Janean Cuffee
Anxiety disorders are among the most prevalent psychiatric disorders affecting American adolescents, with nearly one-fifth of the population experiencing some form of anxiety before adulthood (Hazen et al., 2011). In general, anxiety disorders can include fear and excessive worry about health, social interactions, and everyday circumstances, which may result in feelings of irritability, fatigue, and restlessness, as well as difficulty concentrating and controlling one’s feelings (National Institute of Mental Health [NIMH], 2018). Moreover, symptoms of anxiety negatively influence overall well-being, self-esteem, and academic success which specifically impacts adolescents (Derdikman-Eiron et al., 2011). Research shows that not only are adolescents vulnerable to developing anxiety in response to life events, but also they struggle with developing strategies to manage additional stressors (Garnefki et al., 2002). Race-related experiences, such as consistent exposure to racial discrimination, have been linked to the development of anxiety symptoms (Clark et al., 2004; Gaylord-Harden, Elmore et al., 2011). Specifically, African American adolescents are faced with the highest levels of racial discrimination in the United States, resulting in feelings of worthlessness, hopelessness, and, ultimately, anxiety disorders (Caughy et al., 2004; Sanders-Phillips, 2009). Notably, the impact of racial discrimination on African American adolescents differs depending on whether it is overt (i.e., unfair behaviors towards an individual based on their race; Dovidio & Gaertner 1986; Gaylord-Harden & Cunningham, 2009) or perceived (i.e., an individual’s perception and internalization of someone’s negative actions as being racially driven; Sellers & Shelton, 2003). Nonetheless, both perceived and overt racial discrimination negatively affect African American adolescents’ symptoms of anxiety (Assari et al., 2017; Clark et al., 2004). Furthermore, research shows that both the expression and exacerbation of symptoms of anxiety differ by gender (Assari et al., 2017; Brodish et al., 2011; Palapattu et al., 2006). Therefore, the current review explores the following research question: How does racial discrimination impact symptoms of anxiety in African American adolescents, and how might these symptoms differ by gender?
Overt Racial Discrimination
Racial discrimination is an active and persistent stressor in African American adolescents’ lives; studies show that experiencing racial discrimination correlates to higher levels of anxiety symptoms (Berkel et al., 2008; Gaylord-Harden & Cunningham, 2009; Smith-Bynum et al., 2014). Overt racial discrimination encompasses blatant antipathy, endorsing derogatory stereotypes, and believing one group is inherently inferior (Cortina, 2008). Exposure to overt racial discrimination at high levels may result in an increasingly sensitive neurological structure related to managing threats, which leads to anxiety symptoms (Gaylord-Harden, Elmore, et al., 2011). Adolescent experiences with overt racial discrimination result in heightened negative psychological stress responses, hypervigilance, an increase in unhealthy behaviors, and increased physiological stress responses (Himmelstein et al., 2015; Sellers et al., 2003). As a result, African American adolescents, as compared to non-African American adolescents, are forced to address these additional stressors resulting from everyday racial discrimination, which worsens their symptoms of anxiety (Sellers et al., 2003).
In addition to symptoms of anxiety, overt racial discrimination further taxes African American adolescents’ sense of identity, by decreasing self-worth and sense of control, and increasing mistrust for others (Sanders-Phillips, 2009; Simons et al., 2002). African Americans’ racial discrimination experiences are correlated with heightened levels of anger, nervousness, and assumptions of social interactions as harassment, negatively impacting their mental health (Assari et al., 2017). Additionally, overt racial discrimination is internalized as oppression, which increases anxiety and impacts adolescents’ well-being and academic performance (Wong et al., 2003). Furthermore, discrimination from peers and teachers correlates to a decline in self assessment of academic ability, grades, and the value of academic tasks (Wong et al., 2003). As a result, increased symptoms of anxiety in African American adolescents, caused by the internalization of overt racial discrimination, hinder future success (Berkel et al., 2008; Derdikman‐Eiron et al., 2011).
