When (Passive) Acceptance Hurts: Race-Based Coping Moderates the Association Between Racial Discrimination and Mental Health Outcomes Among Black Americans

There is growing evidence that general coping plays a role in the degree to which racial discrimination is associated with mental health symptoms (e.g., posttraumatic stress, depressive symptoms) for people of color. Relatively less is known about the role that race-based coping may play in the associations between racial discrimination and mental health for Black Americans. Objective: In this study, we examined whether posttraumatic stress and depressive symptoms differed based on race-based coping style and tested whether these responses moderated associations between racial discrimination and posttraumatic stress. Method: Black American adults (n = 401; 56.1% women, x age = 44.02) were recruited from a community hospital setting. Based on a measure assessing race-based coping style, participants were classified as having either a passive, moderate, or active response style. Results: First, we found that posttraumatic stress (F = 5.56, p < .01) and depressive (F = 4.49, p = .01) symptom severity differed based on race-based coping classification, with more severe symptoms found for the passive versus active group. Second, we found that race-based coping moderated racial discrimination's associations with posttraumatic stress (R-2 Delta = .02, F = 4.08, p = .02) and depressive (R-2 Delta = .02, F = 3.26, p = .04) symptoms, such that the associations between racial discrimination and symptom severity were only significant for the passive and moderate (but not active) groups. Conclusions: These results suggest that for Black Americans, coping with racism actively (vs. passively) may buffer the association between racial discrimination and psychological symptom severity. Clinical Impact Statement This study found that responding to racial discrimination using active (vs. passive) strategies reduced the positive association between racial discrimination and psychological symptom severity for Black Americans. These findings provide novel, preliminary support that introducing components of activism and engagement with social support networks in treatment goals may be effective in reducing the negative effects of racial discrimination among Black Americans. Although ending systemic racism is ultimately the most effective solution, these findings nevertheless support the incorporation of culturally relevant and critical consciousness-based therapy models when working with Black American clients.