New study sheds light on risk factors that account for racial/ethnic differences in PTSD, depression, and anxiety symptoms

Different racial and ethnic groups fare better or worse following a trauma, but why? A study published in Psychological Medicine suggests that posttraumatic symptoms differ by race and ethnicity following a traumatic event due to discrepancies in other risk factors.

Many people who are hospitalized for an injury or an illness are at risk for negative mental health outcomes as a result, including PTSD, anxiety, and depression. These mental health struggles can be exacerbated or mitigated by factors such as socioeconomic stability, interpersonal support, and stress levels. Previous studies have found ethnic and racial differences in posttraumatic stress symptomology but have not explored why. This study sought to understand how other factors interact with race and ethnicity to form a person’s posttraumatic response.

For their study, Mario Cruz-Gonzalez and colleagues utilized a sample of 1,310 adults who were in the emergency department following an injury or illness. Hospitals used were located in Ohio, California, and Maryland. Participants had a range of injuries from events including car crashes and animal bites and had a myriad of illnesses including sepsis, sickle cell, and cancer. Participants were assessed days after their hospitalization and then follow-up assessments occurred at 2- and 6-months post-hospitalization. Measures included PTSD, anxiety, and depression symptomology, pre-trauma risk factors, peri-trauma risk factors, post-trauma risk factors, and demographics.

Results showed that Black, Latino, and multiracial participants showed higher levels of acute trauma following their injury or illness. These effects persisted for Black and multiracial patients, but dropped off rapidly for Latino patients, with Latino patients showing quicker improvement in symptoms than White patients.

Latino, Black, and multiracial participants had lower socioeconomic status, lower income, higher levels of financial stress, and increased discrimination, which are significant stressors for traumatic symptomology around the time of the event. Additionally, Black and multiracial participants reported lower expectations of social support and increased daily experiences of discrimination, which are risk factors for trauma symptoms and may explain why these groups experienced persistent trauma symptoms in the months following the incident.

This study took steps into understanding why there are racial and ethnic group differences following a trauma. Despite this, there are limitations to note. One such limitation is that trauma was limited to injury or illness that resulted in hospital care and the effects may not hold with other types of traumas. Additionally, self-report was used to capture trauma symptomology, which has been shown in previous research to differ from clinician-administered measures. Future research could incorporate other methods.

“The present study showed that although experiencing a potentially traumatic event, such as severe injury or illness, impacted patients’ mental health, responses to trauma appeared to differ not by race or ethnicity but by the patients’ underlying risk profile,” the researchers concluded. “Our results identified pre-trauma exposure to everyday discrimination, financial stress, and past mental health problems and post-trauma exposure to social constraints as salient factors that merit early intervention.”

The study, “Racial/ethnic differences in acute and longer-term posttraumatic symptoms following traumatic injury or illness“, was authored by Mario Cruz-Gonzalez, Margarita Alegría, Patrick A. Palmieri, David A. Spain, M. Rose Barlow, Lisa Shieh, Mallory Williams, Pranathi Srirangam, and Eve B. Carlson.

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