RST and the clinical implications that may be generated by future improvements. In each of these areas, we present examples of how ongoing and future research can be leveraged to provide support for psychosocial programs that facilitate autonomous community healing and resilience, increase calls for public policy changes, and support clinical interventions that lessen the burden of racism on ALANA communities.

Perceived Discrimination as a Critical Factor Affecting Self-Esteem, Satisfaction with Physical Appearance and Depression of Racial/Ethnic Minority Adolescents in Korea

“…This study investigated the perceived discrimination-depression relationship accounting for adolescents’ characteristics namely self-esteem and satisfaction with physical appearance in Korea, a country with a relatively shorter immigrant history. Adding to the body of literature on discrimination-depression relationships [ 3 , 4 , 5 , 6 , 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 20 , 23 ], the findings of this study suggest that adolescents’ perceived discrimination is, indeed, the strongest predictor of their depression. Despite the low degree of exposure to discrimination reported by the adolescents, its impact on their mental health remains quite strong accounting for the effect of other variables.…”

“…For racial/ethnic minority adolescents, perceived discrimination functions as a chronic stressor and a major risk factor, making them more vulnerable to depression [ 12 , 13 , 14 ]. Empirical studies testing the association between perceived discrimination and depression are in abundance, all point to a similar finding, which is that discrimination, indeed, significantly predicts adolescents’ mental health problems [ 3 , 4 , 5 , 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Benner et al [ 5 ]’s recent work, a meta-analysis of 214 publications on adolescents and racism, attests to the finding.…”

Race-based trauma and post-traumatic growth through identity transformation

“…As hate crimes on Asian Americans have risen, mental and emotional distress among Asian Americans has increased accordingly ( Cheah et al, 2020 ; Hyun et al, 2021 ), including among those who did not personally experience an attack ( Wu et al, 2020 ). Furthermore, constant vigilance evoked by race-related threat has been associated with cumulative stress and depression symptoms across diverse minorities groups ( Woody et al, 2022 ). In a survey conducted in 2022, nearly one-third of Black Americans (32%) and one-fifth (21%) of Asian Americans said they worried every day or almost every day that they might be threatened or attacked because of their race or ethnicity, compared to 4% of White Americans, and many more changed their everyday routines to avoid possible attacks ( Pew Research Center, 2022 ).…”

Heightened vigilance and perceived discrimination in dental trainees’ readiness for clinical practice

“…For example, evidence of the stronger associations between racism and depression among Asian‐ and Hispanic than among Black Americans 10 or between heightened vigilance and depression among Black men than among Black women 21 may reflect societal expectations that Black individuals in general and, Black men, in particular, naturalize their excessive exposure to racialized trauma and suppress acknowledgment of its harmful effects 18,22 . Active coping responses such as seeking social support, strong coping skills, spirituality, and resilience, have been found to attenuate the deleterious effect of self‐reported racism on mental health disorders 10,16,23 …”