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Capability for Suicide: Discrimination as a painful and provocative event
Abstract
Objective: Developing the capability to die by suicide, and overcoming one's natural instinct of self-preservation, is thought to occur as a result of habituation to the fear and pain surrounding suicide. However, investigations of suicide capability have yet to examine whether perceived discrimination serves as a painful and provocative
event that contributes to capability for suicide. The purpose of the current study was to examine the association of perceived discrimination and suicide capability for Black and White adults.
Method: The study sample included 173 Black adults (67.6% female; Mage = 23.18, SD = 5.74) and 272 White adults (60.7% female; Mage = 22.80, SD = 5.90). Participants completed a questionnaire battery that included measures of perceived discrimination, depression, and suicide ideation.
Results: Regression analyses revealed for Black adults (but not White adults), perceived discrimination was associated with an increased capability for suicide after accounting for depressive symptomatology, suicide ideation, non-discriminatory painful and provocative events experienced, age, and gender (β = .226, t = 3.154, p = .002).
Conclusions: These findings provide preliminary evidence that perceived discrimination may play a role in suicide capability for Black adults and highlight the importance of considering contextual experiences when examining suicidality in underserved groups.
... Data from Black adults suggest that racial discrimination in general was directly, and indirectly through depressive symptoms, associated with greater suicide ideation (Walker et al., 2014). Furthermore, everyday discrimination among Black adults was associated with increased capability for suicide (i.e., ability to enact increasingly lethal behaviors; Ribeiro & Joiner, 2009) even while controlling for suicide ideation and depressive symptoms (Brooks et al., 2020). Controlling for effects of depression clarifies whether effects are specific to suicide outcomes and are not better accounted for by depressive symptoms. ...
... Our findings demonstrated that everyday discrimination predicted suicide thoughts and behaviors when controlling for social anxiety symptom severity, but that controlling for depressive symptom severity and suspiciousness reduced this relationship to nonsignificance. Results are partially consistent with the prior studies that have found everyday discrimination to be predictive of suicide thoughts, plans, attempts, and capability (e.g., Brooks et al., 2020;Oh et al., 2019). However, it appears that a larger proportion of variance in suicide thoughts and behaviors is accounted for by depressive symptoms. ...
... However, our work builds upon this literature in highlighting the harmful effects of everyday discriminatory events in a sample that may experience multiple forms of stigma, due to their social anxiety diagnoses and diverse identities. Even in studies examining and demonstrating its deleterious effects, everyday discrimination has often been construed as "routine" or "minor" (e.g., Brooks et al., 2020;Oh et al., 2019). Although one instance of everyday discrimination may not markedly impact one's overall well-being, our results suggest that chronic experiences of everyday discrimination might represent a stress sensitization process (e.g., Williams et al., 2018), whereby repeated exposures to everyday discrimination contribute to the likelihood of pathological responses including the development of depressive symptoms and possible risk for suicide thoughts and behaviors. ...
Discrimination predicts psychopathology, including suicide risk. Few studies have examined broad effects of major and everyday discrimination. This study examined whether major and everyday discrimination predicted suicide thoughts and behaviors in a diverse sample of socially anxious adults (N = 295). Exploratory analyses assessed the moderating role of identity and mediating role of depressive symptoms. Everyday discrimination predicted suicide thoughts and behaviors (p = .04). This relationship was reduced to nonsignificance after controlling for depression (p = .16). Identity characteristics did not moderate this relationship (p > .05). Depressive symptoms mediated the relationship between everyday discrimination and suicide thoughts and behaviors (95% CI [.001, .006]). Major events did not predict suicide thoughts and behaviors before or after controlling for depression (p > .12). Findings highlight the relevance of repeated instances of discrimination to suicide risk and relatedly, the importance of comprehensive discrimination assessments in research and clinical practice.
... Clinically, significant differences have been observed on variables assessed by the SSF-IV Core Assessment between gender identity (Bryan et al., 2014;Romanowicz et al., 2013) and racial identity (Brooks et al., 2020), but it is telling that the reasons why hopelessness, for example, may emerge among racial and ethnic minorities may be very distinct. For example, acculturative stress and perceived discrimination demonstrate a significant relationship with hopelessness among racial and ethnic minorities, which in turn explains the relationship between these culturally related stressors and greater SI intensity (Polanco-Roman & Miranda, 2013). ...
