Developmental differences in the impact of racial discrimination on depression and anxiety among Black youth: Examining rumination as a mechanism

Abstract

Experiences of racial discrimination are pervasive among Black youth, resulting in psychosocial problems such as depression and anxiety. Rumination plays a key role in linking racial discrimination and internalizing concerns. Developmental age has also been shown to influence the extent to which racial discrimination and rumination impact mental health; however, studies have yet to explore the interplay between these factors. This study examined the association between racial discrimination and internalizing concerns among Black youth, whether racial discrimination was indirectly associated with internalizing concerns through rumination, and whether developmental age moderated these direct and indirect effects. Participants included 158 pre- and early-adolescent youth recruited from a community sample (Mean age = 11.56 years; 53% female). Data were from baseline questionnaire responses from a larger longitudinal study conducted in the southeast USA examining the effects of interpersonal stressors on youth mental health outcomes. Racial discrimination was directly and indirectly associated with internalizing concerns through rumination. Developmental age moderated the indirect link between racial discrimination and depressive symptoms via rumination with the association being stronger as participant age increased. The impact of racial discrimination on mental health among Black youth is informed by maladaptive coping strategies such as rumination and developmental age. Such factors help to identify who is most at risk for the impact of racial discrimination and potential intervening targets.

Racial discrimination, defined as the unfair and demeaning treatment of a group or individual on the basis of race (Kessler et al., 1999) represents a ubiquitous stressor among Black youth with approximately 90% reporting a discriminatory encounter within a given year (Seaton et al., 2008). Concerningly, experiences of racial discrimination are reported among Black youth as early as age seven (Walker et al., 2022) which can fundamentally alter how they perceive themselves and others well before they have developed a sophisticated understanding of race, or the adaptive repertoire of coping skills needed to process and respond to these experiences. The prevalence and chronicity of racial discrimination among Black youth across child development represents a significant public health concern, as these deleterious experiences can increase vulnerability to a wide range of adverse psychosocial outcomes including internalizing symptoms such as anxiety and depression (Cave et al., 2020; Priest et al., 2013). The robust association between racial discrimination and internalizing symptoms persists even after accounting for other potentially traumatic childhood experiences and sociodemographic characteristics (Bernard et al., 2022), highlighting the significant impact of racial discrimination on the psychological well-being of Black youth.

Given the pernicious nature of racial discrimination, researchers have increasingly attended to coping strategies that may influence the link between discrimination and poor mental health outcomes. One specific coping response that has been shown to explain and exacerbate the influence of racial discrimination on mental health is rumination, defined as the passive and repetitive focusing on negative feelings (Nolen-Hoeksema, 1991). Scholars posit that rumination may be used as a primary coping strategy to understand and regulate one’s negative mood state following stressful encounters (Garnefski et al., 2001). Yet, youth who passively focus attention on their negative mood following a stressful encounter are more vulnerable to depression and anxiety relative to those who engage in activities that take one’s mind off negative feelings (Young & Dietrich, 2015). Thus, rumination is conventionally conceptualized as a maladaptive self-regulatory response that increases vulnerability for the onset and intensification of internalizing psychopathology (Watkins & Roberts, 2020).

Maladaptive emotion regulation coping strategies such as rumination demonstrate developmental increases when examined among youth and adolescents. That is, older adolescents may be more likely to ruminate about their negative emotional state relative to their pre-or-early adolescent counterparts (Hampel & Petermann, 2005). Similar developmental patterns have been found to exist with respect to perceptions of racial discrimination, with older Black adolescents more likely to perceive and report such experiences relative to their younger peers (Seaton et al., 2010). Despite this literature, little work has been done to determine if age influences the psychological impact of racial discrimination and related coping responses (i.e., rumination) on internalizing concerns. Thus, the present study builds upon and extends previous research to examine whether rumination accounts for the relationship between racial discrimination and internalizing symptoms and whether these direct and indirect associations differ across developmental age among a sample of Black pre- and early-adolescents.

