Abstract Body: Introduction: Research linking perceived discrimination and depression and anxiety symptoms as well as brain function is limited.
Objective: To examine the relationship between perceived discrimination, particularly racial/ethnic discrimination, and depression and anxiety symptoms, as well as brain function related to emotion and cognition, in individuals with depression and/or anxiety. Differences by race and ethnicity were also explored.
Methods: We analyzed baseline data on perceived discrimination, depression and anxiety symptoms, and brain activities in an ongoing clinical trial, which investigates a voice-based virtual coach for problem-solving treatment. Perceived discrimination was measured using the PhenX Major Experiences and Everyday Discrimination Scales. Depression and anxiety were assessed using the PHQ-9 and GAD-7, respectively. Activity of a priori neural targets, amygdala for emotional reactivity and dorsolateral prefrontal cortex (dlPFC) for cognitive control, was measured using fMRI.
Results: Among 161 participants (mean age 36.6 [SD 11.8] years; 80.8% female; 19.3% Non-Hispanic White, 23.6% Black American, 21.7% AAPI, 31.1% Hispanic), major (r=0.14; p=.01) and everyday (r=0.19; p=.02) discrimination scores were significantly positively correlated with GAD-7 scores. Racial/ethnic discrimination was significantly positively associated with GAD-7 scores (r=.19; p=.01) when reported for everyday discrimination. The association was also positive but not statistically significant when reported for major discrimination (r=.14; p=.07). For differences by race/ethnicity, Black Americans reported the highest levels of both general (p=.002) and racial/ethnic major discrimination (p<.0001). Black Americans, AAPI, and Latinos reported significantly greater racial/ethnic everyday discrimination than non-Hispanic White participants (p<.0001).
Neither major or everyday discrimination correlated significantly with PHQ-9 scores or with the neural targets (dlPFC and amygdala).
Conclusion: Heightened anxiety but not depressive symptoms or the prespecified neural targets are associated with experiences of discrimination, particularly racial/ethnic discrimination, in adults with depression or anxiety. Research on how to address social determinants of health such as discrimination in mental health interventions is warranted.