Racial discrimination and posttraumatic stress: examining emotion dysregulation as a mediator in an African American community sample

Abstract

Background : African Americans experience more severe and chronic posttraumatic stress disorder (PTSD) symptoms compared to other racial groups, and thus it is important to examine factors that are relevant for the aetiology of PTSD in this population. Although racial discrimination has been implicated as an exacerbating factor in the development and maintenance of PTSD, relatively less is known about mechanisms through which this process may occur. Objective : The purpose of this study was to examine one such mechanism, emotion dysregulation, in two independent samples of African American adults. Method : Trauma-exposed participants were recruited in a large, urban community hospital setting (initial sample n = 1,841; replication sample n = 294). In the initial sample, participants completed a unidimensional measure of emotion dysregulation and self-reported PTSD symptoms based on the DSM-IV. In the replication sample, participants completed a multidimensional measure of emotion dysregulation and a diagnostic interview of PTSD symptoms based on the DSM-5. Mediation analyses were used to test our hypotheses. Results : Across both samples, results indicated that racial discrimination was indirectly associated with PTSD symptoms through emotion dysregulation (even when trauma load was added as a covariate). Conclusions : Taken together, these results provide strong evidence that the association between racial discrimination and PTSD symptoms may be partially explained by the association between racial discrimination and worse emotion dysregulation. These findings elucidate the impact of racist incidents on mental health and identify modifiable emotion regulatory processes that can be intervened upon to enhance the psychological and social wellbeing of African Americans.

The Role of Discrimination Experiences in Postrape Adjustment Among Racial and Ethnic Minority Women

“…The current study examined the role of race and discrimination frequency in PTSD, depression, and substance use problems among a racially diverse, primarily low-income sample of women who presented to the ED for a SAMFE and were assigned to an intervention, active control, or TAU and followed up over a six-month period. Consistent with recent work suggesting that racial discrimination is associated with PTSD (Bird et al, 2021; Mekawi et al, 2020; Sibrava et al, 2019), findings revealed positive associations between the frequency of discrimination experiences and both PTSD and depression symptoms six months postrape after controlling for race, intervention condition, and other significant demographics. Contrary to our study hypotheses and to the self-medication model of substance abuse (Khantzian, 1997), discrimination frequency was not associated with alcohol or drug problems in the current sample.…”

Evaluating the Factor Structure of the Emotion Dysregulation Scale-Short (EDS-s): A Preliminary Study

“…In the validation study, the EDS scores were significantly associated with all the subscales of the DERS, and the EDS demonstrated incremental validity over the DERS in predicting different psychopathology conditions (e.g., substance abuse symptoms, post-traumatic stress symptoms, borderline pathology, depressive symptoms, and number of suicide attempts) [ 18 ]. Other studies have supported the use of the EDS in a variety of clinical populations [ 20 , 21 , 22 , 23 ].…”

Characterization of Maternal Psychosocial Stress During Pregnancy: The Healthy Start Study

“…This notion is supported by a recent study showing that experiences of racialized bias or discrimination affect emotional dysregulation. 36 We also note some recent studies indicating a genetic contribution to anhedonia 37 , 38 through this assessment were outside the scope of this analysis.…”