Theoretical Framework

The current investigation is grounded within the Clark and colleagues' (1999) Biopsychosocial Model of Racism, which asserts that an environmental stimulus perceived as racist can produce adverse psychological and physiological responses. According to this model, the link between perceptions of racism and stress responses is mediated by coping (e.g., rumination) and moderated by constitutional (e.g., skin tone), environmental, sociodemographic factors (e.g., age, gender), and psychological/behavioral factors (e.g., self-esteem) factors. As recent literature has shed light on how Black individuals navigate racism related experiences differently across development (Jones et al., 2020), we specifically examine the intersection between coping responses (i.e., rumination) and sociodemographic factors (i.e., youth age) in the context of discrimination and mental health. In particular, it is possible that youth age influences the degree to which youth recognize and label an event as discriminatory which could influence psychological adjustment outcomes (García Coll et al., 1996). Further, as emotion regulation coping strategies may differ as a function of developmental stage (Compas et al., 2017), it also may be that youth age informs the degree to which youth engage in ruminative coping following discriminatory encounters, which may serve to mitigate or amplify the harmful impact of racial discrimination on mental health.

Racial Discrimination and Internalizing Concerns Across Youth Development

Across childhood and adolescence, experiences of racial discrimination represent a significant risk factor for internalizing symptomatology (Priest et al., 2013). For example, Brown and Bigler’s (2005) developmental model of discrimination posits that children can understand race and recognize racially biased behavior by the age of six. Early experiences of racial discrimination may be particularly challenging to cope with among pre- and early-adolescent youth, as critical cognitive and language skills needed to process racism related experiences may be underdeveloped (Saleem et al., 2020). In support of this assertion, studies have found early developmental experiences of racial discrimination to be associated with elevated endorsements of depression and anxiety (Lavner et al., 2022; Marcelo et al., 2018; Nyborg & Curry, 2003), including a recent meta-analysis that found that discrimination was more strongly associated with internalizing symptoms among early adolescents than late adolescents (Benner et al., 2018).

Although attention has been given to understand the experiences and consequences of racial discrimination among Black pre-adolescent youth, studies have also found that Black adolescents may be at equal or greater risk to experience poor mental health outcomes following discriminatory encounters. Indeed, among Black youth, exposure to discriminatory events across different contexts have been shown to increase in frequency across late childhood and early adolescence (Brody et al., 2006; Greene et al., 2006). Consistent with this literature, Black adolescents are estimated to contend with five encounters of racial discrimination per day (English et al., 2020). The chronicity of these discriminatory events are not only stressful, but also have notable implications relating to identity formation as Black youth transition to adolescence and begin grappling with what it means to be Black in a racialized society (Spencer, 2006). When coupled with the fact that adolescent’s evidence developmental advancements in cognitive skill sets that allow for more abstract and sophisticated ways to process discriminatory events (Harrell, 2000; Seaton et al., 2010) it is possible that Black adolescents may be more vulnerable to the pernicious effects of racial discrimination relative to their younger counterparts. To this end, scholarship has found that as Black adolescents get older the effects of racial discrimination on internalizing symptoms becomes more pronounced (Smith-Bynum et al., 2014; Tynes et al., 2020). Taken together with studies demonstrating stronger correlations of internalizing symptoms with older youth (Cannon & Weems, 2006; Nolen-Hoeksema & Girgus, 1994), this evidence suggests that developmental age differences in the pathway from discrimination to internalizing symptoms among Black adolescents require additional investigation to clarify critical periods for intervention.

Rumination as a Linking Mechanism of Racial Discrimination and Mental Health

The biopsychosocial model of racism posits that rumination represents one of many coping responses that ultimately determine health outcomes following a discriminatory encounter (Clark et al., 1999). Discriminatory encounters often occur unexpectedly and across ecological contexts, and are often disorienting, and emotionally laden (Jones et al., 2013; Salvatore & Shelton, 2007). Thus, to make sense of the stressful event (or accumulation of events), individuals may rehearse or replay the event, deliberate on the reasons why the event occurred, and perseverate on negative feelings associated with the event (Hoggard & Hill, 2018). This stress-induced rumination can impair an individual’s ability to engage in adaptive problem-solving and active coping strategies (Michl et al., 2013), intensify and prolong negative mood states (Brosschot et al., 2006) and ultimately increase vulnerability for anxiety and depression among adolescents (McLaughlin & Nolen-Hoeksema, 2011).

