Investigating the Roles of Stereotype Beliefs and Posttraumatic Cognitions in the Relationship Between Experiences of Discrimination and Posttraumatic Stress Symptoms

Abstract

Existing work has demonstrated a relationship between discrimination and posttraumatic stress symptoms (PTSS), but the role of other variables in this association is unclear. The goals of the study were to investigate: (a) racial differences in PTSS and maladaptive posttraumatic cognitions, (b) the association between discrimination and PTSS, and (c) whether maladaptive posttraumatic cognitions and internalized stereotype beliefs act as moderators in the relationship between discrimination and PTSS. The present study included 465 trauma-exposed undergraduates (M_age = 24.04; SD_age = 7.00; 79.4% women; 64.9% white). Despite expectations, racial differences in PTSS were not observed. Further, Black and White participants did not differ on levels of negative beliefs about the world or trauma-related self-blame. Neither maladaptive posttraumatic cognitions nor stereotype beliefs were found to strengthen the association between discrimination and PTSS. More work is needed to establish mechanisms by which discrimination and PTSS are related with the aim of developing prevention and intervention efforts.

Keywords

posttraumatic stress disorder posttraumatic cognitions discrimination racial differences

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References

Alegría

Fortuna

L. R.

Lin

J. Y.

Norris

F. H.

Gao

Takeuchi

D. T.

Jackson

J. S.

Shrout

P. E.

Valentine

(2013). Prevalence, risk, and correlates of posttraumatic stress disorder across ethnic and racial minority groups in the United States. Medical Care, 51(12), 1114–1123. https://doi.org/10.1097/MLR.0000000000000007

Alim

T. N.

Charney

D. S.

Mellman

T. A.

(2006). An overview of posttraumatic stress disorder in African Americans. Journal of Clinical Psychology, 62(7), 801–813. https://doi.org/10.1002/jclp.20280

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed, tex rev). American Psychiatric Association Publishing.

Anderson

R. E.

Stevenson

H. C.

(2019). RECASTing racial stress and trauma: Theorizing the healing potential of racial socialization in families. American Psychologist, 74(1), 63–75. https://doi.org/10.1037/amp0000392

Blascovich

Spencer

S. J.

Quinn

Steele

(2001). African Americans and high blood pressure: The role of stereotype threat. Psychological Science, 12(3), 225–229. https://doi.org/10.1111/1467-9280.00340

Blevins

C. A.

Weathers

F. W.

Davis

M. T.

Witte

T. K.

Domino

J. L.

(2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059

Breslau

Aguilar-Gaxiola

Kendler

K. S.

Williams

Kessler

R. C.

(2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine, 36(1), 57–68. https://doi.org/10.1017/S0033291705006161

Brooks Holliday

Dubowitz

Haas

Ghosh-Dastidar

DeSantis

Troxel

W. M.

(2020). The association between discrimination and PTSD in African Americans: Exploring the role of gender. Ethnicity & Health, 25(5), 717–731. https://doi.org/10.1080/13557858.2018.1444150

Carter

R. T.

(2007). Racism and psychological and emotional injury: Recognizing and assessing race-based traumatic stress. The Counseling Psychologist, 35(1), 13–105. https://doi.org/10.1177/0011000006292033

10.

Carter

R. T.

Lau

M. Y.

Johnson

Kirkinis

(2017). Racial discrimination and health outcomes among racial/ethnic minorities: A meta-analytic review. Journal of Multicultural Counseling and Development, 45(4), 232–259. https://doi.org/10.1002/jmcd.12076

11.

Cénat

J. M.

(2023). Complex racial trauma: Evidence, theory, assessment, and treatment. Perspectives on Psychological Science: A Journal of the Association for Psychological Science, 18(3), 675–687. https://doi.org/10.1177/17456916221120428

12.

Chou

Asnaani

Hofmann

S. G.

(2012). Perception of racial discrimination and psychopathology across three U.S. ethnic minority groups. Cultural Diversity and Ethnic Minority Psychology, 18(1), 74–81. https://doi.org/10.1037/a0025432

13.

Coleman

J. A.

Ingram

K. M.

Sheerin

C. M.

(2019). Racial differences in posttraumatic stress disorder symptoms among African American and Caucasian male veterans. Traumatology, 25(4), 297–302. https://doi.org/10.1037/trm0000201

14.

