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European Journal of Psychotraumatology logoLink to European Journal of Psychotraumatology
. 2026 Sep 28;17(1):2714601. doi: 10.1080/20008066.2026.2714601

Racial discrimination, racial trauma, and complex post-traumatic stress disorder: the role of emotion dysregulation as a mediating factor in Black, African, and Afrodiasporic people in Germany

Discriminación racial, trauma racial y trastorno de estrés postraumático complejo: el papel mediador de la desregulación emocional como factor mediador en personas negras, africanas y de la diáspora africana en Alemania

Freyja Grupp a,b,CONTACT, Andrei-Cristian Tudorache a,c, Cornelia Weise d, Luisa Weiner a,c, Salina Yohannes b
PMCID: PMC13629808  PMID: 42804256

ABSTRACT

Background: Little is known about how racial discrimination affects the mental health of Black, African, and Afrodiasporic people in Germany. Empirical evidence has begun to point to racial trauma and (complex-)post-traumatic stress disorder (PTSD) as a possible consequence of experiencing racial discrimination, but knowledge on how individual psychological processes may influence the development of racial trauma and PTSD is scarce.

Objective: The present study aimed to investigate the influence of racial discrimination on racial trauma and symptoms of PTSD and complex PTSD in Black, African, and Afrodiasporic people in Germany. Moreover, we aimed to examine the role of emotion dysregulation as a mediating factor.

Method: Black, African, and Afrodiasporic people in Germany with and without migration experience (N = 103) completed a questionnaire including measures for perceived discrimination (EDS), Trauma Symptoms of Discrimination (TSDS), symptoms of (complex-)PTSD (ITQ), and emotion dysregulation (DERS-16).

Results: Results revealed that heightened racial discrimination was associated with more emotion dysregulation, as well as higher levels of racial trauma symptoms, PTSD, and complex PTSD. Emotion dysregulation significantly mediated the relationship between discrimination and racial trauma, PTSD, and complex PTSD. However, when controlled for migration experience, an exploratory post-hoc analysis showed that this association only occurred in German-born individuals, but not in participants with migration experience.

Conclusions: These results suggest that the association between racial discrimination and trauma symptoms could be partially accounted for by emotion dysregulation. However, exploratory findings indicate that this association may not be significant in individuals with migration experience.

KEYWORDS: Racial discrimination, minority mental health, PTSD, racial trauma, emotion dysregulation

HIGHLIGHTS

  • Racial discrimination is highly prevalent among Black people in Germany.

  • Heightened racial discrimination is associated with higher levels of racial trauma symptoms, post-traumatic stress disorder (PTSD), and complex PTSD, as well as more emotion dysregulation.

  • Emotion dysregulation mediates the relationship between discrimination and racial trauma, PTSD, and complex PTSD in Germans, but not in individuals with migration experience.

1. Introduction

Racial discrimination is highly prevalent among Black people in Germany. According to the Afrozensus report, 97.3% of Black, African, and Afrodiasporic people in Germany encounter anti-Black racism (Aikins et al., 2021). Alarmingly, compared to other member states of the European Union, the highest rates of racial discrimination can be found in Germany (European Union Agency for Fundamental Rights, 2023). Black and racialized scholars have contributed and advocated for a stronger thematization of racism in the German academic discourse (e.g. Kelly, 2021; Kilomba, 2021; Lazaridou & Yeboah, 2024; Mecheril, 2001; Oguntoye & Lorde, 1992), but the health consequences of racial discrimination against Black people in Germany have been scarcely researched (Yeboah, 2016).

Considered as a systemic form of oppression, racism includes ideologies, actions, and institutional policies that grant privilege and power to individuals on the basis of race,1 a socially constructed concept based on appearance, skin colour, and presumed heritage (Haeny et al., 2021; Osman et al., 2024). The deleterious effects of racial discrimination, the behavioural manifestation of racism on the mental health of Black people, have been well documented by past research (Brooks Holliday et al., 2020; Schouler-Ocak & Moran, 2023), and a compelling literature base has provided evidence for an association between racial discrimination and post-traumatic stress disorder (PTSD) (Comas-Díaz et al., 2019; Saleem et al., 2020). Cumulative experiences of racial discrimination can be conceptualized as a form of social trauma, directly contributing to trauma-related disorders through the severe violation of social integrity and core social motives, such as the need for status and belonging, which can trigger intense emotional reactions (e.g. despair and defeat, Neuner, 2023). Discriminatory experiences are often profoundly humiliating and shaming, potentially leading to disturbances in emotional processing, including dysregulated guilt, shame, and emotional numbing (Carter, 2007; Carter & Reynolds, 2011).

