Racial discrimination ‘may place a burden’ on certain brain regions in Black women

Experiences of racial discrimination appeared linked to disproportionately greater response in brain regions related to emotion regulation, fear inhibition and visual attention among Black women.

Researchers reported these results in a cross-sectional study published in JAMA Psychiatry.

“Almost no studies have examined how racial discrimination is linked to brain responses in Black Americans, so we know very little about how racism affects brain function,” Negar Fani, PhD, director of the Fani Affective Neuroscience Laboratory at Emory University, told Healio Psychiatry. “Our goal was to investigate this link from a brain and behavior perspective.”

Fani and colleagues conducted the current study between May 1, 2014, and July 1, 2019, among 55 Black women in the U.S. (mean age, 37.7 years) who were exposed to trauma, with the aim of assessing correlations between racial discrimination experiences and patterns of neural response and behavior to images relevant to trauma in an affective attentional control task. Participants completed the Experiences of Discrimination Questionnaire (EOD), which evaluated different types of racially discriminatory events they may have experienced throughout their lives. During brain scanning, they completed an emotionally evocative attention task with distracting, emotional images, such as threat-related images. The researchers measured their accuracy in responding and their patterns of brain activation while they performed all conditions of the task.

Fani and colleagues evaluated links between racial discrimination questionnaire responses and patterns of brain activation and task performance. They entered PTSD symptoms and trauma exposure, assessed via the Traumatic Events Inventory (TEI; number of times the person was exposed to trauma; score range, 0 to 112) and PTSD Symptom Scale (PSS; 0 to 51), as covariates to isolate variance linked to experiences of racial discrimination.

Results showed a TEI frequency of 33 and moderate levels of current PTSD symptoms (mean PSS score = 15.4) among participants. The researchers reported mean EOD scores of 2.35 and a moderate association between these scores and current PTSD symptoms but not age or TEI frequency. They also noted an association between more experiences of racial discrimination during attention to trauma-relevant vs. neutral images and significantly greater response in nodes of emotion regulation and fear inhibition and visual attention networks. This association remained after accounting for trauma and severity of PTSD symptoms. Fani and colleagues observed an association between racial discrimination and affective Stroop task performance. They noted a negative correlation between errors on trials with threat-relevant stimuli and experiences of racial discrimination.

“Our findings show that increased experiences of racial discrimination may place a burden on threat regulation and visual attention systems in the brain,” Fani said. “Black Americans who experience more discrimination may be more vigilant for future racist events. Further, a disproportionately high amount of brain power may go into regulating, or inhibiting, their emotional responses to these situations.

“Over time, there is a physical and emotional cost to overburdening these systems, which could be an increased risk for later brain health problems,” Fani added.

In a related editorial, Robert O. Motley Jr., PhD, of Boston College School of Social Work, and Cynthia Rogers, MD, of the department of psychiatry at Washington University School of Medicine in St. Louis, highlighted possible paths for future research in this area.

“Racism in the U.S. is an essential topic that warrants constant discussion, given its prevalence and association with adverse health consequences,” Motley Jr. and Rogers wrote. “There is still much to be learned regarding the underlying processes and mechanisms by which experiences of racism can lead to negative health-associated outcomes. This study by Fani and colleagues is a timely contribution that underscores the need for future research examining the interplay of racism-based experiences, individual and stimuli characteristics, neural response patterns and adverse health outcomes with a diverse ethnic and sociodemographic sample of U.S. residents, which could elevate the next set of empirical questions focused on alternative intervention approaches.”