... STB are pervasive phenomena that affect individuals from a variety of backgrounds (Brooks et al., 2020;Polanco-Roman & Miranda, 2013). Accordingly, clinical tools that support the treatment thereof should adequately account for and accurately characterize individuals from diverse backgrounds. ...
... Findings suggest that the SSF Core Assessment (i.e., psychological vulnerability for suicide) is a quick-to-administer measure of tracking psychological vulnerability for STB, which equivalently assesses individuals from different backgrounds and relates to a number of important clinical outcomes. What is more, the Core Assessment and SSF-IV more broadly are particularly well-suited to culturally competent suicide risk assessment; as previously noted, hopelessness, stress, and psychological pain may be invariant by race and gender, but the source of said hopelessness, stress, and psychological pain may differ by culture (e.g., racial discrimination, acculturation; Brooks et al., 2020;Polanco-Roman & Miranda, 2013). The Core Assessment permits exploration of these important cultural differences via qualitative response to items and facilitates a connection of these variables as contributing to the phenomenology of STB and may thus appropriately model STB as truly ''complex'' (Huang et al., 2020). ...
The Suicide Status Form-IV (SSF-IV) is the measure used in the Collaborative Assessment and Management of Suicidality (CAMS). The SSF-IV Core Assessment measures various domains of suicide risk. Previous studies established a two-factor solution in small, homogeneous samples; no investigations have assessed measurement invariance. The current investigation sought to replicate previous factor analyses and used measurement invariance to identify differences in the Core Assessment by race and gender. Adults (N = 731) were referred for a CAMS consultation after exhibiting risk for suicide. Confirmatory factor analyses indicated good fit for both one- and two-factor solutions while the two-factor solution is potentially redundant. Configural, metric, and scalar invariance held across race and gender. Ordinal logistic regression models indicated that neither race nor gender significantly moderated the relationship between the Core Assessment total score and clinical outcomes. Findings support a measurement invariant, one-factor solution for the SSF-IV Core Assessment.
... However, suicide can be prevented through the implementation of macro-and micro-level public health strategies aimed at identifying and targeting specific factors that increase or decrease resilience within highrisk populations (Suicide Prevention Resource Center & Rodgers, 2011;The Trevor Project, 2019). Emerging research shows social marginalization increases the risk of SI among emerging adult college students (Brooks et al., 2020); however, a dearth of knowledge surrounds factors that may explain the link between marginalization and SI in college students. Thus, research investigating correlates of SI among emerging adults, particularly those who are marginalized, is an important public health priority. ...
... Various manifestations of prejudice, stigma, and discrimination pervade the fabric of institutions in the United States, creating identity-based challenges for diverse emerging adults across a variety of settings (Brooks et al., 2020;Shepherd et al., 2022). For example, research suggests that heterosexism, cissexism, racism, and sizeism in schools, health care, and everyday life all threaten health and generate health disparities (Cobbinah & Lewis, 2018;Pachankis et al., 2022;Puhl & Heuer, 2010;Puhl et al., 2021). ...
... Although it is well-established that environmental and sociocultural factors reflecting exposure to chronic identity-based stressors experienced by marginalized emerging adults play a critical role in influencing suicide risk Brooks et al., 2020;Fulguniti et al., 2020), the suicide literature does not currently have a clear sense of determinants of suicide risk for multiple marginalized groups. As the emerging adult population in the United States becomes more diverse in terms of sexual, gender, racial/ethnic, This document is copyrighted by the American Psychological Association or one of its allied publishers. ...
