6 - (IOP 5) A Meta-analytic Review on Racial and Ethnic Discrimination Influencing PTSD Symptoms Among Black Americans

Background: Black Americans experience disproportionate levels of racial discrimination, which have been linked to a range of maladaptive outcomes, further exacerbating health disparities (Brondolo et al., 2009). In the realm of trauma, racial discrimination can be a source of traumatic stress for Black Americans, associated with PTSD and racism-based traumatic stress, also known as racial trauma (Carter, 2006). As such, it is imperative to synthesize the accumulating existing research regarding PTSD and racial discrimination. The present meta-analysis synthesized the culmination of previous empirical research examining the relationships between racial discrimination and PTSD symptoms.

Method: A comprehensive literature review was conducted by using multiple databases. A total of 25 possible sources were identified in the initial search by entering the following search parameters in Google Scholar and ProQuest Dissertations and Theses databases through October 2024. Search words included: discrimination, race, PTSD, and Black. The following criteria must have been met to be eligible for coding: (a) including a measure of discrimination that focused on race and/or ethnicity, (b) including a measure of PTSD symptom severity or a comparison between clinical and non-clinical samples, (c) an English version of the article was available, (d) sufficient information to calculate an effect size, (e) the article provided data that were not reported in another published study, (f) the study focused on individuals who identified as Black or included separate analyses for their sample of Black individuals. A coding form was created to document relevant information from each article. This information included a) a full bibliographic reference, b) type of publication, c) study design, d) sample characteristics, e) measure of discrimination used, f) PTSD outcome measure(s), and g) effect size information. 14 useable studies containing 17 useable effect sizes were obtained from this process.

Results: A random effects model was run, encapsulating a total sample of 5294 Black Americans. There was a positive correlation between racial discrimination and PTSD symptom severity with a medium effect size of .346 (C.I=.283:.409). More experiences with racial discrimination are associated with higher levels of posttraumatic stress.

Conclusion: This meta-analysis demonstrates a powerful association between racial discrimination and PTSD symptoms, like increased hypervigilance and hyperarousal, among Black Americans. To date, experiences with racism are not considered to be sufficient for classification for a PTSD diagnosis, as racist encounters do not always meet DSM criterion A. Recent literature has considered that criterion A may not be necessary for trauma to elicit posttraumatic stress symptoms (Howard et al., 2024). Clinical implications of this meta-analytic review include serving as a call to action to consider diagnostic options for racism-based traumatic stress and the maladaptive influences of racial discrimination in relation to PTSD.