Beyond discrimination: A systematic review of empirical studies assessing racial trauma and race-based traumatic stress.

OBJECTIVE: Racial trauma has emerged as a significant public health and clinical concern, yet empirical conclusions have been limited by heterogeneous measurement approaches and inconsistent methodological rigor. This systematic review synthesizes empirical studies that explicitly assessed racial trauma or race-based traumatic stress using validated, trauma-specific instruments to clarify symptom expression, mechanisms, contextual influences, and implications for clinical practice. METHOD: A comprehensive search was conducted across four databases, and studies were included if they used a validated racial trauma or race-based traumatic stress-specific measure or involved psychometric validation of such instruments. Dual screening and independent coding were employed. Methodological quality was evaluated using Consensus-Based Standards for the Selection of Health Measurement Instruments for psychometric studies and Appraisal Tool for Cross-Sectional Studies for cross-sectional research. Forty-four studies met the inclusion criteria. Racial trauma measures demonstrated strong reliability, structural validity, and criterion validity, although few studies assessed measurement invariance across racial and ethnic groups. RESULTS: Findings highlight the structural validity of existing instruments and clarify how racial trauma diverges from traditional posttraumatic stress disorder frameworks. Racial trauma was consistently associated with negative cognitions, somatic distress, and pervasive negative affect. Symptom expression was influenced by varying intersecting identities and institutional contexts, leading to comorbidities including risky substance use. Interventions emphasizing collective resilience, culturally grounded coping, and psychedelic-assisted therapy show preliminary promise. CONLUSION: This review consolidates the empirical evidence for racial trauma as a distinct, measurable construct that operates independently of generalized psychopathology. It highlights the need for systemic reform and prioritizes integrating validated measures into clinical practice to foster culturally responsive care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).