Abstract
Background
Racial and ethnic discrimination are known stressors and are associated with negative psychological and physical health outcomes. Previous studies have found relationships between racial/ethnic discrimination and binge-eating disorder (BED), though they have mainly focused on adult populations. The aim of this study was to determine associations between racial/ethnic discrimination and BED in a large, national cohort study of early adolescents. We further sought to explore associations between the racial/ethnic discrimination perpetrator (students, teachers, or other adults) and BED.
Methods
We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (ABCD) (N = 11,075, 2018–2020). Logistic regression analyses examined associations between self-reported racial or ethnic discrimination and binge-eating behaviors and diagnosis. Racial/ethnic discrimination measures were assessed based on the Perceived Discrimination Scale, which measures experiences of discrimination based on race/ethnicity and frequency of ethnic discrimination by teachers, adults outside of school, and students. Binge-eating behaviors and diagnosis were based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSAD-5), adjusting for age, sex, race/ethnicity, household income, parental education, and site.
Results
In this racially diverse sample of adolescents (N = 11,075, mean age: 11 years), 4.7% of adolescents reported racial or ethnic discrimination and 1.1% met the criteria for BED at the one-year follow-up. In the adjusted models, racial/ethnic discrimination was associated with 3 times higher odds of having BED (OR 3.31, CI 1.66–7.74); when investigating associations between the racial/ethnic discrimination perpetrator (students, teachers, or other adults) and BED, experiencing ethnic discrimination by students and adults outside school were associated with significantly increased odds of BED diagnosis (OR 1.36, CI 1.10–1.68 & OR 1.42 CI 1.06–1.90, respectively); further, increased odds of binge eating behaviors was only significantly associated with ethnic discrimination perpetuated by students (OR 1.12, CI 1.02–1.23).
Conclusions
Children and adolescents who have experienced racial/ethnic discrimination, particularly when discrimination was perpetuated by other students, have higher odds of having binge-eating behaviors and diagnoses. Clinicians may consider screening for racial discrimination and providing anti-racist, trauma-informed care when evaluating and treating patients for BED.
Keywords: Racial discrimination, binge-eating disorder, adolescent health
Plain English Summary
Binge-eating disorder is associated with significant psychological and physical consequences including depression, anxiety, impaired relationships, and obesity. Recent research has demonstrated that many of these behaviors develop in early adolescence, a time of immense psychosocial development. Racial and ethnic discrimination are known stressors, and previous studies have found relationships between racial and ethnic discrimination and binge-eating disorder, though they have mainly focused on adult populations. This study helps fill that gap by using data from the Adolescent Brain Cognitive Development Study (ABCD) Study, the largest prospective study of adolescent brain development in the US. In this large, racially diverse, national study of 11,075 adolescents aged primary 11 – 12 years old, we find that early adolescents who have experienced racial/ethnic discrimination, particularly when discrimination was perpetuated by other students, have higher odds of having binge-eating behaviors and diagnoses. These findings have important school and clinical implications. For example, schools may consider implementing curricula focused on anti-racist practices that foster environments where all youth to thrive. In addition, we recommend that clinicians screen for racial discrimination and provide culturally sensitive, equity-focused care when evaluating and treating patients with binge-eating disorder.
Background
Binge-eating disorder (BED), characterized by consuming a large amount of food while feeling a loss of control and negative emotions,(1) is estimated to affect 4.5% of the population across the lifetime,(2) with those from minoritized backgrounds experience even higher rates of BED(3) and binge-eating behaviors.(4) BED is associated with significant psychological and physical consequences including depression, anxiety, impaired relationships, and obesity.(2, 5, 6) Given BED’s prevalence, consequences, and challenges with accessing treatment, identifying risk factors for the development of BED is critical to promote health and health equity.
