Abstract
Racial discrimination and race-based trauma (RBT) have led to the development of various negative psychological and physiological effects among Black adults in the USA. There is a lack of understanding in relation to how various psychosocial factors influence posttraumatic growth (PTG) in the context of RBT among Black adults. The authors examined associations of RBT, racial identity, and mindfulness with PTG among Black adults while controlling for gender, household income, and duration of trauma. The sample consisted of 134 self-identified Black adults who met the criteria for RBT from the USA. The hierarchical regression analysis showed the final model with all the predictors accounted for 35% of the total variance of PTG, with racial identity and mindfulness facets accounting for 26% of the variance. The study provides a foundation for future research addressing RBT and promoting PTG in Black adults.
Introduction
In a climate with high incidences of racially motivated crimes against the Black community, 76% of Black individuals report being discriminated against or treated unfairly because of their race, and 87% of Black adults believe Black individuals are treated less fairly by the criminal justice system and in dealing with the police in America (Pew Research Center, 2019). The rate of fatal police shootings among Black Americans was much higher than that for any other ethnicity, standing at 38 fatal shootings per million of the population as of May 2022 (Statista Research Department, 2022). Constant occurrence and depictions of police brutality in the media have adverse effects on both the psychological and emotional well-being of Black individuals (American Psychiatric Association, 2018; Legal Defense Fund, 2022; National Association for the Advancement of Colored People (NAACP), 2021), which are believed to occur as a result of systemic oppression, such as racial discrimination and race-related stress in the USA.
Race-related stress is defined as the negative impact endured by racial minorities due to direct experience or observation of racial discrimination (Utsey, 1998). Although race-related stress entails overt and discrete instances of discrimination (e.g., direct racial comments, refusal of services), more insidious forms of discrimination are increasing. Specifically, many incidences of contemporary discrimination manifest as microaggressions or more covert expressions of racism, permitting the accumulation of negative effects over time and emerging as a potentially significant and chronic stressor (Nadal et al., 2014).
Racial discrimination and race-related stress have led to the development of various negative psychological and physiological effects (Carter et al., 2017a, b). For Black Americans, discrimination is associated with poorer life satisfaction, interpersonal issues, and psychological distress (Shawn et al., 2019). Increased perception of racial discrimination was also positively associated with poorer general physical health and somatization symptoms (Carter et al., 2017a, b; Richman et al., 2018). Recent research (e.g., Carter et al., 2016; Hemmings & Evans, 2018; Williams et al., 2022) indicated that racial discrimination and race-related stress may produce trauma-like symptoms (such as depression, anger, intrusion, hypervigilance/arousal, and low self-esteem) referred to as race-based trauma (RBT). RBT refers to the symptom response from an individual following a traumatic racial event that is (a) sudden, (b) out of their control, and (c) elicits an emotionally painful reaction (Carter et al., 2013). Williams et al. (2021) further defined racial trauma as “the cumulative traumatizing impact of racism on a racialized individual, which can include individual acts of racial discrimination combined with systemic racism, and typically includes historical, cultural, and community trauma as well” (p. 1). These racial traumatizing events may give rise to posttraumatic stress responses as well as other tertiary psychiatric symptoms associated with posttraumatic stress disorder (PTSD) (American Psychiatric Association, 2013; National Center for PTSD, 2022). One of the defining criteria of PTSD is exposure to actual or threatened death, serious injury, or sexual violence (American Psychiatric Association, 2013), while RBT results from emotional or psychological stress stemming from an act of racial discrimination.
To offer multiculturally sound approaches to mental health services for Black Americans, Evans et al. (2016) highlighted the need to utilize a resiliency-based, posttraumatic growth (PTG) approach, wherein mental health professionals assist in helping clients in the reappraisal process and create a sense of positive psychological well-being after a trauma. PTG refers to the process by which a traumatic event prompts a deconstruction and reconstruction of a person’s schemas about life (Calhoun & Tedeschi, 2004). The change is often indicated by improved psychological well-being observed in enhanced interpersonal relationships, a greater sense of purpose in life, and an increased appreciation for life (Triplett et al., 2012).
Carter’s (2007) framework offers a non-pathologizing conceptualization of RBT through a holistic and ecological perspective, thereby challenging the reduction of trauma-like symptoms experienced by some Black individuals to a mental disorder. Research is warranted to examine factors associated with PTG among Black adults who experience RBT.
Psychosocial Factors and Posttraumatic Growth
Joseph et al. (2012a, b) proposed that multiple biopsychosocial factors impact the appraisal process and coping strategies, thereby influencing a person’s propensity toward PTG or continued stress responses following the traumatic experience, known as the Affective Cognitive Processing Model. An individual’s gender, socioeconomic status (SES), and the duration of trauma are important sociocultural factors that may impact PTG. Past literature indicated that women had greater sensitivity to both PTG and posttraumatic events (Hamama-Raz et al., 2020; Jin et al., 2014). Specifically, women reported to be more engaged in deliberate rumination, which increases awareness of personal strengths or the importance of social connections, thus leading to greater levels of PTG (Jin et al., 2014). Manove et al. (2019) explored the posttraumatic growth in 32 low-income Black mothers whose houses were severely damaged or destroyed by Hurricane Katrina. Five themes including new possibilities, relating to others, personal strength, appreciation for life, and spiritual change, were found influencing PTG with new possibilities being the highest indicator. However, no research has examined the relationship between different household incomes and PTG among Black individuals with RBT.
Past research has yielded mixed results in examining the relationship between the duration of the traumatic events and PTG (Shand et al., 2015; Tedeschi & Calhoun, 1995). Shand et al. (2015) found that the time since the trauma occurred has at best, minimal influence over the PTG process among cancer patients. However, Tedeschi and Calhoun (1995) reported that PTG may increase over time as individuals further process traumatic events. Tedeschi et al. (2018) suggested that a trauma survivor may experience posttraumatic growth two years after the occurrence of a trauma.