Perceived Racial Discrimination
Recent studies show that African American adolescents’ awareness of racism influences the expression of anxiety disorders (Hunter & Schmidt, 2010). Negative group perceptions of African Americans are internalized by African American adolescents, and, thus, increase their anxiety (Tajfel, 1974). Group perceptions, with regard to race, are defined by stereotypes of ethnic groups that create a general perception of an individual’s identity based on their appearance (Duck et al, 2000; Scharrer, 2002). Negative group perception (i.e., race) negatively affects adolescents’ self-perception, resulting in internal blame and an increase in vulnerability to anxiety (Gaylord-Harden & Cunningham, 2009; Taylor et al., 2012).
Increased levels of perceived racial discrimination, negative evaluations and criticism by others, and rejection correlate to poor psychological health in adolescents (Clark et al., 1999; Taylor et al., 2012). African American adolescents who
internalize these negative racial perceptions and foster anti-Black attitudes report higher levels of anxiety (Carter, 1991; Pyant & Yanico, 1991). Specifically, as these negative views are internalized they impact adolescents’ view of themselves, damaging self-esteem and self-worth, thus worsening symptoms of anxiety due to their inability to develop adequate coping mechanisms to manage racial discrimination stressors (Derdikman-Eiron et al., 2011; Garnefki et al., 2002; Sanders-Phillips, 2009). Therefore, perceived racial discrimination is a prevalent stressor in African American adolescent lives, exacerbating symptoms of anxiety (Smith-Bynum et al., 2014).
Gendered Racial Discrimination
Further, the negative effects of overt racial discrimination on African American adolescents differ depending on gender (Assari, 2017; Brodish et al., 2011). While African American males experience significantly more exposure to overt racial discrimination, females reported significantly higher levels of anxiety due to increased internalization of racial discrimination; thus, overall, African American adolescent girls display higher levels of anxiety symptoms than adolescent boys (Gaylord Harden & Cunningham 2011; Palapattu et al., 2006; Voisin et al., 2011). In addition, females endorse significantly higher rates of somatic symptoms, such as stomachaches and fatigue, as a result of anxiety from overt discrimination (Derdikman-Eiron et al., 2011). Furthermore, the internalization of racial discrimination correlates to somatic symptoms as adolescents struggle with understanding the root of their symptoms and forming healthy coping mechanisms (Hazen et al., 2011). Additionally, the correlation between overt racial discrimination exposure and internalizing symptoms (e.g., self blame and negative self perception) is significantly higher in African American adolescent females than males (Fitzpatrick & Boldizar, 1993; Gaylord-Haden, Cunningham et al., 2011).
Similar to overt racial discrimination, perceived racial discrimination’s impact on anxiety in African American adolescents also varies by gender (Kessler et al., 1999; Sellers & Shelton, 2003). In contrast to overt discrimination, perceived racial discrimination has a more significant impact on male African American adolescents than females, as internalization from percieved discrimination significantly increases their symptoms of anxiety (Assari et al., 2017). Male adolescents who internalize negative racial perceptions exhibit high rates of behavior problems (e.g., substance use) as a result of their anxiety (Brodish et al., 2011; Nyborg & Curry, 2003). However, female adolescents who internalize negative racial perceptions resulting in anti-Black attitudes report higher physical symptoms of anxiety, such as fatigue and headaches (Pyant & Yanico, 1991). As a result, anxiety from perceived racial discrimination has more significant long-term negative effects for African American males as compared to females (Assari, 2017). Despite varying responses to perceived racial discrimination, however, both adolescent males and females experience symptoms of anxiety (Derdikman‐Eiron et al., 2011).
Conclusion
Past research highlights that African American adolescents are continuously exposed to high rates of discrimination, both overt and perceived, leading to increased symptoms of anxiety (Clark et al., 1999; Harrell, 2000; Soto et al., 2010; Williams et al., 1997), thus putting African American adolescents at greater risk for poor mental health outcomes (Sellers & Shelton, 2003; Soto et al., 2010). Given that racial discrimination impacts African American adolescents differently based on their gender, future research should explore what factors contribute to females’ increased anxiety as a result of their lived experiences, as well as explore why males exposed to the same life factors, at higher rates, demonstrate lower rates of anxiety and symptoms. Further, research should also explore why male African American adolescents exhibit higher rates of anxiety due to perceived racial discrimination as opposed to overt racial discrimination. Additionally, research should explore the connection between the psychological effects of discrimination and violence in African American adolescents to learn how to mitigate violence correlated to anxiety.
