Sierra Carter

Georgia State University | GSU · Department of Psychology

Objective: This study examined the role of depressive symptoms in mediating the relationship between early life experiences of racial discrimination and accelerated aging in adulthood for African Americans (i.e., prediction over a 19-year period, from ages 10 to 29) after adjusting for gender and health behaviors. Method: Longitudinal self-report d...

The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) initiative aims to understand the mechanisms influencing psychopathology through a dimensional approach. Limited research thus far has considered potential racial/ethnic differences in RDoC constructs that are influenced by developmental and contextual processes. A growi...

Black women in the United States (U.S.) are faced with unrelenting chronic stressors that are often driven by racism and oppression to influence mental health inequities. Similar to common U.S. societal views of Black women, ideological values about Black women’s lives also permeate psychiatry and neuroscience research to prevent likely impactful r...

Objective: The association between childhood adversity and adulthood health is well established, but few studies have examined potential effects of childhood adversity on partner health in couples. This study examined the long-term health impact of childhood adversity on individuals as well as their significant others. Method: The participants were...

In the current study, we investigated the emergence of racial-identity latent profiles and the potential for racial-identity profiles to moderate the relationship between race-related stress and trauma symptoms in nontreatment-seeking, trauma-exposed, Black American women ( N = 222). Racial-identity profiles emerged from latent profile analyses and...

In recent years, researchers and policymakers have called attention to the importance of child and adolescent trauma for understanding adult health status. The primary aim of this study is to describe the adverse childhood events reported in a sample of runaway and homeless youths and examine their impact on these youths’ current health status. We...

Objective: This study examined whether a responsive parenting (RP) intervention for first-time Black mothers had secondary benefits for their mental health by reducing their postpartum depressive symptoms. Method: In total, 212 first-time Black mothers participated in the Sleep Strong African American Families randomized control trial. Mothers w...

Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, post-traumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in...

Previous research has found that both racism and sexual assault are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. Black women have unique relationships to these stressors situated within contexts of oppression, and little is known about factors that may exacerbate these associations among Black women. Among Black women...

Black Americans have demonstrated significant resilience in the face of stress caused by systemic oppression. This resilience is likely to stem from several factors across socioecological levels, including those internal to the individual (assets) and those external to the individual (resources), but existing work has yet to consider these within a...

Background Access to evidence-based interventions is urgently required, especially for individuals of minoritized identities who experience unique barriers to mental health care. Digital mental health interventions have the potential to increase accessibility. Previous pilot studies testing HabitWorks, a smartphone app providing an interpretation b...

Objective: To estimate the effect of geographic variation in historic slavery on perinatal outcomes [chronic hypertension, hypertensive disorders of pregnancy (HDP), very preterm birth (VPTB), or very low birth weight birth (VLBW)] among Black people living in states where slavery was legal in 1860 and test mediation by Black homeownership. Methods...

Importance Racial discrimination is a psychosocial stressor associated with youths’ risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US. Objective To investigate the association between racial discrimination and risk for psychopathology moderated by neuroaffective pr...

Importance Racial discrimination increases the risk of adverse brain health outcomes, potentially via neuroplastic changes in emotion processing networks. The involvement of deep brain regions (brainstem and midbrain) in these responses is unknown. Potential associations of racial discrimination with alterations in deep brain functional connectivit...

The shortage of clinical workforce presents significant challenges in mental healthcare, limiting access to formal diagnostics and services. We aim to tackle this shortage by integrating a customized large language model (LLM) into the workflow, thus promoting equity in mental healthcare for the general population. Although LLMs have showcased thei...

OBJECTIVES/GOALS: Low birth weight and preterm birth are significant contributors to infant mortality in the United States that disproportionally impact Black pregnant persons and their offspring. Although these outcomes are linked to chronic stress, the contribution of race-related stress remains largely understudied. METHODS/STUDY POPULATION: We...

Objective: To characterize the association between percent of county-level elected officials who were female-presenting and perinatal outcomes in Georgia and variation by individual race, 2020–2021. Materials and Methods: We gathered data on the gender composition of county-level elected officials for all Georgia counties (n = 159) in 2022 and calc...

Mindfulness-based cognitive therapy (MBCT) offers promise as a group-based intervention to alleviate posttraumatic stress disorder (PTSD) and depression symptoms in traumatized Black adults. Given the high level of barriers that exist for low-income Black adults, virtual delivery of MBCT may be helpful. This pilot randomized controlled trial assess...

Background Mood disorders such as major depressive and bipolar disorders, along with posttraumatic stress disorder (PTSD), schizophrenia (SCZ), and other psychotic disorders, constitute serious mental illnesses (SMI) and often lead to inpatient psychiatric care for adults. Risk factors associated with increased hospitalization rate in SMI (H-SMI) a...