Racial discrimination, or personally mediated racism, has been recognized as a core driver of health inequities in adolescents and children.(7–9) Personally mediated racism includes experiences of stereotypes and prejudices about a person’s ability, intent, or motives on the basis of race.(10) Personally mediated racism can be expressed implicitly or explicitly and can be experienced directly or indirectly. Minoritized children and adolescents face personally mediated racism in their interactions with teachers and students at school, during extracurricular activities, and increasingly in online, digital environments. (11, 12) Experiencing racial harassment and taunts can over-activate the stress response, and have cascading effects including increased and prolonged levels of exposure to stress hormones and oxidative stress.(13) A growing body of literature has found associations between racial discrimination and BED. Several studies of Latino and African American adults have demonstrated significant associations between racial discrimination and binge eating.(14–16) For example, a US nationally representative sample of Latino individuals found a significant association with discrimination and binge eating, with the average age in the sample being 40 years old (range 18–97).(15) In addition, Assari et al.’s paper demonstrated significant associations between perceived discrimination and BED in a nationally representative example of African American adults (average age 42).(16) Studies have also significant associations between maladaptive eating behaviors in young adult Black women (ages 18–25)(17) and Latino young adults (ages 18–25).(18)
However, little is known about the association between racial discrimination and the development of BED in early adolescents. A better understanding of the development of BED in this age-group is especially critical for several reasons. First, recent research has demonstrated that many of these behaviors develop in early adolescents, a time of immense psychosocial development.(19) A study of 10- to 11-year old children from the ABCD Study, a large, diverse, population-based sample, estimated the prevalence of BED to be 1.1%.(20) In addition, a population-based study of 14 year old early adolescents found a 14% prevalence rate of subclinical binge-eating behaviors.(21) Second, early adolescents experience racism and discrimination at unacceptable rates; a recent study estimated that 4.8% of 10- to 11-year old children reported being treated unfairly because of their race, ethnicity or color, and 10% of Black children reported experiencing racism.(22) Given the prevalence of perceived discrimination experienced by youth in this age group, it is critical to characterize the public health effects and rapidly implement antiracism practices. Given the significant impact that peers, teachers, and non-caregiver adults have on early adolescent development,(23–25) we further sought to characterize the impacts of expressed by these varying groups.
The purpose of the current study was to examine the associations between racial discrimination and BED among a large, diverse cohort of early-adolescents ages 9–14 years old (primarily ages 10–11).
Methods
Study population
This study uses survey data from the Adolescent Brain Cognitive Development (ABCD) Study to determine the association between racial discrimination and BED among US early adolescents. The ABCD Study is a large, prospective cohort study of brain development, health, and health behaviors among US adolescents across 21 recruitment sites.(26) Study design and recruitment strategies have previously been described.(27) We included data collected between 2018–2020, corresponding to Year one of the ABCD Study, the first year adolescent-reported racial discrimination was assessed. Participants missing data for i) sociodemographic characteristics or ii) all discrimination questions (n = 710) were excluded, yielding the total sample of 11,075. All participants gave assent, and parents/caregivers provided signed informed consent. The ABCD Study protocol was approved by the Institutional Review Board of the University of California, San Diego and at each respective study site.
Exposure: Racial discrimination
Racial discrimination was measured using the Perceived Discrimination Scale,(28,29) which was developed to measure adolescents’ perception of being unaccepted in society or being unwanted based on their racial or ethnic background or skin color. Adolescents were asked, “In the past 12 months, have you felt discriminated against: because of your race, ethnicity, or color?” In addition, adolescents were asked how often they had been treated unfairly or negatively because of their ethnic background by each of the following groups: teachers, adults outside the school, and students (1 = almost never; 2 = rarely; 3 = sometimes; 4 = often; 5 = very often).
Outcome: Binge-eating disorder
BED diagnosis and behaviors were assessed that the one-year follow-up through parent/caregiver responses to the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5), a computerized tool developed to categorize child and adolescent mental health based on the DSM-5. (1,30) Parents/caregivers completed all modules of the KSADS-5 to characteristics, frequency, and duration of their child’s binge-eating behaviors as well as associated distress. The presence of binge-eating behaviors was assessed by asking if their child experienced a loss of control of their eating and ate way more than he/she needed. BED was determined using the KSADS-5 computerized scoring system, where responses to the survey questions were extrapolated into their respective diagnosis based on reported behaviors corresponding to the DSM-5. Although bulimia nervosa (BN) also consists of binge eating symptoms, the prevalence of BN in the sample was low and therefore this study focused on binge-eating behaviors and BED.
Covariates
We selected potential confounders for the association between racial discrimination and BED based on prior literature and theory.(16,31) Age, sex (male, female), race/ethnicity (White, Latino/Hispanic, Black, Asian, Native American, Other), nativity (youth born in US or outside of the US), household income ($24,999 or less, $25,000 through $49,999, $50,000 through $74,999, $75,000 through $99,999, $100,000 through $199,999, $200,000 and greater), and highest parent education (high school or less vs. college or more) were selected from parent self-report data at baseline. ABCD Study site (21 total sites) was also included to adjust for potential regional variation.
