Investigating the Longitudinal Effects of Racial Discrimination on Internalizing Behavior Symptoms Among Racial/Ethnic Minority Young Adolescents: Findings from the Adolescent Brain and Cognitive Development Study

Racial/ethnic disparities in health outcomes in the United States (U.S.) have long been recognized as a pervasive issue and is one of the most leading causes of chronic physical and mental health conditions, including all-cause mortality. One aspect of racism that has received increased research attention as a class of stressors linked to health and mental health outcomes is perceived racial discrimination (PRD). Although various studies have examined the association between PRD and mental health outcomes among adolescents, there exist a dearth of research investigating the association between PRD and internalizing behavior symptoms among racial/ethnic minority adolescents using a large, nationally representative longitudinal data. Therefore, drawing on data from the Adolescent Brain and Cognitive Development (ABCD) Study, the objective of this study was to investigate the longitudinal association between PRD and internalizing behavior symptoms among racial/ethnic minority adolescents over and above demographic characteristics, income, and family factors.

Methods: Data for this study came from the ABCD study, the largest long-term study of brain development and child health in the U.S. The ABCD study is comprised from 21 research sites and began in 2016-2018 with 11,880 children ages 9-10 at baseline. The sample (n = 3,087, males = 51%) of young adolescents aged 10-11 at Wave 1 who self-identified as racial/ethnic minority was analyzed with internalizing behavior symptoms at Wave 2 as the main outcome variable. The exposure variable of interest was PRD and was measured using the seven item discrimination measure in the ABCD study that included items such as “I feel that others behave in an unfair or negative way toward my ethnic group?” Data were analyzed using both descriptive and multivariable analytic techniques. Descriptive statistics were employed to examine the distributions of all included variables. The main analyses utilized ordinary least squares (OLS) regression to estimate the association between PRD and internalizing behavior symptoms at Wave 2, while controlling for covariates and demographic characteristics at Wave 1. Three linear regression models were fitted.

Results: The mean PRD score was 1.24 (SD = 0.46) and the mean internalizing behavior symptoms was 4.49 (SD = 5.62). In the fully adjusted model which included demographic factors, income, family conflict, and parental acceptance, PRD was significantly associated with internalizing behavior symptoms whereby each additional unit increase in PRD was significantly associated with 0.94 increase in internalizing behavior symptoms (β = 0.94, SE = 0.23, 95% CI [0.49, 1.38]). Family conflict was positively associated with internalizing symptoms (β = 0.24, SE = 0.06, 95% CI [0.13, 0.35]), while parental acceptance was negatively associated with internalizing symptoms (β = -0.91, SE = 0.35, 95% CI [-1.60, -0.22]).

Conclusion: The findings of this study highlight the adverse long-term effects of PRD on mental health among racial/ethnic minority adolescents, emphasizing the importance of addressing racial discrimination as a public health issue. Understanding the long-term adverse effects of PRD on internalizing behavior symptoms among racial/ethnic minority adolescents using longitudinal data is critical to addressing equitable health outcomes and developing targeted culturally relevant interventions for racial/ethnic minority adolescents.