Department of Psychology, Stony Brook University, Stony Brook, New York.
New York State Psychiatric Institute, New York.
JAMA Psychiatry. 2015 Jul;72(7):706-13. doi: 10.1001/jamapsychiatry.2015.0148.
Multivariable comorbidity research indicates that many common mental disorders are manifestations of 2 latent transdiagnostic factors, internalizing and externalizing. Environmental stressors are known to increase the risk for experiencing particular mental disorders, but their relationships with transdiagnostic disorder constructs are unknown. The present study investigated one such stressor, perceived racial discrimination, which is robustly associated with a variety of mental disorders.
To examine the direct and indirect associations between perceived racial discrimination and common forms of psychopathology.
DESIGN, SETTING, AND PARTICIPANTS: Quantitative analysis of 12 common diagnoses that were previously assessed in a nationally representative sample (N = 5191) of African American and Afro-Caribbean adults in the United States, taken from the National Survey of American Life, and used to test the possibility that transdiagnostic factors mediate the effects of discrimination on disorders. The data were obtained from February 2001 to March 2003. Latent variable measurement models, including factor analysis, and indirect effect models were used in the study.
Mental health diagnoses from reliable and valid structured interviews and perceived race-based discrimination.
While perceived discrimination was positively associated with all examined forms of psychopathology and substance use disorders, latent variable indirect effects modeling revealed that almost all of these associations were significantly mediated by the transdiagnostic factors. For social anxiety disorder and attention-deficit/hyperactivity disorder, complete mediation was found.
The pathways linking perceived discrimination to psychiatric disorders were not direct but indirect (via transdiagnostic factors). Therefore, perceived discrimination may be associated with risk for myriad psychiatric disorders due to its association with transdiagnostic factors.
多变量合并症研究表明，许多常见的精神障碍是 2 种潜在的跨诊断因素，即内在化和外在化的表现。环境压力源已知会增加特定精神障碍的风险，但它们与跨诊断障碍结构的关系尚不清楚。本研究调查了一种这样的压力源，即感知到的种族歧视，它与多种精神障碍密切相关。
研究感知到的种族歧视与常见精神病理形式之间的直接和间接关联。
设计、设置和参与者：对来自美国的具有代表性的全国性样本（N=5191）中的非洲裔美国人和非裔加勒比成年人进行了 12 种常见诊断的定量分析，这些诊断以前在美国生活全国调查中进行了评估，用于检验跨诊断因素是否在歧视对障碍的影响中起中介作用的可能性。数据于 2001 年 2 月至 2003 年 3 月获得。该研究使用了潜在变量测量模型，包括因子分析和间接效应模型。
来自可靠和有效的结构化访谈和基于感知种族的歧视的心理健康诊断。
虽然感知歧视与所有检查的精神病理学形式和物质使用障碍呈正相关，但潜在变量间接效应模型显示，几乎所有这些关联都被跨诊断因素显著中介。对于社交焦虑症和注意缺陷/多动障碍，发现了完全中介。
将感知歧视与精神障碍联系起来的途径不是直接的，而是间接的（通过跨诊断因素）。因此，由于感知歧视与跨诊断因素有关，它可能与多种精神障碍的风险相关。
