Objective

To examine whether anti-Black cultural racism moderates the efficacy of psychotherapy interventions among youth.

Method

A subset of studies from a previous meta-analysis of 5 decades of youth psychotherapy randomized controlled trials was analyzed. Studies were published in English between 1963 and 2017 and identified through a systematic search. The 194 studies (N = 14,081 participants; age range, 2-19) across 34 states comprised 2,678 effect sizes (ESs) measuring mental health problems (eg, depression) targeted by interventions. Anti-Black cultural racism was operationalized using a composite index of 31 items measuring explicit racial attitudes (obtained from publicly available sources, eg, General Social Survey) aggregated to the state level and linked to the meta-analytic database. Analyses were conducted with samples of majority-Black (ie, ≥50% Black) (n = 36 studies) and majority-White (n = 158 studies) youth.

Results

Two-level random-effects meta-regression analyses indicated that higher anti-Black cultural racism was associated with lower ESs for studies with majority-Black youth (β = −0.2, 95% CI [−0.35, −0.04], p = .02) but was unrelated to ESs for studies with majority-White youth (β = 0.0004, 95% CI [−0.03, 0.03], p = .98), controlling for relevant area-level covariates. In studies with majority-Black youth, mean ESs were significantly lower in states with the highest anti-Black cultural racism (>1 SD above the mean; Hedges’ g = 0.19) compared with states with the lowest racism (<1 SD below the mean; Hedges’ g = 0.60).

Conclusion

Psychotherapies tested with samples of majority-Black youth were significantly less effective in states with higher (vs lower) levels of anti-Black cultural racism, suggesting that anti-Black cultural racism may be one contextual moderator of treatment effect heterogeneity.

中文翻译：

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荟萃分析：在反黑人种族主义水平较高的社区中，心理疗法对黑人青年的效果是否较差？

客观的

检验反黑人文化种族主义是否会影响青少年心理治疗干预的效果。

方法

分析了先前对 5 年青年心理治疗随机对照试验进行的荟萃分析的一部分研究。研究在 1963 年至 2017 年间以英文发表，并通过系统搜索进行了识别。跨越 34 个州的 194 项研究（N = 14,081 名参与者；年龄范围，2-19 岁）包含 2,678 个效应值 (ES)，用于测量干预措施针对的心理健康问题（例如，抑郁症）。反黑人文化种族主义是使用一个包含 31 个项目的综合指数来实施的，该指数衡量明确的种族态度（从公开来源获得，例如综合社会调查），这些项目汇总到州一级并链接到元分析数据库。对多数黑人（即≥50% 黑人）（n = 36 项研究）和多数白人（n = 158 项研究）青年样本进行了分析。

结果

两级随机效应元回归分析表明，在以黑人为主的青年研究中，较高的反黑人文化种族主义与较低的 ES 相关（β = −0.2, 95% CI [−0.35, −0.04]，p =  . 02)，但与以白人为主的青年研究的 ESs 无关 (β = 0.0004, 95% CI [−0.03, 0.03], p  = .98)，控制相关区域级协变量。 在对黑人青年占多数的研究中，与种族主义最低的州（低于平均值<1 标准差）相比，反黑人文化种族主义最高的州（高于平均值 > 1 标准差；Hedges' g = 0.19）的平均 ES 明显较低均值；对冲的g  = 0.60）。

结论

在反黑人文化种族主义水平较高（相对于较低）的州，用多数黑人青年样本测试的心理治疗效果明显较差，这表明反黑人文化种族主义可能是治疗效果异质性的一种情境调节剂。