In support of this framework, Bernard and colleagues (2021) found that rumination partially mediated the association between racial discrimination and depressive symptoms among a sample of Black youth. This partial mediating effect has also been replicated among Black college students and adults (Borders & Liang, 2011), emphasizing the impact of discrimination and ruminative coping responses across the life course. However, investigations linking discrimination and internalizing symptoms by way of rumination have been limited to depressive symptoms, with little consideration as to how rumination may similarly link discrimination and anxiety symptoms. Yet, cognitive perseveration on racism-related experiences has been associated with elevations in worry, fear, and physiological stress responses (Harrell et al., 2003; Hope et al., 2021; Steele, 2016; Utsey et al., 2013), which strongly resembles the symptomatic profile of anxiety (American Psychological Association, 2013). To this end, recent findings from Mekawi and colleagues (2021) found that rumination helps explain the association between racial discrimination and anxious affect among Black college students and underscores the importance of clarifying this mechanism in the context of the racial discrimination–anxiety link among younger samples.

Rumination and Internalizing Symptoms Across Youth Development

Although rumination represents an important mechanism by which racial discrimination impacts health, a 2009 meta-analysis found that the link between rumination and internalizing concerns was stronger and more consistent among older adolescents (Rood et al., 2009), suggesting important developmental differences that influence this stress response and the extent to which it is harmful to mental health. In accordance with previous research documenting developmental differences in the link between discrimination and internalizing symptoms, scholars have speculated that ruminative response styles may be underdeveloped among younger adolescents relative to older adolescents who have developed more sophisticated metacognitive skills (Abela et al., 2004). However, empirical findings regarding age differences in the context of ruminative coping responses remain unclear. Although some studies find that rumination and the association between rumination and mental health symptoms generally increase with age (Hampel & Petermann, 2005), other studies report no significant age differences (Abela et al., 2012). Taken with equivocal findings regarding age differences in the link between discrimination and internalizing symptoms, these studies emphasize a gap in knowledge regarding the impact of developmental age on vulnerability for rumination and subsequent internalizing symptoms in the context of racial discrimination.

Current Study

There are a number of limitations in psychological literature that constrain our understanding of the interplay among racial discrimination, rumination, and mental health. First, investigations into ruminative coping in the context of racism-related stress research has predominantly focused on depression. Although this emphasis is indeed logical given that rumination has been conceptualized as a coping response in the context of negative mood states (Lyubomirsky & Nolen-Hoeksema, 1993; Nolen-Hoeksema,1991), scholars have linked the perseverative nature of rumination to anxiety related concerns among adolescent and adult samples (Michl et al., 2013; Taylor & Snyder, 2021). Second, despite research indicating that youth’s metacognitive coping strategies such as rumination may become more advanced complex as they get older (Abela et al., 2004), research has yet to investigate the degree to which endorsements of ruminative coping differ as a function of age among Black youth. Third, no work has examined how rumination operates across different developmental stages to uniquely inform how racial discrimination impacts mental health. As such, our understanding of the developmental significance of rumination, which represents a prime target for intervention following racism-related encounters, remains limited.

In light of these limitations, the purpose of the current study is to investigate whether there are developmental differences in the link between racial discrimination, rumination, and internalizing symptoms among Black youth. Three specific research aims guided the present work. First, we examined whether racial discrimination was directly associated with youth reported symptoms of depression and anxiety. In line with previous research, we hypothesized that racial discrimination would evidence unique positive associations with depressive and anxiety symptoms among Black youth. Second, we sought to elucidate the unique indirect associations among racial discrimination, anxiety, and depression through rumination. As previous research has shown rumination to dually increase vulnerability for internalizing concerns and serve as a proximal mechanism that connects racial discrimination and mental health, we predicted that more frequent reports of racial discrimination would be associated with higher levels of rumination, which in turn, would be associated with greater reported depressive and anxiety symptoms, respectively. Finally, in recognition of research suggesting the link between racial discrimination and mental health and rumination may vary as youth mature, our third, exploratory aim examined if youth age moderated the direct and indirect impact of racial discrimination on internalizing symptoms via rumination (See Figure 1 for conceptual model).

Figure 1.

