Does Racism Cause Psychological and Emotional Injury? Symposium.

My title raises several issues that need clarification

• I will offer a way to define and understand racism that I hope will facilitate understanding it effects. And that can help promote racial justice.
• I will discuss how racism is a stressor.
• I will distinguish between disorder and injury.
• I will report on findings of research to highlight the points noted above.

Racism has many definitions and types

• Jones (1997) presented some 18-20 types and definitions of racism offered by various scholars.
• Some elements involved are; (1) beliefs in biological traits and own group superiority and out-group inferiority, (2) Rejection of in-group customs and beliefs; (3)In-group cultural systems that advantages the in-group in power; (4) evidence is offered to validate race difference to justify policies and social structures based on racial beliefs.
• Thus, racism involves individual, institutional, and cultural practices used by the group in power to maintain the inferior status of the out-group (usually with little power).

Racism and Confusion About Its Meaning

• Some confuse racism with prejudice.
• While others contend that targets of racism can be racists.
• Legal definitions of racism vary and are hard to connect to a person’s daily life or psychological experience. Legally discrimination captures many aspects of racism where group (disparate impact) and individual treatment because of race (disparate treatment) is redressed.
• To win a legal case it necessary toshow that the acts of discrimination were intentional and were specific to one’s race - and not taken for some other reason.

Racism and Psychological Meaning

• If one consults a mental health professional s/he will use assessment and diagnostic criteria usually the DSM.
• Yet most mental disorders have to do with intrapsychic process and behavior that results from internal issues.
• There are DSM criteria that list over 40 stressors associated with Acute stress, Post-traumatic stress and Adjustment reactions none include race or racism.
• There is less recognition for environmental causes of stress or distress that are race-related. In fact, the word racism does not exist in the DSM and discrimination is used once.
• Should racism be considered a stressor? And does it led to psychological and emotional injury? It would help to review briefly the concept of stress and to offer a distinguish injury from damage or disorder.

Injury or Disorder

• Injure - means t”o harm, impair - to give pain to -to inflict bodily hurt on - to impair the soundness of (e.g., injure one’s health).”
• Injury - is defined in the dictionary as “an act that damages or hurts. And as a violation of another’s rights for which the law allows an action to recover damages”.
• Disorder - is defined in the dictionary “as an abnormal physical or mental condition or not functioning in a normal healthy orderly way.” (Merriam-Webster, 2003).
• I believe that it is more accurate to discuss the effects of racism as injury then as disorder since the effects of racism come from the sociocultural environmentt not from any abnormality of its targets.

Defining and Distinguishing Terms: Racial Discrimination

• Carter and Helms (2002) have argued that racial discrimination should be distinguished from racial harassment in the following ways.
• Racial Discrimination – is a form of “Aversive” or avoidant racism – behaviors, actions, policies, and strategies that have the intended or unintended effects of maintaining distance or minimizing contact between members of the dominant and non-dominant racial groups.

Defining and Distinguishing Terms: Racial Harassment

• Racial Harassment - is a form of “Domination or Hostile Racism” that involve actions, strategies, and policies whose intended purpose is to communicate or make salient the subordinate or inferior status due to the race of non-dominant racial group members.
• Racial Harassment may be characterized by active hostility, which may include commission or implied or actual permission to commit flagrant acts of racism.
• Racial Harassment – may also be characterized by “quid pro quo” pressure or threats to “fall-in-line” with institutional racial policies.

Stress

Health professionals have acknowledged for many years that people who are subjugated to particular types of physical, psychological, and emotional experiences - may experience a stress reaction.

Stress is defined as a psychological, emotional and physiological response to perceived particular event(s). Stressors are environmental events that require some coping or adaptation. In this sense, stress is a person-environment interaction. If one’s coping fails stress reactions occur.

At the same time there has been debate about the role of culture and race in prevalence and incidence of traumatic stress and post-traumatic stress disorders.

Definitions of Stress and Traumatic Stress
There are currently two ways to understand and identify extreme stress reactions.