The Affective Cognitive Processing model highlights the social environmental context of the trauma such as levels of traumas to which a person is exposed, culturally laden meanings associated with events, and social systems, which help support the psychological needs of the individual (Joseph et al., 2012a, b). A person’s subjective appraisal of the trauma event impacts both the response to the event and their ability to make meaning of the trauma (Joseph et al., 2012a, b). In a study of Muslim-American college students, individuals who experienced high levels of perceived discrimination and discrimination-related PTSD were also shown to have higher levels of discrimination-related PTG (Tineo et al., 2021). Grier-Reed et al. (2022) further revealed that deepening connections with others, accessing their inner strengths, connecting to their spirituality, and gaining a new perspective on and appreciation for life, individuals are more likely to experience PTG. An individual may achieve PTG by undergoing a cyclical process of appraisal and fully reconciling and accommodating incongruent experiences triggered by a trauma with their existing schema (Joseph et al., 2012a, b).
Racial identity, a key psychosocial factor impacting the subjective appraisal process of an individual experiencing racial discrimination (Carter & Reynolds, 2011; Weiss et al., 2021), may potentially influence their opportunity for PTG. Racial identity refers to a person’s commitment to a positive perspective about their ethnicity and culture in the context of a discriminatory society (Parham & Helms, 1981). Several racial identity models for Black individuals (e.g., Cross, 1995; Cross & Vandiver, 2001) revealed that movement across stages of identity development is associated with changes in racial salience. Racial salience refers to the degree to which ethnicity or race becomes a fundamental factor in a person’s self-representation (Cross, 1995). Cross and Vandiver (2001) operationalized racial identity into pre-encounter, immersion-emersion, and internalization, in an order of low to high racial salience. Carter (2007) suggested that those with low racial salience are less likely to perceive discrimination but are more likely to experience psychological distress due to RBT. However, those endorsing high racial salience related to Internalization (i.e., advocating for other cultures and a positive view of their ethnicity or culture) have a propensity toward positive mental health outcomes, but appear more aware of the existence of cultural racism (Carter & Reynolds, 2011; Carter et al., 2017a, b; Weiss et al., 2021). Despite the importance of racial identity on the appraisal process of RBT and associated mental health outcomes, no research has examined how racial identity may influence PTG over RBT among Black adults.
In addition to racial identity, mindfulness is another psychosocial factor affecting subjective appraisal of traumatic events. Garland et al. (2015) posited that mindfulness directly facilitates the reappraisal process, thus promoting PTG (Hanley et al., 2014, 2017). Mindfulness is “a process of regulating attention in order to bring a quality of relating to a person’s experience within an orientation of curiosity, experiential openness, and acceptance” (Bishop et al., 2004, p. 234). Hilert and Tirado (2019) reported mindfulness as leading to psychological changes by increasing an individual’s ability to observe in an objective manner while accepting and detaching from internal thoughts and emotions. Labelle et al. (2015) demonstrated that mindfulness is associated with PTG in populations having experienced physical and emotional traumas such as cancer patients. In addition, Zapolski et al. (2019) found support for the buffering impact of mindfulness on mood symptoms because of racial discrimination among young Black adults. Mooney (2020) reported that mindfulness has been found useful in combating racial trauma.
Although racial identity and mindfulness are illustrated as factors in race-based stress and PTG, there is a lack of understanding in relation to how much these factors influence PTG in the context of RBT among Blacks. Given that Blacks disproportionately experience racial discrimination and racial trauma (Zapolski et al., 2019), research on how mindfulness facets and racial identity may influence growth following racial traumas is warranted. Moreover, additional studies are necessary to examine how gender, household income, and duration of trauma may be associated with PTG among Black adults considering the limited and/or mixed findings.
The current study examined relationships between degrees of RBT, racial identity, mindfulness, and PTG among Black adults who meet the criteria for RBT, when controlling for gender, household income, and the amount of time since the trauma occurred. The study explored the following research question: Does the degree of RBT, racial identity, and mindfulness facets predict PTG in Black adults who meet the criteria for RBT, when controlling for gender, household income, and the amount of time since the trauma?
Methods
Participants
Among 134 participants, 78 (58.2%) reported as male, 55 (41%) as female, and 1 (0.8%) did not report gender information. One hundred twenty-five (93.3%) participants self-identified as Black, and 9 (6.7%) as multiracial by endorsing both Black and one or more other races. Income ranged from less than $10,000 to more than $150,000, with a mode of $50,000 to $59,999 (n = 22) and $40,000 to $49,000 (n = 21). About 75% of participants reported income rank at about the 50th percentile or lower of the US household income (PK, 2021). Fifty-three (39.91%) reported having below bachelor’s degree (e.g., some high school/or high school degrees or vocational certificate), 55 (41.4%) having bachelor’s degrees, and 25 (18.7%) having master’s or professional/doctoral degrees (see Table 1 for details).
Procedures
This study was approved by the Institutional Review Board of a public research university located in the Southeastern United States. The participants consisted of a convenience sample recruited from Amazon Mechanical Turk (MTurk) and the College of Education Participant Pool of the university through a Qualtrics survey during the year 2018–2019. MTurk is an efficient and valid recruitment strategy used in diverse fields (Keith et al., 2017). Based upon recommended practices on MTurk recruitment (Peer et al., 2012), we set MTurk worker settings in a way that only participants who marked their location as the USAand have a MTurk approval rating of at least 95% were able to participate as a MTurk participant. Research found that limiting the location of participants to the USA and raising the approval rating of MTurk workers improves internal consistency of data (Litman et al., 2015; Peer et al., 2012). Prior to filling out the survey, participants read a preview which stated the inclusion criteria for the study: Individuals who (a) were at least 18 years old, (b) self-identified as Black, and (c) identified at least one racial event that has caused stress or discomfort. Participants also read the definition and examples of racial events: racial events refer to those that initiate stress or discomfort, including events that were subtle or overt acts of racism such as employment discrimination, educational discrimination, and police discrimination because of their ethnicity or race. We recorded a racial event as a RBT when a participant described a traumatic racial event as sudden, out of their control, and emotionally painful, and elevated (i.e., one standard deviation above the mean of T score of 60 or greater indicated an elevation) on at least three subscales, two of which being avoidance, intrusions, or hypervigilance over Race-Based Trauma Stress Symptom Scale (RBTSSS; Carter et al., 2013). We only included participants who met the criteria for RBT based on the RBTSSS scores.
