Examining the unique and additive effect of trauma and racial microaggressions on substance use risk among Black young adults.

Abstract

Objective: Exposure to traumatic events is linked to adverse health outcomes, including substance use. Contemporary models have conceptualized racism, including racial microaggressions, as a form of trauma. However, few studies have been conducted examining the unique and additive effect of racial microaggressions within models that include exposure to traditional forms of trauma on substance use outcomes, as well as whether effects vary by gender. Method: Three hundred and ninety-nine Black young adults between 18 and 29 (61% female, mean age 20.7) completed measures on problem alcohol and cannabis use, and experiences of trauma and racial microaggressions. Results: Controlling for age, gender, income, race (i.e., monoracial vs. multiracial), and recruitment source, regression analyses showed that racial microaggressions predicted problem substance use above the effect of trauma exposure. Moreover, exoticization/assumptions of similarity and workplace/school microaggressions primarily accounted for the effect of racial microaggressions on substance use risk. One gender effect was found, with trauma exposure associated with lower cannabis use for Black males and a nonsignificant effect found for Black females. Conclusions: Racial microaggressions provide unique and additive understanding in risk for substance use outcomes among Black young adults above effects observed from exposure to traditional forms of trauma. This finding highlights the significance of racial microaggression on health outcomes for Black young adults and can inform future research in the area of trauma exposure and substance use risk among this population of young people.

Historical trauma and polysubstance use in Black young adults: The role of contemporary racism.

“…For example, not only are Black young adults becoming cognizant of their social identities in a racialized context (Cross Jr., 1994;Hope et al, 2015;Umaña-Taylor et al, 2014), but also are engaging in different contexts (e.g., employment and public service), which may simultaneously increase their likelihood of being exposed to more major discriminatory events (Volpe et al, 2020). Findings on the significant, yet minimal impact of racial microaggressions on polysubstance use are not consistent with evidence that supports racial microaggressions as a strong risk factor for substance use (Pro et al, 2018) and misuse (Zapolski et al, 2023). Alternatively, experiencing racial microaggressions may be less salient in young adulthood than adolescence (Spears Brown & Bigler, 2005), as major discrimination events become more common in the lives of Black young adults who may experience racial prejudice in navigating new institutional settings-such as higher education, employment, housing, and online (Clark et al, 1999;English et al, 2020).…”

“…Unlike major racial discrimination experiences, which are confined to institutional settings (i.e., workplace, public buildings, and hospitals) and occur less frequently, racial microaggressions are characterized as daily degradations in the forms of insults or assaults that may also threaten an individual’s sense of safety and security (Carter, 2007; Sue et al, 2007). Racial microaggressions are also associated with greater substance misuse among racially minoritized including Black young adults (Torres-Harding & Turner, 2014; Zapolski et al, 2023).…”

Exploring the promotive pathway between ethnic-racial identity, depression and anxiety symptoms, and substance use among African American emerging adults.

“…The CUDIT-R has shown high reliability, with a Cronbach’s α coefficient of 0.91 (Adamson et al, 2010). The CUDIT-R shows high reliability and concurrent validity among samples that include African American college students (Garrison et al, 2021; Risi et al, 2020; Zapolski et al, 2021). For the present study, the scale reliability was good (α = .82).…”

Expanded Conceptual Framework for Ethical Action by Nurses on the “Further Upstream and Farther Downstream” Determinants of Health Equity

“…• Trauma exposure has been linked to numerous adverse health outcomes (Carter et al, 2020) and can predict alcohol and drug use (Dyar et al, 2020;Zapolski et al, 2021). Chronic stress greatly increases the likelihood of adverse medical outcomes, including clinical depression, upper respiratory infections, allergic or autoimmune condition flare-ups, and accelerated progression of chronic diseases (Miller et al, 2007).…”

“…• Racial trauma A specific form of trauma; the experience of racism, including racial microaggressions (Comas-Diaz et al, 2019;Williams et al, 2018;Zapolski et al, 2021).…”