• One is to use diagnostic criteria of post-traumatic stress disorder (PTSD) or Acute Stress Reactions or other diagnosis from DSM.
• The other way to understand strong stress reactions which may not fit DSM criteria would be to use broader signs and symptom and consider the person’s evaluation of the event as an important component of the experience.
• The latter is thought of as traumatic stress reactions.

Need for broader model of trauma

The criteria for PTSD focuses on the reactions to life threatening events. Some life-events may not threaten life but may produce a traumatic stress reaction. Also, the person’s assessment may be less important is the evaluation of PTSD.

• It may be helpful to consider using a broader perspective
• Because the DSM framework for understanding stress reactions is based on the rather narrow criteria for diagnosis of PTSD or Acute Stress

DSM - Post-Traumatic Stress Disorder

Criteria A: An event is life threatening and results in a reaction of intense fear or helplessness or horror, and leads to impairment of functioning (also needed are
Criteria B,C,D,E and F). The criteria uses a exposure or dose response model. Relying on external factors and less on subjective evaluation.
Criteria B: Requires that the person re-experiences or has intrusive memories.
Criteria C: The person engages in avoidance behavior and/or thoughts or tries to numb or push away the experience.
Criteria D: The person has reactions characterized by hyper arousal or startle responses or sleeplessness.
Criteria E: Involves determining the duration of symptoms and requires that all of the symptoms (B, C, & D) must last for more than 1 month.
Criteria F: Used to determine if the symptoms caused clinically significant impairment in life and work

Carlson’s (1997) Conceptual Model for Understanding and Assessing Trauma

Carlson offered a model of traumatic stress because DSM-definitions of PTSD, Acute Stress Reactions and other diagnoses are not applicable to all possible traumatic experiences.

• According to Carlson a variety of potentially traumatic experiences such as physical and sexual assaults, disasters, accidents, war, aggression, sudden death, and witnessing assaults, death and violence share three common elements that qualify a single or chronic event(s) as traumatic.
  
  The Common Elements Are:
  • The perception that the event is negative.
  • The suddenness of its occurrence.
  • and the uncontrollable nature of the event(s).

Identification of Responses to Traumatic Stress:

• Researchers have found wide variation in responses to trauma. Common to all are: Reexperiencing, Arousal and Avoidance or Numbing - (Carlson, 1997).
• Reexperiencing and avoidance are common and are expressed through cognitive, affective, behavioral and physiological modalities.
• Such as intrusive thoughts or images (reexperiencing) and Loss of memory for the event(s) (avoidance) - Anxiety and/or anger (reexperience) and emotional numbing (avoidance) - as well as aggression or hyperactivity (arousal) - denial of situation or place of trauma (avoidance)
• Sleepleness, startle response, inability to concentrate (reexperience) - less pain sensitivity or numbing of senses (avoidance)
• flashbacks/nightmares (reexperience), dissociative states (avoidance) [combinations of modalities]

Associated and Related Responses To Traumatic Stress (Carlson, 1997)

• In addition to reexperiencing, arousal and avoidance people are likely to also have associated responses such as:
• Depression as reflected in inactivity, negative thinking, hopelessness, depressed mood and so on.
• Aggression - such as frustration about inability to control anxiety or self-harm as a way to relieve numbing.
• Self-esteem - loss of self-worth - especially for children wherein the trauma disrupts developmental processes.
• Identity Confusion or disturbance - dissociative symptoms led to feeling detached from oneself.
• Interpersonal relationships--trauma might led to difficulty in intimate, family and friendships relationships.
• Guilt and Shame - Blaming one’s self for the traumatic event(s) and feeling responsible and disgraced by the experience can often led to feeling shame and guilt.

Research Literature on Traumatic Stress

Falls into three broad categories:

• Studies that investigate responses of war veterans to exposure to potentially stressful experiences.
  and
• Studies of the general population that included both clinical and non-clinical groups, to assess reactions to life events such as natural disasters (hurricanes), car accidents, interpersonal violence. And to document the prevalence and incidence of PTSD.
• The third set of studies examined explored peoples reactions to racial discrimination.