This cohort study assesses the level of opioid use, number of vaso-occlusive crises, and days’ supply of opioids among opioid-naive pediatric patients.

From its inception, development and psychopathology theorists have sought to uncover the earliest forms of risk for mental health challenges in children, to prevent the development of more severe, intractable manifestations of psychopathology. Large familial risk registries have advanced our understanding of early, potentially modifiable factors th...

BACKGROUND Access to evidence-based interventions is urgently required, especially for individuals of minoritized identities who experience unique barriers to mental health care. Digital mental health interventions have the potential to increase accessibility. Previous pilot studies testing HabitWorks, a smartphone app providing an interpretation b...

Background: Race-related stress negatively impacts the mental health of Black Americans to a greater degree than other racialized groups. Additionally, trauma exposure is associated with more severe levels of posttraumatic stress disorder for individuals who also experience race-related stress. Therefore, an accurate assessment of race-related stre...

Objective People living with HIV (PLWH) experience high rates of childhood maltreatment, which increases risk for posttraumatic stress disorder (PTSD). Thus, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology. Methods The current study assessed wheth...

Objectives Black older adults have a higher vascular burden compared to non‐Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden w...

Objective brain white matter integrity as a result of vascular burden is associated with a form of late-life depression, known as vascular depression (VaDep). Black older adults may be particularly vulnerable to developing VaDep due to a higher prevalence of vascular conditions compared to White older adults. The current study examined whether clin...

Although offspring of women exposed to childhood trauma exhibit elevated rates of psychopathology, many children demonstrate resilience to these intergenerational impacts. Among the variety of factors that likely contribute to resilience, epigenetic processes have been suggested to play an important role. The current study used a prospective design...

Prior research has shown that racial discrimination (RD) impacts activation in threat network regions, including the ventromedial prefrontal cortex (vmPFC) and middle occipital cortex during attention to threat-relevant stimuli. However, little is known about the biological mechanisms that may modulate these effects; inflammation may be a pathway l...

Purpose: Our goal was to estimate differences in perinatal outcomes by racial differences in political representation, a measure of structural racism. Methods: We gathered data on the racial composition of county-level elected officials for all counties in Georgia (n=159) in 2022. We subtracted the percent of non-white elected officials from the...

The present study investigated differences in perceptions of psychedelic-assisted therapy between Black and White Americans, as well as factors that may influence these perceptions. A final sample of 294 adults (42% female, 44% Black/African American or Mixed Race (of Black/African ancestry), 56% White American; Mage = 36.3 years) completed an onli...

This article serves as an introduction to the special section in the Journal of Traumatic Stress related to the 38th annual meeting of the International Society for Traumatic Stress Studies, held in Atlanta, Georgia (USA) in November 2022. The theme of this meeting, "Trauma as a Transdiagnostic Risk Factor Across the Lifespan," provided an opportun...

Experiencing racism is linked to lower subjective social status (SSS), defined as one's perception of their position in society. SSS is influenced by power, prestige, and objective socioeconomic status (SES). Previous findings suggest that race-related stress may be related to adverse mental health outcomes through SSS in Black Americans, a populat...

This study examines whether shift-and-persist coping, a coping strategy defined by accepting challenges and remaining hopeful for the future, is associated with psychosocial and physical health and/or moderates the effects of contextual stress (i.e., racial discrimination, financial strain) on health among African American adolescents living in the...

Objective: Racism is a multifaceted system of oppression that disproportionately harms Black mothers and children across the lifespan. Despite reliable evidence that racism is associated with worse mental health outcomes (eg, increased depressive symptoms), less is known about potentially intergenerational effects of Black mothers' experiences of...

Centuries of systemic racism in the United States have led to Black Americans facing a disproportionate amount of life stressors. These stressors can have negative effects on mental and physical health, contributing to inequities throughout the life span. In the current study, we used longitudinal data from 692 Black adults in the rural South to ex...

Black Americans living in urban environments are disproportionately impacted by posttraumatic stress disorder (PTSD). Both racial discrimination and neighborhood poverty are factors that contribute to this health disparity. However, studies focused on the intersection of these two oppressive systems on PTSD symptoms are lacking. To address this gap...

The COVID-19 pandemic resulted in substantial hardship for Black Americans, leading to increased stress and mental health difficulties. We used longitudinal data from the Protecting Strong African American Families (ProSAAF) intervention study to test the hypothesis that improved couple functioning following ProSAAF participation would serve as a c...