Statistical analyses
Unadjusted and adjusted logistic regressions were conducted using Stata 17.0 (StataCorp, College Station, TX) to estimate associations between past year experiences of racial/ethnic discrimination and BED diagnosis and behaviors. In addition, unadjusted and adjusted logistic regression analyses estimated the association between frequency of ethnic discrimination (teachers, adults outside school, students), and BED diagnosis and behaviors. The ABCD study sociodemographic varaiabeles were standardized to match the distribution American Community Survey from the U.S. Census.(32)
Results
The 11,075 adolescent respondents were racially and ethnically diverse (53.4% White, 19.6% Latino/Hispanic, 16.5% Black, 5.6% Asian, 3.2% Native American, 1.4% Other, Table 1). Binge-eating behaviors and diagnosis were relative rare at 7.9% and 1.1%, respectively. Approximately one in twenty youth reported experiencing racial or ethnic discrimination in the past year. In addition, adolescents reported higher rates of students perpetuating ethnic discrimination that teachers or other adults outside of school.
Table 1:
Sociodemographic characteristics of participants in the Adolescent Brain Cognitive Development Study (ABCD) Study, 2018–2020, (n=11,075)
| Mean (SD) or % | |
|---|---|
| Demographic characteristics | |
| Age | 12.0 (0.7) |
| Sex | |
| Female | 48.8% |
| Male | 51.2% |
| Race/ethnicity | |
| White | 53.4% |
| Latino / Hispanic | 19.6% |
| Black | 16.5% |
| Asian | 5.6% |
| Native American | 3.2% |
| Other | 1.4% |
| Nativity | |
| Youth born in U.S. | 96.3% |
| Youth born outside U.S. | 3.7% |
| Highest parental education | |
| High school education or less | 15.6% |
| College education or more | 84.4% |
| Household income | |
| $24,999 or less | 16.9% |
| $25,000 to $49,999 | 20.2% |
| $50,000 to $74,999 | 18.2% |
| $75,000 to $99,999 | 16.0% |
| $100,000 to $199,999 | 21.7% |
| $200,000 and greater | 7.0% |
| Type of discrimination reported | |
| Discrimination because of race, ethnicity, or color | 4.7% |
| Been treated unfairly or negatively because of your ethnic background by: | |
| Teachers | |
| Almost never | 92.0% |
| Rarely | 4.3% |
| Sometimes | 2.1% |
| Often | 0.9% |
| Very Often | 0.7% |
| Adults outside school | |
| Almost never | 90.2% |
| Rarely | 6.5% |
| Sometimes | 2.2% |
| Often | 0.6% |
| Very Often | 0.5% |
| Students | |
| Almost never | 74.9% |
| Rarely | 13.1% |
| Sometimes | 7.8% |
| Often | 2.2% |
| Very Often | 2.0% |
| Binge eating | |
| Binge-eating behaviors | 7.9% |
| Binge-eating disorder diagnosis | 1.1% |
ABCD Study sociodemographic variables were standardized to match the distribution American Community Survey from the U.S. Census.
In both the adjusted and unadjusted models, racial/ethnic discrimination was associated with increased binge-eating behaviors and binge-eating disorder diagnosis (Table 2). In the adjusted models, adolescents who reported perceived discrimination had 3.31 higher odds of BED (95% CI 1.66 – 6.63). Increased frequency of ethnic discrimination by students was also significantly associated with a higher odds of BED diagnosis and behaviors. In addition, respondents who reported more frequent ethnic discrimination by adults outside of school had significantly higher odds of BED diagnosis.