Studies of PTSD - Veterans of Color

• Studies have found that 21% of Black, 28% of Hispanic and 14% of White Vietnam veterans had elevated rates of PTSD and other psychological symptoms.
• Another Vietnam project found the lifetime rates of PTSD among Southwest American Indians to be 45% and 57% among Northern Plains Indians and 38% among Native Hawaiians. These finding have been replicated in other studies. And combat stress did not account for the higher stress levels.
• Loo and colleagues (2001) did study the possible effects of race-related stress in Asian American Vietnam veterans and found that the rate for PTSD to be 37% and that the factor that was the best predictor of PTSD was exposure to race-related stress over and above combat exposure and military rank.
• In one study of military personnel it was found that a majority of active duty military were exposed to race-related stress.

Epidemiological Studies of Stress

• Norris (1992) studied a range of events that might produce Post-traumatic stress disorder (PTSD) symptoms or that could cause considerable stress.
• Norris found that 69% of her sample reported being exposed to at least one potentially traumic event in their lifetime and 21% had such an experience within the last year.
• Analysis of demographic variables found that lifetime exposure was highest for Whites and men.Past year exposure was highest for younger adults.
• Perceived stress from exposure was highest for Blacks and in particular, for Black men. Some evidence of delayed onset of PTSD for Black men.
• Racism or race-related events were not part of the stressful events studied.

Epidemiological Study of Trauma A Decade Later

• Breslau (2001) studied 10 traumatic events experienced by 1,000 people from 4 southern cities divided equally by age, race and gender replicated earlier findings.
• She found that 69% of her sample were exposed to at least one potentially traumic event in their lifetime and 21% had such an experience within the last year.
• Prevalence rates for PTSD after exposure to traumatic event(s) were between about 9% for people exposed to violent crimes, accidents, and death and 5% of those exposed to environmental events.
• Lifetime exposure was higher for White, younger people had higher rates of PTSD and Black men “appeared to be the most vulnerable to the effects of traumatic events” ( p.17).

Studies of PTSD - People of Color -Citizens

• Perilla, et al (2002), found six months after a hurricane that Whites had the lowest rate of PTSD 15%, Latino’s who spoke Spanish the highest rate 38%, and Blacks had a rate of 23%.
• In a study of 50 Cambodian adults 94% of sample endorsed 50% of 14 PTSD items. Eight six percent (43) met the DSM-III-R criteria for PTSD Eighty percent (80%) had high scores for depression, anxiety and disassociation. and emotional distress. Many of the symptoms that were reported tended to be somatic.
• In a study of 124 Black and Hispanic men (33%) and women (76%, investigator found that 14.5% of the sample met criteria for PTSD symptoms. Respondents reported 4.5 symptoms of PTSD on average.

Research Literature on Traumatic Stress

Height et al (1996) studied exposure to violence and PTSD in Urban adolescents they found that 29% of the racially diverse (75% were Black and Hispanic) sample met the clinical standards for PTSD. Self-reported exposure to violence was the main predictor variable. “Subjective experience and interpretation of events play and important role in the determination of traumatic stress responses”

Bowman (1999) contends that:

• Definitions and descriptions of traumatic stress events do not consider the person’s subjective experience as relevant.
• Found that a dose-response model or consideration of the severity of the event alone does not explain the exposure to traumatic or toxic events and the development of PTSD.
• She also found that the cultural groups’ history, beliefs and emotional reactions contribute to both adaptive and less adaptive responses.
• And the role of culture is particularly strong for groups or individuals who hold strong cultural beliefs about the power of external forces.