Participants who completed the research study received incentives (i.e., compensation for MTurk participants and course credits for individuals from the participant pool). At the completion of the study, all participants read a debriefing statement, including the purpose of the study and remotely accessible mental health resources if needed.
Measures
A questionnaire collected data regarding participants’ demographic information, including ethnicity, gender, age, education level, and annual household income. The “time since the trauma” variable was calculated by subtracting the age during the trauma from participants’ age at the time of participation in the study. The following measures were also used in the study.
Race-Based Trauma Stress Symptom Scale
The RBTSSS is a 52-item self-report measure of RBT, consisting of seven subscales: depression, intrusion, anger, hypervigilance, physical symptoms, self-esteem, and avoidance (Carter et al., 2013). The scale requires participants to describe three race-based incidents as well as provide the geographical region and the time each event occurred. For the current study, we asked participants to describe one race-based event that was most memorable on three dichotomous scales to determine if the racial event was sudden (yes/no), out of their control (yes/no), and emotionally painful (yes/no). Participants then rated 52 items on a 5-point Likert scale, ranging from 0 (Does not describe my reaction) to 4 (This reaction would not go away). Higher scores on RBTSSS suggest greater evidence of traumatic stress reactions. A sample item includes “I feel emotionally upset when I am reminded of the event.” The RBTSSS demonstrated excellent internal consistency with an alpha level of 0.96 (Carter et al., 2013). Moreover, the instrument demonstrated good discriminant evidence (Carter et al., 2013) and convergent evidence (Carter & Muchow, 2017). Measurement equivalence was evident through no observed significant differences regarding ethnicity/race, gender, or SES in response patterns (Carter & Muchow, 2017; Carter et al., 2013). For the current study, Cronbach’s alpha for the RBTSSS total was 0.90.
Psychological Well-Being Posttraumatic Changes Questionnaire
The Psychological Well-Being Posttraumatic Changes Questionnaire (PWB-PTCQ) is an 18-item self-report PTG instrument, which measures psychological well-being domains of self-acceptance, autonomy, purpose in life, relationships, sense of mastery, and personal growth (Joseph et al., 2012a, b). Respondents rated the degree to which they believe they have changed because of the traumatic event on a 5-point Likert scale, ranging from 1 (Much less so now) and 5 (Much more so now). A sample item includes “I am grateful to have people in my life who care for me.” Higher scores on this measure indicate greater PTG. The scale demonstrated good internal consistencies ranging from 0.87 to 0.95 (Joseph et al., 2012a, b). The scale also demonstrated strong convergent validity (Joseph et al., 2012a, b; la Cour et al., 2016) as well as criterion validity as evidenced by scores in the predicted directions with measures of experienced levels of trauma and psychological distress (la Cour et al., 2016). Joseph et al., (2012a, b) reported that PWB-PTCQ indicated incremental validity as evidenced by its ability to substantially predict variance in subjective well-being above and beyond the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996), Furthermore, la Cour et al (2016) found the PWB-PTCQ demonstrated great psychometrics regarding divergent evidence compared to the PTGI, which was also criticized as not being able to measure actual growth but perceived growth (Bitsch et al., 2011). Thus, we chose PWB-PTCQ in the current study. For the current study, Cronbach’s alpha for the PWB-PTCQ was 0.98.
Cross Racial Identity Scale
The Cross Racial Identity Scale (CRIS) (Cross & Vandiver, 2001) is a 30-item self-report measure of racial identity, consisting of six identities including three (i.e., assimilation, miseducation, and self-hatred subscales) for Pre-Encounter, one (i.e., an anti-White subscale) for Immersion-Emersion, and two (i.e., Afrocentricity and multicultural Inclusive subscales) for Internalization attitudes. Higher scores on this scale indicate stronger racial identity. A sample item includes “I sometimes have negative feelings about being Black.” The CRIS demonstrated good internal consistency for all subscales (Cross & Vandiver, 2001; Worrell et al., 2011). Cross and Vandiver (2001) found good convergent evidence of the CRIS with the Multidimensional Inventory of Black Identity (Sellers et al., 1998). Moreover, the CRIS was not associated with a measure of social desirability (Vandiver et al., 2002). For the current study, Cronbach’s alphas for the CRIS were as follows: Assimilation (0.89), Miseducation (0.83), Self-Hate (0.91), Anti-White (0.90), Afrocentricity (0.84), and Multicultural (0.86).
Five Facet Mindfulness Questionnaire (FFMQ)
The Five Facet Mindfulness Questionnaire (FFMQ) (Baer et al., 2008) is a 39-item self-report measure capturing five facets of mindfulness: Describing, Observing, Acting with Awareness, Nonjudgmental, and Non-reactivity. Participants rated each item on a 5-point Likert scale ranging from 1 (Never or Very Rarely True) to 5 (Very Often or Always True). A sample item includes “I can easily put my beliefs, opinions, and expectations into words.” Higher scores on the FFMQ and its subscales indicate greater mindfulness. The FFMQ has demonstrated strong evidence of test content, based off a review of five measures of mindfulness (Baer et al., 2006). Baer et al. (2008) found the internal consistency was good for all subscales. Moreover, the measure demonstrated good divergent and convergent evidences for all subscales except for the Observing subscale (Baer et al., 2006). Cronbach’s alpha for individual subscales in this study were as follows: Observing (α = 0.85), Describing (α = 0.65), Acting with Awareness (α = 0.86), Nonjudgment (α = 0.85), and Non-reactivity (α = 0.83). We removed the Describing subscale from data analysis due to its alpha level, which is lower than the subthreshold internal consistency of 0.70 (Devillis, 2012).
