Tamika Chere Barkley Zapolski

Despite decades of research on substance use, the unique experiences of Black Americans remain underexamined and often fragmented across subgroups and substance types. Existing studies have shed light on how racism shapes substance use patterns within certain populations, yet they leave critical gaps in understanding the broader landscape of risk, resilience, and treatment among Black communities. The purpose of this study was to fill that gap by exploring the lived experiences of Black adults with substance use histories to identify risk, protective, and treatment factors associated with alcohol and drug use. Qualitative interviews were conducted with 18 Black adults, and rapid qualitative coding and thematic analysis were used to evaluate the interview data. Risk factors were represented by themes addressing psychosocial and structural catalysts for initial substance use (Theme 1) and race-related stressors that increased substance use (Theme 2). The primary protective factor identified was Black collectivism (Theme 3). Prominent treatment themes included therapeutic rapport with the substance use provider: Black providers and lived experience with substance use (Theme 4), the utility of coping skills and group therapy (Theme 5), and factors that facilitate and impede Black substance use treatment participation (Theme 6). This qualitative study provides clinical and empirical guidance for developing culturally specific, multilevel approaches to address substance use in Black American communities.

Media use is a meaningful occupation for adolescents. Black adolescents may be at risk for exposure to racial microaggressions through engagement in this occupation. Racial microaggressions are subtle forms of discrimination that negatively impact health. This study aimed to examine the impact of exposure to racial media microaggressions on mental and behavioral health outcomes among Black adolescents. A 14-day daily diary protocol was used to administer measures on racial media microaggressions, depression, anxiety, aggression, and cannabis use. Neither concurrent nor lagged-day associations between racial media microaggressions and symptoms of anxiety, depression, or cannabis use were significant. The concurrent effect of racial media microaggressions on aggression was non-significant, but the next-day lagged effect of racial media microaggressions on aggression at both the within- (estimate = 0.610, SE = 0.281, t = 2.170, p = .030) and between-person (estimate = −.364, SE = 0.182, t = −2.004, p = .046) levels was statistically significant. Findings indicated that exposure to racial media microaggressions impacted Black adolescent behavioral health.

Adverse experiences during childhood (ACEs) and other adversities, such as experiences of discrimination are important risk factors for substance use, particularly among Black individuals in the United States (U.S.). Given the ethnic diversity of Black people in the U.S., it is important to examine how nativity influences the impact of these stressors on substance use risk. Participants were 484 Black young adults (YA) recruited through opt-in panels and online platforms. Nativity differences in the association between ACEs, everyday discrimination, and count of tobacco/nicotine and cannabis products used were examined with descriptive statistics, zero-inflated negative binomial (ZINB), and logistic regression models. Participants' average age was 21.96 years; 53.1% females and 37.6% foreign-born. There were nativity differences (p < 0.05) in education, ACEs, everyday discrimination and lifetime count of tobacco/nicotine and cannabis product types used. Each additional ACE and experience of everyday discrimination was associated with higher lifetime tobacco/nicotine product count by 5% (IRR = 1.05, 95% CI 1.01-1.09) and 2% (IRR = 1.02, 95% CI 1.01-1.04), respectively. ACEs were associated with lower odds of abstaining from tobacco/nicotine and cannabis products in the lifetime (aOR = 0.87, 95% CI 0.76-0.99 and aOR = 0.83 95% CI 0.73-0.95, respectively) and higher odds of co-occurring product exposure (aOR = 1.17, 95% CI 1.05-1.31). Foreign-born YA had 40% lower cannabis product count (IRR = 0.60, 95% CI 0.41-0.88) relative to U.S.-born YA. Findings emphasize the role of early life (ACEs) and societal stressors (everyday discrimination) on tobacco/nicotine and cannabis product count (i.e., exposure) among U.S.- and foreign-born Black YA.