Social marginalization increases the risk of suicidal ideation (SI) among individuals with diverse identities, yet research examining the effects of marginalization has focused on one identity. Emerging adulthood is a critical period of identity development and the age group with the highest rates of SI. Considering the challenges of living in potentially heterosexist, cissexist, racist, and sizeist environments, we tested whether possessing multiple marginalized identities was associated with severity of SI through factors proposed in the interpersonal-psychological theory (IPT) and the three-step theory (3ST) of suicide and if mediation paths were moderated by sex. A sample of 265 college students completed a cross-sectional online survey assessing SI and constructs related to IPT and 3ST. The number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index >25 kg/m2, sexual attraction to same sex but identified as heterosexual, and gender-fluid identity. In IPT multiple mediation analyses, possessing more marginalized identities was associated with SI severity through burdensomeness and hopelessness, but not belonging. Indirect paths through burdensomeness and belonging were moderated by sex. For 3ST, possessing more marginalized identities was associated with SI severity through hopelessness and psychological pain, but not social connection or meaning in life. Future research should consider intersecting social identities and test mechanisms by which multiply marginalized college students develop resilience to SI risk factors, such as support within their marginalized groups, to inform suicide assessment and intervention efforts on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
... It is this historical context that also places Native American youth at higher risk of experiencing a host of socioecological stressors, such as poverty and maltreatment (e.g., Bohn, 2003;Brockie et al., 2015;Malcoe et al., 2004). Within this context of varying stressors, a range of critical risk factors, such as impulsivity and acquired capability for suicide, may take hold (e.g., Berger & Sarnyai, 2015;Brooks et al., 2020;Simpson et al., 2012). While some facets of Native peoples' experiences are shared with other minority groups in the U.S.-such as minority stress (Meyer, 2003), racism, prejudice -others are unique -for example, a history of forced relocation by the United States government (Biolsi, 2005) into regions with little economic development (Davis et al., 2016), the forced removal of Native American children from their families and homes into boarding schools (Trafzer et al., 2006), and the criminalization of Native American spiritual practices in the United States until 1978(Native American Rights Fund, 1979. ...
... Critically, painful and provocative events, in addition to dispositional factors and means for self-harm (May & Victor, 2018), increase acquired capability for suicide (e.g., Smith & Cukrowicz, 2010). Relevant to our findings, minority stressors such as discrimination act as painful and provocative events to increase acquired capability, as demonstrated among Black/African American adults (Brooks et al., 2020). Further, adolescents with suicide ideation are more likely to also report engaging in a suicide attempt when demonstrating high levels of acquired capability (Vélez-Grau et al., 2022). ...
Objective:
Native American adolescents are disproportionately burdened by suicidality. Here, we examine patterns of reporting of suicide ideation and suicide attempt among Native American youth compared to those from other ethnoracial backgrounds, as this data is important for grounding commonly subscribed to frameworks of suicide risk (e.g., ideation-to-action).
Method:
Data are from the Youth Risk Behavior Surveillance Survey (N = 54,243; grades 9-12; 51.0% female) and Minnesota Student Survey (N = 335,151; grades 8, 9, 11; 50.7% female). Comparing Native American youth to peers from other ethnoracial backgrounds, we examined two suicide reporting patterns: 1) odds of reporting suicide attempt among those who reported ideation and 2) odds of reporting suicide ideation among those who reported an attempt.
Results:
Across both samples, when reporting suicide ideation, youth from other ethnoracial backgrounds were 20-55% less likely than Native American youth to also report attempt. While few consistent differences were observed between Native American youth and those from other racial minority backgrounds in patterns of co-reporting suicide ideation and attempt across samples, White youth were between 37% and 63% less likely than Native American youth to report a suicide attempt without also reporting ideation.
Conclusions:
The increased odds of engaging in a suicide attempt with or without reporting ideation question the generalizability of widely held frameworks of suicide risk to Native American youth and have important implications for suicide risk monitoring. Future research is needed to illuminate how these behaviors unfold over time and the potential mechanisms of risk for engaging in suicide attempts in this disproportionately burdened group.Abbreviations: YRBSS: Youth Risk Behavior Surveillance Survey; MSS: Minnesota Student Survey.
... Suicide is the third leading cause of death among Black youth ages 15-24 and is on the rise (Brooks et al., 2020). Racial discrimination, a pervasive psychosocial stressor experienced by the vast majority of U.S. Black youth (Pachter et al., 2018), predicts Black youths' capacity for suicide above and beyond non-discriminatory stressors (Brooks et al., 2020). ...