Data Analysis Approach
To answer the research question, we employed a hierarchical multiple linear regression. Prior to conducting the hierarchical linear regression, we examined assumptions of linearity and homoscedasticity by examining the scatter plot of standardized residuals and standardized predicted values (Osborne & Waters, 2002). To test the assumption of normality of the errors of the regression, we ran the Shapiro–Wilk statistic test and found non-significant result (W = 0.99, p = 0.34), indicating a normal distribution of residuals of the regression. There was no indication of multicollinearity as the square roots of the variance inflation factor (VIF) for each predictor variable were all below a cutoff value of two (Fox, 1991). We also compared and contrasted participants recruited from MTurk (n = 128) and the participant pool (n = 6) and found no significant difference in relation to variables in the analyses.
Given the conceptual significance of racial identity, mindfulness, and RBT in relation to cognitive appraisal that potentially impact PTG, we entered the independent variables in the hierarchical multiple linear regression as follows: covariates (i.e., gender, household income, and the amount of time since the trauma) in the first block, RBT in the second block, and mindfulness facets and racial identity in the third block. We conducted a priori power analysis to determine the sample size needed for the regression analysis. A sample size of 119 seemed to capture an effect size (f2 = 0.15), with an alpha level of 0.05, and power of 0.80 to conduct a multiple regression with 14 predictors.
Results
We examined bivariate correlations among the PWB-PTCQ and predictor variables (See Table 2). PWB-PTCQ was significantly and negatively related to a lower level of racial identity [i.e., Miseducation (r = − 0.31, p < 0.01), Self-Hatred (r = − 0.45, p < 0.01), and Anti-White (r = − 0.45, p < 0.01)] but significantly and positively related to a higher level of racial identity (Multicultural attitudes (r = 0.23, p < 0.01)). PWB-PTCQ was significantly and positively related to two facets of mindfulness: Acting with Awareness (r = 0.31, p < 0.01), and Nonjudgment (r = 0.17, p < 0.05). Surprisingly, significant and negative correlations existed among some FFMQ subscales, such as between Non-reactivity and Acting with Awareness (r = − 0.48, p < 0.01) and Nonjudgment (r = − 0.57, p < 0.01).
Model 1 for covariates was significant (F (3,128) = 4.86, p < 0.01) and accounted for 8% of the adjusted variance in PTG. The addition of RBT in Model 2 was significant (F (4,127) = 4.13, p < 0.01) and accounted for an additional 1% of the adjusted variance. Model 3 with addition of mindfulness facets and racial identity salience showed a significant model of prediction (F (14,117) = 5.95, p < 0.01), and accounted for 35% of the adjusted variance of PTG. The addition of mindfulness facets and racial identity salience in Model 3 accounted for an additional 26% of the adjusted variance. Among the covariates, gender was the only significant predictor (β = 0.17, p < 0.029), wherein being female had a positive relationship with PWB-PTCQ, as men were identified as the reference group. In addition, Self-Hatred (β = − 0.29, p < 0.004) and Anti-White (β = − 0.32, p < 0.01) racial identity subscales emerged as significant inverse predictors for PTG. The mindfulness subscale of Acting with Awareness (β = 0.22, p = 0.05) also emerged as a predictor for PTG. Afrocentricity identity attitudes, approaching significance, also showed a positive relationship (β = 0.20, p = 0.06) (see Table 3 for detail).
Discussion
This study examined the association of RBT, mindfulness facets, and racial identity with PTG among Black adults, who met the criteria for RBT while controlling for gender, household income, and the duration of the trauma. Among all the independent variables, Self-Hate, Anti-White subscales of racial identity, and gender were significant predictors of PTG, while Acting with Awareness subscale of mindfulness and Afrocentric racial identity beliefs were close to a significant level. The final model of the hierarchical regression accounted for 35% of the total variance of PTG, with racial identity and mindfulness facets accounting for 26% of the variance. All significant and emerging predictors were associated with PTG in the hypothesized direction, wherein women, Acting with Awareness, and Afrocentricity identity showed positive effects. In contrast, Self-Hate and Anti-White racial identity attitudes showed negative effects.
Self-Hate and Anti-White attitudes, associated with lower racial salience, emerged as significant and inverse predictors of PTG, indicating effect sizes higher than moderate effect size values (Sullivan & Feinn, 2012). Self-Hate and Anti-White attitudes represent extreme internalization and externalization, as a response to negative internal processes caused by racial discrimination (Cross & Vandiver, 2001). These attitudes may reflect emotional dysregulated states disrupting a person’s ability for psychological distance to promote PTG. Although demonstrating effect sizes higher than small effect values, Afrocentricity attitudes and Multicultural Inclusivity, indicative of greater racial salience, was not found significant in predicting PTG. Given that PTG generally refers to personal growth (Joseph et al., 2012a, b), racial identity attitudes involving beliefs about oneself or reactions to beliefs about oneself (e.g., Self-hatred, Anti-White, and Afrocentric) may influence PTG. On the other hand, racial identity attitudes involving the valuing of other cultures (i.e., Multicultural Inclusive attitudes) may not inform the PTG process as substantially, thereby showing no predictive relationship.
Gender emerged as the only significant covariate for the model, wherein women showed a greater propensity for PTG. This finding is supported by the past literature in that women had greater sensitivity to PTG and posttraumatic stress (Jin et al., 2014). Past research (e.g., Manove et al., 2019; Mushonga et al., 2021) has identified, among African American women who have experienced various types of traumas, several protective factors that promote PTG including motherhood, spirituality, education, prudence, and new educational and economic ventures as catalysts for PTG. However, more frequent experiences of racial trauma and discriminations have been found to be associated with more severe posttraumatic symptoms in adult Black women and shown to exacerbate the effects of interpersonal trauma (Mekawi et al., 2021).
