The influence of internalized racism on the relationship between discrimination and anxiety
Open accessAbstract
OBJECTIVES: This study used 2 waves of data to longitudinally examine whether internalized racism moderated the association between racial discrimination and anxiety symptom distress. METHOD: Participants were 157 Black college students attending a predominantly White institution who completed measures of racial discrimination, internalized racism, and psychological distress. RESULTS: Using hierarchical linear regression, results indicated a positive association between racial discrimination and subsequent anxiety symptom distress for individuals with moderate and high levels of internalization of negative stereotypes and hair change. CONCLUSIONS: Findings suggest that experiences of anxiety symptom distress, in the context of racial discrimination, may differ as a function of one's acceptance and internalization of dominant White culture's actions and beliefs toward Black people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Internalized racism is associated with psychological distress (e.g., depression and anxiety) in people of color.
“When POC adopt oppressive messages about their ethnoracial identities, perpetuated in the White dominant culture and informed by Eurocentric ideologies and colonization, the internalization of these messages can contribute to self-loathing or worse mental health (i.e., depression and anxiety; [4,7,8]).”
From Internalized Racism and Mental Health: The Moderating Role of Collective Racial Self-Esteem (2024) · cites this paper as [8]
The Role of Internalized Racism as a Vulnerability Factor reports associations with depressive symptoms and psychological distress. The Discussion reports greater anxiety symptom distress among Black college students with moderate or high internalization of negative stereotypes in the context of racial discrimination. The source does not establish that this anxiety finding applies to people of color generally or outside that context. (LLM, conf=0.86)
Experimental — accuracy not yet measuredInternalized racism is positively associated with depression, anxiety, social anxiety, self-esteem, stress, and sleep disturbance among African Americans.
“Previous research on mental distress among AAs demonstrates a positive association between internalized racism and several psychological factors including depression [16,17], anxiety [8], social anxiety [18], self-esteem [19,20], stress [21], and sleep disturbance [22].”
From Internalized Racism and Mental Health: The Moderating Role of Collective Racial Self-Esteem (2024) · cites this paper as [8]
The citation to this paper is attached to anxiety [8], not to the other outcomes in the sentence. The Results and Discussion report that racial discrimination predicted greater anxiety distress among Black emerging adults with moderate or high levels of certain forms of internalized racism. That conditional finding does not establish the claimed general positive association between internalized racism and anxiety. (LLM, conf=0.84)
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“…is closely related to poor mental health outcomes (Pascoe and Richman, 2009; Williams et al., 2003), such as depressive symptoms (Matthews et al., 2013; Woo and Jun, 2022), anxiety (Kogan et al., 2022; Sosoo et al., 2020), and poor psychological well-being (Werkuyten and Nekuee, 1999).”
BackgroundResultInfluentialTurpin, R., King‐Marshall, E., & Dyer, T. V. (2022) · Journal of LGBT Youth · doi:10.1080/19361653.2022.2149659 · Cited by 6 · see citing works
Efird, C. R., Barrington, C., Metzl, J. M., Muessig, K. E., Matthews, D. D., & Lightfoot, A. F. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116245 · Cited by 6 · see citing works
da Silva, P. T., Hochdorn, A., & Chariglione, I. P. F. S. (2024) · Humanities and Social Sciences Communications · doi:10.1057/s41599-024-03447-x · Cited by 5 · see citing works
“…harmful to mental health are experienced more frequently by Black people, and may even exacerbate important clinical conditions, such as post-traumatic stress, anxiety disorders and cardiovascular diseases (Campos et al. 2020; Correia-Zanini et al. 2021; Josiah et al. 2021; Sosoo et al. 2020).”
Sigel, A. N., Udupa, N. S., Wetherall, K., Cleare, S., O’Connor, R. C., Joiner, T. E., & Jeon, M. E. (2024) · Assessment · doi:10.1177/10731911241273444 · Cited by 5 · see citing works
“…gender has repeatedly demonstrated robust correlations with various forms of psychopathology, including depression (e.g., Pellicane & Ciesla, 2022), anxiety (e.g., Sosoo et al., 2020), PTSD (e.g., Livingston et al., 2019), and substance use disorders (e.g., Meyer, 1995, 2003; Testa et al., 2017).”