... Suicide is the third leading cause of death among Black youth ages 15-24 and is on the rise (Brooks et al., 2020). Racial discrimination, a pervasive psychosocial stressor experienced by the vast majority of U.S. Black youth (Pachter et al., 2018), predicts Black youths' capacity for suicide above and beyond non-discriminatory stressors (Brooks et al., 2020). It is increasingly urgent to understand the underlying mechanisms by which discrimination deteriorates mental health. ...
Understanding the underlying mechanisms by which racism degrades mental health and the factors that disrupt these mechanisms is paramount. Black adolescents (Mage = 15.5) and their mothers (Mage = 44) were observed discussing a hypothetical discriminatory situation and surveyed about their discriminatory experiences (N = 110). Results indicated that adolescents’ submissive emotional reactivity (e.g., sadness, embarrassment) in direct response to discrimination, rather than dominant reactivity (e.g., anger, frustration), was the primary mechanism explaining the link between discrimination and internalizing and externalizing symptoms. Maternal advocacy combined with high levels of dyadic warmth and emotion expression reduced girls’ submissive reactivity, whereas a more directive “no-nonsense” advocacy approach reduced boys’ submissive reactivity. Findings demonstrate how racial socialization can disrupt the pain of discrimination.
... Por ejemplo, si la sociedad mantiene estigmas en torno a la conducta suicida, las personas con ideación pueden verse aisladas o reacias a buscar ayuda (van der Burgt et al., 2021). Asimismo, un intento de suicidio puede generar vergüenza o discriminación no solo hacia el afectado, sino también hacia su círculo cercano (Evans y Abrahamson, 2020;Brooks et al., 2020). ...
Resumen El suicidio se ha establecido como la principal causa de muerte en las prisiones españolas. Este estudio tiene como objetivo comparar la incidencia de suicidio en la población penitenciaria española con la población general, analizando las diferencias según sexo, edad y situación procesal (penados vs. preventivos) a lo largo de un periodo de 20 años. Para realizar el análisis comparativo entre la población penitenciaria y la no penitenciaria, fue necesario agrupar los datos en cinco rangos de edad (18-25, 26-30, 31-40, 41-60 y mayores de 60 años). Esta categorización obedece a la forma en que las distintas fuentes oficiales presentaron la información, lo que derivó en discrepancias con respecto a los desgloses habituales de la población española. Concretamente, en los registros de suicidios no penitenciarios, los grupos de edad abarcan rangos que van desde 15 a 24, 25 a 29, 30 a 39, etc. Los resultados revelan que la población penitenciaria presenta un riesgo significativamente mayor de suicidio en comparación con la población general, con un incremento más pronunciado en mujeres. Además, los hombres en situación de prisión preventiva muestran un riesgo mayor de suicidio frente a aquellos que ya están cumpliendo condena. Las implicaciones de este estudio destacan la necesidad de fortalecer las políticas de prevención del suicidio en el ámbito penitenciario, adaptando las intervenciones a las particularidades de género, edad y situación procesal.
... This finding highlights that Hispanic/Latinx university students may possibly be at a higher risk of suicidal ideation and suicide behavior when compared to general university students. However, future work is needed to examine sociocultural factors that may account for these differences, such as minority stress, acculturative stress, and/or racial or ethnic discrimination (Brooks et al., 2020;Brooks Stephens et al., 2023). Consistent with hypotheses, results revealed a significant indirect effect of PTSD symptom severity on both suicidal ideation (Model 1) and suicide risk (Model 2) through PB and TB, examined concurrently. ...
Rates of suicidal ideation and behaviors have been increasing across the past two decades among Hispanic/Latinx adults. Researchers have postulated that these trends may be due, in part, to perceived discrimination and other stressors experienced by minoritized populations. Relations between posttraumatic stress disorder (PTSD) symptom severity and suicidal ideation and suicide risk are well established. The interpersonal theory of suicide suggests that perceived burdensomeness (PB; i.e., the misperception that an individual is a burden on others) and thwarted belongingness (TB; i.e., when an individual feels socially disconnected from others) are critical to understanding suicidal ideation and risk. Elements of Hispanic/Latinx culture, namely a strong familial connection and high value for the family system, are related to PB, TB, and suicide risk. No studies to date have examined these associations among trauma-exposed, Hispanic/Latinx university students. Therefore, the current study evaluated, among trauma-exposed Hispanic/Latinx university students, the association of PTSD symptom severity with suicidal ideation and suicide risk through PB and TB, examined concurrently. The sample included 564 Hispanic/Latinx university students (Mage = 21.63, SD = 4.14, 82.3% female, 72.7% White) who endorsed exposure to at least one potentially traumatic event per the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, PTSD Criterion A. Trauma load (i.e., number of traumatic event types) was included as a covariate in all models. Results indicated that both PB and TB statistically mediated the association of PTSD symptom severity with both suicidal ideation and suicide risk. This research has the potential to inform and advance university mental health outreach programs and policy.