Studies of Discrimination -More Evidence

• Researchers (e.g. Feagin et. al, 1996) have shown that Black people, who experience acts of racial discrimination experience the events as painful, damaging, and distressful.
• People of Color who experience discrimination, in laboratory and naturalistic situations have high levels of psychological distress, lower levels of life satisfaction, and poorer physical health (Lark, Anderson, Lark, & Williams, 1999)
• Utsey, et al (2002) found that for People of Color cultural racism as a stressor was related to lower levels of quality of life and that Blacks reported more experiences of individual and cultural race-related stress and were equal to Asians in reporting institutional race-related stress.

Studies of Discrimination

• Davis (2003) found that stressors associated with perceptions of discrimination compromise physical and mental health and that African-American men have reported higher levels of chronic and acute experiences of discrimination than women.
• Fang & Myers (2001) found that Blacks reports of racial discrimination, as well as holding in (internalizing) responses to discrimination were related to higher blood pressure levels.
• Guyll, et al (2001) measured self-reported mistreatment the findings revealed that AA women who experience racial discrimination had higher risk for CVD.
• Sellers and Shelton (2003) found that more than 50% of their sample reported over a dozen (13) daily racial hassles, experienced as discrimination, most involving strangers. Men reported such incidents more frequently than did women. The more frequent the experience of discrimination, the more negative the psychological outcomes. Racial identity was found to moderate the negative psychological effects.
• For instance, in one study, 96% of the Black respondents reported an experience of racial discrimination or harassment in the past year that left them feeling stressed (Klonoff & Landrine, 1999).

Research Literature in Summary

• That people are exposed to life events which are experienced by some as traumatic. Not all who are exposed develop psychological symptoms.
• The general rates of developing PTSD after exposure are about 5-10%.
• Black people, and Black men in particular, experienced fewer traumatic events but their reactions were more severe. Black men were found to be more vulnerable to higher rates of PTSD symptoms
• Veterans of Color have higher rates of PTSD and other psychological symptom of distress not explained by the specific exposure to trauma
• Researchers suggested that People of Color are confronted with racism which may heighten the effects of a life event crisis.
• Studies of discrimination show that people have physical, psychological, and emotional reactions that appear to have brought harm or injury.

Racial Discrimination Study: Purpose

• Purpose
  • To gain a better understanding of the types of racial discrimination people of Color experience.
  • To discover if people of Color experience psychological and emotional effects as a result of racial discrimination.
  • To determine if there is a relationship between the types of racial discrimination people of Color experience and the psychological and emotional effects they report.

Racial Discrimination Study: Design

• Two Part Internet-Based Study:
  • Part I: Demographic Information - age, gender, race, ethnicity, place of birth, religion, socio-economic status, occupation, years in job, and education level (11 questions).
  • Part II: Experiences of Racial Discrimination/Harassment Questionnaire (10 questions).
    • Closed ended questions were used to assess if the participant had experienced racial discrimination/ harassment and then to determine where and when the event(s) took place.
    • Open ended questions were used to capture each participant’s experience of racial discrimination/ harassment and the resulting psychological and emotional effects.

Racial Discrimination Study: Methods

• To determine what peoples’ experiences with discrimination/ harassment were, the primary investigator derived 10 categories from the participants’ narrative responses to the following question:

  6) What happened? Please describe, be specific.

• To determine the types of psychological and emotional effects the participants experienced as a result of racial discrimination, the primary investigator derived 9 categories from the participants’ narrative responses to the following question:

  8) What were those effects? Please describe, be specific.

• Two independent raters then utilized the categories to code the participants’ narrative responses to the questions.

Racial Discrimination Study: Coding

• First Round of Coding:
  • 68% agreement on question #6: Types of Racial Discrimination 60% agreement on question #8: Psychological and Emotional Effects
• Second Round of Coding:
  • 83% agreement on question #6: Types of Racial Discrimination
  • 68% agreement on question #8: Psychological and Emotional Effects
• Third round: raters reached 100% consensus agreement on discrepancies encountered during the second round of coding for both categories.

