Racialised identity, racism and the mental health of children and adolescents

Abstract As a social justice issue, it is suggested that racialised identity may represent a critical moderator in the association between racism and adverse mental health. We performed a meta-moderation analysis of studies on racialised identity, racism and adverse mental health in children and adolescents. We searched Pubmed, Web of Science, SocINDEX, PsychInfo, Medline, CINAHL and EBSCO Academic Search Ultimate for peer-reviewed articles published between January 2013 and December 2022. Nine studies, encompassing 2146 Black, Moroccan, Turkish, Indigenous, South Korean, Latinx and Multi-heritage children and adolescents between the ages of 7 and 16, were included, covering depressive symptoms, substance use, internalising symptoms and externalising symptoms. A random effect meta-analysis reported a medium size positive correlation of 0.26 (95% CI = 0.20–0.32) between racism and adverse mental health. A comparison between internalising and externalising symptoms revealed a smaller positive correlation of 0.25 (95% CI = 0.09–0.41) for internalising symptoms and a slightly larger positive correlation of 0.30 (95% CI = 0.19–0.41) for externalising symptoms. A small negative moderation of −0.07 (95% CI = −0.17 to 0.02) was found for racialised identity in the association between racism and internalising symptoms, whilst no moderation was found between racism and externalising symptoms. Overall, a negligible moderation of −0.02 (95% CI = −0.08–0.05) was found for racialised identity in the association of racism to adverse mental health. These findings suggest that the effect of racism on internalising symptoms is slightly stronger for children and adolescents with lower racialised identities and slightly weaker for those with higher racialised identities.

[1]  Drexler James.  An initial framework for the study of internalized racism and health: Internalized racism as a racism‐induced identity threat response , 2022, Social and Personality Psychology Compass.

[2]  Crecan-Suciu D. Bianca,et al.  The relationship between coping strategies and life quality in major depressed patients , 2022, The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.

[3]  K. Scott,et al.  Do African American adolescents internalize direct online discrimination? Moderating effects of vicarious online discrimination, parental technological attitudes, and racial identity centrality , 2022, Frontiers in Psychology.

[4]  J. Kaminski,et al.  Racism and psychosis: an umbrella review and qualitative analysis of the mental health consequences of racism , 2022, European Archives of Psychiatry and Clinical Neuroscience.

[5]  A. Heinz,et al.  A Systematic Review of Qualitative Research on Substance Use among Refugees. , 2022, Addiction.

[6]  S. Schwartz,et al.  Racial Discrimination, Self-compassion, and Mental Health: the Moderating Role of Self-judgment , 2022, Mindfulness.

[7]  Masumi Iida,et al.  The Impact of Internalized Racism on Daily Depressive Symptoms Among Black American Adolescents , 2022, Adversity and Resilience Science.

[8]  Stephanie L. Haft,et al.  Systematic Review: The Association Between Race-Related Stress and Trauma and Emotion Dysregulation in Youth of Color. , 2022, Journal of the American Academy of Child and Adolescent Psychiatry.

[9]  E. Fahmy,et al.  Association between blood coagulability and migraine , 2022, The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.

[10]  C. Yeh,et al.  Exploring Black adolescent males' experiences with racism and internalized racial oppression. , 2021, Journal of counseling psychology.

[11]  Rhea W. Boyd,et al.  Structuring Poverty: How Racism Shapes Child Poverty and Child and Adolescent Health. , 2021, Academic pediatrics.

[12]  Mehran Nassim,et al.  Spatiality of Social Stress Experienced by Refugee Women in Initial Reception Centers , 2021, Journal of International Migration and Integration.

[13]  Eraka Bath,et al.  Impact of Racial Discrimination on the Mental Health of Minoritized Youth , 2021, Current Psychiatry Reports.

[14]  L. Juang,et al.  Understanding Ethnic-Racial Identity in a Context Where “Race” Is Taboo , 2021 .

[15]  Ashley M. Ebbert,et al.  Risk and resilience among Asian American youth: Ramifications of discrimination and low authenticity in self-presentations. , 2021, The American psychologist.