However, in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2022), as well as in the International Statistical Classification of Diseases and Related Health Problems (11th ed.; ICD-11; World Health Organization, 2022), PTSD is restricted to the consequences of traumatic events involving physical or sexual threat, which precludes the possibility of a formal diagnosis associated with racial discrimination (Holmes et al., 2016; Kira et al., 2021).

The concept of racial trauma, a similar but not equivalent construct to PTSD (Cole et al., 2024; Comas-Díaz et al., 2019), may address this diagnostic gap. In contrast to PTSD, racial trauma is exclusively caused by experiences of racial discrimination and refers to Black, Indigenous, and people of color’s (BIPOC) psychological response to cumulative racism and race-based stress (RBS). It includes typically experiences of harm and injury, humiliating and shaming events, and witnessing racial discrimination towards other BIPOC (Comas-Díaz et al., 2019). Racial trauma is a multidimensional construct sharing four symptom clusters with PTSD, including reexperiencing the event, avoiding trauma reminders, worsening of cognitions and mood, and heightened arousal and hypervigilance (Williams, Metzger, et al., 2018). Racial trauma has been distinguished from PTSD due to ongoing collective and individual injuries from exposure and re-exposure to RBS. Due to the ongoing nature of racial discrimination and societal oppression, the aspect of ‘post’ outlined in PTSD does not display racial trauma adequately (Cénat, 2023; Saleem et al., 2020). Moreover, racial trauma might be conceptualized as a complex form of traumatization, akin to complex PTSD (c-PTSD) (Cénat, 2023; Reynolds et al., 2025), due to the complexities associated with the repetitive, constant, inevitable, and cumulative victimization of Black people to RBS on an interpersonal, societal, and institutional level (Awad et al., 2019; Harrell, 2000). C-PTSD is usually associated with prolonged or repeated exposure to trauma, from which escape is difficult or impossible (Hyland et al., 2017). It emerged primarily from clinical and research work on the consequences of childhood sexual abuse and other forms of prolonged interpersonal trauma (Hébert et al., 2025). In addition to the core symptoms of classic PTSD, c-PTSD is defined by major disturbances in self-organization such as negative self-beliefs, interpersonal difficulties, and emotion dysregulation (Cloitre et al., 2013).

Research on racial discrimination has predominantly focused on mental health outcomes, whereas comparatively little attention has been devoted to identifying shared transdiagnostic mechanisms that may help explain how experiences of racial discrimination, as an important contextual factor, might contribute to the development and maintenance of trauma-related symptoms among Black individuals (Forrest-Bank & Cuellar, 2018). A potential pathway through which chronic exposure to racial discrimination might adversely affect trauma-related symptoms is emotion dysregulation, which has been identified as a key mechanism linking experiences of racial discrimination to trauma-related disorders (Cole et al., 2024; Mekawi et al., 2020; Roach et al., 2023).

Emotion dysregulation is characterized by high emotional sensitivity, intense and frequent negative affect, and reliance on maladaptive rather than adaptive regulation strategies (Carpenter & Trull, 2013). Emotion dysregulation arises from the interaction between an individual's heightened emotional sensitivity and a persistently invalidating environment that rejects or dismisses valid emotional responses as not understandable or acceptable within the current life context (Fruzzetti et al., 2005; Linehan, 1993). Black individuals are frequently subjected to chronic invalidation within broader societal structures, particularly in response to experiences of prejudice, exclusion, and racial discrimination (Cardona et al., 2022; Nelson et al., 2018). This invalidation emerges from structural and ideological systems of racial hierarchy that shape how racial experiences are recognized, interpreted, and responded to across different social contexts (Bijou & Colen, 2022; Feagin & Bennefield, 2014). These conditions create environments in which Black individuals’ emotional reactions are systematically disregarded or delegitimized.

In consequence, repeated exposure to such invalidating contexts may undermine the development of adaptive emotion regulation processes, particularly with regard to the recognition and acceptance of one’s emotional experiences (Mekawi et al., 2020; Roach et al., 2023). In interaction with biological vulnerability, such invalidating environments may contribute to emotion dysregulation, as proposed in Linehan’s (1993) biosocial model and supported by empirical work (Cole et al., 2024; Mekawi et al., 2020; Roach et al., 2023). This might in turn heighten vulnerability for trauma-related disorders. Moreover, the unpredictability of RBS and the link with an unchangeable identity attribute render racial discrimination particularly threatening (Roach et al., 2023). The social learning involved may damage Black individuals’ sense of safety, security, and self-worth (Cardona et al., 2022). In turn, this may result in elevated levels of emotional distress, imposing higher demands on adaptive emotion regulation and engagement in goal-directed behaviour (Brondolo et al., 2009).