Racial Discrimination Study: Categories and Analyses

• Following the coding of the participants responses for questions 6 and 8 frequencies were generated for each category.
• The participants’ responses were then analyzed as follows:
  • For each location that was reported, frequencies were generated on the types of racial discrimination that took place.
  • For each the type of racial discrimination, frequencies were generated on the resulting psychological and emotional impact.
  • For each racial group, frequencies were calculated on the type of racial discrimination they experienced as well as the psychological and emotional effect reported.

Demographics: Age
Demographics: Gender
Demographics: Race
Demographics: Education
Reports of Discrimination
Frequency of Events
Coded Types of Racial Discrimination
Experiences of Racial Discrimination (coded)
There were a total of 233 participants who reported an experience of discrimination. Each response was placed into one of ten categories:

• Multiple Experiences - multiple acts or discrimination and harassment.
  • “At jobs I've often been the sole African-American in a department. I've had Caucasians group together to tell me a racial joke. I've had coworkers talk about my hometown in degrading ways. I've had Black speech imitated. In stores, I've been followed around and watched. At some social events, I've been treated as though I weren't welcome.”
• Hostile Work Environment - low performance evaluations, demeaned (ability, performance, qualification) not promoted, lower pay.
  • “I have two masters degrees. I worked at a social service agency conducting research. My boss was a white male who had not earned a bachelors degree. Although I did high-quality work, he unjustifiably criticized me and demeaned me by pointing his finger in my face. He also accused me of incompetence and of making underhanded attempts to undermine him.”

Experiences of Racial Discrimination

• Verbal Assault - called a name, racial slurs, stereotype used in conversation, subject to racist jokes and false accusation.
  • “I was walking down the school hallway and a white boy said were are you going nigger."
• Denied Access or Service - ignored, made to wait, not allowed in, told had less ability,advised not to go to college, told do not have ability to progress.
  • “Was told on the phone property was available, but when showed up it had "just" been rented.”
• Profiled - followed in store, accused or suspected of theft, stopped by police, searched.
  • “Followed by store security, stopped by police, had my pockets emptied by a store patron who lost his wallet only for his daughter to find it in his bag.”
• Treated on Basis of Stereotype - should step aside, pay more for goods,denigrate achievements, deny personal accomplishments, (school/work/social), failed to recognize ability,question qualifications.
  • “One of my professors was impressed with one of my papers and ability to express myself so well in English and was amazed that I speak English well. I said I was born in the US, she gave me a blank look and said, "Really, with your accent i thought you had just moved here. My grade was a C+.”
• Violated Racial Rules - did not belong (school/job/social), thought to be foreigner (could not speak english), cross racial dating.
  • “Walking down the street, hand-in-hand, we were harassed by a group of Black people who were hanging out. They yelled "sell-out!", "look at that sista with a white man!"
• Other Event - perceptions of institutional racism, complaints for success.
  • “Disproportionate number of Black faculty and staff to those of the student body.”

Experiences of Racial Discrimination

• Physical Assaults - spat on, beaten, intimated by police or other authority person, arrested and charges dropped.
  • “Went to an all white school. Was slapped by a priest and called a "spic" in front of the whole class.”
• Discriminated by Own Group - experienced hostility due to skin-color, looks, speech, behavior , etc.
  • “Because of my lighter complexion, other black students would tease me and call me half-breed and not associate with me. They did not consider me black.”

Location of Experiences of Racial Discrimination
Types of Discrimination Experience by Location
Discrimination Experience by Location
Discrimination Experience by Location
Discrimination Experience by Location
Types of Discrimination Experience by Location
Discrimination Experience by Location

Reports of Psychological and Emotional Effects
Psychological and Emotional Effects