Acting with Awareness, a mindfulness facet associated with behavioral regulation, had a moderate effect on PTG in the context of RBT in the current study. The findings mirror results of past research regarding the positive association between Acting with Awareness and PTG (Hanley et al., 2014; Labelle et al., 2015). Garland et al. (2015) pointed out that awareness facilitates the reappraisal process by fostering emotional and cognitive diffusion (i.e., separation of an emotion-provoking stimulus from the unwanted emotional response as part of a therapeutic process), thereby promoting cognitive flexibility when appraising the traumatic experience. Awareness of a person’s internal experience without becoming reactive facilitates the meaning-making process that may lead to PTG following a traumatic experience (Larsen & Berenbaum, 2015). However, the absence of association and prediction between PTG and other mindfulness facets in the current study might be that mindfulness facets may function differently in a clinical sample (i.e., met the criteria for RBT) and/or with a population with relatively low SES status (i.e., 75% of the participants reported household incomes are 50th percentile or below the national average and around 40% of participants with relatively low education levels). The negative relationships among some mindfulness facets (e.g., observing, acting with awareness, and non-reactivity) might also be related to the nature of the clinical sample with low SES. Finally, observing and non-reactivity facets of mindfulness each have an effect size much higher than the criterion for a small effect size value (Sullivan & Feinn, 2012), though no statistically significant results were found. Kline (2004) highlighted the significance of effect size in comparison with statistical significance. Future research is warranted to further examine the relationships for this population.
The lack of relationship between severity of racial trauma and PTG in the current study may be attributed to a potentially unique reappraisal process within the clinically significant sample in the current study, whereas an inverted U-shape correlation was found among a non-clinical sample (Kleim & Ehlers, 2009). Previous research has also found that PTG may be differentially processed depending on the type or nature of trauma (e.g., isolated incident, recurring, personal, shared) (Kira et al., 2013). With the rise in social media and technology over the past few years, depictions of racialized violence against Black individuals [e.g., shooting of Jacob Blake and murder of George Floyd (NAACP, 2021)] have become more publicly viewed and may also account for a difference in the processing of these raced-based traumas. It is important to consider how current traumatic events such as COVID-19 and police brutality can and have affected PTG and RBT among the Black community.
Limitations
Several limitations exist in this study. First, the convenience sample recruited online may limit the generalizability of the results. Although MTurk and Qualtrics survey provide the benefit of geographical diversity, they may exclude participants who may not have access to the technology necessary to take this online study and/or those who do not use MTurk. In addition, no attention check items were used in the survey. Second, regarding the internal validity of the study, there was no way of determining with certainty whether those taking the survey met the inclusion criteria using an online data collection protocol, due to the self-report nature. Third, some of the measures (e.g., FFMQ and PWB-PTCQ) were not normed on Black adults. Fourth, RBTSSS (Carter et al., 2013) requires participants to use their recollection of their past experiences. The retrospective self-report nature may compromise the validity of this measure. Thus, the findings of the study should be interpreted with caution.
Practical Implications
As lower racial identity salience (e.g., self-hate and anti-White) negatively impacted the PTG among Black adults facing RBT in the current study, mental health counseling professionals need to pay special attention to promote racial identity development and PTG. Considering positive relations between PTG and forgiveness among various trauma survivors (e.g., Amaranggani & Dewi, 2022; Ha et al., 2016), mental health professionals need to locate the impetus for growth in the arena of struggle with traumatic events through multiple strategies such as forgiveness writing therapy. Forgiveness leads to PTG through various channels including enhanced emotion-focused coping skill, a catalyst to change an individual’s perception to neutral or positive, and allowing self-disclosure and social support (Amaranggani & Dewi, 2022). Helms (1990) suggests growth in racial development occurs through the observation of in-group exhibiting greater racial salience. It has also been suggested that sharing experiences of discrimination and racism with individuals who have had similar experiences may promote PTG in Black men (Evans et al., 2016). Thus, mentorship may serve to both promote greater racial salience in those with less racial salience and to further validate the experience of RBT. Interventions for promoting racial identity development are particularly important following RBT, which may serve as a catalyst for a racial awakening (Neville & Cross, 2017). During the sensitive period, mentors can assist others in the meaning-making process to achieve greater racial salience. Additional supports such as individual and group mentoring should be accessible to African American males given the high prevalence of RBT for this group.
Considering the recent research on the positive impact of mindfulness on forgiveness (Bullock, 2019) and the close relation between forgiveness and PTG, mental health counseling professionals might consider nurturing PTG through mindfulness approaches. Increasing mindfulness, especially a person’s ability to act with awareness might be a potentially effective strategy facilitating PTG in dealing with race-based trauma for Black adults. Mental health professionals may promote cognitive flexibility and engender mindful reflection through facilitating the reappraisal process of race-based trauma and fostering positive meaning-making by incorporating mindfulness meditation and relaxation activities.
Research Implications
This exploratory study has several research implications. First, future research may need to examine how distinct types of racial discrimination may be differentially processed leading to PTG. The nature of racial discrimination presents in a variety of ways such as overt vs. covert; a single incident vs. an accumulation of incidences; and physical vs. emotional harm. Further research is necessary to determine how the nuances in discriminatory experiences may differentially impact the PTG process. Second, an experimental research design is necessary to appropriately evaluate whether mindfulness and/or racial identity development interventions yield PTG. Previous studies (e.g., Labelle et al., 2015) have shown the benefits of mindfulness interventions in increasing PTG for individuals diagnosed with medical conditions. However, no such study has examined mindfulness interventions within the context of RBT. Thus, future research is warranted. Finally, research suggests the best way to understand racial identity is to consider the pattern of racial identity attitudes (e.g., Chevez-Korell & Vandiver, 2012). As the current research examined individual attitudes of racial identity rather than their racial identity profiles, future research should consider using racial identity attitude profiles when investigating its association with PTG.
Conclusion
Fostering PTG for African Americans is pivotal considering the high prevalence of RBT. The current study identified negative effects of low racial identity salience such as self-hate and anti-White on PTG as well as positive effects of acting with awareness facet of mindfulness and being a female on PTG. Mental health counselors need to consider incorporating mindfulness and racial identity salience training through the use of culturally specific strategies in bolstering PTG among Black adults experiencing RBT.
