Abstract Introduction We define vigilance as an extreme state of awareness of a prospective threat, often associated with visible identities such as race and gender. Chronic vigilance has been shown to elevate stress and impair sleep quality in adults; however, the impact of vigilance on youth mental and physical health remains understudied. This project examined how vigilance, as a measure of limited empowerment, impacts adolescent mental health symptoms and sleep difficulties. We aimed to characterize distinct aspects of adolescent mental health, such as internalizing (e.g., sadness), externalizing (e.g., anger, irritability) symptoms, and attentional difficulties. We also examine the physiological components of high self-reported vigilance through altered circadian rhythms and insomnia. Methods Participants are adolescents (n=52) ages 12 to 18 years (M=13.64, SD=1.08), recruited from child and adolescent mental health hospitals and community-based settings in the Northeast. Participants and their caregivers completed a series of mental health surveys, including the Youth Pediatric Symptom Checklist (YPSC), the Racism-Related Vigilance Scale (RRVS), the Insomnia Severity Index (ISI), and the PROMIS Sleep Disturbance measure. Results A series of linear regressions showed that higher vigilance was associated with greater overall mental health symptoms (β=0.73, SE=0.16, p 0.001), including greater internalizing (β = 0.35, SE=0.07, p 0.001) and attention problems (β=0.27, SE=0.07, p 0.001), but not externalizing problems (p0.05). Participants with higher vigilance also showed higher levels of sleep problems (β=0.73, SE=0.31, p=0.02) and insomnia (β=0.54, SE=0.19, p=0.01). Conclusion These findings can expand our understanding of how social and structural factors may shape developmental trajectories in adolescent populations by impacting core mental and physical health. These implications of our findings may inform clinical practice for prevailing issues facing youth and contribute to improved approaches to mitigating sleep disturbance patterns. Support (if any) NIMH Career Development (K23MH122587); Bradley Hospital COBRE Center (P20GM139743).
Recel-Chang et al. (2026) studied this question.