Table 2:
Associations between discrimination and binge-eating behaviors and diagnosis (N=11,075)
| Panel A: Bivariate Model | ||
| Binge-eating behaviors | Binge-eating disorder diagnosis | |
| OR | OR | |
| (95% CI) | (95% CI) | |
| Discrimination because of race, ethnicity, or color | 2.22*** | 4.31*** |
| (1.62 – 3.05) | (2.40 – 7.74) | |
| Been treated unfairly or negatively because of your ethnic background by: | ||
| Teachers | 1.20** | 1.44** |
| (1.06 – 1.36) | (1.16 – 1.79) | |
| Adults outside school | 1.19* | 1.55** |
| (1.03 – 1.37) | (1.19 – 2.01) | |
| Students | 1 18*** | 1 54*** |
| (1.08 – 1.28) | (1.28 – 1.86) | |
| Panel B: With Confounding Variables | ||
| OR | OR | |
| (95% CI) | (95% CI) | |
| Discrimination because of race, ethnicity, or color | 2 12*** | 3.31* |
| (1.50 – 3.00) | (1.66 – 6.63) | |
| Been treated unfairly or negatively because of your ethnic background by: | ||
| Teachers | 1.12 | 1.26 |
| (0.97–1.23) | (0.98 – 1.60) | |
| Adults outside school | 1.11 | 1.42* |
| (0.95 – 1.30) | (1.06 – 1.90) | |
| Students | 1.12* | 1.36** |
| (1.02 – 1.23) | (1.10 – 1.68) | |
indicates p<0.05
indicates p<0.01
indicates significant at <0.001.
ABCD Study sociodemographic variables were standardized to match the distribution American Community Survey from the U.S. Census. Panel B models include sex, race/ethnicity, household income, parent education, and site.
Discussion
In this national, sociodemographically diverse sample of early adolescents in the U.S., we found that experiencing racial/ethnic discrimination was associated with binge-eating behaviors and diagnosis, even when adjusting for confounding factors including race, sex, nativity, parental education, and socioeconomic status.
The relationship between discrimination and binge-eating is consistent with prior studies in minoritized adult populations that have demonstrated associations between experiencing racial/ethnic discrimination and binge-eating behaviors in Latino and Black the general adult population and young adults.(14, 16) Our findings contribute to the literature by demonstrating that perceived discrimination is significantly associated with higher odds of binge-eating behaviors and diagnosis in a national, diverse population of US early adolescents; importantly, early-adolescents represent an under-researched age group whose developmental period is vulnerable to developing health-related risk behaviors.(19, 33) As BED is associated with significant distress, morbidity, and mortality, it is critical to investigate risk factors in this age group to design primary and secondary prevention interventions.(34, 35)
A potential mechanism of this relationship is experiencing discrimination may impact adolescents’ self-esteem and increases risk for depression symptoms, both of which are associated with increased rates of BED.(28, 36, 37) In addition, several theoretical models have conceptualized racial/ethnic discrimination as an important stressor that drives binge eating from maladaptive coping responses from the resultant increased stress and changes in cortisol levels.(38, 39)
Our study further adds to the literature by exploring how unique groups of perpetrators influence the association between discrimination and BED. In our study, adolescents reported students to be the most common perpetuators of ethnic discrimination with one if four adolescents reporting experiencing ethnic discrimination by students rarely or more frequently; in addition, reporting ethnic discrimination perpetuated by students was significantly associated with increased odds of binge-eating disorder behaviors and diagnosis. The significant impact of peer discrimination on adolescent’s mental health has been supported in prior literature.(24, 40) From a developmental perspective, peer discrimination may be particularly impactful for early adolescents as they increasing spend time outside of the home and rely more on peers for psychosocial acceptance, self-concept, socialization, and identity formation.(41, 42) Several studies have shown that peer victimization in early adolescence is predictive of subsequent development of depressive symptoms.(43, 44) Our study builds upon these studies by highlighting that discrimination is also associated with BED in a national, diverse sample of early adolescents. Of note, experiencing discrimination by other adults outside school was also associated with a significantly higher odds of BED diagnosis. This is consistent with literature that shows the important influence that nonparental adults, such as mentors and police, can have on adolescent mental health.(45–47) Importantly, in the adjusted models, discrimination perpetuated by teachers was not significantly associated with binge-eating behaviors or diagnosis and discrimination by adults outside school was not associated with binge eating symptoms. However, this may be partially due to the smaller sample size in these groups. Prior studies have found that teachers play a critical role in adolescent development and mental health.(48, 49) Further studies should continue to investigate the relationships between ethnic discrimination perpetuated by teachers and adults outside school and binge eating.
This study has several limitations. This study used parent report of binge eating diagnosis and behaviors. While parents are important reporters for eating disorders in early adolescents as children have less insight into their eating behaviors,(26, 50) parent and child reports of binge-eating behaviors have a tendency of low concordance.(26, 50, 51) In addition, this study did not explore the setting where the discrimination occurred so we are unable to assess how the location (ie school, virtual settings, community) estimate the impacts BED behaviors.