Contrada

R. J.

Ashmore

R. D.

Gary

M. L.

Coups

Egeth

J. D.

Sewell

Ewell

Goyal

T. M.

Chasse

(2001). Measures of ethnicity-related stress: Psychometric properties, ethnic group differences, and associations with well-being. Journal of Applied Social Psychology, 31(8), 1775–1820. https://doi.org/10.1111/j.1559-1816.2001.tb00205.x

15.

Cross

W. E.

(with Internet Archive). (1991). Shades of black: Diversity in African-American identity. Temple University Press. http://archive.org/details/shadesofblackdiv0000cros_e9y3

16.

Dale

S. K.

Safren

S. A.

(2019). Gendered racial microaggressions predict posttraumatic stress disorder symptoms and cognitions among Black women living with HIV. Psychological Trauma: Theory, Research, Practice, and Policy, 11(7), 685–694. https://doi.org/10.1037/tra0000467

17.

Dalgleish

(2004). Cognitive approaches to posttraumatic stress disorder: The evolution of multirepresentational theorizing. Psychological Bulletin, 130, 228–260. https://doi.org/10.1037/0033-2909.130.2.228

18.

David

E. J. R.

Schroeder

T. M.

Fernandez

(2019). Internalized racism: A systematic review of the psychological literature on racism’s most insidious consequence. Journal of Social Issues, 75(4), 1057–1086. https://doi.org/10.1111/josi.12350

19.

Ehlers

Clark

D. M.

(2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0

20.

Ehring

Ehlers

Glucksman

(2006). Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents. Behaviour Research and Therapy, 44(12), 1699–1716. https://doi.org/10.1016/j.brat.2005.11.013

21.

Foa

E. B.

Ehlers

Clark

D. M.

Tolin

D. F.

Orsillo

S. M.

(1999). The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychological Assessment, 11(3), 303–314. https://doi.org/10.1037/1040-3590.11.3.303

22.

Geronimus

A. T.

(1992). The weathering hypothesis and the health of African-American women and infants: Evidence and speculations. Ethnicity & Disease, 2(3), 207–221.

23.

Goldstein

R. B.

Smith

S. M.

Chou

S. P.

Saha

T. D.

Jung

Zhang

Pickering

R. P.

Ruan

W. J.

Huang

Grant

B. F.

(2016). The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Social Psychiatry and Psychiatric Epidemiology, 51(8), 1137–1148. https://doi.org/10.1007/s00127-016-1208-5

24.

Graham

J. R.

West

L. M.

Martinez

Roemer

(2016). The mediating role of internalized racism in the relationship between racist experiences and anxiety symptoms in a Black American sample. Cultural Diversity and Ethnic Minority Psychology, 22(3), 369–376. https://doi.org/10.1037/cdp0000073

25.

Hall-Clark

B. N.

Kaczkurkin

A. N.

Asnaani

Zhong

Peterson

A. L.

Yarvis

J. S.

Borah

E. V.

Dondanville

K. A.

Hembree

E. A.

Litz

B. T.

Mintz

Young-McCaughan

Foa

E. B.

(2017). Ethnoracial differences in PTSD symptoms and trauma-related cognitions in treatment-seeking active duty military personnel for PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 9(6), 741–745. https://doi.org/10.1037/tra0000242

26.

Hall-Clark

B. N.

Sawyer

Golik

Asnaani

(2016). Racial/ethnic differences in symptoms of posttraumatic stress disorder. Current Psychiatry Reviews, 12(2), 124–138. https://doi.org/10.2174/1573400512666160505150257

27.

Hayes

A. F.

(2017). The PROCESS macro for SPSS and SAS [Computer software]. http://www.processmacro.org/index.html

28.

Inzlicht

Tullett

A. M.

Gutsell

J. N.

(2012). Stereotype threat spillover: The short- and long-term effects of coping with threats to social identity. In Inzlicht

Schmader

(Eds.), Stereotype threat: Theory, process, and application (pp. 107–123). Oxford University Press.

29.

Joseph

J. S.

Gray

M. J.

(2010). PTSD, attributions, ethnicity. Annals of the American Psychotherapy Association, 13(4), 38–80.

30.

Juang

Ittel

Hoferichter

Miriam Gallarin

(2016). Perceived racial/ethnic discrimination and adjustment among ethnically diverse college students: Family and peer support as protective factors. Journal of College Student Development, 57(4), 380–394.

31.

Judd

C. M.

Park

Ryan

C. S.

Brauer

Kraus

(1995). Stereotypes and ethnocentrism: Diverging interethnic perceptions of African American and White American youth. Journal of Personality and Social Psychology, 69(3), 460–481. https://doi.org/10.1037/0022-3514.69.3.460

32.