• A total of 173 participants reported that they experienced psychological and emotional effects as a result of their experience of discrimination. Each of their responses were placed into one category. The ten categories were:
  • Extreme Emotional Distress - upset, multiple emotions (sad, anger, depression),shocked, rage, physically ill.
    • “Recurring feelings of rage, sadness, helplessness, getting a cold after an incident of discrimination, recurrent memories of incidents.”
  • Hypervigilent Arousal - more aware, recognized reality of racism, self-conscious.
    • “I feel as if i need to protect myself constantly from the stares, the subtle non-verbal cues, and overt language that I'm the perpetual foreigner, the exotic doll from "South Pacific." You're on constant alert and seek more fervently the company of other POC.”
  • Mild Emotional Distress - single mild emotion (disappointed, frustration,anxious, resentful).
    • “Firstly, I felt violated, ie. they had no right to say something like that. But then angry.”
  • Avoidance/Numbing - stayed away, more distant,withdrew, didn't go back, work to dispel negative beliefs, could not sleep, could not remember.
    • “I'm overall pretty disinterested in relationships with white people. I went to an all black college so that I could live without white people for a while.”
  • Intrusion - recurring memories,nightmares,dreams,can not forget, could not concentrate.
    • “Distraction for weeks because I was afraid it would happen again. Isolation because it was clear I wasn't welcome.”
      n Distrust - unwilling to have cross-race relationships, will not believe what people say, think most are ignorant, aware of true feelings.
      n “I have difficulty in trusting supervisors outside my race.”
  • Lower Self-Worth - doubt about choices, lower self-esteem, hurt my performance or ability, created confusion.
    • “I felt less secure and I lacked confidence in myself. It took me until graduate school to feel comfortable raising my hand in my classes. I didn't think I was intelligent.”
  • Positive Outcome - stronger, more determined.
    • “After this experience - I grew stronger in the knowledge that I must ALWAYS surround myself with POSITIVE mentors, family and friends. I must surround myself with dream boosters, not dream killers.”
  • Other – effects that could not be captured in other categories. (e.g. -community harassment, isolated in midwest, poor relationship with neighbors for 20 years).

Psychological and Emotional Effects by Type of Discrimination
Multiple Experiences
Multiple Experiences and Their Effects

The original number of participants
who logged onto the survey was 353.

The number of participants who
indicated that they had experienced
discrimination was 262.

Of those that reported an experience
of discrimination, 42 (16%) were
categorized as Multiple Experiences.

The Multiple Experiences described
by these participants were comprised
of either a series of distinct
experiences occurring at different
times or one event where the
participant was subject to several
types of discrimination concurrently.
Multiple Experiences and Their Effects
cont’d
When each report of a Multiple
experience was broken down by the
events that compromised it, the
number of experiences that the 42
participants reported collectively was
122.

The descriptive statistics for
the descriptive statistics for the # of
experiences each of the participants
reported are:
Range: 1-12
Mean: 2.9
Median: 6.5
Mode: 2
The participants’ experiences were
also categorized as either being
discrimination, harassment or a
combination.

Discrimination: 4 (10%
Harassment 12 (26%)
Combination 26 (64%)
Frequency of specific types of
Discrimination/Harassment that comprise
Multiple Experiences

Multiple Experiences:
Psychological and Emotional Effects
Of the 42 subjects that reported Multiple Experiences of Discrimination, 36 (or 86%) reported psychological and emotional effects.

Of the 86%, 18 (50%) reported effects that were categorized as Extreme (or Complex) Emotional Distress.

What follows is a breakdown (sub-categorization) of the types of psychological and emotional effects that are categorized as Extreme Complex Emotional Distress
When reports of Extreme Complex Emotional Distress were broken down, 100% of these reports included a sub-categorization of Extreme Emotional Distress.

Of these, 4 (or 22%) consisted of Extreme Emotional Distress
and

14 (or 78%) consisted of Extreme Emotional Distress and some combination of other effects

Statistics for the # of effects for each subject were:

Range: From 1 to 6 per subject

Mean: 2.7 effects per subject

Mode: 2 effects
The participants reported effects were also categorized as either an injury or not an injury.