Conceptual Model of Moderated Indirect Effects

Method

Participants

Data reported in the current study are from baseline data of a subset of youth who participated in an ongoing longitudinal study examining the effects of interpersonal stressors on youth mental health outcomes (the “CHARM” study). Participants were recruited from 3rd, 6th, or 9th grade at study entry and fell between the ages of seven years and 16 years at the time of consent. For the present study, only data from Black youth were included (n = 158; 53% female). Within this subsample of youth, 146 (92.4%) identified as Black, 10 (6.3%), identified as Black and White, and two (1.3%) identified as Black Hispanic. Youth in the current sample were between the ages of 8 and 16 years old (M = 11.56, SD = 2.46), and the parent-reported median household income was reported to be $30,001—$40,000. See Table 1 for age frequency and distribution for the current sample.

Table 1.

Frequency and Distribution of Participants by Age

Age	Frequency	Proportion
8	26	.182
9	16	.112
10	2	.014
11	25	.175
12	23	.161
13	6	.042
14	26	.182
15	18	.126
16	1	.070

Procedures

Participants were recruited from schools, pediatric outpatient clinics, and other community settings in a mid-sized Southeastern city. Research staff posted flyers in public locations and pediatric outpatient clinics, published ads on social media and in local periodicals, and distributed letters to caregivers with the permission of participating schools. Caregivers self-referred their children to the study and provided written informed consent for their participation. At baseline, youth and caregivers (i.e., legal guardians) attended a laboratory visit that included youth completing self-report questionnaires via interviews with trained research assistants. All data were entered into REDCap for data analysis. All procedures were approved by the Medical University of South Carolina’s institutional review board. The variables of interest in the current study were derived from responses to the self-report questionnaires described below.

Measures

Demographics.

Caregivers reported demographic characteristics of youth including age, gender, race/ethnicity, and socioeconomic status during the baseline data collection.

Racial Discrimination.

Experiences of racial discrimination were assessed using the 22-item Race-Related Events Scale (RES), a checklist that assesses lifetime exposure to racial discrimination (Waelde et al., 2010). Respondents indicated whether they encountered any events on the checklist (e.g., “Insulted or called an insulting name”) due to their race or ethnicity. Responses of “yes” were summed for analysis, with higher scaled scores indicating more lifetime experiences of discrimination. The RES has demonstrated strong psychometric properties among Black samples (Crusto et al., 2015) and demonstrated high internal consistency in the current sample (alpha = .82).

Rumination.

The Children’s Response Styles Questionnaire (CRSQ), a scale describing specific cognitive responses to internalizing symptoms, was used to assess rumination (Abela et al., 2002). The 13-item Ruminative Response subscale of the CRSQ specifically measures self-focused responses to negative mood (e.g., “When I am sad, I think about a recent situation, wishing it had gone better”) and was used for the current study. Responses ranging from 1 (almost never) to 4 (almost always) were summed for a scaled score with higher scores suggestive of a more ruminative response style. This scale has demonstrated strong psychometric properties among diverse samples of children and adolescents (Abela et al., 2004; Daryanani et al., 2017), including in the current sample (alpha = .88).

Anxiety.

Anxiety symptoms were assessed with the youth report version of the Multidimensional Anxiety Scale for Children-2nd edition (MASC-2; March et al., 1997). The MASC-2 is a commonly used measure of child anxiety and consists of 50-items. Likert-type scale responses on the MASC-2 ranged from 0 to 3 (0- Never, 1- rarely, 2-sometimes and 3-often), with higher summed scores being representative of higher levels of anxiety. Sample items on the MASC-2 include “I get shaky or jittery” and “I worry about what other people think of me”. The MASC-2 has been widely validated among a diverse body of children and adolescent populations and has demonstrated strong psychometric properties (Kingery et al., 2009; Wei et al., 2014), which is consistent with what was found in the current sample (alpha = .91).

Depression.

Youth depressive symptoms were assessed using the Children's Inventory (CDI; Kovacs, 1992) a 27-item self-report measure with items corresponding to common depressive symptoms in children. Each item is scored on a three-point Likert scale (e.g., I am sad some of the time [0] / most of the time [1] / all the time [2]). Item scores are summed for a composite score, with higher scores indicating greater symptom severity. The CDI has been used extensively among diverse research and clinical samples of children and adolescents and has demonstrated strong psychometric properties (Gonzales-Backen et al., 2020; Twenge & Nolen-Hoeksema, 2002). Internal consistency in the current sample was high (alpha = .87).

