More than skin deep: Stress neurobiology and mental health consequences of racial discrimination
Open accessAbstract
Ethnic minority groups across the world face a complex set of adverse social and psychological challenges linked to their minority status, often involving racial discrimination. Racial discrimination is increasingly recognized as an important contributing factor to health disparities among non-dominant ethnic minorities. A growing body of literature has recognized these health disparities and has investigated the relationship between racial discrimination and poor health outcomes. Chronically elevated cortisol levels and a dysregulated hypothalamic-pituitary-adrenal (HPA) axis appear to mediate effects of racial discrimination on allostatic load and disease. Racial discrimination seems to converge on the anterior cingulate cortex (ACC) and may impair the function of the prefrontal cortex (PFC), hence showing substantial similarities to chronic social stress. This review provides a summary of recent literature on hormonal and neural effects of racial discrimination and a synthesis of potential neurobiological pathways by which discrimination affects mental health.
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The impacts of racism on dysregulation of cognitive-affective regions share similarities with pathways leading to anxiety, depression and psychosis.
“The impacts of racism on the dysregulation of cognitive-affective regions such as the prefrontal cortex, anterior cingulate cortex, amygdala and thalamus share similarities with pathways leading to anxiety, depression and psychosis [404].”
From Racism as a Determinant of Health: A Systematic Review and Meta-Analysis (2015) · cites this paper as [404]
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Perceived discrimination and the risk of schizophrenia in ethnic minorities
Veling, W., Hoek, H. W., & Mackenbach, J. P. (2008) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-008-0381-6 · Cited by 91 · see citing works
A pure salience response in posterior parietal cortex
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Ødegaard’s Selection Hypothesis Revisited: Schizophrenia in Surinamese Immigrants to the Netherlands
Selten, J., Cantor‐Graae, E., Slaets, J. P. J., et al. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.4.669 · Cited by 80 · see citing works
Anglin, D. M., Lighty, Q., Greenspoon, M., & Ellman, L. M. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0870-8 · Cited by 72 · see citing works
Bízik, G., Picard, M., Nijjar, R., Tourjman, V., McEwen, B., Lupien, S., & Juster, R. (2013) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000012 · Cited by 70 · see citing works
Thomason, M. E., Hamilton, J. P., & Gotlib, I. H. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02422.x · Cited by 69 · see citing works
Paradies, Y., & Cunningham, J. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0332-x · Cited by 65 · see citing works
Martin, C. G., Bruce, J., & Fisher, P. A. (2012) · Hormones and Behavior · doi:10.1016/j.yhbeh.2012.02.025 · Cited by 62 · see citing works
Wagner, J. A., Lampert, R. J., Tennen, H. A., & Feinn, R. (2013) · Stress and Health · doi:10.1002/smi.2542 · Cited by 59 · see citing works
Racial Discrimination, Mood Disorders, and Cardiovascular Disease Among Black Americans
Chae, D. H., Nuru‐Jeter, A., Lincoln, K. D., & Arriola, K. J. (2011) · Annals of Epidemiology · doi:10.1016/j.annepidem.2011.10.009 · Cited by 57 · see citing works
Masten, C. L., Eisenberger, N., Pfeifer, J. H., & Dapretto, M. (2013) · Developmental Science · doi:10.1111/desc.12056 · Cited by 49 · see citing works
Adolescent social defeat alters markers of adult dopaminergic function
Novick, A. M., Forster, G. L., Tejani‐Butt, S. M., & Watt, M. J. (2011) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2011.06.009 · Cited by 47 · see citing works
Refining and integrating schizophrenia pathophysiology – Relevance of the allostatic load concept
Misiak, B., Frydecka, D., Zawadzki, M., Krefft, M., & Kiejna, A. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2014.06.004 · Cited by 47 · see citing works
Butts, K. A., & Phillips, A. G. (2013) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713000187 · Cited by 45 · see citing works
Early Exposure to Traumatic Stressors Impairs Emotional Brain Circuitry
Korgaonkar, M. S., Antees, C., Williams, L. M., Gatt, J. M., Bryant, R. A., Cohen, R. A., Paul, R. H., O'Hara, R. M., & Grieve, S. M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0075524 · Cited by 43 · see citing works
The Effect of Dopamine Agonists on Adaptive and Aberrant Salience in Parkinson's Disease
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Perceived discrimination in those at clinical high risk for psychosis
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Racism, mental illness and social support in the UK
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Perceived Stigmatization, Ingroup Pride, and Immune and Endocrine Activity
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Ethnic Minorities in the Netherlands
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Experience of social discrimination correlates with neurometabolism: a pilot study in heroin addicts
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Discrimination and delusional ideation
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Structural racism and health inequities in the USA: evidence and interventions
Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., & Bassett, M. T. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30569-x · Cited by 5,203 · see citing works
Racism as a Determinant of Health: A Systematic Review and Meta-Analysis
Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., Gupta, A., Kelaher, M., & Gee, G. (2015) · PLOS ONE · doi:10.1371/journal.pone.0138511 · Cited by 2,610 · see citing works
“The impacts of racism on the dysregulation of cognitive-affective regions such as the prefrontal cortex, anterior cingulate cortex, amygdala and thalamus share similarities with pathways leading to anxiety, depression and psychosis [404].”