Conclusions
This study demonstrates that experiencing racial or ethnic discrimination in early adolescence is associated with BED diagnosis and symptoms, which has important school, clinical, and public policy implications. For example, schools may consider implementing curricula focused on anti-racist practices that foster environments where all youth to thrive.(52) In addition, minoritized populations, for instance, have historically received inadequate access to eating disorder care and inclusion in eating disorders research, which increases the risk of delayed and poorer outcomes.(53) Policy changes that that target these systemic issues, such as increased education about BED among diverse populations, increased food assistance among marginalized communities,(54) and increased access to eating disorder trained mental health professionals,(53) may profoundly impact the risk of BED. The US Preventive Services Task Force (USPSTF) recently reviewed eating disorder screening in asymptomatic adolescents and adults and determined there to be insufficient evidence to recommend routine screening in this population, especially among racial/ethnic minority populations (55). However, clinicians may still consider screening for eating disorder behaviors in early adolescents with significant risk factors, such as racial discrimination, given the significant physician and mental health consequences of eating disorders.(56)
Acknowledgements
The ABCD Study was supported by the Nacional Institutes of Health and additional federal partners under award numbers U01DA041022, U01DA041025, U01DA041028, U01DA041048, U01DA041089, U01DA041093, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, and U24DA041147. A full list of supporters is available at https://abcdstudy.org/federal-partners/. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/principal-investigators.html. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in the analysis or writing of this report.
Funding
J.M.N. was funded by the National Institutes of Health (K08HL159350), the American Heart Association Career Development Award (CDA34760281), and the Doris Duke Charitable Foundation (2022056). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Abbreviations
- ACEs
Adverse Childhood Experiences
- ABCD
Adolescent Brain Cognitive Development study
- BED
Binge-eating disorder
- KSADS-5
Kiddie Schedule for Affective Disorders and Schizophrenia
- BN
Bulimia Nervosa
- SD
Standard Deviation
Footnotes
Declarations
Ethics approval and consent to participate
- Children’s Hospital Los Angeles, Los Angeles, California
- Florida International University, Miami, Florida
- Laureate Institute for Brain Research, Tulsa, Oklahoma
- Medical University of South Carolina, Charleston, South Carolina
- Oregon Health and Science University, Portland, Oregon
- SRI International, Menlo Park, California
- University of California San Diego, San Diego, California
- University of California Los Angeles, Los Angeles, California
- University of Colorado Boulder, Boulder, Colorado
- University of Florida, Gainesville, Florida
- University of Maryland at Baltimore, Baltimore, Maryland
- University of Michigan, Ann Arbor, Michigan
- University of Minnesota, Minneapolis, Minnesota
- University of Pittsburgh, Pittsburgh, Pennsylvania
- University of Rochester, Rochester, New York
- University of Utah, Salt Lake City, Utah
- University of Vermont, Burlington, Vermont
- University of Wisconsin—Milwaukee, Milwaukee, Wisconsin
- Virginia Commonwealth University, Richmond, Virginia
- Washington University in St. Louis, St. Louis, Missouri
- Yale University, New Haven, Connecticut
All methods were carried out in accordance with relevant guidelines and regulations.
Consent for publication
Not applicable
Competing interests
The authors declare that they have no competing interests.
Contributor Information
Julia H Raney, University of California, San Francisco.
Abubakr A Al-shoaibi, University of California, San Francisco.
Iris Y. Shao, University of California, San Francisco
Kyle T Ganson, University of Toronto.
Alexander Testa, The University of Texas Health Science Center at Houston.
Dylan B. Jackson, Johns Hopkins University
Jinbo He, Chinese University of Hong Kong, Shenzhen.
David V. Glidden, University of California, San Francisco
Jason M. Nagata, University of California, San Francisco
Availability of data and materials
Data used in the preparation of this article were obtained from the ABCD Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). Investigators can apply for data access through the NDA (https://nda.nih.gov/).