In the past, studies investigating the mediating role of emotion dysregulation on the impact of racial discrimination on mental health were conducted in the United States (Mekawi et al., 2020) or among racially diverse samples (Cole et al., 2024). Studies specifically addressing Black, African, and Afrodiasporic communities in European contexts, including participants with and without migration experiences, are lacking but urgently needed (Yeboah, 2016). We had three main hypotheses: (i) racial discrimination would be positively associated with racial trauma and (c-)PTSD; (ii) racial discrimination would be positively associated with heightened emotion dysregulation; (iii) racial discrimination would be indirectly associated with racial trauma and symptoms of (c-)PTSD through the mediating effect of emotion dysregulation. As we included Black, African, and Afrodiasporic people in our sample, we additionally controlled for the influence of their migration experience (i.e. whether they were born in Germany or not).

2. Method

2.1. Procedures

The study was conducted in accordance with the Declaration of Helsinki and ethical approval was obtained from the local review board of Marburg University (2023-07k). All participants provided written informed consent prior to participation.

The study specifically invited self-identifying Black, African, and Afrodiasporic people over the age of 18 years who were living in Germany to participate. As the study was conducted in German, participants were required to have a basic understanding of the German language. The study’s objective was to survey the unique experiences of discrimination that Black, African, and Afrodiasporic individuals in Germany experience because of their racialization. As they form a very heterogeneous group, we explored differences among participants using migration experience as a reference point.

Participants were recruited using the snowball sampling method, via gatekeepers, mail distribution lists, WhatsApp and Facebook groups, Instagram stories, or the like. The gatekeepers were mainly local associations, health-related online communities or racism critical online platforms, African communities or non-governmental organizations. The study was available online through the platform SoSci Survey.

2.2. Measures

2.2.1. Measures of socioeconomic variables

The following sociodemographic variables were assessed: age, gender (male, female, non-binary, other), socioeconomic status, educational background, German citizenship (yes, no), and place of birth in Germany (yes, no). Participants who were born outside of Germany were asked (1) in which country they were born, (2) in which country they had lived the longest since their birth, (3) since when they had been living in Germany, (4) what their current residence status was, and (5) how they had come to Germany.

2.2.2. Measures of racial and ethnic background

By self-identification, participants were asked to assign themselves to one of three specified race categories (Black, African, Afrodiasporic; White; Mixed); alternatively, they were also allowed to state another race category in a blank field. This question was preceded by a short definition of race based on Williams (2020).

2.2.3. Perceived racial discrimination: subtle, everyday discrimination

The Everyday Discrimination Scale (EDS; Williams et al., 1997) is a 9-item questionnaire that aims to assess the frequency of rather subtle forms of unfair treatment in day-to-day life on a 6-point Likert scale ranging from 1 (never) to 6 (almost every day). The mean value of items was used to obtain an overall score ranging from 6 to 54, with higher overall scores indicating higher levels of perceived everyday discrimination. Cronbach’s alpha for the present sample was .89.

2.2.4. Emotion dysregulation

We used the 16-item self-report Difficulties in Emotion Regulation Scale (DERS-16; Bjureberg et al., 2016) in order to measure emotion dysregulation. The DERS-16 is a short version of the original 36-item DERS (Gratz & Roemer, 2004). Items are scored on a 5-point scale ranging from 1 (almost never) to 5 (almost always). The mean value of items was used to obtain an overall score ranging from 16 to 80 points, with higher overall scores indicating greater levels of emotion dysregulation. Cronbach’s alpha for the present sample was .93.

2.2.5. Trauma symptoms of discrimination

Racial trauma was measured using the Trauma Symptoms of Discrimination Scale (TSDS; Williams, Printz, et al., 2018), a 21-item, 4-point Likert scale ranging from 1 (never) to 4 (often), to measure distress resulting from discrimination with a focus on anxiety-related trauma symptoms. The mean value of items was used to obtain an overall score, with higher overall scores denoting higher levels of trauma symptoms. Cronbach’s alpha for the present sample was .96.

2.2.6. ICD-11 PTSD and C-PTSD

The International Trauma Questionnaire (ITQ, Cloitre et al., 2018) is a self-report measure of the ICD-11 diagnoses of PTSD and c-PTSD. The ITQ includes six items measuring each PTSD symptom from the three clusters of ‘Re-experiencing’, ‘Avoidance’, and ‘Sense of Threat’. The ITQ also includes six items measuring each ‘Disturbance in Self-Organization’ (DSO) symptom from the three clusters of ‘Affective Dysregulation’, ‘Negative Self-Concept’, and ‘Disturbed Relationships’. These items are accompanied by three items measuring functional impairments in the domains of social, occupational, and other important areas of life. All ITQ items are answered on a five-point Likert scale anchored by 0 (not at all) to 4 (extremely). Thus, PTSD and DSO symptom scores range from 0 to 24 (i.e. the sum of the six items from each subscale), and c-PTSD symptom scores range from 0 to 48 (i.e. the sum of the 12 ITQ items). Cronbach’s alpha for the present sample was .93.