... These differences in study populations may have influenced our findings specific to the minority stress domain. Scholars point to additional social factors as drivers of suicide risk for Black adolescents, such as racially motivated discrimination and microaggressions, as well as structural racism, which may better capture the unique cultural aspects that instigate suicide risk for Black adolescents (Arshanapally et al. 2018;Brooks et al. 2020;English et al. 2022;Goodwill, Taylor, and Watkins 2021). In fact, most of the minority stress CARS-S domain focuses on items related to sexual and gender minority status. ...
Although rates of suicide among Black American youth have increased in recent years, few brief assessment tools have been culturally tailored and validated to better identify suicide risk for this population. The current study addresses this gap by testing the validity and reliability of the Cultural Assessment of Suicide Risk‐short form (CARS‐S) in an online sample of Black American adolescents. Three hundred eighty‐one Black adolescents (Mage = 17.5) completed a 13‐item CARS‐S measure online. Cronbach's alpha and exploratory and confirmatory factor analysis were computed in Stata v.15 and Mplus v.8.0. The revised CARS‐S scale demonstrated acceptable internal consistency (Cronbach's α = 0.82). A four‐factor solution retained through exploratory analysis demonstrated the best model fit (χ² = 46.62, p < 0.001; RMSEA = 0.05, 95% CI = 0.01–0.08 CFI = 0.99; TLI = 0.97) compared to other model solutions. Confirmatory analysis supported a four‐factor model with no cross‐loaded items. The four factors were: (1) Family conflict and idioms of distress‐suicidal actions (four items); Social Support (two items); Minority‐specific distress (three items); Idioms of distress‐emotional/somatic and cultural sanctions (four items). Researchers conducting future suicide prevention research focused on Black American adolescents and including the CAR‐S measure should consider the inclusion of items related to family conflict and racism‐related stress to better capture risk.
... This finding is consistent with the interpersonal theory of suicide, which suggests that acquiring the capability to overcome one's natural fear of death combined with the desire for suicide leads to a serious suicide attempt, and such capability of suicide may be acquired through repeated exposure to painful and fear-inducing events 30,31,37 . Empirical evidence in previous research suggests that perceived discrimination may be an example of a fear-inducing event from which individuals from certain minoritized groups may acquire suicide capability 38 . ...
From 2018 to 2022, 48 anti-transgender laws (that is, laws that restrict the rights of transgender and non-binary people) were enacted in the USA across 19 different state governments. In this study, we estimated the causal impact of state-level anti-transgender laws on suicide risk among transgender and non-binary (TGNB) young people aged 13–17 (n = 35,196) and aged 13–24 (n = 61,240) using a difference-in-differences research design. We found minimal evidence of an anticipatory effect in the time periods leading up to the enactment of the laws. However, starting in the first year after anti-transgender laws were enacted, there were statistically significant increases in rates of past-year suicide attempts among TGNB young people ages 13–17 in states that enacted anti-transgender laws, relative to states that did not, and for all TGNB young people beginning in the second year. Enacting state-level anti-transgender laws increased incidents of past-year suicide attempts among TGNB young people by 7–72%. Our findings highlight the need to consider the mental health impact of recent anti-transgender laws and to advance protective policies.
