National Center for PTSD, Women's Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America.
Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America.
PLoS One. 2023 Sep 26;18(9):e0291965. doi: 10.1371/journal.pone.0291965. eCollection 2023.
Black and Hispanic/Latinx individuals experience a greater burden of mental health symptoms as compared to White individuals in the general population. Examination of ethnoracial disparities and mechanisms explaining these disparities among veterans is still in its nascence. The current study examined perceived everyday discrimination and income as parallel mediators of the association between race/ethnicity and PTSD, depression, and general anxiety symptoms in a sample of White, Black, and Hispanic/Latinx veterans stratified by gender.
A random sample of 3,060 veterans living across the U.S. (oversampled for veterans living in high crime communities) completed a mail-based survey. Veterans completed self-report measures of perceived discrimination via the Everyday Discrimination Scale, PTSD symptoms via the Posttraumatic Stress Disorder Checklist-5, depressive symptoms via the Patient Health Questionnaire, and anxiety symptoms via the Generalized Anxiety Disorder Questionnaire.
Models comparing Black vs. White veterans found that the significant effect of race on PTSD, depression, and anxiety symptoms was mediated by both perceived discrimination and income for both male and female veterans. Results were less consistent in models comparing Hispanic/Latinx vs. White veterans. Income, but not perceived discrimination, mediated the relationship between ethnicity/race and depression and anxiety symptoms, but only among women.
Results suggest that discrimination and socioeconomic status are important mechanisms through which marginalized social status negatively impacts mental health.
与普通人群中的白人相比,黑人和西班牙裔/拉丁裔个体经历着更大的心理健康症状负担。对退伍军人中种族差异和解释这些差异的机制的研究仍处于起步阶段。本研究在按性别分层的白种人、黑人和西班牙裔/拉丁裔退伍军人样本中,考察了感知日常歧视和收入作为种族/民族与 PTSD、抑郁和广泛性焦虑症状之间关联的平行中介因素。
一项针对居住在美国各地的 3060 名退伍军人的随机抽样(对居住在高犯罪社区的退伍军人进行了超额抽样)完成了一项基于邮件的调查。退伍军人通过日常歧视量表(Everyday Discrimination Scale)完成了感知歧视的自我报告测量,通过创伤后应激障碍检查表-5(Posttraumatic Stress Disorder Checklist-5)完成了 PTSD 症状测量,通过患者健康问卷(Patient Health Questionnaire)完成了抑郁症状测量,通过广泛性焦虑症问卷(Generalized Anxiety Disorder Questionnaire)完成了焦虑症状测量。
比较黑人和白人退伍军人的模型发现,种族对 PTSD、抑郁和焦虑症状的显著影响通过感知歧视和收入两个因素在男女退伍军人中均得到了中介。在比较西班牙裔/拉丁裔与白人退伍军人的模型中,结果则不太一致。收入而不是感知歧视,在种族/民族与抑郁和焦虑症状之间的关系中起到了中介作用,但仅在女性中如此。
研究结果表明,歧视和社会经济地位是边缘化社会地位对心理健康产生负面影响的重要机制。