Fox, J. K., Martin, G., Walls, T., Perrone, L., Francois, M., Saha, P. R., Lekas, H., & Warner, C. M. (2025) · Psychology in the Schools · doi:10.1002/pits.23437 · Cited by 5 · see citing works
“For example, in a study of Black under-graduates by Sosoo et al. (2020), internalized negative stereotypes and hair change attitudes (e.g., “ straight hair is better than my natural hair texture ” ) worsened the association between racial discrimination and subsequent anxiety distress.”
A Population Health Perspective on Racism and Racial Microaggressions
Jadotte, Y. T., Salmond, S. W., & Allread, V. (2022) · Orthopaedic Nursing · doi:10.1097/nor.0000000000000834 · Cited by 5 · see citing works
Phillips, T. K., Rose, A. L., & Strickland, M. L. (2022) · International Journal of Systemic Therapy · doi:10.1080/2692398x.2022.2084316 · Cited by 5 · see citing works
Xiao, Z., & Wu, A. (2024) · Ethnicity and Health · doi:10.1080/13557858.2024.2412853 · Cited by 5 · see citing works
“According to Sosoo, Bernard, and Neblett (2020), the greater level of endorsement for internalized racism is associated with greater levels of anxiety.”
Cuing disparities: The consequences of race‐based social stressors for academic achievement
Green, D. J.-A., Kroeper, K. M., & Murphy, M. C. (2023) · Journal of Community & Applied Social Psychology · doi:10.1002/casp.2747 · Cited by 5 · see citing works
Browning, M. E., Lloyd-Richardson, E. E., Satterfield, S. L., & Trisal, A. V. (2023) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465823000188 · Cited by 4 · see citing works
Harrington, E. E., Gamaldo, A. A., Sliwinski, M. J., Hakun, J. G., Buxton, O. M., Katz, M. J., Derby, C. A., Foor, K., Engeland, C. G., & Graham‐Engeland, J. E. (2025) · Current Psychology · doi:10.1007/s12144-024-07266-w · Cited by 4 · see citing works
“It has been shown that individuals who internalize (i.e., readily believe stereotypes to be accurate) are more likely to experience anxiety (Sosoo et al., 2020), lower self-esteem (Marquet et al., 2018), and poorer memory performance (Weiss, 2018) when they encounter discrimination.”
Jones, A. R., Hoard, L., Brown, G., Dean, M., Underwood, D., Jang, H. S., Karademitrou, N. A., Vancol, A., Washington, L., Horton, A. J., et al. (2025) · The Counseling Psychologist · doi:10.1177/00110000251348273 · Cited by 4 · see citing works
“The Counseling Psychologist 53(4) online experiences of racism, it often leads to diminished self-worth, shame, and inferiority, as re fl ected in our data (Mouzon & McLean, 2017; Sosoo et al., 2020; Tao & Scott, 2022; Tynes et al., 2012).”
Liu, L. (2022) · Criminal Justice Policy Review · doi:10.1177/08874034221083264 · Cited by 4 · see citing works
Mah, P. M. (2023) · Journal of Information Technology and Digital World · doi:10.36548/jitdw.2023.1.002 · Cited by 4 · see citing works
Frisby, C. M. (2023) · Howard Journal of Communications · doi:10.1080/10646175.2023.2242308 · Cited by 4 · see citing works
“…facts presented and believed by the majority group (whites), AND the acceptance of beliefs about superiority or entitlement by white people is significantly related to mental health (David et al., 2019; Molina & James, 2016; Mouzon & McLean, 2017; Sosoo et al., 2020; Taylor & Grundy, 1996).”
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Polanco-Roman, L. A., Reyes‐Portillo, J. A., Ebrahimi, C. T., Powell, A. E., & Tynes, B. M. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02381-1 · Cited by 5 · see citing works
“For instance, in a longitudinal study of African American college students attending a Predominantly White Institution, researchers reported that higher levels of racial discrimination prospectively predicted higher levels of internalized rac-ism a year later [46].”