Data Analytic Plan

Preliminary data cleaning and descriptive analyses were conducted using SPSS. Continuous study variables were assessed for normality using a combination of several outlier detection criteria including Mahalanobis distance (De Maesschalck et al., 2000), Cook’s Distance (Cook, 1977), and the leverage method (Rousseeuw & van Zomeren, 1990). Twelve cases were removed due to missing data and another two cases were identified as outliers and were subsequently removed. Primary analyses (i.e., testing of moderated indirect effects) were conducted using structural equation modeling (SEM) within Mplus 8.7 (Muthén & Muthén, 2017) using full information maximum likelihood with robust standard errors (MLR).

In recognition of the inherent limitations of mediation approaches with cross-sectional data (see Maxwell et al., 2007), we approach analyses of indirect effects from an atemporal mediation perspective (Winer et al., 2016). Our rationale for utilizing an atemporal mediation approach was informed by theory and the current state of the field. Specifically, although we are unable to establish causality, the hypothesized pathway (racism-related experiences would lead to ruminative coping responses, which in turn could increase internalizing problems) is theoretically grounded (Clark et al., 1999). Further, longitudinal investigations of rumination in the context of discriminatory events remain absent from the field. As such, findings from the current work can set the stage for future longitudinal studies to establish temporal precedence.

Figure 1 presents the initial indirect effects model. Racial discrimination and age were exogenous variables. Gender was included as a covariate with paths to rumination, anxiety, and depression given that females generally report elevated levels of rumination and internalizing symptoms relative to male adolescents (Altemus et al., 2017; Rood et al., 2009). Direct paths were specified from racial discrimination to rumination, from rumination to both depression and anxiety, and from age to both depression and anxiety. Lastly, conditional direct and indirect effects were calculated for this path analysis using bias-corrected bootstrap confidence intervals. Model fit was evaluated using several goodness-of-fit indices—specifically, the Root Mean Square Error of Approximation (RMSEA ≤ .08; Steiger & Lind, 1980), Tucker-Lewis Index (TLI; ≥ .95; Tucker & Lewis, 1973), and Comparative Fit Index (CFI; ≥ .95; Bentler, 1990).

Results

Descriptive Statistics

Descriptive statistics and correlations are shown in Table 2. Female participants reported greater levels of rumination, depression, and anxiety. Older participants reported greater depression, while younger participants reported greater anxiety. Participant age was unrelated to rumination. Greater racial discrimination and rumination were significantly associated with increased depression and anxiety.

Table 2.

Correlations Between Observed Variables and Descriptive Statistics (N=143)

	1	2	3	4	5	M (SD)	Range	Skew
1. Gender
2. Age	−.06					11.36 (2.73)	7 – 16
3. Racial Discrimination	.01	.09				2.43 (3.05)	0 – 12	1.23
4. Rumination	−.18*	.10	.25**			24.21 (8.49)	7 – 49	0.75
5. Depression	−.30***	.17*	.24**	.63***		8.06 (6.83)	0 – 34	1.20
6. Anxiety	−.32***	−.22**	.19*	.52***	.53***	57.19 (21.45)	9 – 112	0.18

Note. Gender (Male = 1, Female = 0).

^***p<.001

^**p<.01

^*p<.05

Moderated Indirect Effects Model

The initial indirect effect model without moderation was a good fit to the data, χ2 (1, N = 143) = 0.840, p = < .359; RMSEA = .000, 90% CI [.000, .214]; CFI = 1.00; SRMR = .021. As hypothesized, there was a significant effect of racial discrimination on rumination (b = 0.71, p = .001) and significant effect of rumination on depression (b = 0.39, p < .001) and anxiety (b = 1.15, p < .001). Age was significantly associated with anxiety (b = −2.37, p < .001), but not depression (b = 0.24, p = .115). The error terms of depression and anxiety were allowed to covary (r = .33, p < .001). Rumination had significant direct effects on both depression and anxiety across all ages (all main effects are reported in Table 3). Next, a Racial Discrimination x Age interaction and a Rumination x Age interaction were introduced to the model with paths to depression and anxiety. The Racial Discrimination x Age interaction was not significant for either depression (p = .137) or anxiety (p = .796). The Rumination x Age interaction was significant for depression (b = 0.06, p = .017; see Figure 2), but not for anxiety (p = .371). The indirect effect of racial discrimination on both depression and anxiety via rumination was significant. For depression specifically, there was a significant moderated mediation such that the indirect effect was observed to strengthen as participant age increased. See Table 4 for conditional direct and indirect effects.

