Understanding the Role of Perceived Racial Discrimination on Adolescent Mental Health During the COVID-19 Pandemic Open Access

Klosky, Jill (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/pz50gx624?locale=en


Background: Adolescent mental health has declined since the onset of the COVID-19 pandemic. Racial discrimination, which may negatively affect adolescent mental health, has increased. The goal of this study was to gain an understanding of the role of racial discrimination on adolescent mental health during the COVID-19 pandemic. The primary research question was whether pre-pandemic racial discrimination predicted changes in adolescent depression, anxiety, and self-esteem from before to during the pandemic. A second research question looked for an association between experiences of racial discrimination and discrimination-related distress during the pandemic, and COVID-19 worry. 


Methods: This secondary analysis of a longitudinal study consisted of two online surveys administered at two public high schools in semi-rural, north-central Georgia. The first survey was administered to ninth-graders in Spring 2020, just before the closing of public schools due to the COVID-19 pandemic. The second survey was administered to the same students in Fall 2020. This provided a unique opportunity for comparison of the pre-COVID-19 baseline data with the data collected during the pandemic.


Results: No significant associations were found between baseline perceived racial discrimination and changes in mental health outcomes (depression, p=0.6194; anxiety, p=0.8240; self-esteem, p=0.0731). Analysis between racial discrimination during the pandemic and associated distress, with COVID-19 worry yielded no significant associations.


Conclusions: Although this study did not find racial discrimination affected adolescent mental health during the COVID-19 pandemic, the importance of this topic should not be discounted. There is a need for future research to examine adolescent racial discrimination in rural communities while including diverse racial and ethnic groups and sub-groups. Additionally, there is a need to study racial discrimination and mental health stigma among rural adolescents. These findings could help to improve access to mental health services as well as promote policy reform to foster more equitable practices.  

Table of Contents

Introduction. 1

Background. 1

Theoretical Framework. 3

Study Purpose and Research Questions. 4

Literature Review.. 5

Adolescent Mental Health Prior to COVID-19 Pandemic. 5

Pandemics and Adolescent and Child Mental Health. 6

COVID-19 and Youth and Parent Mental Health. 7

Racial Discrimination and Adolescent Mental Health. 8

Prevalence of Racial Discrimination. 10

Racial Discrimination and Racism During the COVID-19 Pandemic. 11

Theoretical Framework. 12

Study Purpose and Research Questions. 13

Methods. 16

Study Design. 16

Population and Sample. 16

Data Sources. 17

Study Measures. 18

Data analysis. 22

Results. 24

Demographics and Descriptive Statistics. 24

Bivariate analyses. 24

Multivariate Linear Regression. 26

Correlation Matrix between COVID-19 Worry with Perceived Racial Discrimination. 26

and Associated Distress. 26

Comparison of Perceived Discrimination and Mental Health by Race and Ethnicity. 27

Correlation between Change Scores. 27

Discussion. 28

Key Results. 28

Strengths. 30

Limitations. 30

Implications. 31

Future Directions. 33

Conclusion. 33

References. 35

Tables. 47

Table 1. Participant characteristics, health behaviors, intra- and interpersonal 47

Table 2. Bivariate analysis of covariates and risk factor, with depression from Spring 2020 (T1), Fall 2020 (T2), and depression change score. 49

Table 3. Bivariate analysis of covariates and risk factor with anxiety from Spring 2020 (T1), Fall 2020 (T2), and anxiety change score. 51

Table 4. Bivariate analysis of covariates and risk factor with self-esteem from Spring 2020 (T1), Fall 2020 (T2), and self-esteem change score. 53

Table 5. Multivariate Linear Regression for Self-Esteem Change Score with risk factor and variables significant at the bivariate level 55

Table 6. Bivariate analysis between COVID-19 Worry with perceived racial discrimination and racial discrimination-related distress, Fall 2020 (T2) 56

Table 7. Comparison of perceived racial discrimination with mental health change scores by race and ethnicity, using ANOVA.. 57

Table 8. Correlation matrix between mental health change scores for depression, anxiety, and self-esteem.. 58

Appendices. 59

Appendix A. National Institute on Minority Health and Health Disparities Research Framework. 59

Appendix B. Adapted National Institute on Minority Health and Health Disparities Research Framework for Adolescents in the COVID-19 Pandemic. 60

Appendix C. Modified Patient Health Questionnaire (PHQ)-8. 61

Appendix D. Severity Measure for Generalized Anxiety Disorder – Child Age11-17. 62

Appendix E. Modified Adolescent Stress Questionnaire -Short 63

Appendix F. 4-Item Loneliness Scale. 65

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