Supriya Misra

Background: Research on vicarious racial discrimination and its relation to mental health outcomes has increased over the past decade. However, the literature on vicarious racial discrimination suffers from conceptual ambiguity. As such, we conducted a scoping review to help clarify the state of research on vicarious racial discrimination as a risk factor for mental health problems across ethno-racially minoritized adult populations. Methods: We systematically searched ten databases for articles published from 2010 to 2023, using the terms ‘vicarious discrimination’ and ‘mental health’, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We then screened and extracted data and presented a synthesis of findings. Results: We selected 33 studies to include in the scoping review. All studies were conducted in the US, except for one study conducted in Australia and one in New Zealand. Samples ranged in size from small ( n = 81) to large ( n = 64,041). There was an increase in the number of publications over the past decade, particularly following 2020. Several studies focused on Black Americans and Asian Americans, though other studies included multiple racial/ethnic groups. Studies did not consistently use a standard instrument to measure vicarious racial discrimination nor a consistent analytic approach to isolate its effects. The most common mental health outcomes included depression symptoms, anxiety symptoms, and psychological distress. Vicarious racial discrimination was generally related to greater risk for mental health problems, with a couple of studies showing null findings. Conclusion: The literature on vicarious racial discrimination requires greater clarity and nuance when describing various types of vicarious racial discrimination. Vicarious racial discrimination is prevalent and is related to a range of mental health problems impacting ethno-racial minoritized populations. Potential mediators such as self-esteem and hypervigilance, along with moderators such as social support and service utilization, are important topics of future research.

We explore the dynamics of mental health, family, and migration within the experiences of United States–based South Asian immigrants with severe mental illness (SMI) diagnoses and their family members. We utilized a grounded theory approach to understand emerging unique cultural aspects (i.e., on economic hardship, racial discrimination) that have not been previously identified. Semi-structured interviews were conducted with 21 South Asian patients with an SMI diagnosis, 11 family members of South Asian patients with an SMI diagnosis, and four clinicians. Thematic analysis was used to interpret the data with a specific focus on family relationships, migration experiences, and South Asian cultural influences. We identified three themes: “Stories of Isolation,” “Complexities of Care,” and “Dynamics of Gender, Illness, and Family.” These themes reflect the complex dynamics involved in migration, family, and mental health for South Asian immigrant families in the United States. Furthermore, we expanded the notion of familial vulnerability by focusing on how structural vulnerabilities induce widespread distress within a family unit and affect multiple kinds of gendered relations within a family.

South Asians (SAs) underutilize mental health services compared to many racial and ethnic groups in the United States (US), yet there is limited research on the experiences of SAs living with severe mental illness (SMI). This study examined psychiatric healthcare experiences of SA patients with SMI diagnoses (e.g., severe depression, bipolar disorder, schizophrenia) in New York City. Data collection included semi-structured interviews with 36 participants (21 patients, 11 family members, 4 clinicians). Data was managed in NVivo. Two pairs of SA researchers conducted thematic analysis. Limited mental health knowledge led to delayed care for SAs due to a low perceived need for help. Ease of access, linguistic resources, patient-provider relationships, and family involvement influenced psychiatric healthcare experiences. Prescribed medications, self-motivation, communication, and religious practices were factors aiding symptom management and recovery. Findings highlight the need for improving psychiatric healthcare access and culturally-salient mental health education for SA communities.

Background Asian American (AA) young adults face a looming diet-related non-communicable disease crisis. Interactions with family members are pivotal in the lives of AA young adults and form the basis of family-based interventions; however, little is known on the role of these interactions in shared family food behaviors. Through an analysis of 2021 nationwide survey data of 18–35-year-old AAs, this study examines how the quality of family member interactions associates with changes in shared food purchasing, preparation, and consumption. Method Interaction quality was assessed through 41 emotions experienced while interacting with family, and was categorized as positive (e.g., “I look forward to it”), negative (e.g., “I feel annoyed”), and appreciation-related (e.g., “I feel respected”) interactions. Participants were also asked how frequently they ate meals, ate out, grocery shopped, and cooked with their family. Results Among the 535 AAs surveyed (47.6% East Asian, 21.4% South Asian, 22.6% Southeast Asian), 842 unique family interactions were analyzed; 43.5% of interactions were with mothers, followed by siblings (27.1%), and fathers (18.5%). Participants most frequently ate meals with their family (at least daily for 33.5% of participants), followed by cooking (at least daily for 11.3%). In adjusted analyses, an increase in shared food behaviors was particularly associated with positive interactions, although most strongly with cooking together and least strongly with eating meals together; significant differences between ethnic subgroups were not observed. Conclusion Findings revealed the importance of family interaction quality when leveraging family relationships to develop more tailored, impactful AA young adult dietary interventions.