... A recent study analyzing the National Survey on Drug Use and Health from 2015 to 2019 reported 4.3% of the adult U.S. population had past-year thoughts of suicide. Importantly, as risk for dehumanization (Kteily & Bruneau, 2017;Utych, 2018), symptoms of depression (Goodwin et al., 2022;Lipson et al., 2019;Sakharkar & Friday, 2022), and suicide (Brooks et al., 2020;Silva & Van Orden, 2018) are elevated among those with marginalized identities; self-dehumanization may be a particularly timely topic in this context. Additionally, known risk factors for suicidal ideation, such as interpersonal beliefs that one hinders their community (i.e., perceived burdensomeness) or is socially isolated from other humans (i.e., thwarted belongingness; [Joiner, 2005;Van Orden et al., 2010]) may be further explained through perceptions of nonhumanness. ...
Self-dehumanization, a phenomenon relevant to social psychology, has been somewhat absent from clinical psychology research. Furthermore, measures of self-dehumanization are few, and to our knowledge, no validated and generalizable self-report measure exists. To address this gap, we present a Self-Dehumanization Scale (SDS). This work incorporates evidence from three studies examining the reliability, validity, and factor structure of the SDS in an undergraduate sample, a clinically relevant community sample, and a sample with at least one minoritized identity. The SDS was derived from dehumanization theory and was developed to measure animalistic and mechanistic self-dehumanization. All studies suggested an 8-item SDS, with Study 1 suggesting a single-factor solution with, however, some indication of a two-factor structure, and Studies 2 and 3 affirming a two-factor solution. The SDS, and its respective factors, generally showed discriminant validity from related, yet distinct, measures of self-hate, self-esteem (Study 2), dissociation, and measures of
discrimination (in Study 3). Finally, animalistic and mechanistic SDS showed somewhat mixed but promising evidence regarding their associations to minoritized identities and to symptoms of depression, and suicide risk, above and beyond each study’s fairly stringent control variables. Thus, self-dehumanization may prove to be a clinically promising leverage point in assessing psychopathology, particularly among minoritized communities.
... Suicide is the third leading cause of death for Black American emerging adults, with approximately 3000 Black Americans dying by suicide per year (Arshanapally et al., 2018;Brooks et al., 2020;Kochanek et al., 2016). ...
Background
Suicidal ideation and behavior and non‐suicidal self‐injury (NSSI) among Black emerging adults is a major public health concern. Intimate partner violence (IPV) is a significant risk factor for suicidal ideation and behavior and NSSI, but there is little work examining the buffering effect of psychological well‐being (PWB). The purpose of this study was to examine the associations between IPV, suicide ideation and behavior, and NSSI, and the moderating role of PWB on these associations.
Method
Secondary data analyses were conducted using a subsample of Black American emerging adults ( N = 4694) from the National College Health Assessment.
Results
IPV was associated with greater odds of suicide ideation, past‐year suicide attempt, and NSSI. PWB was associated with lower odds of suicide ideation, past‐year suicide attempt, and NSSI. PWB did not moderate the relationships between IPV and the outcomes.
Conclusions
IPV was a risk factor for suicidal ideation, suicide attempt, and NSSI among Black American emerging adults. PWB was associated with lower suicidal ideation and behavior and NSSI engagement, suggesting it can be a protective factor. Bolstering PWB in Black communities may be beneficial in intervention and prevention efforts.
... Importantly, given the context of increased suicide rates among Black youth in recent years (Robertson et al., 2022), scholars have begun to explore whether experiences of chronic racial discrimination can also be considered painful and provocative experiences contributing to suicide. Brooks et al. (2020) found that among Black participants, experiences of discrimination were significantly predictive of acquired capability for suicide as measured by the Acquired Capability for Suicide Scale (ACSS; Bender et al., 2007) after adjusting for depressive symptomatology, age, and gender. ...
In this article we frame the crisis of Black transgender and gender-nonconforming (TGNC) youth suicide in the context of interpersonal theory of suicide, intersectionality theory, postmodern therapeutic approaches, and critical suicidology in promoting liberatory care. The constructs of each theory are illuminated by a case study that explores the narrative of a Black trans femme teen as she navigates mental health treatment after a suicide attempt. Opportunities for clinician learning, advocacy, and best practice are discussed. Practical resources are provided in case excerpts to enhance clinicians’ understanding of topics such as gender-affirming care, respectful language, and intersections of anti-Black racism and transphobia. We close with a discussion of future directions for skill development and cultural humility in novice and seasoned providers working with this community.
