Importance Racial discrimination has a clear impact on health-related outcomes, but little is known about how discriminatory experiences are associated with neural response patterns to emotionally salient cues, which likely mediates these outcomes. Objective To examine associations of discriminatory experiences with brainwide response to threat-relevant cues in trauma-exposed US Black women as they engage in an attentionally demanding task. Design, Setting, and Participants A cross-sectional study was conducted from May 1, 2014, to July 1, 2019, among 55 trauma-exposed US Black women to examine associations of racial discrimination experiences with patterns of neural response and behavior to trauma-relevant images in an affective attentional control task. Posttraumatic stress disorder (PTSD) symptoms and trauma exposure were entered as covariates to isolate variance associated with experiences of racial discrimination. Exposures Varying levels of trauma, PTSD symptoms, and experiences of racial discrimination. Main Outcomes and Measures Experiences of Discrimination Questionnaire (EOD) (range, 0-9) for count of the number of situations for which each participant reported having unfair treatment for a racial reason. Experiences of trauma and PTSD symptoms were assessed with the Traumatic Events Inventory (TEI) (number of times the person was exposed to trauma; score range, 0-112) and PTSD Symptom Scale (PSS) (score range, 0-51). Response to trauma-relevant vs neutral distractor cues were assessed via functional magnetic resonance imaging during performance of an affective Stroop (attentional control) task. Statistical analyses were conducted at a whole-brain, voxelwise level with familywise error correction. Results In this study of 55 Black women in the US (mean [SD] age, 37.7 [10.7] years; range, 21-61 years), participants reported a mean (SD) TEI frequency of 33.0 (18.8) and showed moderate levels of current PTSD symptoms (mean [SD] PSS score, 15.4 [12.9]). Mean (SD) EOD scores were 2.35 (2.44) and were moderately correlated with current PTSD symptoms (PSS total: r = 0.36; P=.009) but not with age (r = 0.20; P = .15) or TEI frequency (r = -0.02; P = .89). During attention to trauma-relevant vs neutral images, more experiences of racial discrimination were associated with significantly greater response in nodes of emotion regulation and fear inhibition (ventromedial prefrontal cortex) and visual attention (middle occipital cortex) networks, even after accounting for trauma and severity of PTSD symptoms (brainwide familywise error corrected; r = 0.33 for ventromedial prefrontal cortex; P = .02). Racial discrimination was also associated with affective Stroop task performance; errors on trials with threat-relevant stimuli were negatively correlated with experiences of racial discrimination (r = -0.41; P = .003). Conclusions and Relevance These findings suggest that experiences of racial discrimination associate with disproportionately greater response in brain regions associated with emotion regulation and fear inhibition and visual attention. Frequent racism experienced by Black individuals may potentiate attentional and regulatory responses to trauma-relevant stressors and lead to heightened modulation of regulatory resources. This may represent an important neurobiological pathway for race-related health disparities.

中文翻译：

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种族歧视与美国遭受创伤的黑人女性对威胁的神经反应的关联。

重要性种族歧视对与健康相关的结果有明显的影响，但人们对歧视性经历与对情绪显着线索的神经反应模式之间的关系知之甚少，这可能是这些结果的中介。目的 研究受创伤的美国黑人女性在从事一项需要注意力的任务时，歧视性经历与全脑对威胁相关线索的反应之间的关联。设计、环境和参与者 从 2014 年 5 月 1 日到 2019 年 7 月 1 日，对 55 名遭受创伤的美国黑人女性进行了一项横断面研究，以检验种族歧视经历与神经反应模式和创伤行为模式之间的关联。情感注意力控制任务中的相关图像。将创伤后应激障碍 (PTSD) 症状和创伤暴露作为协变量输入，以分离与种族歧视经历相关的方差。暴露程度不同的创伤、创伤后应激障碍症状和种族歧视经历。歧视问卷 (EOD)（范围，0-9）的主要结果和措施经验，用于计算每个参与者报告因种族原因受到不公平待遇的情况数量。创伤经历和 PTSD 症状通过创伤事件量表 (TEI)（人遭受创伤的次数；评分范围，0-112）和 PTSD 症状量表（PSS）（评分范围，0-51）进行评估。在执行情感 Stroop（注意力控制）任务期间，通过功能性磁共振成像评估对创伤相关与中性干扰线索的反应。在全脑、体素水平上进行了统计分析，并进行了家庭误差校正。结果 在这项针对美国 55 名黑人女性（平均 [SD] 年龄，37.7 [10.7] 岁；范围，21-61 岁）的研究中，参与者报告的平均 (SD) TEI 频率为 33.0 (18.8)，并表现出中等水平当前 PTSD 症状（平均 [SD] PSS 评分，15.4 [12.9]）。平均 (SD) EOD 评分为 2.35 (2.44)，与当前的 PTSD 症状（PSS 总数：r = 0.36；P=.009）中度相关，但与年龄（r = 0.20；P = .15）或 TEI 频率（ r = -0.02；P = .89）。在关注与创伤相关的图像和中性图像时，更多的种族歧视经历与情绪调节和恐惧抑制（腹内侧前额叶皮层）和视觉注意（枕中皮层）网络的反应显着相关，即使在考虑了创伤和 PTSD 症状的严重程度（全脑家庭错误更正；对于腹内侧前额叶皮层，r = 0.33；P = .02）。种族歧视也与情感 Stroop 任务表现有关；与威胁相关的刺激试验的错误与种族歧视的经历呈负相关（r = -0.41；P = .003）。结论和相关性 这些研究结果表明，种族歧视的经历与与情绪调节、恐惧抑制和视觉注意力相关的大脑区域的反应不成比例地增加有关。黑人经常遭受的种族主义可能会增强对与创伤相关的压力源的注意力和监管反应，并导致监管资源的高度调节。这可能代表了与种族相关的健康差异的重要神经生物学途径。