Stone-Sabali, S., Uanhoro, J., McClain, S., Bernard, D., Makari, S., & Chapman-Hilliard, C. (2023) · Current Psychology · doi:10.1007/s12144-023-04579-0 · Cited by 3 · see citing works
“Moreover, the alteration of physical appearance to be more consistent with Eurocentric aesthetics (e.g., the whitening of skin or straightening of hair) has been associated with negative attitudes towards the self among a sample of African American participants (Sosoo et al., 2020).”
Self-citationKincade, L. L. (2023) · Advances in higher education and professional development book series · doi:10.4018/978-1-6684-8597-2.ch006 · Cited by 3 · see citing works
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Pour une santé publique en faveur d’une justice épistémique
Fillol, A., Fonquerne, L., Cambon, L., & Ridde, V. (2023) · Global Health Promotion · doi:10.1177/17579759231183325 · Cited by 3 · see citing works
“L’adoption consciente ou non de telles stratégies favorise de nombreux problèmes de santé mentale et physique, dont la responsabilité reviendrait moins aux individus qu’à l’organisation de la société (14,15).”
BackgroundRace for Social Justice in Higher Education
Patterson, B. Q. (2021) · Advances in religious and cultural studies (ARCS) book series · doi:10.4018/978-1-7998-8532-0.ch009 · Cited by 2 · see citing works
Anxiety Disorders in Childhood and Adolescence: Prevalence and Diagnostic Considerations
Sanchez, A. L., Becker‐Haimes, E. M., & Wolk, C. B. (2022) · Springer eBooks · doi:10.1007/978-3-031-12737-3_10 · Cited by 2 · see citing works
Lateef, H. A., Baldwin‐White, A., Jellesma, F., Borgstrom, E., & Nartey, P. B. (2023) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-023-01536-2 · Cited by 2 · see citing works
“Internalized racism — the process by which Black populations endorse negative self-concept stereotypes while rejecting Afrocentric cultural norms and ideas [77] — may also increase Black men’s acceptance of intimate partner violence.”
Chaw, A. (2023) · Undergraduate Research · doi:10.58361/2766-3590.1063 · Cited by 2 · see citing works
“…of racial discrimination and anxiety in black college students, the authors found that students that experienced anxiety in relation to racial discrimination, were dependent upon the student’s acceptance or internalization of white student’s actions and beliefs (Sosoo et al., 2020, p. 580).”
BackgroundMoore, S. P., Fryer, C. S., Lee, E., & Sterling, K. L. (2025) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2025.100593 · Cited by 2 · see citing works
“…strategies were at greater odds of blunt use which aligns with literature showing that emotion-focused strategies are associated with poor psychological outcomes. such as distress (Sosoo et al., 2020) which may subsequently increase risk of tobacco-cannabis co-use (Mattingly et al., 2024).”
Conroy, K., Urcuyo, A. E., Schiavone, E. M., Obee, A. F., Frazier, S. L., Cramer, E., & Comer, J. S. (2024) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2024.2361731 · Cited by 2 · see citing works
“…& Albano, 1996) do not assess discrimination, accultura-tive stress, or poverty-related stressors, despite research suggesting they are associated with higher rates of anxiety (Alegria et al., 2019; A. E. Gaylord-Harden et al., 2009; Miller De Rutté & Rubenstein, 2021; Sosoo et al., 2020).”
National Institutes of Health R-series Grants portfolio of racism and healthcare, 2017–2022
Aponte, J., & Roldós, M. I. (2023) · BMC Public Health · doi:10.1186/s12889-023-17407-8 · Cited by 1 · see citing works
“Unlike internalized racism which is within an individual, interpersonal is between individuals [19].”
BackgroundDarteh, E. K. M., Ninnoni, J. P., Okyere, J., Darteh, F., John-Langba, J., & Dickson, K. S. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1274585 · Cited by 1 · see citing works
Lins, R. M. L., Paiva, S. M., Mattos, F. D. F., Prado, I. M., Bastos, J. L., & Serra‐Negra, J. M. (2024) · Acta odontológica latinoamericana/Acta odontológica latinoamericana · doi:10.54589/aol.37/2/134 · Cited by 1 · see citing works
“People in vulnerable situations tend to accept their own oppression and internalise the racism perpetuated by the majority in society 29 .”