The frequencies are as follows: (Note that all of the effects were categorized as being an injury unless it was labeled as moderate (transitory) emotional distress, positive, or if the participants indicated that their experience did not result in an effect):

Injury: 30 (54%)
No Injury: 12 (36%
Frequencies of Psychological and Emotional Effects reported in Multiple Experiences

The Relationship between type of Multiple Experience and Psychology Injury, cont’d

a. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 14.0

b. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 21.0
Multiple Experiences

• 98% of those who reported experiencing Multiple Events characterized them as recurring events.
• 86% reported experiencing emotional effects as a result of Multiple Events.
• Extreme Emotional Distress was reported most often by Blacks, followed by Latinos, Asians and biracial.
• Mild Emotional Distress was reported five times more often by Blacks than by Asians and biracial.

Hostile Work Environment

• 73% of those who reported hostility in the work environment characterized these events as recurring rather than single events.
• 83% reported experiencing emotional effects as a result of Hostile Work Environment.
• More than half reported experiencing Extreme Emotional Distress.
• Blacks reported Extreme Emotional Distress most often, followed by Asians, Latinos and biracial.
• Blacks reported Extreme Emotional Distress at least twice as often as Asians, Latinos and biracial.

Verbal Assault

• 63% of experiences of Verbal Assault were characterized as single events.
• 75% reported experiencing emotional effects as a result of Verbal Assault.
• About one third reported experiencing Mild Emotional Distress.
• Asians and biracial were most likely to report experiencing Mild Emotional Distress, followed by Blacks.
• Asians were three times more likely to report Extreme Emotional Distress as a result of a Verbal Assault than Blacks and Latinos.
• Blacks reported Hypervigilence three times more often than Latinos and biracial.

Denied Access or Service

• 59% of respondents who reported being denied access or service characterized the events as single rather than reoccurring events.
• 48% reported experiencing emotional effects as a result of being Denied Access or Service.
• 80% of those reporting Denied Access were Black or Latino.
• Most frequent effects were reported only by Blacks and Latinos.
• Blacks reported Hypervigilence four times more often than Latinos.
• Blacks reported Extreme Emotional Distress twice as often as Latinos.
• Blacks and Latinos reported Lower Self-Worth with equal frequency.

Profiled

• 68% of those who reported being Profiled, characterized these events as recurring.
• 75% reported experiencing emotional effects as a result of being Profiled.
• 80% of those who reported being Profiled were Black or Latino.
• The four most frequently reported effects, were reported by Blacks and Latinos only.
• 100% of those who reported experiencing Mild Emotional Distress were Black.
• Blacks reported Extreme Emotional Distress and Avoidance three times more often than Latinos.
• Latinos reported Hypervigilence three times more often than Blacks.

Psychological and Emotional Effects by Types of Discrimination

General Trends:

• Multiple Events, Hostile Work Environment and Profiled were more often than not recurring events.
• Verbal Assaults and Denied Access were more often than not single events.
• Extreme and Mild Emotional Distress were the effects most commonly associated with all events, except for Denied Access.
• Denied Access was the only event where less than three quarters of the respondents reported
• experiencing psychological and emotional effects.
• There were some notable differences in how members of different racial groups were affected by different types of discrimination and harassment.

Psychological and Emotional Effects by Types of Discrimination

General Trends for racial groups:

• Asians were more effected by verbal assaults. Blacks more effected at work.
• Blacks were Hypervilgent when verbally assaulted and denied access.
• Blacks and Latino’s were denied access and profiled more often.
• The effects for Blacks and Latino’s varied.
• Blacks experienced mild and extreme distress and were avoidant when profiled.
• Latino’s when profiled were Hypervilgent.

Discussion - Demographics

• People of Color report experiences of racial discrimination. But some do not have such experiences. Discrimination not specific to Blacks.
• When racial discrimination or harassment is experienced it is more often than not as a recurring or repeated experience.
• Racial discrimination and harassment occur in many areas of daily living (school, work, shopping, traveling). But the occurrence were about equally divide between school and work (30%) and social, residential, and shopping
  (28%).
• Participants reported greater frequency of racial Harassment (e.g. hostility) 54% of experiences (i.e., hostility at work, verbal assaults, being profiled, violations of racial rules, and physical assaults), than discrimination (e.g. avoidance) which accounted for about 22% of experiences reported (I.e., denied access, and stereotyped) not including multiple experiences.