References
- 1.American Psychiatric Association D, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Vol. 5. Washington, DC: American psychiatric association; 2013. [Google Scholar]
- 2.Hudson JI, Hiripi E, Pope HG, Kessler RC. The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007. Feb 1;61(3):348–58. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Alegria M, Woo M, Cao Z, Torres M, Meng X li, Striegel-Moore R. Prevalence and Correlates of Eating Disorders in Latinos in the U.S. Int J Eat Disord. 2007. Nov;40(Suppl):S15–21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Marques L, Alegria M, Becker AE, Chen C nan, Fang A, Chosak A, et al. Comparative Prevalence, Correlates of Impairment, and Service Utilization for Eating Disorders across U.S. Ethnic Groups: Implications for Reducing Ethnic Disparities in Health Care Access for Eating Disorders. Int J Eat Disord. 2011. Jul;44(5):412–20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Rosenbaum DL, White KS. The relation of anxiety, depression, and stress to binge eating behavior. J Health Psychol. 2015. Jun 1;20(6):887–98. [DOI] [PubMed] [Google Scholar]
- 6.Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2011. Jul 1;68(7):714–23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Gee GC, Walsemann KM, Brondolo E. A Life Course Perspective on How Racism May Be Related to Health Inequities. Am J Public Health. 2012. May;102(5):967–74. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Pachter LM, Coll CG. Racism and Child Health: A Review of the Literature and Future Directions. J Dev Behav Pediatr. 2009. Jun;30(3):255. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Trent M, Dooley DG, Dougé J, SECTION ON ADOLESCENT HEALTH, COUNCIL ON COMMUNITY PEDIATRICS, COMMITTEE ON ADOLESCENCE, et al. The Impact of Racism on Child and Adolescent Health. Pediatrics. 2019. Aug 1;144(2):e20191765. [DOI] [PubMed] [Google Scholar]
- 10.Jones CP. Invited Commentary: “Race,” Racism, and the Practice of Epidemiology. Am J Epidemiol. 2001. Aug 15;154(4):299–304. [DOI] [PubMed] [Google Scholar]
- 11.Stevens R, Gilliard-Matthews S, Dunaev J, Woods M, Brawner BM. The Digital Hood: Social Media Use among Youth in Disadvantaged Neighborhoods. New Media Soc. 2017. Jun;19(6):950–67. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Njoroge WFM, Forkpa M, Bath E. Impact of Racial Discrimination on the Mental Health of Minoritized Youth. Curr Psychiatry Rep. 2021. Oct 14;23(12):81. [DOI] [PubMed] [Google Scholar]
- 13.Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci. 2012. Apr 17;109(16):5995–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Beccia AL, Jesdale WM, Lapane KL. Associations between perceived everyday discrimination, discrimination attributions, and binge eating among Latinas: results from the National Latino and Asian American Study. Ann Epidemiol. 2020. May;45:32–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Johnson SN, Forbush KT, Swanson TJ. The impact of discrimination on binge eating in a nationally representative sample of Latine individuals. Int J Eat Disord. 2022. Aug;55(8):1120–9. [DOI] [PubMed] [Google Scholar]
- 16.Assari S. Perceived Discrimination and Binge Eating Disorder; Gender Difference in African Americans. J Clin Med. 2018. Apr 24;7(5):89. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Brown KL, Graham AK, Perera RA, LaRose JG. Eating to cope: Advancing our understanding of the effects of exposure to racial discrimination on maladaptive eating behaviors. Int J Eat Disord. 2022. Dec;55(12):1744–52. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Hagiwara N, Green TL, Moreno O, Smith D, Corona R. Ethnic discrimination and weight outcomes among Latinx emerging adults: Examinations of an individual-level mediator and cultural moderators. Cultur Divers Ethnic Minor Psychol. 2021;27:189–200. [DOI] [PubMed] [Google Scholar]
- 19.Dahl RE, Allen NB, Wilbrecht L, Suleiman AB. Importance of investing in adolescence from a developmental science perspective. Nature. 2018. Feb;554(7693):441–50. [DOI] [PubMed] [Google Scholar]