BackgroundMerriweather, L. R., Wang, V., Wheatley, T. C., & Stone, C. (2024) · International Journal of Technology-Enhanced Education · doi:10.4018/ijtee.358749 · Cited by 1 · see citing works
White Psychotherapists: Whiteness and the Lack of Racial Literacy for Attending Black Patients
Marques, S. S., Saratt, M. M., Santana, J. P., & Habigzang, L. F. (2025) · Trends in Psychology · doi:10.1007/s43076-025-00435-1 · Cited by 1 · see citing works
“…act as a risk factor for mental and physical health, contributing to the development of symptoms of anxiety, depressed mood, perception of low self-esteem, and behaviors such as social isolation (APA, 2019; Gale et al., 2020, Graham et al., 2016, Roberson & Pieterse, 2021, Sosoo et al., 2020).”
Sullivan, N., & Kurki, T. (2025) · NORA - Nordic Journal of Feminist and Gender Research · doi:10.1080/08038740.2025.2558946 · Cited by 1 · see citing works
Imperato, C., & Mancini, T. (2025) · Aggression and Violent Behavior · doi:10.1016/j.avb.2025.102092 · Cited by 1 · see citing works
Farmer, N. M., Gordon, T., Middleton, K. R., Brooks, A. T., & Wallen, G. R. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibab108 · Cited by 1 · see citing works
Abraham, A., & Balachandran, K. (2023) · Undergraduate Research · doi:10.58361/2766-3590.1062 · Cited by 1 · see citing works
“…of racial discrimination and anxiety in black college students, the authors found that students that experienced anxiety in relation to racial discrimination, were dependent upon the student’s acceptance or internalization of white student’s actions and beliefs (Sosoo et al., 2020, p. 580).”
BackgroundPitner, R., & Cooper, Z. (2024) · Journal of Evidence-Based Social Work · doi:10.1080/26408066.2024.2427629 · Cited by 1 · see citing works
Ivande, S. K., Schopper, I., & Lou, N. M. (2024) · International Journal of Intercultural Relations · doi:10.1016/j.ijintrel.2024.102112 · Cited by 1 · see citing works
Exploring racial persistence in South Africa through Black Liberation Theology
Baloyi, G. T. (2025) · HTS Teologiese Studies / Theological Studies · doi:10.4102/hts.v81i1.10415 · Cited by 1 · see citing works
“As racism occurs, it affects people’s capacity for self-love and self-worth and thereby brings shame that affects their psychological functioning as normal beings (Sosoo, Bernard & Neblett 2020:570–580).”
Guo, C., Li, M., & Hou, L. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1599706 · Cited by 1 · see citing works
Object-oriented framework for curves and surfaces with applications
Slusallek, P., Klein, R., Kolb, A., & Greiner, G. (1994) · Cited by 1 · see citing works
Analyzing the mediating effects between discrimination and depression: A cross-sectional studyPreprint
Cooper, Z., Pitner, R., & Ali, M. K. (2023) · Research Square · doi:10.21203/rs.3.rs-3178286/v1 · Cited by 1 · see citing works
Chronicles of the "model minority"
Canty, L.-T. M. (2022) · doi:10.17760/d20439301
Sanders, S. M., Williams, T. R., Berry, A. T., Mitchell, J. M., Martin, R., & Jones, P. (2023) · doi:10.31234/osf.io/c79fj
Cooper, Z., & Pitner, R. (2024) · Research Square · doi:10.21203/rs.3.rs-4271141/v1
Suicide and Substance Use among African American Adolescents
Blassingame, J. C., Sumlin, E. D., & Ng, S. Y. C. (2024) · Adolescent Psychiatry · doi:10.2174/0122106766297141241001073433
Injustice, Discrimination, and Devaluation in Neurology
Bvunzawabaya, B., Robbins, N. M., & Brown, T. (2024) · Springer eBooks · doi:10.1007/978-3-031-62727-9_2
Balaghi, D., Cusick, K. M., Forbes-Dyczkowski, K., Harp, M., & Matanos, K. (2025) · Journal of Humanistic Psychology · doi:10.1177/00221678251321194
Associations Between Mental Health and Social Needs Among Black Patients in Primary Care Settings
Kirk, K. F., Budd, S. G., Splain, A., Parsons, C. L. B., Kini, A., Daniel, G. D., Kim, L., Alexander, K., Rubio, D. S., Warren, J., et al. (2025) · Journal of Primary Care & Community Health · doi:10.1177/21501319251338912
“21-23 Some research suggests, that despite greater exposure to stress, material hardship, and disparate physical health outcomes, Black Americans report similar or lower rates of psychiatric disorders than White Americans.”
