Influence of perceived discriminatory experiences on mental health and function among early adolescent children.

Thesis (Master's)--University of Washington, 2013Background: Studies suggest that Perceived Discrimination (PD) is a stressor that is associated with mental health problems and risky health behaviors among both adolescents and adults. Little is known about the prevalence of PD and its relationship with mental health during early adolescence, a critical phase of development. Objectives: In this cross sectional study, we first determined the prevalence of PD among early adolescent children drawn from an urban multicultural school-based population. Secondly, we examined the relationship of PD with mental health problems including depression, anxiety and substance use, after controlling for socio-demographic factors (gender, age race and family nativity status) and children's sense of school and family connectivity. Methods: A sample of 1185 early adolescent children (11 to 15 years), from four public schools in Seattle was screened for a randomized clinical trial, testing a depression intervention. Cross sectional analyses of children's responses from an initial screening process were completed for the purpose of this study. Perceived discrimination was the primary exposure of interest. After controlling for socio-demographic (age, gender, race and family nativity) variables we examined the association between PD and mental health problems (depression, anxiety, substance use) in multivariable analyses. We also examined if children's functioning (sense of belonging in school as well as their perceptions of parent-child communication and parent-child conflicts) had a potential mediating effect on the association between PD and mental health problems. Results: PD was endorsed in slightly more than half of the sample (57%), irrespective of age or gender. Early adolescents who experienced perceived discrimination had a higher risk of mental health problems including depression (OR 5.0; p < 0.001), anxiety (OR 2.3; p < 0.001) and substance use (OR 2.8; p < 0.001) after adjusting for socio-demographic factors. Girls had a higher prevalence of anxiety (OR 2.1; p < 0.001) and depression (OR 1.6; p < 0.05), but were less likely to report substance use (OR 0.8; p < 0.01), when compared to boys. Native American and Hispanic/Latino children showed higher risks for substance use (p < 0.01) and depression (p < 0.05) compared to Caucasian peers. School connectivity and parent child conflicts had only partial mediating influences on the association between PD and mental health problems. Conclusions: Perceived discrimination was prevalent during early adolescence, a sensitive developmental period, and was a risk factor for mental health problems (depression, anxiety, and/or substance use). School and family connectedness had a partial mediating role in the association between PD and mental health