Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Trauma Research Consortium, Baylor Scott and White Research Institute, Baylor Scott & White Health, Dallas, TX, USA.
Eur J Psychotraumatol. 2023;14(2):2211486. doi: 10.1080/20008066.2023.2211486.
Racial discrimination is a traumatic stressor that increases the risk for posttraumatic stress disorder (PTSD), but mechanisms to explain this relationship remain unclear. Peritraumatic dissociation, the complex process of disorientation, depersonalization, and derealization during a trauma, has been a consistent predictor of PTSD. Experiences of frequent racial discrimination may increase the propensity for peritraumatic dissociation in the context of new traumatic experiences and contribute to PTSD symptoms. However, the role of peritraumatic dissociation in the relationship between experiences of discrimination and PTSD has not been specifically explored. The current study investigated the role of peritraumatic dissociation in the impact of racial discrimination on PTSD symptoms after a traumatic injury, and the moderating role of gender. One hundred and thirteen Black/African American individuals were recruited from the Emergency Department at a Level I Trauma Center. Two weeks after the trauma, participants self-reported their experiences with racial discrimination and peritraumatic dissociation. At the six-month follow-up appointment, individuals underwent a clinical assessment of their PTSD symptoms. Results of longitudinal mediation analyses showed that peritraumatic dissociation significantly mediated the effect of racial discrimination on PTSD symptoms, after controlling for age and lifetime trauma exposure. A secondary analysis was conducted to examine the moderating role of gender. Gender was not a significant moderator in the model. Findings show that racial discrimination functions as a stressor that impacts how individuals respond to other traumatic events. The novel results suggest a mechanism that explains the relationship between racial discrimination and PTSD symptoms. These findings highlight the need for community spaces where Black Americans can process racial trauma and reduce the propensity to detach from daily, painful realities. Results also show that clinical intervention post-trauma must consider Black Americans' experiences with racial discrimination.
种族歧视是一种创伤性应激源,会增加创伤后应激障碍(PTSD)的风险,但解释这种关系的机制仍不清楚。创伤时的定向障碍、人格解体和现实解体的复杂过程即创伤后分离,一直是 PTSD 的一致预测因素。频繁的种族歧视经历可能会增加在新的创伤经历中发生创伤后分离的倾向,并导致 PTSD 症状。然而,创伤后分离在歧视经历与 PTSD 之间的关系中的作用尚未得到专门探讨。本研究调查了创伤后分离在种族歧视对创伤后应激障碍症状的影响中的作用,以及性别在其中的调节作用。从一级创伤中心的急诊室招募了 113 名黑人和非裔美国人。在创伤后两周,参与者自我报告了他们的种族歧视和创伤后分离经历。在六个月的随访预约时,对个人进行了 PTSD 症状的临床评估。纵向中介分析的结果表明,在控制年龄和终生创伤暴露后,创伤后分离显著中介了种族歧视对 PTSD 症状的影响。进行了二次分析以检验性别调节作用。性别在模型中不是一个显著的调节因素。研究结果表明,种族歧视是一种应激源,会影响个体对其他创伤事件的反应方式。新的结果表明了一种解释种族歧视和 PTSD 症状之间关系的机制。这些发现强调了需要为非裔美国人提供处理种族创伤和减少与日常痛苦现实脱节倾向的社区空间。研究结果还表明,创伤后临床干预必须考虑到非裔美国人的种族歧视经历。
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