Culturally Responsive Approaches to Assessment and Case Conceptualization
Graham-LoPresti, J. R., Sawdy, M., & Borrero, G. (2025) · CBT: science into practice · doi:10.1007/978-3-031-91439-3_9
Making the Invisible Visible: Calling Out Racism Within CrossFit
Mayeda, D. T. (2025) · Global culture and sport series · doi:10.1007/978-3-031-91046-3_15
Richardson, J., & Wamser‐Nanney, R. A. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251399679
The role of race-related vigilance on smoking cessation challenges among Black individuals who smoke
Jo, D., Heggeness, L. F., Thai, J. M., Ruiz, A. L., Jones, A. A., Shepherd, J. M., Redmond, B. Y., Garey, L., & Zvolensky, M. J. (2026) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2026.2654472
“However, racial/ethnic discrimination is not a singular experience but rather a complex and multifaceted one occurring at multiple levels and includes various forms, such as interpersonal, institutional, and internalized racism (15, 16).”
Racial Discrimination and Relationship Outcomes: A Meta-Analysis
Kelley, Z., Lam, P. H., Huang, L., Trujillo, M. A., McLeod, L., & Helgeson, V. S. (2026) · Journal of Social and Personal Relationships · doi:10.1177/02654075261448934
“Third, compared to some other stressors, racial discrimination is unavoidable, and the pervasiveness of this stressor may make it more likely that the person internalizes others’ negative perceptions, which can further negatively affect health (Sosoo et al., 2020).”
Ahmadi, A., & Prosek, E. A. (2026) · The Journal of Humanistic Counseling · doi:10.1002/johc.70045
Agrawal, V., Razzak, A. M., & Oorjitham, N. S. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03149-6
“As a result, this disengagement from the healthcare system exacerbates mental health issues, as individuals who repeatedly encoun - ter discrimination are more likely to internalize negative societal attitudes, resulting in feelings of worthlessness, depression, and anxiety [30, 31].”
Trauma and the role of colorism in racial microaggressions
Williams, M. T., Tullis-Robinson, L., Kavanagh, K., & Faber, S. C. (2026) · Discover Psychology · doi:10.1007/s44202-026-00735-2
Birnkammer, S., Applewhite, B., Altmann, Y., Zubala, A., Kringelbach, M. L., & Calvano, C. (2026) · Frontiers in Health Services · doi:10.3389/frhs.2026.1824536
“BIPoC (Black, Indigenous, and People of Color) youth are at elevated risk for developing mental health difficulties such as anxiety, depression, and posttraumatic symptoms (11, 12).”
Navigating the national imaginary: internalized racism within integration narratives
Abdel-Fatah, D. (2026) · Ethnic and Racial Studies · doi:10.1080/01419870.2026.2693652
Discrimination and Mental Health: Influence of Structural Racism
Bartle‐Haring, S., & Jofferion, J. (2026) · Journal of Marital and Family Therapy · doi:10.1111/jmft.70171
- Authors
- Sosoo, E. E., Bernard, D. L., & Neblett, E. W.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Sosoo, Effua E.
- Venue
- Cultural Diversity & Ethnic Minority Psychology
- Published
- 2020-10
- Volume
- 26
- Issue
- 4
- Pages
- 570-580
- ISSN
- 1077-341X (ISSN-L)
- 1939-0106
- 1099-9809
- PMC
- PMC7359777
- OpenAlex
- W2997416280
- Cited by
- 94
- References
- 65
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 15 · 2023: 20 · 2022: 20 · 2021: 10 · 2020: 2
- FWCI
- 16.07
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Cultural Diversity & Ethnic Minority Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institute of Mental Health (R25MH118935, T32MH018869)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- internalized racism, racial discrimination, anxiety, psychological distress, African American college students, predominantly white institutions, hair changes
- MeSH terms
- Anxiety, Anxiety Disorders, Black or African American, Humans, White People, Racism
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