Microaggression and discrimination exposure on young adult anxiety, depression, and sleep

Ritika Rastogi; G Alice Woolverton; Richard M Lee; Tiffany Yip; Courtney Stevens; Justin A Chen; Cindy H Liu

doi:10.1016/j.jad.2024.07.083

Microaggression and discrimination exposure on young adult anxiety, depression, and sleep

J Affect Disord. 2024 Oct 15:363:141-151. doi: 10.1016/j.jad.2024.07.083. Epub 2024 Jul 17.

Authors

Ritika Rastogi¹, G Alice Woolverton¹, Richard M Lee², Tiffany Yip³, Courtney Stevens⁴, Justin A Chen⁵, Cindy H Liu⁶

Affiliations

¹ Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA.
² Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
³ Department of Psychology, Fordham University, New York, NY, USA.
⁴ Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychology, Willamette University, Salem, OR, USA.
⁵ Department of Psychiatry, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA.
⁶ Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: [email protected].

PMID: 39029681
PMCID: PMC11343644 (available on 2025-10-15)
DOI: 10.1016/j.jad.2024.07.083

Abstract

Background: Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups.

Methods: Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure.

Results: Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (OR_Micro = 1.42, OR_Discrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (OR_Depress = 1.24, OR_Sleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents.

Limitations: Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences.

Conclusions: The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.

Keywords: College students; Health disparities; Mental health; Minority health; Minority stress; Psychosocial stress.

MeSH terms

Adolescent
Adult
Anxiety* / ethnology
Anxiety* / psychology
Asian / psychology
Black or African American / psychology
Depression* / ethnology
Depression* / psychology
Female
Hispanic or Latino / psychology
Humans
Male
Microaggression*
Sleep Wake Disorders / ethnology
Sleep Wake Disorders / psychology
Social Discrimination* / psychology
Students / psychology
United States / epidemiology
White / psychology
Young Adult

Abstract

MeSH terms

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