[16]  Enrique W. Neblett,et al.  The Associations Between Internalized Racism, Racial Identity, and Psychological Distress , 2021, Emerging adulthood.

[17]  E. Mayo-Wilson,et al.  The PRISMA 2020 statement: an updated guideline for reporting systematic reviews , 2021, BMJ.

[18]  Anthony Appiah,et al.  Stereotypes and the Shaping of Identity , 2020, Prejudicial Appearances.

[19]  E. Adam,et al.  Racial discrimination and ethnic racial identity in adolescence as modulators of HPA axis activity , 2020, Development and Psychopathology.

[20]  D. Bhugra,et al.  Black and minority mental health in the UK: Challenges and solutions , 2020, Forensic Science International: Mind and Law.

[21]  F. Murtin,et al.  Excess mortality , 2020, OECD Health Working Papers.

[22]  You‐kyung Lee,et al.  Stereotype Threat in High School Classrooms: How It Links to Teacher Mindset Climate, Mathematics Anxiety, and Achievement , 2020, Journal of Youth and Adolescence.

[23]  C. Danielson,et al.  Making the “C-ACE” for a Culturally-Informed Adverse Childhood Experiences Framework to Understand the Pervasive Mental Health Impact of Racism on Black Youth , 2020, Journal of Child & Adolescent Trauma.

[24]  R. Sellers,et al.  A Daily Examination of African American Adolescents' Racial Discrimination, Parental Racial Socialization, and Psychological Affect. , 2020, Child development.

[25]  A. Umaña‐Taylor,et al.  APPLYING THE LIFESPAN MODEL OF ETHNIC-RACIAL IDENTITY: EXPLORING AFFECT, BEHAVIOR, AND COGNITION TO PROMOTE WELL-BEING , 2020, Research in human development.

[26]  B. Green,et al.  Ethnic Disparities in Trauma-Related Mental Illness: Is Ethnic Identity a Buffer? , 2020, Journal of interpersonal violence.

[27]  A. Umaña‐Taylor,et al.  Ethnic-racial discrimination experiences and ethnic-racial identity predict adolescents’ psychosocial adjustment: Evidence for a compensatory risk-resilience model , 2020 .

[28]  Monnica T. Williams,et al.  Addressing the “Myth” of Racial Trauma: Developmental and Ecological Considerations for Youth of Color , 2019, Clinical Child and Family Psychology Review.

[29]  J. Unger,et al.  Discrimination and ethnic identity: Establishing directionality among Latino/a youth. , 2020, Developmental psychology.

[30]  B. McEwen,et al.  Stress, allostatic load and mental health in Indigenous Australians* , 2020, Stress.

[31]  Miri Song.  Rethinking minority status and ‘visibility’ , 2020 .

[32]  Kohske Takahashi,et al.  Welcome to the Tidyverse , 2019, J. Open Source Softw..

[33]  Gerta Rücker,et al.  How to perform a meta-analysis with R: a practical tutorial , 2019, Evidence-Based Mental Health.

[34]  E. David,et al.  Internalized Racism: A Systematic Review of the Psychological Literature on Racism's Most Insidious Consequence , 2019, Journal of Social Issues.

[35]  E. Adam,et al.  Emotional pathways to the biological embodiment of racial discrimination experiences , 2019, Psychoneuroendocrinology.

[36]  C. Montag,et al.  Migration and schizophrenia: meta-analysis and explanatory framework , 2019, European Archives of Psychiatry and Clinical Neuroscience.

[37]  Tuppett M. Yates,et al.  Young Children’s Ethnic–Racial Identity Moderates the Impact of Early Discrimination Experiences on Child Behavior Problems , 2019, Cultural diversity & ethnic minority psychology.

[38]  Samuel H. Allen,et al.  “No [Right] Way to Be a Black Woman”: Exploring Gendered Racial Socialization Among Black Women , 2019, Psychology of women quarterly.

[39]  M. Syed,et al.  Revisiting Erik Erikson’s Legacy on Culture, Race, and Ethnicity , 2018, Identity.

[40]  Paul C. Gorski.  Racial battle fatigue and activist burnout in racial justice activists of color at predominately White colleges and universities , 2018, Race Ethnicity and Education.

