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Abstract

Depression among individuals who have been racially and ethnically minoritized in the United States can be vastly different from that of non-Hispanic White Americans. For example, African American adults who have depression rate their symptoms as more severe, have a longer course of illness, and experience more depression-associated disability. The purpose of this review was to conceptualize how structural racism and cumulative trauma can be fundamental drivers of the intergenerational transmission of depression. The authors propose that understanding risk factors for depression, particularly its intergenerational reach, requires accounting for structural racism. In light of the profoundly different experiences of African Americans who experience depression (i.e., a more persistent course of illness and greater disability), it is critical to examine whether an emerging explanation for some of these differences is the intergenerational transmission of this disorder due to structural racism.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 434 - 440
PubMed: 35599541

History

Received: 8 October 2021
Revision received: 1 February 2022
Accepted: 15 February 2022
Published online: 23 May 2022
Published in print: June 2022

Keywords

  1. Depressive Disorders
  2. Major Depressive Disorder
  3. Sociopolitical Issues
  4. Racism
  5. Posttraumatic Stress Disorder (PTSD)

Authors

Affiliations

Sidney H. Hankerson, M.D., M.B.A. [email protected]
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Nathalie Moise, M.D., M.S.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Diane Wilson, M.S.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Bernadine Y. Waller, Ph.D., L.M.H.C.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Kimberly T. Arnold, Ph.D., M.P.H.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Cristiane Duarte, Ph.D., M.P.H.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Claudia Lugo-Candelas, Ph.D.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Myrna M. Weissman, Ph.D.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Milton Wainberg, M.D.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Rachel Yehuda, Ph.D.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).
Ruth Shim, M.D., M.P.H.
Department of Psychiatry (Hankerson, Yehuda) and Department of Population Health Sciences and Policy (Hankerson), Icahn School of Medicine at Mount Sinai, New York; Department of Medicine (Moise, Wilson) and Department of Psychiatry (Waller, Duarte, Lugo-Candelas, Wainberg), Columbia University Irving Medical Center, New York; City University of New York (Wilson); New York State Psychiatric Institute, New York (Waller, Duarte, Lugo-Candelas, Wainberg, Weissman); Department of Family Medicine and Community Health, Perelman School of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Arnold); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York (Weissman); James J. Peters VA Medical Center, Bronx, N.Y. (Yehuda); Department of Psychiatry, University of California, Davis (Shim).

Notes

Send correspondence to Dr. Hankerson ([email protected]).
Presented in part at the National Institute of Mental Health Workshop “Identifying New Directions in Mental Health Disparities Research: Innovations With a Multidimensional Lens,” November 9–10, 2020.

Funding Information

Funding for this study was provided by the National Institute of Mental Health (award 1R01 MH-121590 to Dr. Hankerson and award T32 MH-096724 to Dr. Waller).The authors report no financial relationships with commercial interests.

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