Understanding Depression risk in Multiracial Americans: A Social Safety Approach

PROJECT SUMMARY/ABSTRACT Multiracial adults have the highest prevalence of major depression compared to those who select any single racial category. Despite this disparity, very few studies have attempted to identify unique risks factors facing this population, and those that have exhibit theoretical and methodological limitations. The overarching goal of this proposal is to initiate a research program focusing on the reduction and elimination of Multiracial mental health disparities. As a first step towards this goal, the proposed research investigates a novel hypothesis to explain elevated rates of major depressive episodes (MDE) in Multiracial adults based on the generalized unsafety theory of stress: lower levels of racial identity affirmation. In addition, it identifies inconsistent categorization of Multiracial identity as a critical barrier undermining progress in the field, examines the effects of this inconsistency, and moves towards a solution for future research. Thus, I propose the following three aims that will facilitate the development of future research and interventions to reduce MDE risk in Multiracial Americans. Aim 1 is to test the hypothesis that lower racial identity affirmation partially explains elevated rates of MDE in Multiracial compared to six monoracial adult groups, above and beyond other proposed explanations, using mediation analyses and sophisticated epidemiological methods to adjust for potential confounding. Aim 2 is to test whether the association between racial identity affirmation and MDE varies across Multiracial categorization schemes. Aim 2a is to inform future categorization decisions by testing which Multiracial categorization scheme has the best statistical fit to seven potential MDE disparities mechanisms: racial identity affirmation, racial discrimination, unmet treatment needs, chronic illness, adverse childhood experiences, other traumatic events, and major life events. Findings from this research will advance the National Institute of Mental Health’s research priority of reducing and eliminating mental health disparities. In addition, this mentored dissertation will support the doctoral training and future independent research career of an emerging Black and Biracial mental health scholar.