[41]  Kate C. McLean,et al.  An integrated developmental model for studying identity content in context. , 2017, Developmental psychology.

[42]  Marko Sarstedt,et al.  Advanced Issues in Partial Least Squares Structural Equation Modeling , 2017 .

[43]  J. Eccles,et al.  The Relationships of Teacher Ethnic Discrimination, Ethnic Identification, and Host National Identification to School Misconduct of Turkish and Moroccan Immigrant Adolescents in Belgium , 2017 .

[44]  F. Worrell,et al.  Ethnic Identity, Stereotype Threat, and Perceived Discrimination Among Native American Adolescents. , 2016, Journal of research on adolescence : the official journal of the Society for Research on Adolescence.

[45]  Christina Maslach,et al.  Understanding the burnout experience: recent research and its implications for psychiatry , 2016, World psychiatry : official journal of the World Psychiatric Association.

[46]  M. Bair-Merritt,et al.  Adverse Childhood Experiences: Expanding the Concept of Adversity. , 2015, American journal of preventive medicine.

[47]  Stephanie M. H. Camp.  Black Is Beautiful: An American History , 2015 .

[48]  Richard M. Lee,et al.  Ethnic Identity as a Moderator against Discrimination for Transracially and Transnationally Adopted Korean American Adolescents. , 2015, Asian American journal of psychology.

[49]  A. Umaña‐Taylor,et al.  A Brief Form of the Ethnic Identity Scale: Development and Empirical Validation , 2015 .

[50]  P. Tolan,et al.  The Protective Role of Ethnic Identity for Urban Adolescent Males Facing Multiple Stressors , 2014, Journal of youth and adolescence.

[51]  Stuart Hall.  Cultural Identity and Diaspora , 2014, Undoing Place?.

[52]  N. Gonzales,et al.  Perceived Discrimination, Coping Strategies, and Mexican Origin Adolescents' Internalizing and Externalizing Behaviors: Examining the Moderating Role of Gender and Cultural Orientation , 2013, Applied developmental science.

[53]  A. Heinz,et al.  Construction and interpretation of self-related function and dysfunction in Intercultural Psychiatry , 2012, European Psychiatry.

[54]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[55]  Shauna M. Cooper,et al.  Racial Barrier Socialization and the Well-being of African American Adolescents: The Moderating Role of Mother-Adolescent Relationship Quality. , 2011, Journal of research on adolescence : the official journal of the Society for Research on Adolescence.

[56]  Karen D. Pyke.  What is Internalized Racial Oppression and Why Don't We Study It? Acknowledging Racism's Hidden Injuries , 2010 .

[57]  Wolfgang Viechtbauer,et al.  Conducting Meta-Analyses in R with the metafor Package , 2010 .

[58]  Lee M. Pachter,et al.  Perceptions of Racism in Children and Youth (PRaCY): properties of a self-report instrument for research on children's health and development , 2010, Ethnicity & health.

[59]  S. Ginwright.  Black Youth Rising: Activism and Radical Healing in Urban America , 2009 .

[60]  L. Hedges,et al.  Introduction to Meta‐Analysis , 2009, International Coaching Psychology Review.

[61]  R. Sellers,et al.  A measure of racial identity in African American adolescents: the development of the Multidimensional Inventory of Black Identity--Teen. , 2008, Cultural diversity & ethnic minority psychology.

[62]  William A. Smith,et al.  “Assume the Position . . . You Fit the Description” , 2007 .

[63]  A. Ong,et al.  Conceptualization and measurement of ethnic identity: Current status and future directions. , 2007 .

[64]  Chase L. Lesane-Brown,et al.  A review of race socialization within Black families , 2006 .

[65]  L. Blitz.  Racism and Racial Identity: Reflections on Urban Practice in Mental Health and Social Services , 2006 .

[66]  Eric A. Stewart.  RETRACTED ARTICLE School social bonds, school climate, and school misbehavior: A multilevel analysis , 2003 .

[67]  I. Meyer.  Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. , 2003, Psychological bulletin.

[68]  B. Laursen,et al.  Paths to Successful Development: The role of ethnic identity in personality development , 2002 .