Introduction: Posttraumatic stress disorder (PTSD) and depression are common in service members and veterans, and the response to currently available treatments is often modest at best. Recent studies suggest potential benefit with psychedelic-assisted therapies (PATs), particularly 3,4-methylenedioxymethamphetamine-assisted therapy for PTSD and ps...

Considerable racial/ethnic disparities persist in exposure to life stressors and socioeconomic resources that can directly affect threat neurocircuitry, particularly the amygdala, that partially mediates susceptibility to adverse posttraumatic outcomes. Limited work to date, however, has investigated potential racial/ethnic variability in amygdala...

Introduction Posttraumatic stress disorder (PTSD) and depression are common in service members and veterans, and the response to currently available treatments is often modest at best. Recent studies suggest potential benefit with psychedelic-assisted therapies (PATs), particularly 3,4-methylenedioxymethamphetamine-assisted therapy for PTSD and psi...

Objective: There is support for the use of mindfulness-based approaches with trauma-exposed adults. However, limited data are available on feasibility and acceptability of group-based mindfulness interventions in urban medical clinics serving primarily Black adults with low socioeconomic resources, where rates of trauma exposure are high. The prese...

In a sample of 685 late middle-aged Black adults (M age at 2019 = 57.17 years), we examined the effects of loneliness and per capita income on accelerated aging using a newly developed DNA-methylation based index: the DunedinPACE. First, using linear, mixed effects regression in a growth curve framework, we found that change in DunedinPACE was depe...

Early experiences of school disengagement may serve as a warning sign for later young adult adjustment difficulties and eventually contribute to accelerated aging among Black American youth. At the same time, supportive parenting may play a protective role. Using longitudinal data from the Family and Community Health Study (FACHS), we examined psyc...

Experiences of racial discrimination are common among Black youth and predict worse mental health cross-sectionally and over time. Additional research is needed to address lingering questions regarding the direction of effect(s) underlying these patterns, differences in the magnitude of effects across adolescence, and gender differences. To address...

Racial discrimination (RD) has been consistently linked to adverse brain health outcomes. These may be due in part to RD effects on neural networks involved with threat appraisal and regulation; RD has been linked to altered activity in the rostral anterior cingulate cortex (rACC) and structural decrements in the anterior cingulum bundle and hippoc...

The current study examined concurrent and longitudinal associations between experiences of racial discrimination and private regard (i.e., feelings about being Black and other Black people) among 346 Black early adolescents who completed four assessments over two years. Between-person (interpersonal) and within-person (intrapersonal) effects were t...

Neuropsychiatry is beginning to reevaluate current research approaches in the wake of contemporary events of racialized violence against Black and other minoritized individuals. Although researchers, clinicians, and leaders have proposed reactionary personal and institutional commitments for change, many have done so without thoughtful consideratio...

Physical activity has well-known benefits for older adults' mood and cognitive functioning; however, it is not clear whether risk factors for cardiovascular disease (CVD) affect the relationships of physical activity with these health outcomes among diverse older adults. This study investigated the impact of CVD risk burden on the relationships amo...

Background Racial discrimination is consistently associated with adverse health outcomes and has been linked to structural decrements in brain white matter. However, it is unclear whether discrimination-related neuroplastic changes could indirectly affect health outcomes. Our goal was to evaluate racial discrimination’s indirect associations on hea...

Black Americans are more likely to be exposed to certain types of traumatic events and experience posttraumatic stress disorder (PTSD) compared to other racial groups. Consequently, sound assessment of PTSD in this underserved and understudied population is necessary to develop and accurately answer research questions about etiology and interventio...

We expand upon prior work (Gibbons et al., 2012) relating childhood stressor effects, particularly harsh childhood environments, to risky behavior and ultimately physical health by adding longer-term outcomes – deoxyribonucleic acid (DNA) methylation-based measures of accelerated aging (DNA m -aging). Further, following work on the effects of early...

The current study investigated the relationship between trauma exposure and psychopathology in a sample of predominately African-American women of low socioeconomic status (SES). Women (N = 7430) were recruited from medical clinics at two large public hospitals in Atlanta, GA, from 2005 to 2017. Women were assessed for sociodemographics, life-cours...

Black Americans have been disproportionately affected by the COVID-19 pandemic. To better understand changes in and predictors of their mental and physical health, in the current study, we used three waves of data (two prepandemic and a third during summer 2020) from 329 Black men and women in the rural South. Results indicated that health worsened...

Black adults in the rural South experience elevated financial strain and other contextual stressors, increasing their risk for poor health. Supportive relationships, particularly positive romantic relationships, have been shown to offset these risks. The present study aims to provide experimental evidence of the buffering effect of supportive relat...