BackgroundKlein, E. M., Brähler, E., Dreier, M., Reinecke, L., Müller, K. W., Schmutzer, G., Wölfling, K., & Beutel, M. E. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0875-9 · Cited by 716 · see citing works
Racial discrimination and adverse birth outcomes: an integrative review
Alhusen, J. L., Bower, K. M., Epstein, E., & Sharps, P. (2016) · Journal of Midwifery & Women's Health · doi:10.1111/jmwh.12490 · Cited by 382 · see citing works
Chae, D. H., Yip, T., Martz, C. D., Chung, K., Richeson, J. A., Hajat, A., Curtis, D. S., Rogers, L. O., & LaVeist, T. A. (2021) · Public Health Reports® · doi:10.1177/00333549211018675 · Cited by 264 · see citing works
Saleem, F. T., Anderson, R. E., & Williams, M. (2020) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-019-00304-1 · Cited by 210 · see citing works
Braveman, P., Dominguez, T. P., Burke, W., Dolan, S. M., Stevenson, D. K., Jackson, F. M., Collins, J. W., Driscoll, D. A., Haley, T., Acker, J., et al. (2021) · Frontiers in Reproductive Health · doi:10.3389/frph.2021.684207 · Cited by 189 · see citing works
Measures of maternal stress and mood in relation to preterm birth
Hoffman, M. C., Mazzoni, S. E., Wagner, B. D., Laudenslager, M. L., & Ross, R. G. (2016) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000001287 · Cited by 168 · see citing works
Opara, I., Assan, M. A., Pierre, K., Gunn, J. F., Metzger, I., Hamilton, J., & Arugu, E. (2020) · Journal of Black Studies · doi:10.1177/0021934720935641 · Cited by 136 · see citing works
Resilience: A psychobiological construct for psychiatric disorders
Shrivastava, A., & Desousa, A. (2016) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.174365 · Cited by 127 · see citing works
Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults
Vadiveloo, M., & Mattei, J. (2017) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9831-7 · Cited by 124 · see citing works
“etary and exercise practices and health care avoidance [11, 12], akin to how experienced racism correlates with negative health outcomes like cancer risk [13, 14].”
BackgroundThe influence of internalized racism on the relationship between discrimination and anxiety
Sosoo, E. E., Bernard, D. L., & Neblett, E. W. (2020) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000320 · Cited by 94 · see citing works
Lewis, R. J., Mason, T. B., Winstead, B. A., Gaskins, M., & Irons, L. B. (2016) · Psychology of Women Quarterly · doi:10.1177/0361684316662603 · Cited by 66 · see citing works
A Landscape of Subjective and Objective Stress in African-American Dementia Family Caregivers
Cothran, F. A., Chang, E., Beckett, L., Bidwell, J. T., Price, C. A., & Gallagher-Thompson, D. (2022) · Western Journal of Nursing Research · doi:10.1177/01939459211062956 · Cited by 30 · see citing works
Fibromyalgia patients should always be screened for post-traumatic stress disorder
Nardi, A. E., Karam, E. G., & Carta, M. G. (2020) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2020.1794824 · Cited by 15 · see citing works
- Authors
- Berger, M., & Sarnyai, Z.
- ORCID
- Berger, Maximus
- Venue
- Stress
- Publisher
- Informa UK Limited
- Published
- 2014-12-29
- Volume
- 18
- Issue
- 1
- Pages
- 1-10
- ISSN
- 1025-3890 (ISSN-L)
- 1607-8888
- OpenAlex
- W1992521712
- Cited by
- 606
- References
- 126
- Citations by year
- 2026: 41 · 2025: 73 · 2024: 71 · 2023: 67 · 2022: 75 · 2021: 82 · 2020: 73 · 2019: 38 · 2018: 26 · 2017: 23 · 2016: 27 · 2015: 8 · 2014: 1
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stress (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- racial discrimination, mental health, health disparities, ethnic minorities, cortisol, hypothalamic-pituitary-adrenal axis, allostatic load, anterior cingulate cortex, prefrontal cortex, chronic social stress, neuroendocrine effects
- MeSH terms
- Ethnicity, Gyrus Cinguli, Health Status, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Mental Health, Minority Groups, Pituitary-Adrenal System, Risk Factors, Social Isolation, Stress, Psychological, Biomarkers, Prefrontal Cortex, Allostasis, Health Status Disparities, Racism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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