3. Data analyses

Three main mediation models were used to test the mediating effect of emotion dysregulation (DERS scores) on the relationship between discrimination (EDS scores) and the three outcome variables (PTSD, c-PTSD and racial trauma). To test the effect of the migration experience, the models were additionally applied to participants with migration experience and to participants born in Germany. Across the models, ‘a’ measures the association between the predictor (discrimination) and the mediator (emotion dysregulation), ‘b’ measures the association between the mediator (emotion dysregulation) and the outcomes (PTSD, c-PTSD, or racial trauma), and ‘c′’ measures the association between the predictor and the outcomes controlling for the mediator. Finally, ‘a*b’ measures the indirect effect (i.e. the association between the predictor and the outcome mediated by the mediator). Mediation models were calculated using the general mediation model in Jamovi software by a 5000 bootstrapping method (see, for instance, Hayes, 2018).

4. Results

4.1. Sample

A total of 103 participants (66.0% female) was included in the study. Most participants reported an average socioeconomic status (59.2%) and a university degree (47.6%). Regarding migration experience, the groups did not differ significantly in their scores on scales assessing discrimination or mental health outcomes, but participants with migration experience were significantly older (Mean age = 38.5) and identified primarily as male (65.6%) compared to participants born in Germany (Mean age = 26.3; 16.9% male). Descriptive statistics are presented in Table 1.

Table 1.

Sociodemographic characteristics and mean outcome scores for the overall sample and differences by migration experience.

  Total sample (n = 103),   
M (SD) / n (%)		 Born in Germany (n = 71),   
M (SD) / n (%)		 Migration experience (n = 32),   
M (SD) / n (%)		 Group
differences, U (p)
Age (years) 30.1(10.8) 26.3(4.7) 38.5(15.0) 6.23 (<.001)
Gender       572 (<.001)
 Female 68 (66.0%) 57 (80.3%) 11 (34.4%)  
 Male 33 (32.0%) 12 (16.9%) 21 (65.6%)  
 Other 2 (1.9%) 2 (2.8%) 0 (0%)  
Socioeconomic status       1087 (.695)
 Very Low 6 (5.8%) 5 (7.0%) 1 (3.1%)  
 Low 10 (9.7%) 7 (9.9%) 3 (9.4%)  
 Average 61 (59.2%) 39 (54.9%) 22 (68.7%)  
 High 26 (25.2%) 20 (28.2%) 6 (18.7%)  
Education       944 (.137)
 University degree 49 (47.6%) 35 (49.3%) 14 (43.7%)  
 High school diploma 36 (35.0%) 29 (40.8%) 7 (21.9%)  
 Secondary school certificate 11 (10.7%) 4 (5.6%) 7 (21.9%)  
 No degree 2 (1.9%) 0 (0%) 2 (6.3%)  
 Other 5 (4.9%) 3 (4.2%) 2 (6.3%)  
Discrimination (EDS) 27.3 (8.13) 26.5 (7.82) 29.0 (8.66) 1.44 (.153)
Emotion Dysregulation (DERS-16) 39.1 (13.1) 40.5 (13.1) 35.9 (12.6) 1.64 (.105)
PTSD (ITQ) 13.8 (5.42) 13.9 (5.50) 13.7 (5.35) 0.16 (.876)
C-PTSD (ITQ) 42.9 (15.5) 43.4 (15.7) 41.6 (15.2) 0.557 (.579)
Racial trauma (TSDS) 51.5 (15.7) 51.3 (16.6) 51.9 (13.6) 0.20 (.839)
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Note: n = number of participants. M = mean. SD = standard deviation. EDS = Everyday Discrimination Scale; DERS = Difficulties in Emotion Regulation Scale (16 items); PTSD (ITQ) = Post-traumatic Stress Disorder subscale of the International Trauma Questionnaire; C-PTSD (ITQ) = Complex Post-traumatic Stress Disorder reflecting the total score of the International Trauma Questionnaire; TSDS = Trauma Symptoms of Discrimination Scale.

4.2. Associations between racial discrimination, emotion dysregulation, and trauma-related symptoms

As expected, racial discrimination was positively associated with PTSD (r = .38, p < .001), c-PTSD (r = .38, p < .001), and racial trauma (r = .52, p < .001). Additionally, in line with our second hypothesis, racial discrimination was positively associated with heightened emotion dysregulation (r = .29, p = .003; see Table 2.

