Given the diversity of military veterans and growing evidence of ethnoracial disparities in posttraumatic stress disorder (PTSD) within this population, elucidating the role of discrimination-related stress in contributing to these disparities is crucial. We examined the relative impact of discriminatory stress (i.e., due to race/ethnicity, religion, nationality, gender, sexual orientation, or physical appearance) on 6-month changes in PTSD symptom severity among trauma-exposed White (74%), Black (11%) and Hispanic/Latino/a/x (15%) veterans (17% female). PTSD symptoms were measured with the 8-item PTSD Checklist for DSM-5. A measure of the extent to which discrimination has caused stress for the respondent assessed discriminatory stress. Hierarchical regression analyses examined interactions among race/ethnicity, gender and discriminatory stress in predicting six-month changes in PTSD severity. Black and Hispanic/Latino/a/x veterans reported higher baseline PTSD severity and discriminatory stress than White veterans, with some variation by gender. Three-way interactions of race/ethnicity by discriminatory stress by gender were significant, controlling for income, education and age. The relationship between discriminatory stress and increases in PTSD severity was significantly stronger for Black women compared with Black men and did not differ between White men and women. There was also a stronger relationship between discriminatory stress and increases in PTSD severity for Hispanic/Latino/x men as compared to Black men. These findings suggest that discriminatory stress impacts PTSD severity differentially for various ethnoracial/gender groups and highlight the value of applying an intersectional framework that accounts for the synergistic connections among multiple identities to future screening, intervention, and research efforts.

中文翻译：

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种族/民族和性别交叉处歧视性压力对创伤后压力严重程度变化的影响

鉴于退伍军人的多样性以及越来越多的证据表明该人群中创伤后应激障碍 (PTSD) 存在种族差异，阐明与歧视相关的压力在促成这些差异中的作用至关重要。我们检查了歧视性压力（即由于种族/民族、宗教、国籍、性别、性取向或外貌）对暴露于创伤的白人 (74%)、黑人 PTSD 症状严重程度 6 个月变化的相对影响(11%) 和西班牙裔/拉丁裔/a/x (15%) 退伍军人（17% 女性）。PTSD 症状是用 DSM-5 的 8 项 PTSD 检查表测量的。衡量歧视对受访者评估的歧视压力造成压力的程度。层次回归分析检查了种族/民族之间的相互作用，性别和歧视性压力预测 PTSD 严重程度的六个月变化。与白人退伍军人相比，黑人和西班牙裔/拉丁裔/a/x 退伍军人报告的基线 PTSD 严重程度和歧视性压力更高，性别有所不同。通过性别歧视性压力对种族/民族的三向交互作用显着，控制了收入、教育和年龄。与黑人男性相比，黑人女性的歧视性压力与 PTSD 严重程度增加之间的关系显着更强，并且在白人男性和女性之间没有差异。与黑人男性相比，西班牙裔/拉丁裔/x 裔男性的歧视性压力与 PTSD 严重程度增加之间也存在更强的关系。