References
Amaranggani, A. P., & Dewi, K. S. (2022). The role of forgiveness in post-traumatic growth: A cross-sectional study of emerging adults with adverse childhood experiences. Proceedings of International Conference on Psychological Studies, 3, 1–12.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition). Author.
American Psychiatric Association (2018). Position statement on police brutality and Black males. https://www.psychiatry.org/File%20Library/About-APA/Organization-Documents-Policies/Policies/Position-Police-Brutality-and-Black-Males.pdf
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., & Williams, J. M. (2008). Construct validity of the Five Facet Mindfulness Questionnaire in meditating and non-meditating samples. Assessment, 15(3), 329–342. https://doi.org/10.1177/1073191107313003
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241. https://doi.org/10.1093/clipsy/bph077
Bitsch, L. J., Elklit, E., & Christiansen, D. M. (2011). Basic problems with the measurement of posttraumatic growth. University of Southern Denmark.
Bullock, B. G. (2019). New research on mindfulness and forgiveness. https://www.mindful.org/mindful-people-may-be-more-willing-to-forgive/
Calhoun, L. G., & Tedeschi, R. G. (2004). The foundations of post-traumatic growth. Psychological Inquiry, 15(1), 93–102.
Carter, R. T. (2007). Racism and psychological and emotional injury: Recognizing and assessing race-based traumatic stress. The Counseling Psychologist, 35(1), 13–105. https://doi.org/10.1177/0011000006292033
Carter, R. T., & Muchow, C. (2017). Construct validity of the Race-Base Traumatic Stress Symptom Scale and tests of measurement equivalence. Psychological Trauma: Theory, Research, Practice, and Policy, 96(6), 688–695. https://doi.org/10.1037/tra0000256
Carter, R. T., & Reynolds, A. L. (2011). Race-related stress, racial identity statuses and emotional reactions of Black Americans. Cultural Diversity and Ethnic Minority Psychology, 17(2), 156–162. https://doi.org/10.1037/a0023358
Carter, R. T., Mazzula, S., Victoria, R., Vazquez, R., Hall, S., Smith, S., Sant-Barket, S., Forsyth, J., Bazelais, K., & Williams, B. (2013). Initial development of the race-based trauma stress symptom scale assessing the emotional impact of racism. Psychological Trauma: Theory, Research, and Policy, 5(1), 1–9. https://doi.org/10.1037/a0025911
Carter, R. T., Johnson, V. E., Muchow, C., Lyons, J., Forquer, E., & Galgay, C. (2016). Development of classes of racism measures for frequency and stress reactions: Relationship to race-based traumatic symptoms. Traumatology, 22(1), 63–74. https://doi.org/10.1037/trm0000057
Carter, R. T., Johnson, V. E., Roberson, K., Mazzula, S., Kirkins, K., & Sant-Barket, S. (2017a). Race-based traumatic stress racial identity statuses, and psychological functioning: An exploratory investigation. Professional Psychology, Research and Practice, 48(1), 30–37. https://doi.org/10.1037/pro000016
Carter, R. T., Lau, M. Y., Johnson, V. E., & Kirkinis, K. (2017b). Racial discrimination and health outcomes among racial/ethnic minorities: A meta-analysis review. Journal of Multicultural Counseling and Development, 45(4), 232–259. https://doi.org/10.1002/jmcd.12076
Chevez-Korell, S., & Vandiver, B. J. (2012). Are CRIS cluster patterns differentially associated with African American enculturation and social distance? The Counseling Psychologist, 40(5), 755–788. https://doi.org/10.1177/0011000011418839
Cross, W. E. (1995). The psychology of nigrescence: Revising the Cross model. In J. G. Ponterotto, M. J. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 93–122). Sage.
Cross, W. E., Jr., & Vandiver, B. J. (2001). Nigrescence theory and measurement: Introducing the Cross Racial Identity Scale (CRIS). In J. G. Ponterotto, J. M. Casas, L. M. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (2nd ed., pp. 371–393). Sage.
Devillis, R. F. (2012). Scale development: Theory and applications. Sage.
Evans, A., Hemmings, C., Burkhalter, C., & Lacy, V. (2016). Responding to race related trauma: Counseling and research recommendations to promote post-traumatic growth when counseling African American males. The Journal of Counselor Preparation and Supervision, 8(1), 78–103. https://doi.org/10.7729/81.1085
Fox, J. (1991). Regression diagnostics. Sage Publications.
Garland, E. L., Farb, N. A. R., Goldin, P., & Fredrickson, B. L. (2015). Mindfulness broadens awareness and build eudaimonic meaning: A process model of mindful positive emotion regulation. Psychological Inquiry, 26(4), 293–314. https://doi.org/10.1016/S0191-8869(00)00113-6
Grier-Reed, T., Maples, A., Houseworth, J., & Ajayi, A. (2022). Posttraumatic growth and flourishing in the face of racial trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 15(1), 37–44. https://doi.org/10.1037/tra0001200
Ha, N., Bae, S. M., & Hyun, M. H. (2016). The effect of forgiveness writing therapy on post-traumatic growth in survivors of sexual abuse. Sexual and Relationship Therapy, 34(1), 10–22. https://doi.org/10.1080/14681994.2017.1327712
Hamama-Raz, Y., Ben-Ezra, M., Bibi, H., Swarka, M., Gelernter, R., & Abu-Kishk, I. (2020). The interaction effect between gender and profession in posttraumatic growth among hospital personnel. Primary Health Care Research & Development, 21, e35. https://doi.org/10.1017/S1463423620000377
Hanley, A. W., Peterson, G. W., Canto, A. I., & Garland, E. L. (2014). The relationship between mindfulness and post-traumatic growth with respect to contemplative practice engagement. Mindfulness, 6(3), 654–662. https://doi.org/10.1007/s12671-014-0302-6
Hanley, A. W., Garland, E. L., & Tedeschi, R. G. (2017). Relating dispositional mindfulness, contemplative practice, and positive reappraisal with post-traumatic cognitive coping, stress, and growth. Psychological Trauma: Theory, Research, Practice, and Policy, 9(5), 526–536. https://doi.org/10.1037/tra0000208
Helms, J. E. (Ed.). (1990). Black and White racial identity: Theory, research, and practice. Greenwood.