Table 3.

Model Results

Dependent Variable	Independent Variable	b	S.E.	p
Rumination
	Racial Discrimination	0.71	0.21	.001
	Gender	−3.03	1.35	.024
Depression
	Racial Discrimination	0.28	0.17	.091
	Rumination	0.39	0.06	>.001
	Age	0.24	0.15	.115
	Gender	−2.39	0.84	.004
	Racial Discrimination x Age	−0.08	0.05	.137
	Rumination x Age	0.06	0.02	.017
Anxiety
	Racial Discrimination	0.85	0.50	.086
	Rumination	1.15	0.20	>.001
	Age	−2.37	0.53	>.001
	Gender	−9.99	2.85	>.001
	Racial Discrimination x Age	0.07	0.08	.371
	Rumination x Age	0.05	0.17	.796

Note. Gender (Male = 1, Female = 0).

Figure 2.

Conditional indirect effects of racial discrimination on youth depressive symptoms at one standard deviation below and above the mean for youth age.

Table 4.

Conditional Direct and Indirect Effects of the Relation Between Racial Discrimination and Internalizing Symptoms Through Rumination

	Path	b	SE	95% CI
Age (−1 SD)
	RD → Depression	0.36	0.18	[0.01, 0.70]
	RD → Anxiety	0.81	0.54	[−0.29, 1.83]
	RUM → Depression	0.33	0.07	[0.18, 0.47]
	RUM → Anxiety	1.08	0.23	[0.60, 1.52]
Age (Mean)
	RD → Depression	−0.08	0.05	[−0.19, 0.03]
	RD → Anxiety	0.05	0.17	[−0.28, 0.41]
	RUM → Depression	0.06	0.02	[0.01, 0.11]
	RUM → Anxiety	0.07	0.78	[−0.08, 0.22]
Age (+1 SD)
	RD → Depression	0.20	0.18	[−0.16, 0.53]
	RD → Anxiety	0.90	0.51	[−0.09, 1.91]
	RUM → Depression	0.45	0.06	[0.33, 0.56]
	RUM → Anxiety	1.22	0.19	[0.83, 1.57]
Age (−1 SD)
	RD → RUM → Depression	0.23	.08	[0.11, 0.42]
	RD → RUM → Anxiety	0.76	.28	[0.32, 1.44]
Age (Mean)
	RD → RUM → Depression	0.27	.08	[0.14, 0.46]
	RD → RUM → Anxiety	0.81	.28	[0.36, 1.46]
Age (+1 SD)
	RD → RUM → Depression	0.31	.09	[0.16, 0.51]
	RD → RUM → Anxiety	0.86	.29	[0.38, 1.52]

Note. RD = Racial Discrimination. RUM = Rumination. Effects were calculated using bias corrected bootstrapped confidence intervals. Significance is represented by a confidence interval that does not contain zero. All values are non-standardized coefficients

Discussion

Although scholarship has recurrently demonstrated that racial discrimination confers substantial risk to the mental well-being of Black youth, our understanding of developmental pathways and periods that explain and influence this association remain limited (Neblett, 2019). In recognition of this gap, and in line with tenets of the Biopsychosocial Model of Racism, the present study examined the direct and indirect effect of racial discrimination on internalizing symptoms via rumination, and the extent to which these associations were influenced by developmental age. Study results replicate the long-standing finding that racial discrimination is directly associated with internalizing concerns among pre- and early-adolescent youth and build upon recent work highlighting that rumination is a key pathway by which racial discrimination is associated with negative mental health outcomes among Black youth (Wang & Yip, 2020). Notably, findings also illustrated that developmental age differentially impacts the pathway from racial discrimination to internalizing symptoms via ruminative coping as youth get older.

