Racial Discrimination and PTSD Symptoms Among Black Women: The Mediating Roles of Anxiety and Depression.

Black Americans experience disproportionately high rates of posttraumatic stress disorder (PTSD), with Black women at particularly elevated risk. Racial discrimination is a well-documented social determinant of mental health and is increasingly linked to PTSD symptoms. However, the pathways through which discrimination contributes to PTSD remain underexplored. Guided by minority stress theory, this study examined whether depression and anxiety mediate the relationship between racial discrimination and PTSD symptoms among Black women. Data come from a cross-sectional survey of 377 Black women in Chicago, collected between September 2021 and March 2022. Path analyses tested the direct and indirect effects of discrimination on PTSD symptoms, with anxiety and depression modeled as separate mediators. Racial discrimination had a significant indirect effect on PTSD via anxiety symptoms (β = 0.19, 95% CI = 0.112, 0.271) and depressive symptoms (β = 0.19, 95% CI = 0.117, 0.270). Findings suggest that the mental health burden of racial discrimination accumulates through anxiety and depression before manifesting as PTSD. Results support calls to expand PTSD diagnostic frameworks to better capture race-based trauma and underscore the need for interventions that address depression and anxiety as pathways linking discrimination to traumatic stress among Black women.