Future studies should seek to understand the causal relation between discrimination, negative perceptions, and anxiety, with gender as a moderator. Factors such as sensitivity, normalization, and level of exposure may play a role in the differences across gender. Understanding the differences between the effects of perceived and overt racial discrimination, in addition to the difference between gender and symptoms of anxiety induced by racial discrimination, will help create interventions for African American adolescents of any gender identity that are struggling with anxiety as a result of racial discrimination. Overall, exploring the various psychological impacts of discrimination on African American adolescents will allow for effective mental health counseling for these individuals.
References
Al Haddad, M. (2000). Towards an understanding of prejudice, racism, and community violence. Bahrain Medical Bulletin, 22(1), 1-4. https://www.bahrainmedicalbulletin.com/march_2000/racism.pdf
Assari, S., Moazen-Zadeh, E., Caldwell, C. H., & Zimmerman, M. A. (2017). Racial discrimination during adolescence predicts mental health deterioration in adulthood: Gender differences among blacks. Frontiers in Public Health, 5(104), 1-10.
Berkel, C., Murry, V., Hurt T., Chen, Y., Brody, G., Simons, R., Gibbons, F. (2008). It takes a village: Protecting rural African American youth in the context of racism. Journal of Youth and Adolescence, 28, 175–188.
Brodish, A., Cogburn, C., Fuller-Rowell, T., Peck, S., Malanchuk, O., Eccles, J. (2011). Perceived racial discrimination as a predictor of health behaviors: The moderating role of gender. Race Social Problems, 3(3),160–169.
Carter, R. (1991). Racial identity attitudes and psychological functioning. Journal of Multicultural Counseling and Development, 19 (3), 105–114.
Caughy, M., O’Campo, P., & Muntaner, C. (2004). Experiences of racism among African American parents and the mental health of their preschool-aged children. American Journal of Public Health, 94(12), 2118–2124.
Clark, R., Anderson, N., Clark, V. R., & Williams, D. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54(10), 805-816.
Clark, R., Coleman, A., & Novak, J. (2004). Brief report: Initial psychometric properties of the everyday discrimination scale in black adolescents. Journal of Adolescence, 27(3), 363-368.
Cortina, L. M. (2008). Unseen injustice: Incivility as modern discrimination in organizations. Academy of Management Review, 33, 55-75.
Derdikman‐Eiron, R., Indredavik, M., Bratberg, G., Taraldsen, G., Bakken, I., & Colton, M. (2011). Gender differences in subjective well‐being, self‐esteem, and psychosocial functioning in adolescents with symptoms of anxiety and depression: Findings from the Nord‐Trøndelag health study. Scandinavian Journal of Psychology, 52(3), 261-267.
Dovidio, J. F., & Gaertner, S. L. (1986). Prejudice, discrimination, and racism. Academic Press.
Duck, J. M., Hogg, M. A., & Terry, D. J. (2000). The perceived impact of persuasive messages on “us” and “them” In D. J. Terry & M. A. Hogg (Eds.), Applied social research. Attitudes, behavior, and social context: The role of norms and group membership (p. 265–291). Lawrence Erlbaum Associates Publishers.
Fitzpatrick, K., & Boldizar, J. (1993). The prevalence and consequences of exposure to community violence among African American youth. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 424–430.
Garnefski, N., Legerstee, J., Kraaij, V., van Den Kommer, T., & Teerds, J. (2002). Cognitive coping strategies and symptoms of depression and anxiety: A comparison between adolescents and adults. Journal of Adolescence, 25(6), 603-611.
Gaylord-Harden, N., & Cunningham, J. (2009). The impact of racial discrimination and coping strategies on internalizing symptoms in African American youth. Journal of Youth and Adolescence, 38(4), 532-543.
Gaylord-Harden, N., Cunningham, J., & Zelencik, B. (2011). Effects of exposure to community violence on internalizing symptoms: Does desensitization to violence occur in African American youth? Journal of Abnormal Child Psychology, 39(5), 711-719.
Gaylord-Harden, N., Elmore, C., Campbell, C., & Wethington, A. (2011). An examination of the tripartite model of depressive and anxiety symptoms in African American youth: Stressors and coping strategies as common and specific correlates. Journal of Clinical Child & Adolescent Psychology, 40(3), 360-374.
