Life Stress Pathways and Resilience to Substance Misuse in Black and White Youth

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Exposure to life stressors across development is known to increase the likelihood of adolescent substance misuse, but the few available comparisons of Black and White youth have revealed a paradox. Whereas Black youth are more likely than White youth to experience stressors in the form of socioeconomic disadvantage, traumatic events, and discrimination, often within a context of structural racism, studies show they have lower rates of nearly all types of substance misuse. This paradox could have health consequences, for example, by contributing to stigma among Black individuals who do struggle with substance misuse, because the adverse consequences of substance misuse, once initiated, are more severe for Blacks than Whites. However, significant gaps in knowledge exist and will be addressed in the proposed study. Little is known about how the different types, timing, and trajectories of stress exposures, including those associated with the ongoing COVID-19 pandemic, may differentially predict substance misuse for Black and White youth (Aim 1), and potentially through different mediating mechanisms (Aim 2), including parenting, neurocognitive functioning, and psychopathology. Also, it is important to understand the resilience-promoting protective factors that may be stronger buffers against stressor-related risk for substance misuse for Blacks than Whites (Aim 3). This application proposes to extend the ongoing CANDLE (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) study. CANDLE is a longitudinal cohort study involving 1,136 women recruited from 2006-2011 in Shelby County/Memphis, TN during their second trimesters of pregnancy, and has followed them and their children upon birth throughout childhood. The sample is 60% Black and 34% White, with the small balance reflecting other racial/ethnic minority groups. Extensive multi-method data have been collected during the prenatal period and through childhood up to age 8 years. A clinic visit with dyads at child age 10 is nearing completion and another funded clinic visit at age 12 is underway. The proposed research will collect new data in adolescence at ages 14, 15, and 16 years to examine life stressors in relation to the onset and progression of substance misuse for Black compared to White youth, with tests of differences as well as similarities in mediating pathways and resilience factors. Sex differences also will be explored. A local advisory board of Black community members and advocates has already been formed and will help guide this study. Guided by the minority stress model and stress-coping theories of addiction, the central hypotheses are that, despite a Black-White paradox, different patterns of life stress exposures will predict substance misuse for both Black and White youth, operating through selected group-specific mediating mechanisms; based on resiliency theory, Black youth also are expected to display certain unique patterns of resilience against substance misuse. CANDLE is one-of-a-kind, and the current aims hold promise for informing tailored preventive efforts.