This study examines the association between healthcare experiences and LGBTQ + connectedness with beliefs about pre-exposure prophylaxis (PrEP) among adolescent sexual minority males in romantic relationships. Results revealed that connection to the LGBTQ + community and comfort discussing sexual health with a healthcare provider was positively associated with perceived confidence in taking PrEP daily, while experiences of discrimination by a healthcare provider was negatively associated with the perceived PrEP effectiveness to prevent HIV. Findings highlight the importance of fostering an affirming environment for learning about HIV prevention and for increasing confidence in taking care of one's sexual health.

Adolescence is characterized by heightened emotion dysregulation, impulsivity, and engagement in high-risk behaviors, such as substance use, violence, and unprotected sexual activity. Dialectical Behavioral Therapy for Adolescents (DBT-A) is an evidence-based intervention that targets emotion regulation and impulsivity among adolescents, proven effective at decreasing high-risk behaviors. However, limited research exists on adolescents' perceptions of DBT-A, particularly in schools. The current study aimed to understand adolescents’ perspectives on a DBT-A skills group delivered within urban high schools in a midwestern state. The study sample of 18 youth (mean age 14.7; 66.7% male; 38.9% Black) completed individual semi-structured qualitative interviews assessing their perspectives on the DBT-A skills group. Interview topics included the program’s impact on youths’ daily lives, risk-taking behaviors, skill acquisition, and general feedback about the group. Fifteen of the eighteen participants (86%) reported acceptability of the program, expressing that they enjoyed the content and would recommend the group to peers. Participants observed positive impacts on their daily lives, including self-reported enhanced ability to regulate their emotions, communicate with teachers, effectively adapt their mindsets and motivations, and make healthy relationship decisions. Additionally, some noted an increased feeling of connection to their peers following the group. Delivering the DBT-A skills group in schools was shown to have high rates of acceptability among youth and resulted in improved emotion regulation and reduced impulsivity. Further research is needed to assess long-term effects of this program and to identify best training practices for school staff to implement and sustain the program long-term.

Introduction: Adolescence is a key developmental period characterized by increased maladaptive risky behaviors. Two related but distinct constructs, urgency (the tendency to act rashly in response to strong negative or positive emotions) and emotion dysregulation, are important risk factors for engaging in maladaptive risky behaviors. Thus far, research has largely agreed that these two risk factors are highly correlated. However, the causal direction between these constructs is less understood. The goal of the current study is to determine whether urgency predicts emotion dysregulation change among adolescents.Method: This project is an analysis of 544 youth (49.8% female, M_age=14.22, SD=0.52). We tested whether urgency at baseline predicts change in emotion dysregulation over a nine-week period, and whether that relationship differs across boys and girls.Results: Two multigroup latent change score path analyses found that negative, but not positive, urgency significantly predicted emotion dysregulation change (negative urgency: b= -0.57, p=0.001; positive urgency: b=0.22, p=0.06). There was no evidence of moderation by gender.Discussion: This work provides initial evidence of a temporal relationship between higher negative urgency and increased emotion dysregulation. The next step is to determine whether negative urgency imparts risk for maladaptive behaviors through its effect on emotion dysregulation. The long-term goal of this program of research is to design and test interventions to reduce the impact of negative urgency for adolescent risk-taking.

Ethnic-racial identity (ERI) has been shown to have a promotive effect on substance use; however, the factors impacting this relationship have been explored less. The present study examined whether a promotive pathway exists between ERI, depression and anxiety symptoms, and problem substance use (i.e., alcohol and cannabis use) among a sample of African American emerging adults. Participants were 388 African American or Black emerging adults aged 18-24 (M = 20.6), mostly female (62%) attending a Midwestern university or residing in the neighboring community. Data on demographics, ERI based on a total score and affirmation and exploration subscales, depression and anxiety symptoms, and problem alcohol and cannabis use were collected. The PROCESS macro for simple mediation was conducted to examine the role of depression and anxiety symptoms in the relationship between ERI and problem alcohol and cannabis use. A significant indirect effect was found for the pathway between ERI, depression and anxiety symptoms, and each substance use outcome. Among African American emerging adults, ERI may reduce the risk for problem alcohol and cannabis use through reductions in depression and anxiety symptoms. Therefore, implementation of substance use interventions that strengthen ERI may be particularly beneficial to reduce risk, as well as promote psychological well-being among African American emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).