- 20.Chu J, Raney JH, Ganson KT, Wu K, Rupanagunta A, Testa A, et al. Adverse childhood experiences and binge-eating disorder in early adolescents. J Eat Disord. Forthcoming; [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Derks IPM, Harris HA, Staats S, Gaillard R, Dieleman GC, Llewellyn CH, et al. Subclinical binge eating symptoms in early adolescence and its preceding and concurrent factors: a population-based study. J Eat Disord. 2022. Nov 23;10(1):180. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Nagata JM, Ganson KT, Sajjad OM, Benabou SE, Bibbins-Domingo K. Prevalence of Perceived Racism and Discrimination Among US Children Aged 10 and 11 Years. JAMA Pediatr. 2021. Aug;175(8):861–3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Bennett M, Roche KM, Huebner DM, Lambert SF. School Discrimination and Changes in Latinx Adolescents’ Internalizing and Externalizing Symptoms. J Youth Adolesc. 2020. Oct;49(10):2020–33. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Bennett M, Roche KM, Huebner DM, Lambert SF. Peer Discrimination, Deviant Peer Affiliation, and Latino/a Adolescent Internalizing and Externalizing Symptoms: A Prospective Study. J Clin Child Adolesc Psychol. 2022. Jul 19;0(0):1–17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.McFarland L, Murray E, Phillipson S. Student–teacher relationships and student self-concept: Relations with teacher and student gender. Aust J Educ. 2016. Apr 1;60(1):5–25. [Google Scholar]
- 26.Barch DM, Albaugh MD, Avenevoli S, Chang L, Clark DB, Glantz MD, et al. Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description. Dev Cogn Neurosci. 2017. Nov 3;32:55–66. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Garavan H, Bartsch H, Conway K, Decastro A, Goldstein RZ, Heeringa S, et al. Recruiting the ABCD sample: Design considerations and procedures. Dev Cogn Neurosci. 2018. Apr 16;32:16–22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Cano MÁ, Schwartz SJ, Castillo LG, Romero AJ, Huang S, Lorenzo-Blanco EI, et al. Depressive Symptoms and Externalizing Behaviors among Hispanic Immigrant Adolescents: Examining Longitudinal Effects of Cultural Stress. J Adolesc. 2015. Jul;42:31–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Phinney JS, Madden T, Santos LJ. Psychological variables as predictors of perceived ethnic discrimination among minority and immigrant adolescents. J Appl Soc Psychol. 1998;28:937–53. [Google Scholar]
- 30.Townsend L, Kobak K, Kearney C, Milham M, Andreotti C, Escalera J, et al. Development of Three Web-Based Computerized Versions of the Kiddie Schedule for Affective Disorders and Schizophrenia Child Psychiatric Diagnostic Interview: Preliminary Validity Data. J Am Acad Child Adolesc Psychiatry. 2020. Feb 1;59(2):309–25. [DOI] [PubMed] [Google Scholar]
- 31.Berry OO, Londoño Tobón A, Njoroge WFM. Social Determinants of Health: the Impact of Racism on Early Childhood Mental Health. Curr Psychiatry Rep. 2021. Mar 12;23(5):23. [DOI] [PubMed] [Google Scholar]
- 32.Heeringa SG, Berglund PA. A Guide for Population-based Analysis of the Adolescent Brain Cognitive Development (ABCD) Study Baseline Data [Internet]. 2020. Feb [cited 2022 Jan 6] p. 2020.02.10.942011. Available from: 10.1101/2020.02.10.942011v1 [DOI] [Google Scholar]
- 33.Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. N Engl J Med. 2015. Oct;373(14):1307–17. [DOI] [PubMed] [Google Scholar]
- 34.van Hoeken D, Hoek HW. Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden. Curr Opin Psychiatry. 2020. Nov;33(6):521–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.O’Brien D, Fisher J. 5 ways bosses can reduce the stigma of mental health at work.:6. [Google Scholar]
- 36.Cheng HL. Disordered Eating Among Asian/Asian American Women: Racial and Cultural Factors as Correlates. Couns Psychol. 2014. Aug 1;42(6):821–51. [Google Scholar]
- 37.Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A, et al. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PLoS ONE. 2015. Sep 23;10(9):e0138511. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 38.Heatherton TF, Baumeister RF. Binge eating as escape from self-awareness. Psychol Bull. 1991;110:86–108. [DOI] [PubMed] [Google Scholar]
- 39.Zeiders KH, Doane LD, Roosa MW. Perceived Discrimination and Diurnal Cortisol: Examining Relations among Mexican American Adolescents. Horm Behav. 2012. Apr;61(4):541–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 40.Dulin-Keita A, Hannon Iii L, Fernandez JR, Cockerham WC. The defining moment: children’s conceptualization of race and experiences with racial discrimination. Ethn Racial Stud. 2011. Apr 1;34(4):662–82. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 41.Hughes DL, Watford JA, Del Toro J. Chapter One - A Transactional/Ecological Perspective on Ethnic–Racial Identity, Socialization, and Discrimination. In: Horn SS, Ruck MD, Liben LS, editors. Advances in Child Development and Behavior [Internet]. JAI; 2016. [cited 2023 Mar 29]. p. 1–41. (Equity and Justice in Developmental Science: Implications for Young People, Families, and Communities; vol. 51). Available from: https://www.sciencedirect.com/science/article/pii/S0065240716300209 [DOI] [PubMed] [Google Scholar]
