Dissertation Title: An Examination of the Effects of Individual and Environmental Factors on Mental Health and Alcohol Use Outcomes among Black College Students 

Student Concentration: Health Promotion and Behavior

Dissertation Chair: Dr. Amanda Gilmore

Dissertation Abstract: 

Introduction: Black college students face significant disparities in mental health and substance use, with racial and ethnic differences observed in mental health care utilization, alcohol-related consequences, and PTSD symptoms. While much research has explored experiences with racism as a primary explanation of these disparities, the multilevel and multidimensional nature of these experiences have received less attention. Furthermore, there is a need to uncover and understand differences within Black college student populations as Black students are not a monolithic group and may experience varying outcomes influenced by distinct factors. Examining the influence of various campus environments (e.g., predominantly White institutions) may provide deeper insights into the drivers of these disproportionate outcomes.

Methods: To investigate the effect of individual and environmental factors on alcohol use and mental health outcomes among Black college students, the following three studies were conducted: 1) a secondary data analysis on the associations between multiple dimensions of barriers and help-seeking intentions as well as the moderating role of racial discrimination 2) a hierarchical regression analysis to determine the impact of racial discrimination, racism-related stress, and trauma exposure on alcohol use and posttraumatic stress symptoms and examine the unique variance contributed by institution type over and beyond the foregoing factors, and 3) a multilevel analysis exploring the impact of individual (e.g., racial climate, sense of belonging) and institutional level factors (i.e., institution type, number of Black counselors) on alcohol use and posttraumatic stress symptoms.

Results: The secondary data analysis showed that negative perceptions of counseling and discomfort with emotions significantly predicted lower intentions to seek mental health help among Black college students. Discrimination was not found to significantly moderate the relationship between barriers and intentions. Hierarchical regression analyses showed that racial discrimination, trauma exposure, and sexual minority status predicted higher PTSD symptom severity, while trauma exposure and Greek membership were linked to greater alcohol use. Institution type did not significantly impact PTSD or alcohol use, but differences in experiences with racism and alcohol behavior were observed across institution types. Results from the multilevel analysis showed significant individual level predictors of outcomes. Higher racism-related stress and trauma exposure were linked to greater PTSD symptom severity, while positive racial climate perceptions were associated with lower severity. Greek membership and trauma exposure predicted higher alcohol use, and students with positive university perceptions or peer belonging were more likely to report drinking.

Conclusions: Continued examination of within group differences among Black college students exposed to different institutional environments may offer a better understanding of the factors influencing mental health and alcohol use outcomes as these findings highlight a complex interplay of individual and institutional factors. Public health efforts by colleges and universities are needed and should prioritize addressing and preventing experiences of racism and related harms on campus. Intervention programming that integrates the management of posttraumatic stress symptoms and prevention of risky drinking behaviors may more adequately address the health needs of Black college students.