Background . Methylation of FKBP5 is involved in the regulation of the stress response and is influenced by early stress exposure. Two CpG sites, cg20813374 and cg00130530, have been identified as potential reporters of early stress. We examined whether FKBP5 methylation was associated with accelerated DNA methylation aging and indirectly predicted...

Objective: Race-related lifetime stress exposure (LSE) including racial discrimination, trauma, and stressful life events have been shown to contribute to racial health disparities. However, little is known about associations between race-related stressors and premature biological aging that confer the risk of adverse health outcomes. Even less is...

Background Exposure to traumatic events is a risk factor for negative physical and mental health outcomes. However, the underlying biological mechanisms that perpetuate these lasting effects are not known. Methods We investigated the impact and timing of sexual trauma, a specific type of interpersonal violence, experienced during key developmental...

Background Experiences of racial discrimination are linked to a range of negative brain health outcomes, but little is known about how these experiences impact neural architecture, including white matter microstructure, which may partially mediate these outcomes. Our goal was to examine associations between racially discriminatory experiences and w...

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-re...

There is growing evidence that general coping plays a role in the degree to which racial discrimination is associated with mental health symptoms (e.g., posttraumatic stress, depressive symptoms) for people of color. Relatively less is known about the role that race-based coping may play in the associations between racial discrimination and mental...

Reduced heart rate variability (HRV) in response to stress is a biomarker of emotion dysregulation (ED) and is related to posttraumatic stress disorder (PTSD), yet less is known about its role with dissociation in trauma-exposed adults. The goals of the current study were to examine unique patterns of associations between ED, dissociation, and PTSD...

Objective Sickle cell disease (SCD) is a group of inherited blood disorders. The central feature of this chronic condition is pain. Several identified risk factors exacerbate the impact of pain on quality of life (QOL) in SCD; however, there are relatively fewer investigations of strengths-based resilience variables that might buffer the influence...

Objective Black youth experience racial discrimination at high rates. This study sought to further understand the longitudinal effects of racial discrimination on their mental health by examining cross-lagged associations between perceived racial discrimination and depressive symptoms at the between-person (interindividual) level and the within-per...

Background: Sexual assault (SA) is common, but Black individuals might be at higher risk of SA and negative health sequalae. Racial differences in SA characteristics and health care utilization after SA are largely unknown. Materials and Methods: We reviewed medical records of 690 individuals (23.9% Black; 93.6% women) who received a SA medical fo...

The adverse impact of racial discrimination on youth, and particularly its impact on the development of depressive symptoms, has prompted attention regarding the potential for family processes to protect youth from these erosive effects. Evidence from non-experimental studies indicates that protective parenting behavior (PPB) which occurs naturally...

Despite a consistent body of work documenting associations between racial discrimination and negative mental health outcomes, the utility and validity of these findings have recently been questioned because some authors have posited that personality traits may account for these associations. To test this hypothesis in a community sample of African...

This study examines mental health symptoms among Black adolescents who were currently in mental health treatment and those who were not in treatment. The study uses a sample of Black adolescents (N= 154) and logistic regression was performed to determine which psychological factors were associated with exhibiting mental health symptoms. Both groups...

People of color in the United States disproportionately bear the burden of trauma and posttraumatic stress disorder (PTSD). Pregnant women of color are at particular risk, as perinatal PTSD is associated with adverse maternal and child health. However, PTSD is a heterogeneous disorder comprising discrete symptom dimensions. Adopting a dimensional u...

Adverse childhood experiences (ACEs) disproportionately impact African Americans because of profound subjection to historical-systemic oppression in addition to personal and intergenerational trauma exposure. This article utilizes a biopsychosocial-cultural framework to understand the correlates of ACE exposure in African Americans and attends to t...

There is evidence that the more frequent, severe, and chronic posttraumatic stress disorder (PTSD) symptomatology experienced by Black compared to White individuals cannot be explained by disparities in socioeconomic status or trauma exposure. One factor that may be important to consider is racial discrimination, which is associated with numerous n...

Posttraumatic stress disorder (PTSD) has a specified precipitant (i.e., trauma), and thus, is particularly well-suited to examine risk and maintenance factors for the development of the disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) alternative model of personality disorder (AMPD) is based, in part, on a...

Background: African Americans experience more severe and chronic posttraumatic stress disorder (PTSD) symptoms compared to other racial groups, and thus it is important to examine factors that are relevant for the aetiology of PTSD in this population. Although racial discrimination has been implicated as an exacerbating factor in the development an...

Objective To determine the influence of maternal trauma and posttraumatic stress disorder (PTSD) symptoms on children’s physiological response to threat and safety signals during a fear conditioning task in trauma-exposed mothers and children. Method Participants were African American mother-child dyads (N = 137; children aged 8-13 years). Mothers...