Table 2.

Bivariate correlations between discrimination and mental health outcomes.

  1 2 3 4 5
1. Discrimination (EDS) –        
2. Emotion dysregulation (DERS) 0.290** –      
3. PTSD (ITQ) 0.377*** 0.559*** –    
4. C-PTSD (ITQ) 0.378*** 0.642*** 0.831*** –  
5. Racial trauma (TSDS) 0.524*** 0.575*** 0.629*** 0.612*** –
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Note: ** indicates p < .01; *** indicates p < .001. EDS = Everyday Discrimination Scale; DERS = Difficulties in Emotion Regulation Scale (16 items); PTSD (ITQ) = Post-traumatic Stress Disorder subscale of the International Trauma Questionnaire; C-PTSD (ITQ) = Complex Post-traumatic Stress Disorder reflecting the total score of the International Trauma Questionnaire; TSDS = Trauma Symptoms of Discrimination Scale.

4.3. Serial mediation analyses

The first mediation model, examining the relationship between racial discrimination and PTSD symptoms with emotion dysregulation as a mediator, is presented in Figure 1.

Figure 1.

A path diagram showing Discrimination, Emotion dysregulation, and PTSD as labeled boxes linked by arrows with path coefficients. The figure shows a mediation path diagram with 3 labeled rectangles connected by arrows and annotated coefficients. On the left, a rectangle is labeled Discrimination and Everyday Discrimination Scale. In the center top, a rectangle is labeled Emotion dysregulation and Difficulties in Emotion Regulation Scale. On the right, a rectangle is labeled Posttraumatic Stress Disorder and International Trauma Questionnaire. An arrow runs from Discrimination to Emotion dysregulation, with 3 coefficients written along it: a1 equals 0.45 with two *s, a2 equals 0.61 with three *s, and a3 equals 0.28. A second arrow runs from Emotion dysregulation to Posttraumatic Stress Disorder, annotated with b1 equals 0.20 with three *s, b2 equals 0.19 with three *s, and b3 equals 0.20 with two *s. A third arrow runs directly from Discrimination to Posttraumatic Stress Disorder along the bottom, labeled Total effects in italics followed by ( c ) near the center. Under this label, the coefficients are c1 equals 0.25 with three *s, c2 equals 0.38 with three *s, and c3 equals 0.02. To the right, text labeled Direct effects in italics followed by ( c prime ) lists c1 prime equals 0.16 with two *s, c2 prime equals 0.26 with three *s, and c3 prime equals negative 0.03. A note indicates that two *s mark p less than 0.01 and three *s mark p less than 0.001. All data are approximate.

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Indirect effect of discrimination on PTSD.

Note: Subscripts 1, 2, 3 reflect coefficients for the total sample, German-born participants and participants with migration experience respectively. ** indicates p < .01; *** indicates p < .001. EDS = Everyday Discrimination Scale; DERS = Difficulties in Emotion Regulation Scale (16 items); PTSD (ITQ) = Post-traumatic Stress Disorder subscale of the International Trauma Questionnaire.

In line with our hypotheses, racial discrimination appeared to be indirectly associated with PTSD through emotion dysregulation (indirect effect (a1*b1) = 0.090, 95% CI (0.032, 0.159), p = .010). This effect remained significant for German-born participants (a2*b2 = 0.120, 95% CI (0.044, 0.221), p = .006) but not for participants with migration experience (a3*b3 = 0.054, 95% CI (−0.074, 0.183), p = .322).

The second mediation model, examining the relationship between racial discrimination and c-PTSD symptoms with emotion dysregulation as a mediator, is presented in Figure 2.

Figure 2.

A path diagram showing Discrimination, Emotion dysregulation, and Complex PTSD boxes linked by arrows with labeled coefficients and *s. The figure shows a path diagram illustrating a mediation model linking Discrimination, Emotion dysregulation, and Complex posttraumatic stress disorder. On the left, a rectangle labeled Discrimination and Everyday Discrimination Scale appears. On the right, a rectangle labeled Complex posttraumatic stress disorder and International Trauma Questionnaire total score appears. At the top center, a rectangle labeled Emotion dysregulation and Difficulties in Emotion Regulation Scale appears. An arrow runs from Discrimination to Emotion dysregulation. Along this arrow, the text a1 equals 0.46 with three *s, a2 equals 0.64 with three *s, and a3 equals 0.28 appears, each on its own line. A second arrow runs from Emotion dysregulation down to Complex posttraumatic stress disorder, with the text b1 equals 0.68 with three *s, b2 equals 0.65 with three *s, and b3 equals 0.74 with three *s beside it. A horizontal arrow runs directly from Discrimination to Complex posttraumatic stress disorder. Under this arrow, the phrase Total effects with ( c ) appears, followed by c1 equals 0.71 with three *s, c2 equals 0.86 with three *s, and c3 equals 0.53. To the right, the phrase Direct effects with ( c primed ) appears, followed by c primed 1 equals 0.40 with two *s, c primed 2 equals 0.45 with one *, and c primed 3 equals 0.32. A note states that one * indicates p less than 0.05, two *s indicate p less than 0.01, and three *s indicate p less than 0.001. All data are approximate.