Harrell, S. (2000). A multidimensional conceptualization of racism-related stress: Implications for the well-being of people of color. American Journal of Orthopsychiatry, 70, 42–57.
Hazen, E., Goldstein, M., Goldstein, M., & Jellinek, M. (2011). Anxiety Disorders. In Mental Health Disorders in Adolescents: A Guide for Parents, Teachers, and Professionals (pp. 112-128). Rutgers University Press.
Himmelstein, M., Young, D., Sanchez, D., Jackson, J. (2014). Vigilance in the discrimination-stress model for Black Americans. Psychological Health 30(3):253–67.
Hunter, L. & Schmidt, N. (2010). Anxiety psychopathology in African American adults: Literature review and development of an empirically informed sociocultural model. Psychological Bulletin, 136(2), 211-235.
Kessler, R., Mickelson, K., & Williams, D. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 208-230. National Institute of Mental Health (2018). Anxiety disorders. National Institutes of Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
Nyborg, V., & Curry, J. (2003). The impact of perceived racism: Psychological symptoms among African American boys. Journal of Clinical Child and Adolescent Psychology, 32(2), 258-266.
Palapattu, A., Kingery, J., & Ginsburg, G. (2006). Gender role orientation and anxiety symptoms among African American adolescents. Journal of Abnormal Child Psychology, 34(3), 423-431.
Pyant, C., & Yanico, B. (1991). Relationship of racial identity and gender-role attitudes to Black women’s psychological well-being. Journal of Counseling Psychology, 38(3), 315.
Sanders-Phillips, K. (2009). Racial discrimination: A continuum of violence exposure for children of color. Clinical Child and Family Psychology Review, 12(2), 174-195.
Scharrer, E. (2002). Third-person perception and television violence: The role of out-group stereotyping in perceptions of susceptibility to effects. Communication Research, 29(6), 681-704.
Sellers, L., Caldwell, C., Schmeelk-Cone, K., & Zimmerman, M. (2003). Racial identity, racial discrimination, perceived stress and psychological distress among African American young adults. Journal of Health and Social Behavior, 43, 302–317.
Sellers, R., & Shelton, J. (2003). The role of racial identity in perceived racial discrimination. Journal of Personality and Social Psychology, 84(5), 1079.
Simons, R., Murray, V., McLoyd, V., Lin, K., Cutrona, C., & Conger, R. (2002). Discrimination, crime, ethnic identity, and parenting as correlates of depressive symptoms among African American children: A multilevel analysis. Development and Psychopathology, 14(2), 371–393.
Smith-Bynum, M., Lambert, S., English, D., & Ialongo, N. (2014). Associations between trajectories of perceived racial discrimination and psychological symptoms among African American adolescents. Development and Psychopathology, 26(4 Pt 1), 1049-1065.
Soto, J., Dawson-Andoh, N., & BeLue, R. (2011). The relationship between perceived discrimination and generalized anxiety disorder among African Americans, Afro Caribbeans, and non-Hispanic Whites. Journal of Anxiety Disorders, 25(2), 258-265.
Tajfel, H. (1974). Social identity and intergroup behaviour. Information (International Social Science Council), 13(2), 65-93.
Taylor, K., Sullivan, T., & Kliewer, W. (2012). A longitudinal path analysis of peer victimization, threat appraisals to the self, and aggression, anxiety, and depression among urban African American adolescents. Journal of Youth and Adolescence, 42(2), 178-189.
Voisin, D., Neilands, T., & Hunnicutt, S. (2011). Mechanisms linking violence exposure and school engagement among African American adolescents: Examining the roles of psychological problem behaviors and gender. American Journal of Orthopsychiatry, 81(1), 61-71.
Williams, D., Yu, Y., Jackson, J., & Anderson, N. (1997). Racial differences in physical and mental health: Socioeconomic status, stress, and discrimination. Journal of Health Psychology, 2, 335–351.
Wong, C., Eccles, J., & Sameroff, A. (2003). The influence of ethnic discrimination and ethnic identification on African American adolescents’ school and socioemotional adjustment. Journal of Personality, 71(6), 1197-1232.
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