Woody Mary L, Bell Elizabeth C, Cruz Nicolas A, Wears Anna, Anderson Riana E, Price Rebecca B
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Chronic Stress (Thousand Oaks). 2022 Aug 9;6:24705470221118574. doi: 10.1177/24705470221118574. eCollection 2022 Jan-Dec.
There are known disparities in the burden of illness and access/quality of care for African, Latino/a, Asian, and Native American (ALANA) patients diagnosed with depressive disorders, which may occur because of health inequities. Racial stress and trauma (RST), or the significant fear and distress that can be imparted from exposure to racism, is one such inequity linked to the development of depression. The current review summarizes past research examining the association between racism, RST, and depression, as well as avenues in which RST becomes biologically embedded in ALANA individuals. We describe multimodal research that supports vigilance as a potential mediator of the association between RST and depression and consider the nuanced role that vigilance plays during experiences with racism. Finally, we describe methodological advances in the assessment of vigilance evoked by RST and the clinical implications that may be generated by future improvements. In each of these areas, we present examples of how ongoing and future research can be leveraged to provide support for psychosocial programs that facilitate autonomous community healing and resilience, increase calls for public policy changes, and support clinical interventions that lessen the burden of racism on ALANA communities.
在被诊断患有抑郁症的非洲裔、拉丁裔、亚裔和美国原住民(ALANA)患者中,疾病负担以及医疗服务的可及性/质量存在已知差异,这可能是由于健康不平等所致。种族压力与创伤(RST),即因接触种族主义而可能产生的重大恐惧和痛苦,就是与抑郁症发展相关的一种此类不平等现象。本综述总结了以往研究,这些研究考察了种族主义、RST与抑郁症之间的关联,以及RST在ALANA个体中如何在生物学层面扎根。我们描述了多模式研究,该研究支持警惕性作为RST与抑郁症之间关联的潜在中介,并探讨了警惕性在种族主义经历中所起的微妙作用。最后,我们阐述了评估RST引发的警惕性方面的方法学进展以及未来改进可能产生的临床意义。在上述每个领域,我们都给出了实例,说明如何利用正在进行的研究和未来的研究为促进自主社区康复与恢复力的社会心理项目提供支持,增加对公共政策变革的呼声,并支持减轻种族主义对ALANA社区造成负担的临床干预措施。