- 42.DiClemente RJ, Santelli JS, Crosby R. Adolescent Health: Understanding and Preventing Risk Behaviors. John Wiley & Sons; 2009. 610 p. [Google Scholar]
- 43.Delgado MY, Nair RL, Updegraff KA, Umaña-Taylor AJ. Discrimination, Parent-Adolescent Conflict, and Peer Intimacy: Examining Risk and Resilience in Mexican-Origin Youths’ Adjustment Trajectories. Child Dev. 2019. May;90(3):894–910. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 44.Stein GL, Castro-Schilo L, Cavanaugh AM, Mejia Y, Christophe NK, Robins R. When Discrimination Hurts: The Longitudinal Impact of Increases in Peer Discrimination on Anxiety and Depressive Symptoms in Mexican-origin Youth. J Youth Adolesc. 2019. May;48(5):864–75. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 45.Hurd NM, Stoddard SA, Bauermeister JA, Zimmerman MA. Natural Mentors, Mental Health, and Substance Use: Exploring Pathways via Coping and Purpose. Am J Orthopsychiatry. 2014. Mar;84(2):190–200. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 46.Jindal M, Mistry KB, Trent M, McRae A, Thornton RLJ. Police Exposures and the Health and Well-being of Black Youth in the US: A Systematic Review. JAMA Pediatr. 2022. Jan 1;176(1):78–88. [DOI] [PubMed] [Google Scholar]
- 47.Szapocznik J, Coatsworth JD. An ecodevelopmental framework for organizing the influences on drug abuse: A developmental model of risk and protection. In: Drug abuse: Origins & interventions. Washington, DC, US: American Psychological Association; 1999. p. 331–66. [Google Scholar]
- 48.Maene C, D’hondt F, Van Lissa CJ, Thijs J, Stevens PAJ. Perceived Teacher Discrimination and Depressive Feelings in Adolescents: The Role of National, Regional, and Heritage Identities in Flemish Schools. J Youth Adolesc. 2022;51(12):2281–93. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 49.Butler-Barnes ST, Leath S, Inniss-Thompson MN, Allen PC, D’Almeida MEDA, Boyd DT. Racial and gender discrimination by teachers: Risks for Black girls’ depressive symptomatology and suicidal ideation. Cultur Divers Ethnic Minor Psychol. 2022. Oct;28(4):469–82. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 50.Braet C, Soetens B, Moens E, Mels S, Goossens L, Van Vlierberghe L. Are two informants better than one? Parent–child agreement on the eating styles of children who are overweight. Eur Eat Disord Rev. 2007;15(6):410–7. [DOI] [PubMed] [Google Scholar]
- 51.Tanofsky-Kraff M, Yanovski SZ, Yanovski JA. Comparison of child interview and parent reports of children’s eating disordered behaviors. Eat Behav. 2005. Jan 1;6(1):95–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 52.Priest N, Alam O, Truong M, Sharples R, Nelson J, Dunn K, et al. Promoting proactive bystander responses to racism and racial discrimination in primary schools: a mixed methods evaluation of the ‘Speak Out Against Racism’ program pilot. BMC Public Health. 2021. Jul 21;21:1434. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 53.Moreno R, Buckelew SM, Accurso EC, Raymond-Flesch M. Disparities in access to eating disorders treatment for publicly-insured youth and youth of color: a retrospective cohort study. J Eat Disord. 2023. Jan 24;11:10. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 54.Food insecurity and binge-eating disorder in early adolescence - Nagata - International Journal of Eating Disorders - Wiley Online Library [Internet]. [cited 2023 Apr 27]. Available from: 10.1002/eat.23944 [DOI] [PMC free article] [PubMed]
- 55.Feltner C, Peat C, Reddy S, Riley S, Berkman N, Middleton JC, et al. Screening for Eating Disorders in Adolescents and Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. Vol. 327, JAMA - Journal of the American Medical Association. 2022. [DOI] [PubMed] [Google Scholar]
- 56.Nagata JM, Golden NH. New US Preventive Services Task Force Recommendations on Screening for Eating Disorders. Vol. 182, JAMA Internal Medicine. 2022. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Data used in the preparation of this article were obtained from the ABCD Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). Investigators can apply for data access through the NDA (https://nda.nih.gov/).