Hemmings, C., & Evan, A. M. (2018). Identifying and treating race-based trauma in counseling. Journal of Multicultural Counseling and Development, 46, 20–39. https://doi.org/10.1002/jmcd.12090
Hilert, A. J., & Tirado, C. (2019). Teaching multicultural counseling with mindfulness: A contemplative pedagogy approach. International Journal for the Advancement of Counselling, 41, 469–480. https://doi.org/10.1007/s10447-018-9363-x
Jin, Y., Xu, J., & Liu, D. (2014). The relationship between post-traumatic stress disorder and post traumatic growth: Gender differences in PTG and PTSD subgroups. Social Psychiatry: Psychiatric Epidemiology, 49(12), 1903–1310. https://doi.org/10.1007/s00127-014-0865-5
Joseph, S., Maltby, J., Wood, A. M., Stockton, H., Hunt, N., & Regel, S. (2012a). The Psychological Well-Being—Post-Traumatic Changes Questionnaire: Reliability and validity. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 420–428. https://doi.org/10.1037/a0024740
Joseph, S., Murphy, D., & Regel, S. (2012b). An affective cognitive processing model of post-traumatic growth. Clinical Psychology and Psychotherapy, 19(4), 316–325. https://doi.org/10.1002/cpp.1798
Keith, M. G., Tay, L., & Harms, P. D. (2017). Systems perspective of Amazon Mechanical Turk for organizational research: Review and recommendations. Frontier Psychology, 8, 1359. https://doi.org/10.3389/fpsyg.2017.01359
Kira, I. A., Aboumediene, S., Ashby, J. S., Odenat, L., Mohanesh, J., & Alamia, H. (2013). The dynamics of posttraumatic growth across different trauma types in a Palestinian sample. Journal of Loss and Trauma, 18(2), 120–139. https://doi.org/10.1080/15325024.2012.679129
Kleim, B., & Ehlers, A. (2009). Evidence for a curviliear relationship between post-traumatic growth and post-traumatic depression and PTSD in assault survivors. Journal of Traumatic Stress, 22(1), 45–52. https://doi.org/10.1002/jts.20378
Kline RB. (2004). Beyond significance testing: Reforming data analysis methods in behavioral research. American Psychological Association.
la Cour, P., Nielsen, A. B. S., Andersen, S. B., & Madsen, T. (2016). The Psychological Well-Being–Post-Traumatic Changes Questionnaire: Validation of the Danish version. Traumatology, 22(4), 271–277. https://doi.org/10.1037/trm0000080
Labelle, L. E., Lawlor-Savage, L., Campbell, T. S., Faris, P., & Carlson, L. E. (2015). Does self-report mindfulness mediate the effect of mindfulness-based stress reduction (MBSR) on spirituality and post-traumatic growth in cancer patients? The Journal of Positive Psychology, 10(2), 153–166. https://doi.org/10.1080/17439760.2014.927902
Larsen, S. E., & Berenbaum, H. (2015). Are specific emotion regulation strategies differentially associated with posttraumatic growth versus stress? Journal of Aggression, Maltreatment, & Trauma, 24(7), 794–808. https://doi.org/10.1080/10926771.2015.1062451
Legal Defense Fund, (2022). LDF Issues statement in response to racially-motivated Buffalo mass shooting. https://www.naacpldf.org/press-release/ldf-issues-statement-in-response-to-racially-motivated-buffalo-mass-shooting/
Litman, L., Robinson, J., & Rosenzweig, C. (2015). The relationship between motivation, monetary compensation, and data quality among US- and India-based workers on Mechanical Turk. Behavior Research Methods, 47, 519–528. https://doi.org/10.3758/s13428-014-0483-x
Manove, E. E., Lowe, S. R., Bonumwezi, J., Preston, J., Waters, M. C., & Rhodes, J. E. (2019). Posttraumatic growth in low-income Black mothers who survived Hurricane Katrina. The American Journal of Orthopsychiatry, 89(2), 144–158. https://doi.org/10.1037/ort0000398
Mekawi, Y., Carter, S., Brown, B., Martinez de Andino, A., Fani, N., Michopoulos, V., & Powers, A. (2021). Interpersonal trauma and posttraumatic stress disorder among Black Women: Does racial discrimination matter? Journal of Trauma Dissociation, 22(2), 154–169. https://doi.org/10.1080/15299732.2020.1869098
Mooney, K. (2020). How mindfulness can help with racial trauma. https://www.huffpost.com/entry/mindfulness-meditation-racial-trauma_l_5f19df61c5b6128e6822bc25
Mushonga, D. R., Rasheem, S., & Anderson, D. (2021). And still I rise: Resilience factors contributing to posttraumatic growth in African American women. Journal of Black Psychology, 47(2–3), 151–176. https://doi.org/10.1177/0095798420979805
Nadal, K. L., Griffin, K. E., Wong, Y., Hamit, S., & Rasmus, M. (2014). The impact of racial microaggressions on mental health: Counseling implications for clients of color. Journal of Counseling & Development, 92, 57–66. https://doi.org/10.1002/j.1556-6676.2014.00130.x
National Association for the Advancement of Colored People (2021). George, Daunte, Breonna: Policing must change. https://naacp.org/articles/george-daunte-breonna-policing-must-change
National Center for PTSD (2022). Racial trauma. https://www.ptsd.va.gov/understand/types/racial_trauma.asp
Neville, H. A., & Cross, W. E., Jr. (2017). Racial awakening: Epiphanies and encounters in Black racial identity. Cultural Diversity and Ethnic Minority Psychology, 23(1), 102–108. https://doi.org/10.1037/cdp0000105
Osborne, J. W., & Waters, E. (2002). Four assumptions of multiple regression that researchers should always test. Practical Assessment, Research & Evaluation, 8(2), 1–5.33
Parham, T. A., & Helms, J. E. (1981). The influence of Black students’ racial identity attitudes on preferences for counselor’s race. Journal of Counseling Psychology, 28(3), 250–257. https://doi.org/10.1037/0022-0167.28.3.250
Peer, E., Paolacci, G., Chandler, J., and Mueller, P. (2012). Selectively recruiting participants from Amazon Mechanical Turk using Qualtrics. http://ssrn.com/abstract=2100631
Pew Research Center. (2019, April). Race in America 2019. https://www.pewresearch.org/social-trends/2019/04/09/race-in-america-2019/
PK (2021). Average, median, top 1% and all United States household income percentiles in 2021. https://dqydj.com/average-median-top-household-income-percentiles/
Richman, L. S., Pascoe, E., & Lattanner, M. (2018). Interpersonal discrimination and physical health. In B. Major, J. F. Dovidio, & B. G. Link (Eds.), The Oxford handbook of stigma, discrimination, and health (pp. 203–218). Oxford University Press.