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Indirect effect of discrimination on complex PTSD.

Note: Subscripts 1, 2, 3 reflect coefficients for the total sample, German-born participants and participants with migration experience respectively. * indicates p < .05; ** indicates p < .01; *** indicates p < .001. EDS = Everyday Discrimination Scale; DERS = Difficulties in Emotion Regulation Scale (16 items); Complex PTSD (ITQ) = Complex Post-traumatic Stress Disorder reflecting the total score of the International Trauma Questionnaire.

In line with our hypotheses, racial discrimination appeared once again to be indirectly associated with c-PTSD through emotion dysregulation (a1*b1 = 0.314, 95% CI (0.126, 0.530), p = .006). This effect remained significant for German-born participants (a2*b2 = 0.414, 95% CI (0.187, 0.723), p = .003) but not for participants with migration experience (a3*b3 = 0.204, 95% CI (−0.251, 0.614), p = .305).

Finally, the third mediation model, assessing the relationship between racial discrimination and symptoms of racial trauma with emotion dysregulation as a mediator, is presented in Figure 3.

Figure 3.

A path diagram showing Discrimination, Emotion dysregulation, and Racial Trauma boxes linked by arrows with coefficients and p value *s. The figure shows a mediation path diagram with 3 labeled rectangles connected by arrows. On the left, a rectangle is labeled Discrimination with Everyday Discrimination Scale in parentheses. On the right, a rectangle is labeled Racial Trauma with Trauma Symptoms of Discrimination Scale in parentheses. Centered above the connecting line between these, a third rectangle is labeled Emotion dysregulation with Difficulties in Emotion Regulation Scale in parentheses. An arrow runs from Discrimination to Emotion dysregulation. Next to this arrow are 3 coefficient labels stacked diagonally: a subscript 1 equals 0.47 followed by 3 *s, a subscript 2 equals 0.64 followed by 3 *s, and a subscript 3 equals 0.27. An arrow runs from Emotion dysregulation down to Racial Trauma. Along this arrow, 3 coefficients are printed: b subscript 1 equals 0.55 followed by 3 *s, b subscript 2 equals 0.57 followed by 3 *s, and b subscript 3 equals 0.48 followed by 2 *s. A horizontal arrow runs directly from Discrimination to Racial Trauma. Above this horizontal line, the phrase Total effects with ( c ) appears, followed by c subscript 1 equals 1.01 with 3 *s, c subscript 2 equals 1.26 with 3 *s, and c subscript 3 equals 0.58 with one *. Below the same line, the phrase Direct effects with ( c prime ) appears, followed by c prime subscript 1 equals 0.75 with 2 *s, c prime subscript 2 equals 0.89 with one *, and c prime subscript 3 equals 0.45. All data are approximate.

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Indirect effect of discrimination on racial trauma.

Note: Subscripts 1, 2, 3 reflect coefficients for total sample, German-born participants and participants with migration experience respectively. * indicates p < .05; ** indicates p < .01; *** indicates p < .001. EDS = Everyday Discrimination Scale; DERS = Difficulties in Emotion Regulation Scale (16 items); TSDS = Trauma Symptoms of Discrimination Scale.

Consistent with our hypotheses and the results obtained for PTSD and c-PTSD, racial discrimination appeared to be indirectly associated with racial trauma through emotion dysregulation (a1*b1 = 0.258, 95% CI (0.095, 0.454), p = .006). This effect remained significant for German-born participants (a2*b2 = 0.371, 95% CI (0.135, 0.679), p = .004) but not for participants with migration experience (a3*b3 = 0.133, 95% CI (−0.132, 0.448), p = .308).

5. Discussion

This study aimed to investigate the association between racial discrimination with racial trauma and symptoms of (c-)PTSD in Black, African, and Afrodiasporic people in Germany. Specifically, we focused on the role of emotion dysregulation as a mediating factor. As hypothesized, we found that higher racial discrimination was associated with more emotion dysregulation, as well as higher levels of racial trauma symptoms, symptoms of PTSD and c-PTSD. Moreover, emotion dysregulation significantly mediated the relationship between discrimination and all forms of traumatic stress.

