Yale Child Study Center, Yale University, United States.
Department of International Health; Center for American Indian Health, Johns Hopkins University.
Transcult Psychiatry. 2024 Jun;61(3):372-384. doi: 10.1177/13634615221079146. Epub 2022 Feb 28.
American Indian (AI) people experience disproportionate exposure to stressors and health inequities, including type 2 diabetes (T2D) and mental health problems. There is increasing interest in how historical trauma and ongoing experiences of discrimination and marginalization (i.e., historical oppression) interact to influence AI health. The purpose of this study is to examine the relationships between historically traumatic experiences (i.e., boarding schools, relocation programs, and foster care), current reports of historical cultural loss, microaggressions, and their relationship to internalizing symptoms among AI adults living with T2D. This community-based participatory research study with five AI tribal communities includes data from 192 AI adults with T2D recruited from tribal clinics. Results from structural equation modeling revealed that personal experiences in foster care and ancestral experiences in boarding schools and/or relocation were associated with increased reports of historical loss, and indirectly associated with internalizing symptoms through racial microaggressions and historical losses. The findings highlight the importance of considering multiple dimensions of historical trauma and oppression in empirical and practice-based assessments of mental health problems.
美国印第安人（AI）经历了不成比例的压力和健康不平等，包括 2 型糖尿病（T2D）和心理健康问题。人们越来越关注历史创伤以及持续的歧视和边缘化经历（即历史压迫）如何相互作用影响 AI 的健康。本研究旨在探讨历史创伤经历（即寄宿学校、搬迁计划和寄养）、当前历史文化丧失、微侵犯的报告与 2 型糖尿病 AI 成年患者内化症状之间的关系。这项具有五个 AI 部落社区的社区参与式研究包括了从部落诊所招募的 192 名 AI 成年 2 型糖尿病患者的数据。结构方程模型的结果表明，在寄养中个人经历以及在寄宿学校和/或搬迁中的祖先经历与历史丧失的报告增加有关，并且通过种族微侵犯和历史丧失与内化症状间接相关。研究结果强调了在基于经验和实践的心理健康问题评估中考虑历史创伤和压迫的多个维度的重要性。
