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Correlates of Discrimination and Vigilance Severity Profiles in a National United States Sample
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Journal of Medical Education and Curricular Development
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2025-11-10
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Background: There are long-standing disparities in discrimination and hypervigilance, however there is no research exploring correlates of different severity profiles using a national U.S. sample. We identified patterns in discrimination and vigilance, and examined sociodemographic, health, and geographic factors associated with severity. Methods: Data was retrieved from 28,202 individuals in the 2023 National Health Interview Survey, a nationally representative U.S. sample of adults aged 18+. Respondents completed the Everyday Discrimination Scale and Heightened Vigilance Scale, and a latent class analysis (LCA) identified severity subgroups. Weighted multinomial logistic regression analyzed sociodemographic, health, and geographic variables associated with discrimination-vigilance severity. Results: Three discrimination-vigilance severity latent classes emerged: low (45.6 %), moderate (39.8 %), and high (14.7 %). High severity was significantly associated with Black (Relative Risk Ratio [RRR] = 3.62, 95 % CI = 3.07–4.27) and Asian (RRR = 1.25, 95 % CI = 1.04–1.51) racial groups, female (RRR = 1.14, 95 % CI = 1.03–1.26), higher education such as graduate degree (RRR = 2.48, 95 % CI = 1.92–3.20), U.S. citizenship (RRR = 1.75, 95 % CI = 1.39–2.22), employed (RRR = 1.64, 95 % CI = 1.39–2.22), sexual minoritized groups such as bisexual orientation (RRR = 3.95, 95 % CI = 2.91–5.37), poor health (RRR = 2.14, 95 % CI = 1.54–2.97), disability (RRR = 1.22, 95 % CI = 1.02–1.46), depression (RRR = 3.11, 95 % CI = 2.53–3.84), anxiety (RRR = 4.07, 95 % CI = 3.39–4.87), and West region (RRR = 1.45, 95 % CI = 1.17–1.78). Conclusions: We identified discrimination-vigilance severity subgroups, with numerous sociodemographic, health, and geographic factors linked to high severity. These results may identify high-risk individuals and guide clinical practice given the influence of discrimination and vigilance on psychological distress and mental health disorders.
Citation
Wong, R. & Irfan, O. Correlates of discrimination and vigilance severity profiles in a national United States sample. Journal of Affective Disorders, 2025. https://doi.org/10.1016/j.jad.2025.120647
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