Sellers, R. M., Smith, M. A., Shelton, J. N., Rowley, S. A. J., & Chavous, T. M. (1998). Multidimensional model of racial identity: A reconceptualization of African American identity. Personality and Social Psychology Review, 2(1), 18–39. https://doi.org/10.1207/s15327957pspr0201_2
Shand, L. K., Cowlishaw, S., Brooker, J. E., Burney, S., & Ricciardelli, L. A. (2015). Correlates of post-traumatic stress symptoms and growth in cancer patients: A systematic review and meta-analysis. Psycho-Oncology, 24(6), 624–634. https://doi.org/10.1002/pon.3719
Shawn, C. T., Jones, J. H., Brooks, A. J., Milam, C. B., Barajas, T. A., LaVeist, E., Kane, C., & Debra, M. F. (2019). Racial discrimination, John Henryism coping, and behavioral health conditions among predominantly poor, urban African Americans: Implications for community-level opioid problems and mental health services. Journal of Community Psychology, 47(5), 1032–1042. https://doi.org/10.1002/jcop.22168
Statista Research Department. (2022). Number of people shot to death by the police in the United States from 2017 to 2022, by race. https://www.statista.com/statistics/585152/people-shot-to-death-by-us-police-by-race/
Sullivan, G. M., & Feinn, R. (2012). Using effect size-or why the p value is not enough. Journal of Graduate Medical Education, 4(3), 279–282. https://doi.org/10.4300/JGME-D-12-00156.1
Tedeschi, R. G., & Calhoun, L. G. (1996). Posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1007/bf02103658
Tedeschi, R., Shakespeare-Finch, J., Taku, K., & Calhoun, L. G. (2018). Post traumatic growth: Theory, research and applications. Routledge.
Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma & transformation: Growing in the aftermath of suffering. Sage Publications.
Tineo, P., Bonumwezi, J. L., & Lowe, S. R. (2021). Discrimination and posttraumatic growth among Muslim American youth: Mediation via posttraumatic stress disorder symptoms. Journal of Trauma & Dissociation, 22(2), 188–201. https://doi.org/10.1080/15299732.2020.1869086
Triplett, K. N., Tedeschi, R. G., Cann, A., Calhoun, L. G., & Reeve, C. L. (2012). Post-traumatic growth, meaning in life, and life satisfaction in response to trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 400–410. https://doi.org/10.1037/a0024204
Utsey, S. O. (1998). Assessing the stressful effects of racism: A review of instrumentation. Journal of Black Psychology, 24(3), 269–288. https://doi.org/10.1177/00957984980243001
Vandiver, B. J., Cross, W. E., Jr., Worrell, F. C., & Fhagen-Smith, P. E. (2002). Validating the Cross Racial Identity Scale. Journal of Counseling Psychology, 49(1), 71–85. https://doi.org/10.1037//0022-0167.49.1.71
Weiss, N. H., Schick, M. R., Reyes, M. E., Thomas, E. D., Tobar-Santamaria, A., & Contractor, A. A. (2021). Ethnic-racial identity and posttraumatic stress disorder: The role of emotional avoidance among trauma-exposed community individuals. Psychological Trauma: Theory, Research, Practice and Policy, 13(1), 35–43. https://doi.org/10.1037/tra0000974
Williams, T. R., Walker, T. L., & Wyatt, W. N. (2022). Conceptualizing racism through a systemic trauma lens: Impacts on Black college students. Journal of Psychotherapy Integration, 32(1), 49–63. https://doi.org/10.1037/int0000206
Williams, M. T., Haeny, A. M., & Holmes, S. C. (2021). Posttraumatic stress disorder and racial trauma. PTSD Research Quarterly, 32(1), 1–9. https://www.ptsd.va.gov/publications/rq_docs/V32N1.pdf
Worrell, F. C., Mendoza-Denton, R., Telesford, J., Simmons, C., & Martin, J. F. (2011). Cross Identity Scale (CRIS) scores: Stability and relationships with psychological adjustment. Journal of Personality Assessment, 93(6), 637–648. https://doi.org/10.1080/00223891.2011.608762
Zapolski, T. C. B., Faidley, M. T., & Beutlich, M. (2019). The experience of racism on behavioral health outcomes: The moderating impact of mindfulness. Mindfulness, 10(1), 168–178. https://doi.org/10.1007/s12671-018-0963-7
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Dong, S., Campbell, A., Shadden, P. et al. Racial Identity and Mindfulness as Predictors of Posttraumatic Growth in Black Adults Experiencing Race-Based Trauma. Int J Adv Counselling 45, 403–421 (2023). https://doi.org/10.1007/s10447-023-09509-0
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DOI: https://doi.org/10.1007/s10447-023-09509-0