Exposure to potentially traumatic events (PTE) is common and increases an individual’s risk of developing post-traumatic stress disorder (PTSD) and other psychiatric disorders. PTEs can be screened with the Life Events Checklist for DSM 5 (LEC-5). However, the psychometric properties of the LEC-5 have never been assessed in Uganda. We aimed to estimate the prevalence of PTEs and evaluate the factor structure of the LEC-5 in a sample of N = 4,479 Ugandan adults between February 2018 –March 2020. We used the phenotyping data from a case-control study (NeuroGAP-Psychosis) in Uganda investigating the genetic and environmental risk factors for psychosis spectrum disorders with 4,479 participants (2,375 cases and 2,104 controls). Prevalence for PTEs was determined for all participants and by case-control status. The factor structure of the LEC-5 was assessed using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). The overall prevalence of exposure to one or more types of PTEs was 60.5%. Cases reported more frequency of exposure to PTEs than controls (64.2% vs 55.4%; p<0.001). The most frequently endorsed traumatic event was physical assault (22.8%), while exposure to toxic substances was the least endorsed (1.7%). There were several differences among the types of events experienced between cases and controls, including cases reporting more experiences of physical (28.6% vs. 16.2%, p<0.001) and sexual assault (11.5% vs. 5.0%, p<0.001) than controls. The EFA yielded a six-factor model that explained 49.8% of the total variance. The CFA showed that a theoretical seven-factor model based on the South African Stress and Health survey was a better fitting model (CFI = 0.935; TLI = 0.908; RMSEA = 0.026) than the EFA. This study revealed a high prevalence of PTEs among cases and controls, and the LEC-5 was found to have good psychometric properties among Ugandan adults.

Background: Trauma exposure is widespread and linked to chronic physical and mental health conditions including posttraumatic stress disorder. However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma exposure. Objective: The Life Events Checklist for the DSM-5 (LEC-5) is a free, widely used questionnaire to assess traumatic events that can be associated with psychopathology. As part of a case–control study on risk factors for psychosis spectrum disorders, we used the LEC-5 to examine the frequency of traumatic events and to assess the questionnaire’s factor structure in South Africa (N = 6,765). Method: The prevalence of traumatic events was measured by individual items on the LEC-5 across the study sample, by case–control status, and by sex. Cumulative trauma burden was calculated by grouping items into 0, 1, 2, 3, and ≥4 traumatic event types. Psychometric properties of the LEC-5 were assessed through exploratory and confirmatory factor analyses. Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p < .001) and 94% of male participants reported ≥1 traumatic event compared to 89.5% of female participants (p < .001). Exploratory factor analysis revealed a 6-factor model. Confirmatory factor analyses of three models found that a 7-factor model based on the South African Stress and Health survey was the best fit (standardized root mean square residual of 0.024, root mean square error of approximation of 0.029, comparative fit index of 0.910). Conclusion: Participants reported very high exposure to traumatic events. The LEC-5 has good psychometric priorities and is adequate for capturing trauma exposure in South Africa.

Psychotic disorders (e.g., schizophrenia, schizoaffective disorder) are a leading cause of morbidity and premature mortality and an overlooked health inequity in the United States. European data indicate inequities in incidence, severity, and treatment of psychotic disorders, particularly for Black communities, that appear to be primarily attributable to social adversities. The dominant US narrative is that any observed differences are primarily a result of clinician bias and misdiagnosis.We propose that employing the framework of structural racism will prompt European and US research to converge and consider the multifaceted drivers of inequities in psychotic disorders among Black Americans. In particular, we describe how historical and contemporary practices of (1) racialized policing and incarceration, and (2) economic exploitation and disinvestment, which are already linked to other psychiatric disorders, likely contribute to risks and experiences of psychotic disorders among Black Americans.This framework can inform new strategies to (1) document the role of racism in the incidence, severity, and treatment of psychotic disorders; and (2) dismantle how racism operates in the United States, including defunding the police, abolishing carceral systems, and redirecting funds to invest in neighborhoods, housing, and community-based crisis response and mental health care. (Am J Public Health. 2022;112(4):624–632. https://doi.org/10.2105/AJPH.2021.306631 )