Study findings corroborate recent literature that asserts that how one copes with a discriminatory event may have greater implications for health and psychological outcomes relative to the event itself (Anderson et al., 2021). Specifically, we found that racial discrimination was associated with elevated endorsements of rumination among Black youth, which was in turn associated with elevated endorsements of depression and anxiety concerns. This is significant as previous work has only examined the interplay between racial discrimination and rumination within the context of depressive symptoms, despite the significant co-morbidity that exists between anxiety and depression symptoms. As such, the current work is among the first to demonstrate that rumination in the context of racial discrimination is associated with depression and anxiety among Black youth. On the one hand, results lend credence to previous work highlighting that rumination can function as a transdiagnostic factor in the context of depression and anxiety (McLaughlin & Nolen-Hoeksema, 2011), and provide preliminary evidence to suggest that rumination represents a robust target for intervention in the context of racial discrimination. On the other hand, when considered in tandem with previous work suggesting that rumination can lead to depression and anxiety for different reasons (Hankin, 2008; Olatunji et al., 2013), findings raise an important question regarding the unique ways in which discrimination related rumination may be associated with depression and anxiety. For example, it may be that ruminating in the context of racial discrimination may increase perceptions of threat in one’s environment and decrease feelings of safety, thereby increasing anxiety symptomatology. However, in line with our anchoring theoretical model, it could also be that discrimination related rumination may lead individuals to perseverate on negative cognitive and emotional reactions to discrimination, which may give rise to and perpetuate depressive symptoms. Nevertheless, understanding developmental processes that discern unique pathways by which rumination relating to racial discrimination contributes to depression and anxiety merits further investigation.

Although not a primary aim of the study, it is also worth noting the significant effects of gender across models predicting rumination and internalizing symptoms in the current sample. Specifically, findings suggest that Black girls are at increased vulnerability to utilize ruminative coping strategies and to report internalizing symptoms, relative to Black boys. Our results align with prior work that documents gender differences in rumination and internalizing symptoms across childhood and adolescence (e.g., Ohannessian et al., 2017; Rood et al., 2009), and suggests that additional work is warranted to understand what positions Black girls to be at an elevated risk for these negative outcomes in the context of racial discrimination. Drawing from intersectionality literature, one possibility is that Black girls may have to contend with marginalizing experiences associated with their race and gender (i.e., double jeopardy status; Beal, 2008), which may increase the likelihood of rumination and related internalizing concerns. Previous work lends credence to this notion, demonstrating that adolescent girls who report greater levels of stress are more likely to utilize rumination, and evidence higher levels of internalizing symptoms compared to boys (Driscoll et al., 2009).

With respect to our exploratory aim, we found that age played an important role in informing the interplay among racial discrimination, rumination, and internalizing symptoms. Specifically, although racial discrimination was indirectly associated with internalizing concerns via rumination regardless of age, findings demonstrated that these indirect effects were larger among older youth in the sample for depressive symptoms. As children age, they spend more time outside of the home increasing the likelihood that they will be victimized by experiences of racial discrimination within their communities, schools, and online (Clark et al., 1999; English et al., 2020). At the same time, research has found that as youth age, metacognitive skills increase, which increase their capacity to engage in more sophisticated, yet cognitively taxing, styles of coping (i.e., rumination) in efforts to make sense of the stressful event (Seaton et al., 2010). Thus, when considered in tandem, it is possible that older adolescents may be more apt to utilize rumination as a primary coping strategy in the face of chronic encounters of racial discrimination, which may place them at greater risk for mental health concerns relative to their younger peers.

Conversely, although no significant interactions were observed between age and racial discrimination, younger children appeared more susceptible to anxiety as a function of racial discrimination, supporting previous meta-analytic data among youth of color (Benner et al., 2018). Younger youth may be particularly vulnerable to the nefarious impact of racial discrimination due to their less developed reasoning, cognitive, and processing abilities (Seaton et al., 2010). However, more longitudinal work is needed to clarify whether racial discrimination differentially impacts affect and internalizing symptoms based on developmental age among Black youth specifically.