The present study contributes to our understanding of mental health disparities among Black individuals in Germany. Overall, our findings suggest an association between racial discrimination and all forms of traumatic stress symptoms and might therefore constitute a risk factor (Wamser & Richardson, 2024). The findings suggest that, like explicit traumatic stressors such as threats or harassment (Georgescu et al., 2025; Hatzenbuehler, 2009), racial discrimination, may function as a chronic and pervasive stressor that is associated with an increased risk of developing trauma-related symptoms, although not classified as a ‘traumatic’ event under the DSM-5 (American Psychiatric Association, 2022), or ICD-11 (World Health Organization, 2022). Therefore, these results may contribute to the ongoing debate regarding a potential expansion of the concept of ‘trauma’ (Holmes et al., 2016; Kira et al., 2021) as a gateway criterion in both classificatory systems.

This might be particularly relevant in light of a growing body of evidence (Bjornsson et al., 2020; Neuner, 2023) suggesting that some of the most harmful events may involve no direct threat to life, but rather threaten a person’s social integrity and status (Iffland et al., 2014; Neuner et al., 2025). The Physical and Social Trauma (PAST) theory (Neuner, 2023) introduces the concept of social trauma that involves highly distressing and often recurrent events that jeopardize an individual’s standing within the social hierarchy, including experiences of humiliation, degradation, defeat, or ongoing social exclusion. Although social trauma may sometimes accompany physical threats, it can also occur independently and is more appropriately conceptualized through a transdiagnostic framework rather than being confined to the narrow event-based definition of PTSD (Neuner et al., 2025).

Importantly, the findings add to previous research by providing evidence that the link between racial discrimination and symptoms of racial trauma, PTSD, and c-PTSD may, in part, be explained by emotion dysregulation. This finding echoes previous studies reporting the mediating influence of emotion dysregulation on the association between racial discrimination and PTSD in an African American community (Mekawi et al., 2020), in Youth of Color (Roach et al., 2023), and racial trauma and PTSD in racial and ethnic minority undergraduate students (Cole et al., 2024).

It is possible that the negative emotions elicited by racial discrimination, particularly in the context of chronic invalidation of discrimination experiences and the social pressure to suppress related emotions (Mekawi et al., 2020; Watson-Singleton, 2017), may disrupt adaptive processes of emotion regulation. This may, in turn, increase the risk for symptoms of traumatic stress in individuals with vulnerability.

However, when controlled for migration experience, the association between racial discrimination and symptoms of (c-) PTSD occurred in German-born individuals, but not in participants with migration experience. One possible explanation for this finding is that participants with migration experience might have evolved in an environment where most people shared their race. Therefore, it is likely that individuals who were not socialized in Germany were less exposed to cumulative invalidation during childhood and adolescence. By contrast, participants born and raised in Germany were embedded in a social environment that might have consistently invalidated, denied, or ignored their experiences of racial discrimination (Khalil, 2023). In other words, they were socialized in a discriminatory system that may have persistently marginalized their lived experiences and presumably dismissed their emotional responses, including those related to racial discrimination, which is an invalidation in itself (Mekawi et al., 2020; Roach et al., 2023). Hence, it is possible that they are more likely to experience two kinds of invalidation: the first is due to racial discrimination per se, while the second is related to the invalidation of their experience of racial discrimination by others. The present findings might be interpreted within the complex racial trauma framework proposed by Cénat (2023), as they suggest that emotion dysregulation and (c-)PTSD symptoms develop over time as a result of cumulative exposure to racial discrimination, on the one hand, coupled with the repeated invalidation of one's emotional experience of these traumatic experiences.

Akin to the impact of invalidation of childhood sexual abuse reports on the development of mental health difficulties (e.g. PTSD and Borderline personality disorder; Hong & Lishner, 2016), it is likely that similar mechanisms might be involved in trauma-related symptoms in people who experience repeated RBS throughout their early development.

At the same time, differences in migration experience might point to additional protective mechanisms. Individuals with migration experience may be more likely to establish close connections and social support networks within co-ethnic communities after arrival, which could serve as a protective factor for mental health (Johnson-Singh et al., 2024). In contrast, German-born individuals may have less access to such community-specific support networks.

In general, research in Germany suggests that recent migrants tend to be healthier than both German-born and more established migrants (Holz, 2022). However, longitudinal evidence indicates that these health advantages may diminish over time, with a potential decline in mental health outcomes (Ferrara et al., 2024). With regard to the present results, no significant difference was found between participants with and without migration experience regarding trauma-related outcomes. The literature on the association between migration status and PTSD in Germany is inconsistent, with some studies reporting significant effects of migration status on PTSD symptomatology (Bermejo et al., 2010; Simich et al., 2007; Sisenop & Lindert, 2024), while others found no effects (Glaesmer et al., 2009).