Discussion - Settings

• The difference in discrimination and harassment varied by settings. Work place accounted for the greatest amount of harassment (hostility,v. assault) at 88% with about 6% being described as discrimination.
• School was also a place were more harassment took place but not at the level of work. Harassment accounted for 43% (v. assualt, VRR, PA) of people’s experiences verse discrimination that was reported at about 34% (stereotype, denied, own group).
• In residential setting and while shopping people were also harassed more than discriminated against. Harassment accounted for 47% (v. assault, VRR, Profil, PA) and discrimination accounted for 21% ( denied) not including multiple experiences. People were harassed 74% (no PA) of the time while shopping and discriminated 23% of the time (denied).
• Thus, the deconstruction of racism seems useful in that it helps distinguish people’s experiences and could lead to more effective policies and procedures in organization and institutions and well as in filing claims for legal redress.

Racial Trauma

• As note before evidence shows that racial trauma produces stress symptoms like DSM anxiety disorders (e.g., acute anxiety reactions, and PTSD).
• However, most DSM diagnoses do not match the etiology or symptom manifestations of persons experiencing racial trauma.
• The threat required for racial trauma may be experienced in the present or vicariously.
• Fear and helplessness associated with racial trauma may not be openly shared due to the chronic and pervasive nature of racism.

Discussion - Emotional and Psychological trauma

• Given the types of racial discrimination and harassment People of Color experience the psychological and emotional effects seem to correspond to traumatic stress reactions.
  For instance, At work excluding Extreme emotional distress (EED) people reported Low self-worth (LEW) (9%), hypervilgent (9%), avoidance (9%) and distrust (9%), Intrusion (3%) = 39% - if EED (55%) is added = 94% of symptoms or reactions meet traumatic stress criteria.
  Similar trends can be seen with verbal assault (44%) and EED (26%) = 66%. Denied Access (65%) (LEW,intrusion,distrust, hyper) and with EED = 86% - Profiled (52%) traumatic stress reactions (hyper,avoid, distr) + EED at (19%) =71%
• The frequency with which respondents reported extreme and mild emotional distress suggests that the psychological and emotional effects associated with racial discrimination and harassment are both acute and chronic.

Discussion - Traumatic Stress

• The emotional and psychological effects reported by the participants qualify as traumatic stress according Carlson’s model.
• The reporting of hypervigilence, avoidance, and lower self-esteem indicate that race-based traumatic stress or racial trauma produces symptoms of stress similar to those associated with anxiety disorders as classified by the DSM IV-R (e.g., PTSD or Acute Stress Disorder ).
• However, not one DSM IV-R diagnosis is congruent with the etiology and symptom manifestation of persons experiencing race- based traumatic stress.

Discussion - Race-Based Traumatic Stress

• Racial harassment and discrimination appear to involve negative, sudden and uncontrollable experience and on-going physical and/or psychological threats that produces extreme emotional distress and other PTSD related symptoms (avoidance, intrusion, viligence, distrust etc.).
• Thus, actions or words that may not appear threatening to “a reasonable person” (a White person) may appear so to members of the threatened group (People of Color).
• Racial trauma is real and seems to result for harassment more than discrimination. The effects of harassment may be effecting people without their or your awareness.
• The distress associated with race-based traumatic stress or racial trauma may not be openly shared due to the chronic and pervasive nature of harassment and discrimination.

Discussion

• What is needed is:
  • Clarification of and consistency in the definitions of racial discrimination and harassment in the legal and psychological literature.
  • Clear and user friendly policies and procedures for filing complaints of racial harassment and discrimination in organizations and institutions.
  • Recognition of the effects of race-based stress in assessment and diagnostic criteria.
  • Treatment strategies specifically designed to assist people in coping with effects of race based traumatic stress.