Limitations and Future Directions

Although there are many strengths to this study, it is not without its limitations. First, we acknowledge the limited generalizability of the present findings given the small sample size, relatively low levels of discrimination and internalizing concerns reported by youth, and inability to explore differences across the diverse ethnic population of Black youth (e.g., Black Caribbean, bi-racial, Black Hispanic). Thus, more work is needed to replicate the current findings within a larger and more representative sample. Second, the cross-sectional nature of the current study constrains our ability to determine causality in the context of direct and indirect effects. Although there is certainly evidence demonstrating that racial discrimination and rumination can prospectively predict increases in internalizing concerns independent from one another (Lavner et al., 2022; Michl et al., 2013), less is clear regarding the temporal associations between racial discrimination and rumination, or how racial discrimination may be indirectly associated with internalizing concerns through rumination over time. Accordingly, there is a pressing need for longitudinal research in this area to establish temporal precedence to inform potential targets for intervention to disrupt the noxious nature of racial discrimination on mental health. Physiological and neuroimaging approaches may also be useful approaches in understanding how rumination relating to racial discrimination impacts health outcomes across sensitive developmental periods. Third, the RRES may not accurately capture discriminatory encounters among adolescents, as it has not been properly validated among adolescent youth samples, nor does it differentiate between the frequency and level of distress caused by discrimination, which are important distinctions given their unique psychosocial consequences (Neblett et al., 2016). Relatedly, the rumination measure used within the present study was not specific to discrimination and did not allow for us to disentangle subtypes of rumination (e.g., brooding, reflection) that may uniquely explain the association between racial discrimination and mental health. As such, future scholarship is encouraged to utilize more robust measures of racial discrimination and rumination to gain a more precise understanding of their interplay in the context of mental health. Subsequent studies should also continue to assess age effects in relationships between discrimination and cognitive vulnerabilities such as rumination since there continues to be scholarly disagreement on the developmental stage that cognitive vulnerabilities begin to emerge (Steca et al., 2014; Hankin et al., 2005). The age and developmental emergence of these risk factors is crucial in order to better understand how these factors affect the relationship between stressful events (e.g., discrimination) and internalizing symptoms (Abela & Hankin, 2008).

Clinical Implications

Limitations notwithstanding, implications drawn from this study warrant consideration within the clinical context. For example, the current study provides further evidence that experiences of racial discrimination are psychologically injurious, and that such experiences may be particularly harmful among youth across the transition into adolescence. Younger youth may be particularly susceptible to racial discrimination as they may have yet to develop the language or skills to make sense of the discriminatory event or how it made them feel. In line with recommendations from Metzger et al. (2020), clinicians are encouraged to assess and discuss experiences of and reactions to racial discrimination across the course of treatment. Moreover, results point to rumination as a key mechanism by which racial discrimination may be associated with internalizing concerns among Black youth. Thus, clinicians may find value in targeting rumination as a potential strategy to mitigate the impact of racial discrimination on mental health. Although there may be benefits in targeting rumination among youth regardless of age, study findings suggest that this is a particularly relevant consideration as youth maturate through adolescence. To this end, a recent systematic review suggested that rumination may be mitigated in response to a potentially traumatic experience through targeting underlying cognitive themes such as anger, guilt, or shame–which are common in ruminative thinking associated with traumatic stress (Moulds et al., 2020). These themes may also apply to racism-related rumination, but others such as despair and social desirability have also been identified as maladaptive ruminative responses (da Silva Rebelo, 2022). Thus, clinicians should assess specific emotional and cognitive responses to racial discrimination among their youth clients and assist them in labeling and processing those responses. This approach could potentially decrease their racism-related rumination, and in turn, reduce associated internalizing concerns.

Conclusion

In conclusion, the present study adds to emergent evidence indicating that rumination is a key mechanism by which racial discrimination confers risk to the mental health of Black adolescents. A novel contribution of this study is that it provided evidence to suggest that the direct and indirect associations among racial discrimination, ruminative coping strategies, and mental health may be influenced by developmental age. As a composite, findings from the current study underscore the developmental heterogeneity in the direct and indirect association between racial discrimination and mental health outcomes and highlights that there is an immediate need for research to understand optimal time points and targets of intervention to mitigate the impact of racism on health.

Public Policy Relevance Statement.

Racial discrimination has a significant negative impact on Black youth’s mental health. The link between racial discrimination and mental health outcomes may be explained by rumination, or repetitive thoughts about negative feelings or experiences. This study found rumination in the context of racial discrimination had a stronger negative impact on the mental health of older Black adolescents relative to their younger counterparts. Findings demonstrate that coping responses to racial discrimination may be age dependent and emphasize the need for interventions that provide healthy and effective coping strategies for Black youth in response to racism, especially during the transition to adolescence.