Racial Discrimination and Alcohol Use Among Adolescents: The Role of Emotion Regulation

Abstract

Background: Racial discrimination has been consistently associated with risk for alcohol use outcomes among racial/ethnic minority groups. This is particularly concerning given that engagement in alcohol use during adolescence has significant downstream effects on an individual's health into adulthood. Understanding factors that influence the relationship between racial discrimination and alcohol outcomes are needed to better understand the risk pathway and to identify malleable targets for interventions to reduce alcohol use among racial/ethnic minority adolescents. One potential candidate is emotion regulation as there is evidence that exposure to discrimination is associated with emotion regulation difficulties, and that emotion regulation difficulties are associated with alcohol outcomes. It is also plausible that emotion regulation is an external factor that strengthens or weakens to direct association between racial discrimination and alcohol use. Thus, the current study examined difficulties in emotion regulation (as measured by the State Difficulties in Emotion Regulation, S-DERS) as a mediator and moderator separately on the relationship between racial discrimination related stress (RDRS) and alcohol outcomes (i.e., use, quantity, frequency, alcohol use disorder, binge drinking, high intensity alcohol use) and risk for problems associated with substance use. To better understand the nuances within the emotion regulation construct, this study also examined the four subscales of the S-DERS (e.g., difficulties in nonacceptance, modulation, lack of awareness, lack of clarity) in a parallel mediation and moderation model to account for each domain’s unique effect on the racial discrimination-alcohol pathway. Methods: 714 self-identifying racial/ethnic minority adolescents aged 10-19 years old (62.9% male, mean age 16.21 years old, 58.1% African American/Black, 19% American, 9.9% Hispanic/Latino, 9.7% Asian American/Pacific Islander, 1.3% Middle Eastern/North African) completed an online questionnaire that included measures assessing experiences of racial discrimination related stress, state difficulties in emotion regulation, and alcohol outcomes. Results: Findings indicated a significant indirect effect of RDRS on alcohol outcomes through total state difficulties in emotion regulation (past year use b = 0.002, p <0.001; frequency b = 0.005, p <0.001; quantity b = 0.003, p <0.001; alcohol use disorder b = 0.056, p <0.001; binge drinking b = 0.004, p <0.001; high intensity alcohol use b = 0.003, p <0.001; risk for problems associated with substance use b = 0.007, p <0.001). When examining the subscales of emotion regulation, a significant indirect effect was found for difficulties in modulation within the relationship between RDRS and past year use, quantity, frequency, alcohol use disorder, binge drinking, and high-intensity alcohol use, but not for risk for problems associated with substance use. There were no significant indirect effects observed for the other subscales of emotion regulation. Additionally, when examining whether S-DERS or the S-DERS subscales moderated the relationship between RDRS and alcohol outcomes, no significant effects were found. Conclusion: These findings expand our understanding on potential mechanisms that underlie the racial discrimination-alcohol risk pathway among racial/ethnic minority adolescents, which may in turn help clarify the multifaceted nature of emotion regulation. As such, findings suggest that a unique effect was found for difficulties in modulation of emotions when accounting for the other domains of emotion regulation when examining the RDRS and alcohol outcomes relationship. Given that this study was cross-sectional, additional research utilizing a prospective study design can build off the current findings to confirm the proposed temporal pathway between RDRS, emotion regulation, and alcohol use outcomes. Moreover, findings suggest that difficulties in modulation and emotion regulation may be important constructs to include within treatments aimed at reducing alcohol use and prevention efforts among racial/ethnic minority adolescents experiencing racial discrimination related distress.