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Childhood trauma is an increasingly significant public health issue, influenced by various individual, relational, communal, and societal factors. Studies suggest that specific racial/ethnic groups (i.e., Black and/or Latino) are at greater risk of increased exposure to trauma, bereavement, and related mental health issues (Lopez et al., 2017). Alongside racial and ethnic disparities, Neighborhood Income Disadvantage (NID; a collection of community-level economic stressors that have negative implications for residents of a given neighborhood) is also associated with increased exposure to traumatic events in youth (Carbone et al., 2019). While research shows that Black and Latino youth have a higher likelihood of residing in areas with NID, NID is its own distinct system of oppression, separate from racial/ethnic identity, and therefore may be related to trauma and bereavement-related experiences in unique ways (Baker et al., 2005).  
Black and Non-Black Latino individuals who reside amongst high NID appear to be particularly vulnerable to traumatic circumstances such as polyvictimization (i.e., exposure to multiple types of traumatic events) and experiencing deaths of multiple loved ones, including greater exposure to homicide deaths (Andrews et al., 2015; Ulmer et al., 2012). However, few studies have explicitly examined the unique contributions of race/ethnicity, NID, and related trauma- and bereavement-related factors in diverse samples of youth and how they may predict posttraumatic stress symptoms (PTSS) and maladaptive grief reactions. The primary aim of the current study was to examine the predictive utility of race/ethnicity and NID in relation to PTSS and maladaptive grief reactions. Additionally, we aimed to test the potential mediating roles of polyvictimization and bereavement-related contextual factors (deaths of multiple loved ones and homicide-related deaths). 
Our sample included 429 children and adolescents receiving treatment for exposure to trauma and/or bereavement. Youth were 6-18 years-old (Mage = 12.20, SD = 2.98), 55% female, 40.3% Latino/Hispanic, 33.5% White/Caucasian, and 24.8% Black/African American. Participants who provided consent completed a standardized psychological assessment battery administered by trained clinicians that included measurement of trauma- and grief-related experiences and symptoms. 

Identifying as Black was indirectly associated with higher posttraumatic stress symptoms via greater polyvictimization even after accounting for NID. Identifying as Black was also associated with elevated maladaptive grief symptoms, and this relationship was partially explained by an increased likelihood of experiencing a loved one’s death to homicide compared to all other types of deaths. Identifying as Latino and living amongst greater NID were directly associated with higher maladaptive grief reactions. 

These findings highlight the importance of carefully examining various systems of oppression and related experiences, such as polyvictimization and exposure to violent death, that can shape youth's responses to trauma and bereavement (e.g., higher levels of maladaptive grief among Black youth due to greater exposure to homicide). Although the current study did not identify significant mediating mechanisms that may help explain links between Latino and NID-residing youth and trauma- and grief-related outcomes, future research should investigate other experiences that may be able to explain these associations. For example, race-related trauma, racial discrimination, police brutality, immigration-related trauma, deportation, financial stress, and/or transnational grieving (loss of loved one in their country of origin), may also play important roles in the development of PTSS and/or maladaptive grief.

Future work that helps to delineate life conditions contributing to trauma- and grief-related outcomes among diverse samples of youth may have important implications for risk screening and preventive intervention. For example, various stakeholders may wish to consider the following recommendations:

  1. Clinicians: Prioritize screening for relevant socioeconomic and sociocultural factors when working with trauma- and bereavement-exposed youth to better address the unique needs of certain groups.
  2. Educators: Provide trauma- and bereavement-informed context to help explain behavioral manifestations of traumatic stress and maladaptive grief exhibited by Black students in particular. Be conscious of potential biases and disparities before considering instituting punitive discipline approaches. 
  3. Researchers: Increase culturally-informed research efforts focused on youth identity and life conditions and the ways in which systems of oppression may contribute to trauma- and grief-related mental health outcomes. 
  4. Policymakers: Consider racial, ethnic, and income disparities in social action efforts aimed at mitigating childhood trauma, bereavement, and related mental health issues

Discussion Questions

  • What other factors may potentially play a role in how youth of color and youth from low-income communities respond to trauma and bereavement?
  • How might researchers, clinicians, educators and advocacy workers identify and intervene on mediating factors related to traumatic stress and grief in Black, Latino, and NID-residing youth?
  • How might polyvictimization and homicide exposure uniquely influence post-traumatic stress and maladaptive grief symptoms in youth as they age overtime? 

About the Authors

Robyn Douglas, M.A,
 is Clinical Psychology Doctoral student at Texas A&M University under Dr. Noni Gaylord-Harden. Her research, clinical, and advocacy work examines the experiences of Black youth and youth of color exposed to community violence, racial trauma, and neighborhood poverty. Additionally, she is passionate about class-conscious and culturally informed mental health treatments, community-based healing practices, and the overall resiliency of oppressed communities. For more information, Robyn can be contacted at douglard@tamu.edu
Lauren Alvis, PhD
, is a Research Psychologist at the Trauma and Grief Center at The Hackett Center for Mental Health/Meadows Mental Health Policy Institute. Dr. Alvis’ research is focused on promoting positive youth development in racially oppressed youth exposed to trauma and bereavement. Her training is in advanced quantitative analyses and life-span developmental psychology. Dr. Alvis can be contacted at lalvis@mmhpi.org.
Julie Kaplow, PhD, ABPP 
is the Executive Director of the Trauma and Grief Center at The Hackett Center for Mental Health/Meadows Mental Health Policy Institute as well as the Executive Director of the Trauma and Grief Center at the Children’s Hospital, New Orleans. Dr. Kaplow’s work focuses on the development, implementation, evaluation, and national dissemination of trauma- and grief-informed, evidence-based practices for children and adolescents exposed to trauma and bereavement. Dr. Kaplow can be contacted at jkaplow@mmhpi.org.

References Cited

Andrews, A. R., Jobe-Shields, L., López, C. M., Metzger, I. W., De Arellano, M. A., Saunders, B., & Kilpatrick, D. G. (2015). Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence. Social psychiatry and psychiatric epidemiology50(8), 1223-1234.
Baker, E. A., Metzler, M. M., & Galea, S. (2005). Addressing social determinants of health inequities: learning from doing. American Journal of Public Health95(4), 553–555. https://doi.org/bgv69n
Carbone, J. T., Holzer, K. J., & Vaughn, M. G. (2019). Posttraumatic Stress Disorder Among Low‐Income Adolescents Experiencing Family–Neighborhood Income Disparities. Journal of traumatic stress32(6), 899-907.
López, C. M., Andrews III, A. R., Chisolm, A. M., De Arellano, M. A., Saunders, B., & Kilpatrick, D. (2017). Racial/ethnic differences in trauma exposure and mental health disorders in adolescents. Cultural diversity and ethnic minority psychology23(3), 382.

Ulmer, J. T., Harris, C. T., & Steffensmeier, D. (2012). Racial and ethnic disparities in structural disadvantage and crime: White, Black, and Hispanic comparisons. Social science quarterly93(3), 799-819.

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