Major

O’Brien

L. T.

(2005). The social psychology of stigma. Annual Review of Psychology, 56, 393–421. https://doi.org/10.1146/annurev.psych.56.091103.070137

33.

McClain

Beasley

S. T.

Jones

Awosogba

Jackson

Cokley

(2016). An examination of the impact of racial and ethnic identity, impostor feelings, and minority status stress on the mental health of black college students. Journal of Multicultural Counseling and Development, 44(2), 101–117. https://doi.org/10.1002/jmcd.12040

34.

Meyer

I. H.

(2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. https://doi.org/10.1037/0033-2909.129.5.674

35.

Mouzon

D. M.

McLean

J. S.

(2017). Internalized racism and mental health among African-Americans, US-born Caribbean Blacks, and foreign-born Caribbean Blacks. Ethnicity & Health, 22(1), 36–48. https://doi.org/10.1080/13557858.2016.1196652

36.

Okazaki

Sue

(1995). Methodological issues in assessment research with ethnic minorities. Psychological Assessment, 7(3), 367–375. https://doi.org/10.1037/1040-3590.7.3.367

37.

Paradies

Ben

Denson

Elias

Priest

Pieterse

Gupta

Kelaher

Gee

(2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS One, 10(9), Article e0138511. https://doi.org/10.1371/journal.pone.0138511

38.

Pieterse

A. L.

Todd

N. R.

Neville

H. A.

Carter

R. T.

(2012). Perceived racism and mental health among Black American adults: A meta-analytic review. Journal of Counseling Psychology, 59(1), 1–9. https://doi.org/10.1037/a0026208

39.

Roberts

A. L.

Gilman

S. E.

Breslau

Koenen

K. C.

(2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine, 41(1), 71–83. https://doi.org/10.1017/S0033291710000401

40.

Seawell

A. H.

Cutrona

C. E.

Russell

D. W.

(2014). The effects of general social support and social support for racial discrimination on African American women’s well-being. Journal of Black Psychology, 40(1), 3–26. https://doi.org/10.1177/0095798412469227

41.

Sosoo

E. E.

Bernard

D. L.

Neblett

E. W.

(2020). The influence of internalized racism on the relationship between discrimination and anxiety. Cultural Diversity and Ethnic Minority Psychology, 26(4), 570–580. https://doi.org/10.1037/cdp0000320

42.

Stangor

Sechrist

G. B.

Jost

J. T.

(2001). Changing racial beliefs by providing consensus information. Personality and Social Psychology Bulletin, 27(4), 486–496. https://doi.org/10.1177/0146167201274009

43.

Steele

C. M.

Aronson

(1995). Stereotype threat and the intellectual test performance of African Americans. Journal of Personality and Social Psychology, 69(5), 797–811. https://doi.org/10.1037/0022-3514.69.5.797

44.

Wagner

G. J.

Bogart

L. M.

Galvan

F. H.

Banks

Klein

D. J.

(2012). Discrimination as a key mediator of the relationship between posttraumatic stress and HIV treatment adherence among African American men. Journal of Behavioral Medicine, 35(1), 8–18. https://doi.org/10.1007/s10865-011-9358-1

45.

Weathers

F.W.

Blake

D.D.

Schnurr

P.P.

Kaloupek

D.G.

Marx

B.P.

Keane

T.M.

(2013a). The Life Events Checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD at www.ptsd.va.gov

46.

Weathers

F.W.

Litz

B.T.

Keane

T.M.

Palmieri

P.A.

Marx

B.P.

Schnurr

P.P.

(2013b). The PTSD Checklist for DSM-5 (PCL-5).

47.

Williams

D. R.

Mohammed

S. A.

(2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47. https://doi.org/10.1007/s10865-008-9185-0

48.

Williams

Jayawickreme

Sposato

Foa

E. B.

(2012). Race-specific associations between trauma cognitions and symptoms of alcohol dependence in individuals with comorbid PTSD and alcohol dependence. Addictive Behaviors, 37(1), 47–52. https://doi.org/10.1016/j.addbeh.2011.08.008

49.

Zhu

Deng

(2023). Moderating the link between discrimination and adverse mental health outcomes: Examining the protective effects of cognitive flexibility and emotion regulation. PLoS One, 18(10), Article e0282220. https://doi.org/10.1371/journal.pone.0282220