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Diversity Science Spotlight

SoAP Box: 
Diversity Science Spotlight

Fall 2022

Delisa Brown, PhD

What stage are you in your career, and what is your current affiliation?
I am a Research Assistant Professor in the Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, at the Medical University of South Carolina.

How would you describe your research interests?
My research interests include health disparities, in particular, racial mental health disparities. Currently, my program of research seeks to develop culturally-tailored treatments for trauma-related disorders co-occurring with substance use disorder, namely alcohol use disorder and opioid use disorder; through the identification of factors that mediate and/or moderate outcomes with a particular emphasis on the impact of race-related stressors (i.e., racial trauma).

How did you become interested in researching racial equity in the research and treatment of addictive behaviors?
As cliché as it may sound, several of family members struggled with addiction, and while we saw the devastation it caused in their lives no one really talked about it; it was the family secret.  We were told to pray for them, and God would make it better.  I am a very spiritual person, but my beliefs tell me that faith without works is dead, so I decided to pray and do something about it. For me that turned into working with people who look like me and struggled with addiction in whatever capacity I could.  As I moved through my masters and Ph.D. programs and learned more about addictive behaviors, it became overwhelmingly apparent to me that many addictive behaviors are a result of trauma. Listening to many of the stories of Black people I realized that some of their trauma was not necessarily defined by criterion A events, but years of experiencing oppression simply because of their skin color.  Not many researchers discussed negative sequala resulting from racial discrimination and other race-related stressors, especially as it related to substance use. Research on trauma has historically focused solely on posttraumatic stress disorder (PTSD), but trauma begets a myriad of comorbid diagnoses which have been understudied and excluded from research investigations until recently. So, treatments that address these issues are non-existent and I wanted to change that narrative. While there has been scientific progress in the development of evidence-based integrated psychotherapies that target PTSD and SUD simultaneously, these treatments are limited in their ability to adapt to the specific needs of marginalized populations (i.e., African Americans), and those with atypical presentations of PTSD and SUD and bring more equity to treatment for these disorders.

Congratulations on your work published in Journal of Ethnicity and Substance Abuse, titled, “Ethnoracial differences in treatment-seeking veterans with substance use disorders and co-occurring PTSD: Presenting characteristics and response to integrated exposure-based treatment.” What do you view as the key takeaways from this work that are important for Division 50 members to know? What are the implications of this work?
Thank you! This paper is one of the many catalysts for my specific interest in culturally-tailored treatment.  As the results demonstrated in this paper, while integrated treatment for co-occurring SUD/PTSD was effective for both African American and White participants, some important racial differences emerged.  I will allow you to read the paper to see what those difference were, but the big takeaway highlighted the misconception of the “one-size fits all” approach to treatment. Yes, race is a socially constructed concept, but the differences that emerge in treatment outcomes when we examine the data by race/ethnicity compels us to learn what might be driving these differences. If we have a better understanding of the needs of diverse patients, specifically marginalized groups with SUD/PTSD and other trauma-related disorders, we are better able to optimize treatment outcomes, increase treatment equity, and decrease mental health disparities. This includes understanding culturally salient variables that can impact symptom severity and utilizing cultural factors that have been identified as strengths and/or protective factors to adapt treatments that will better address the needs of African-Americans and other marginalized groups.

How do you see your research interests evolving in the future?
Currently most of my research highlights ethnoracial differences in symptom severity for trauma/other stress-related and substance use disorders, treatment outcomes, how racial trauma impacts substance use disorders, and identifying what culturally salient coping strategies or mechanisms mitigate symptom severity – to identify factors that can be integrated into evidence-based treatments. As my research continues to evolve, I hope to be able to adapt or develop and test the efficacy of integrated treatments that address both racial trauma and other race related stress and co-occurring substance use disorder for African-Americans. I also want to expand my research to include marginalized intersecting identities (e.g., African-American women) and tailoring treatment for these specific groups.

What would you like to share with someone in the field of addictive behaviors who is interested in examining racial equity in their own work?
I wish I had something inspirational to say, but I don’t.  If you want to do it, like the Nike slogan encourages us all, “Just Do It!” I personally believe that examining racial equity in addictive behaviors should be the standard and not an afterthought anyway, but since we world we live in is such that racial equity must be promoted rather automatically included, make sure you have a good team of mentors and real passion for this work.  The reality is not many researchers engage in racial equity work in any field, so the “how” can sometimes be a mystery. A great team of mentors and collaborators make the work itself less stressful and more meaningful.  To my latter point regarding passion, if you are not passionate about racial equity work, you will quit and do something else very quickly.  Yes, racial equity is the “hot topic” now but that doesn’t negate the fact that it’s a relatively new area of research. Passion will help you push past the journal rejections, unfunded grant applications and the general feeling that no one really cares about your work or the people it impacts for that matter.  Passion will help you press past the frustration of it all and continue moving forward.

What do you think other researchers in the field of addictive behaviors should consider when conducting research with populations who may experience racial discrimination?
Think first about their strengths and protective factors. Too often has health disparities work focused on what is wrong.  I understand why that is; there is a so much wrong that has yet to be discussed, but people who have experienced racial discrimination, especially those who live with addiction(s), are stigmatized enough. Engaging in racial equity is not only pointing out the problems but understanding the strengths and protective factors among marginalized groups; it’s important to understand both.  When doing racial equity work that specifically focuses on racial discrimination, I would also encourage researchers to remember racial identity is often more than one’s skin color.  Often the questions we ask about racial discrimination are deeper than what happened to this Black or Brown complexion person.  So, make sure your questions are framed in such a way that goes beyond the social construct of race.

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