[69]  L. Whitbeck,et al.  Perceived discrimination and early substance abuse among American Indian children. , 2001, Journal of health and social behavior.

[70]  Celia B. Fisher,et al.  Discrimination Distress During Adolescence , 2000 .

[71]  W. Stephan,et al.  The measurement of racial and ethnic identity , 2000 .

[72]  C P Jones,et al.  Levels of racism: a theoretic framework and a gardener's tale. , 2000, American journal of public health.

[73]  T. Seeman,et al.  Protective and Damaging Effects of Mediators of Stress: Elaborating and Testing the Concepts of Allostasis and Allostatic Load , 1999, Annals of the New York Academy of Sciences.

[74]  R. Goodman,et al.  The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. , 1999, Journal of child psychology and psychiatry, and allied disciplines.

[75]  D. Williamson,et al.  Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. , 1998, American journal of preventive medicine.

[76]  P. Collins.  Comment on Hekman's "Truth and Method: Feminist Standpoint Theory Revisited": Where's the Power? , 1997, Signs: Journal of Women in Culture and Society.

[77]  J Bound,et al.  Excess mortality among blacks and whites in the United States. , 1996, The New England journal of medicine.

[78]  Bill Arnold,et al.  Acculturation Rating Scale for Mexican Americans-II: A Revision of the Original ARSMA Scale , 1995 .

[79]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[80]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[81]  J. Rodgers,et al.  Thirteen ways to look at the correlation coefficient , 1988 .

[82]  Joseph A. Flaherty,et al.  Achievement and Achievement Motives: Psychological and Sociological Approaches , 1984 .

[83]  A. Kazdin,et al.  Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children. , 1983, Journal of consulting and clinical psychology.

[84]  C. Edelbrock,et al.  A typology of child behavior profile patterns: distribution and correlates for disturbed children aged 6–16 , 1980, Journal of abnormal child psychology.

[85]  L. Radloff.  The CES-D Scale , 1977 .

[86]  J. Zubin,et al.  Vulnerability--a new view of schizophrenia. , 1977, Journal of abnormal psychology.

[87]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[88]  L. Lunsky.  Childhood and Society. , 1965 .

[89]  W. Devillé,et al.  Cultural Identity Confusion and Psychopathology A Mixed-Methods Study Among Refugees and Asylum Seekers in the Netherlands , 2019 .

[90]  Dale Nordenberg,et al.  Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. , 2019, American journal of preventive medicine.

[91]  Jessica Daecher,et al.  Maslach Burnout Inventory Manual , 2016 .

[92]  D. Hughes,et al.  A Transactional/Ecological Perspective on Ethnic-Racial Identity, Socialization, and Discrimination. , 2016, Advances in child development and behavior.

[93]  M. Killen,et al.  Social Exclusion Based on Group Membership is a Form of Prejudice. , 2016, Advances in child development and behavior.

[94]  Janelle T. Billingsley,et al.  Racism, Racial Resilience, and African American Youth Development: Person-Centered Analysis as a Tool to Promote Equity and Justice. , 2016, Advances in child development and behavior.

[95]  P. Tugwell,et al.  The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses , 2014 .

[96]  Ariel M. Aloe,et al.  The Synthesis of Partial Effect Sizes , 2013, Journal of the Society for Social Work and Research.

[97]  M. Knight.  BECOMING BLACK: Creating Identity in the African Diaspora , 2006 .

[98]  B. Major,et al.  The social psychology of stigma. , 2005, Annual review of psychology.

[99]  Steven P. Brown,et al.  On the use of beta coefficients in meta-analysis. , 2005, The Journal of applied psychology.

[100]  Hyde Barbara.  There ain't no black in the Union Jack , 2003 .

[101]  A. Geronimus,et al.  The weathering hypothesis and the health of African-American women and infants: evidence and speculations. , 1992, Ethnicity & disease.

[102]  T. Achenbach.  Manual for the Youth Self-Report and 1991 profile , 1991 .

[103]  P. Gilroy,et al.  'There ain't no black in the Union Jack' : the cultural politics of race and nation , 1987 .