However, these studies did not specifically examine the effects of racial discrimination. Lukate (2025) shows that African migrants in Germany report a gradual process of experiences of racialized Othering, in which they are socially constructed and categorized as Black, regardless of their prior self-identification. This highlights that racialized experiences are shaped by broader social processes of racial categorization by the majority society, which might ultimately influence the perception and experience of racial discrimination (Biddle et al., 2025). Scholars (Lerch, 2019; Yeboah, 2016) have criticized that research on migrants’ mental health in Germany often ignores, denies, or dismisses racism, therefore reinforcing racial discrimination in mental health care.

6. Limitations

Our research presents with limitations: While we recruited participants from different backgrounds, the results cannot be generalized to the entire population of Black people living in Germany. Moreover, as the study was only made available in German, it was not equally accessible to all Black individuals in Germany, especially those with recent migration experience. Thus, a selection bias cannot be ruled out. This might have further contributed to the relatively small sample size of participants with migration experience. Although group differences were examined only in an exploratory manner, caution is warranted in the interpretation of these findings. Due to the limited size of the migrant subsample, the statistical power may have been insufficient to detect potentially existing effects. However, given that the collection of racial data has been uncommon in clinical psychological research in Germany so far (Aikins et al., 2020), this study provides a valuable first step towards highlighting the impact of racial discrimination on mental health in Black individuals living in Germany.

A further limitation is that the measure of discrimination used in this study captured general experiences of discrimination, while in our analyses we still focused on the common characteristic shared by all participants – their self-identification as Black individuals. However, in the present analyses we did not differentiate between specific social identity categories such as discrimination experiences based on gender identity, socioeconomic status, or other identity dimensions that may intersect with experiences of racial discrimination (Nadal et al., 2015).

To advance the field, future research should more thoroughly address the particularities of racial discrimination in European contexts and examine how intersecting identity dimensions shape the experiences of Black individuals (Nadal et al., 2015; Singh et al., 2021).

Furthermore, although we were able to find results that are largely consistent with the findings of previous studies, caution should be exercised in interpreting the results, as we assessed discrimination via self-report, even though interpretation of experiences of racial discrimination remains subjective, may vary for each person, and may never be completely objectively standardized (Karlsen & Nazroo, 2002).

Lastly, we focused on experiences of racial discrimination and did not capture participants’ cumulative trauma exposure, which constitutes a major limitation of the present study (Wilker et al., 2015). The lack of information concerning participants’ trauma load limits our ability to analyze different responses to experiences of racial discrimination based on trauma load, which could represent an alternative explanatory pathway. Future research with larger sample sizes should aim to integrate measures of trauma history in order to analyze these effects more precisely and to test potential interaction.

7. Implications

Racial trauma in clinical contexts is likely underreported due to clinicians’ lack of knowledge, clinicians’ bias and discomfort surrounding racial topics (Comas-Díaz et al., 2019; Saleem et al., 2020). Moreover, it has been shown that people who experience discrimination tend to seek psychotherapy less often (Burgess et al., 2008; Lazaridou & Yeboah, 2024). Previous literature has emphasized the need for racism-sensitive psychotherapy and therefore also specific training for psychotherapists so that they can deal appropriately with individuals affected by racial discrimination (Flores et al., 2010; Kahraman, 2023). While there have been recent efforts to acknowledge and tackle the specific impacts of racial trauma and invalidation on mental health and emotion dysregulation (e.g. in dialectical behaviour therapy; Pierson et al., 2022), perceived discrimination and related symptoms urgently need to be more fully addressed in psychotherapy. While exposure to racial discrimination is often beyond individual control, interventions targeting emotion dysregulation may support racially marginalized clients in coping with the adverse effects of discrimination. However, such interventions do not address the underlying racist attitudes and behaviours that cause harm and do not remove the onus of responsibility from society’s collective obligation to combat racism as a root cause of mental health difficulties; it is rather one of many strategies being pursued in the interest of reducing racial oppression (Carter, 2007; Comas-Díaz et al., 2019; Pierson et al., 2022).

Note

1

We use the term ‘race’ to refer to skin colour or other visible characteristics, while acknowledging that it has no scientific or biological basis and is instead a socially constructed category (Roig, 2017).

Disclosure statement

No potential conflict of interest was reported by the author(s).

AI statement

An AI-based language model (ChatGPT-5.5) was used for English language editing, including grammar and spelling correction. After using this tool, the principal author reviewed and edited the content as needed and takes full responsibility for the accuracy, integrity, and originality of the work.

Data availability statement

The data that support the findings of this study are available from the corresponding author, FG, upon reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, FG, upon reasonable request.

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