Everyday discrimination and mood and substance use disorders: A latent profile analysis with African Americans and Caribbean Blacks
Introduction
An often overlooked but major source of health-related stress stems from perceived discrimination (Whitbeck, Hoyt, McMorris, Chen, & Stubben, 2001), the effects of which are comparable to other major stressors such as death of a loved one, divorce, or job loss (Kessler, Mickelson, & Williams, 1999). Evidence suggests that a powerful link exists between experiences of discrimination and mood and substance-use disorders among racial/ethnic minority populations in the United States, including African Americans and Caribbean Blacks (Gibbons et al., 2004, Seaton et al., 2008). In particular, studies have highlighted the direct relationship between discrimination and both anxiety (Gaylord-Harden & Cunningham, 2009) and depressive disorders (Schulz et al., 2006). Recent research with a large sample of African Americans and Caribbean Blacks demonstrated the association between discrimination and higher odds of lifetime anxiety disorders (Soto, Dawson-Andoh, & BeLue, 2011), although the association was significant only for African Americans. Similarly, perceived discrimination has been shown to be positively associated with depression among African American and Caribbean Black adults (Clark, 2014, Schulz et al., 2006). This association is noteworthy because anxiety disorders are the most common type of mental disorder in the United States (Kessler, Chiu, Demler, & Walters, 2005) and major depressive disorder is a leading cause of disease burden worldwide (Ferrari et al., 2013).
The effects of perceived discrimination have also been linked with use of alcohol and illicit drugs in that substance use has been identified as a means of coping with the stress of everyday discrimination (Clark, 2014, Martin et al., 2003). For example, Hunte and Barry (2012) found that every one unit increase in everyday discrimination predicted increases of alcohol- and drug-use disorders. Repeated or ongoing experiences of discrimination can be a chronic stressor, elevating distress and negative physical arousal, which in turn, can deplete psychological resources (Gee, Spencer, Chen, & Takeuchi, 2007) and lead to stress-sensitive disorders, such as generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder (Hunte and Barry, 2012, Schulz et al., 2006, Soto et al., 2011).
Although an increasing amount of research has examined the effects of discrimination on mental and physical health, much of this research has conceptualized discrimination as a continuous construct. However, emerging research has suggested that discrimination can manifest as a multifaceted, multidimensional phenomenon across four types of discrimination: individual racism (i.e., actions of a personal, degrading nature that promote inferiority beliefs among minority individuals), cultural racism (i.e., beliefs of the dominant group are regarded as superior to those of the subordinate group), institutionalized racism (i.e., systematic inequality based on race that is reinforced by differential access to societal resources, services, and opportunities), and collective racism (i.e., members of the dominant group work to restrict or deny basic rights and privileges of minority group members; Jones, 1997). Jones’ (1997) conceptualization of individual racism can be referred to as everyday discrimination, meaning it is found in the normal course of events, and, in the same way that the larger domain of discrimination is heterogeneous, everyday discrimination can be heterogeneous.
Section snippets
Present study
The purpose of this study was to model the heterogeneity of everyday-discrimination experiences among African American and Caribbean Blacks and identify differences in the prevalence of mood and substance use outcomes, including generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder among the identified subgroups. To our knowledge, this is the first study to examine classes of everyday discrimination. In addition, it is the first to compare
Sample and procedures
Study findings are based on data from the National Survey of American Life (NSAL), which is a comprehensive survey of the mental health of the United States Black and non-Hispanic White populations (NSAL; Jackson et al., 2004). NSAL data were obtained between 2001 and 2003 from a nationally representative sample of non-institutionalized African American (n = 3570), Caribbean Black (n = 1623), and non-Hispanic White (n = 1006) adults 18 years and older. Using the Diagnostic and Statistical Manual,
Latent profile analysis
As displayed in Table 1, the statistical criteria suggested that a four-class solution was the best modeling of the heterogeneity of the data. Although the log likelihood, BIC, AIC, and CAIC values for the five-class solution were slightly superior to that of the four-class solution, these were relatively minor differences. The accelerated flattening of the fit statistics, in combination with the decrease in entropy values between the four-class (S = 85.97) and five-class (S = 80.59) solutions,
Discussion
Drawing from a population-based study of African American and Caribbean Black adults in the United States, our aim was to address gaps in the knowledge base by addressing two salient, interrelated questions. First, can we model the heterogeneity of experiences of perceived discrimination among African American and Caribbean Blacks? Second, can we identify differences in the prevalence of generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder
Conclusions
This study supports previous research which suggested that discrimination is detrimental to the mental and physical health of African Americans and Caribbean Blacks. More than 4 of 5 (83%) African American and Caribbean Black adults in our sample reported some extent of recurrent discrimination over the past year, and respondents in the four distinct discrimination subgroups differed significantly by sociodemographic factors such as age. Consistent with previous research, our study findings
Conflict of interest
This manuscript is original research (i.e., does not contain data that is currently submitted or published), has been submitted solely to Addictive Behaviors, has not been previously published, nor has its findings been posted online. If accepted for publication, it will not be published elsewhere. The work in its entirety is in compliance with ethical standards governing the treatment of human subjects. We declare no conflict of interest.
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