The association between everyday discrimination and adolescents’ mental health: The role of coping approaches
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Jocelyn Gutierrez, MPHc; Rasmey Gomez, MPHc; Christopher Rogers, PhD, MPH; Myriam Forster, PhD, MPH
 
Background: Everyday discrimination, daily microaggressions, and unfair treatment by people due to factors such as race and gender has been linked to poor mental health among adolescents. Given that early life mental health issues can undermine school performance, future orientation, and increase risk for later life psychopathology, identifying protective factors that can facilitate health adaptation during this critical period of development is a priority. To fill this gap, we investigated the association between everyday discrimination and depression, anxiety, non-suicidal self-injury (NSSI), and suicidal ideation (SI) and whether specific coping strategies (e.g., avoidant, problem- or emotion-focused) moderated this association among a diverse group of adolescents.  
 
Methods: Data are baseline surveys of high school students (N=2,360) enrolled in a school-based study assessing health and developmental outcomes. GLMs tested the hypothesized association between everyday discrimination and youths’ depression, anxiety, NSSI, and SI, and whether coping strategies moderated these relationships, adjusting for age, sex, ethnicity, poverty status, and state.
 
Results: Half of the sample was female (52%), 31% identified as non-Hispanic White, followed by African American (29%), Hispanic (24%), Multiracial (9%), and Asian (7%). One-third of students (34%) experienced moderate to severe anxiety, half (51%) reported moderate to severe depressive symptoms, 17% engaged in NSSI, and 19% seriously considered suicide. Three out of four adolescents (78%) experienced some form of everyday discrimination. Everyday discrimination scores were associated with higher odds of moderate to severe anxiety (AOR = 1.15, 95%CI[1.10, 1.20]) or depression (AOR = 1.18, 95% CI[1.13, 1.23]), NSSI (AOR = 1.12, 95%CI[1.06, 1.18]), and SI (AOR = 1.08, 95%CI[1.03, 1.14]). In contrast to avoidant and emotion-focused coping strategies, problem-focused coping strategies were inversely associated with all four mental health indicators. Notably, avoidant and emotion-focused coping approaches exacerbated the negative effect of everyday discrimination for anxiety and depression (ps < 0.05).

Conclusion: Although policy and structural changes are needed, it is vital to develop and deliver programs that help adolescents develop adaptive coping strategies rather than coping approaches that amplify the negative effects of discrimination.