... Conversely, effective approaches to problem-solving lessen life stress, decreasing the likelihood of STB (O'Connor and Kirtley, 2018). Importantly, discrimination may increase risk over and above other non-discriminatory stressors (Broosk et al., 2020), yet existing work has not tested whether PO moderates the relation between discrimination and passive SI. Given the rise of discrimination after the start of the COVID-19 pandemic (e.g., Addo, 2020), identification of malleable treatment targets, such as PO, may help reduce suicide risk among individuals who experience discrimination. ...
Passive suicidal ideation (i.e., the desire to be dead) may be an important, yet understudied, risk factor for suicidal behavior. Experiences of discrimination have been linked to greater severity of suicidal ideation though less work has examined factors that influence this relation. Though not explicitly tested, prior work suggests that problem orientation, defined as an individual's general beliefs about problems in daily life, may be an important moderator of this relation. In the present study, positive and negative problem orientation were hypothesized to moderate the relation between everyday discrimination and past month frequency of passive suicidal ideation. The study consisted of a diverse (62.4 % non-White; 21.4 % Latino/a/x; 27 % sexual minority) adult sample (N = 392; Mage = 20.24, SD = 2.49, 67.3 % female) recruited from a U.S. Mid-Atlantic college campus. Discrimination, problem orientation, past-month depressive symptoms, and past-month frequency of passive suicidal ideation were assessed using self-report measures. A single path model with Bayesian estimation was used to evaluate concurrent relations among study variables. After controlling for depressive symptoms, sex, sexual identity, and age, positive problem orientation buffered the impact of lifetime discrimination on past month passive suicidal ideation (b = -0.01, 95 % credibility interval [CI]: [-0.008, -0.001]). Negative problem orientation did not moderate this relation (b = 0.00, 95 % CI: [-0.002, 0.003]). Results suggest that bolstering positive problem orientation in treatment with young adults who have experienced discrimination may help reduce suicide risk.
... Mental health disorders, such as depression and substance use, are known risk factors for suicide among Black Americans [6,7], but recent research also highlights racism and associated contextual stressors as important, but underresearched, explanatory risk factors for suicidal thoughts and behaviors (STB) among Black adults [8][9][10]. Previous studies have demonstrated the significant impact of racism and associated daily stressors on mental health outcomes, including depression, anxiety, sleep disturbances, and posttraumatic stress disorder (PTSD), among Black individuals [11][12][13][14][15]. ...
Background
Suicide rates in the United States have increased recently among Black men. To address this public health crisis, smartphone-based ecological momentary assessment (EMA) platforms are a promising way to collect dynamic, real-time data that can help improve suicide prevention efforts. Despite the promise of this methodology, little is known about its suitability in detecting experiences related to suicidal thoughts and behavior (STB) among Black men.
Objective
This study aims to clarify the acceptability and feasibility of using smartphone-based EMA through a pilot study that assesses the user experience among Black men.
Methods
We recruited Black men aged 18 years and older using the MyChart patient portal messaging (the patient-facing side of the Epic electronic medical record system) or outpatient provider referrals. Eligible participants self-identified as Black men with a previous history of STB and ownership of an Android or iOS smartphone. Eligible participants completed a 7-day smartphone-based EMA study. They received a prompt 4 times per day to complete a brief survey detailing their STB, as well as proximal risk factors, such as depression, social isolation, and feeling like a burden to others. At the conclusion of each day, participants also received a daily diary survey detailing their sleep quality and their daily experiences of everyday discrimination. Participants completed a semistructured exit interview of 60-90 minutes at the study’s conclusion.
Results
In total, 10 participants completed 166 EMA surveys and 39 daily diary entries. A total of 4 of the 10 participants completed 75% (21/28) or more of the EMA surveys, while 9 (90%) out of 10 completed 25% (7/28) or more. The average completion rate of all surveys was 58% (20.3/35), with a minimum of 17% (6/35) and maximum of 100% (35/35). A total of 4 (40%) out of 10 participants completed daily diary entries for the full pilot study. No safety-related incidents were reported. On average, participants took 2.08 minutes to complete EMA prompts and 2.72 minutes for daily diary surveys. Our qualitative results generally affirm the acceptability and feasibility of the study procedures, but the participants noted difficulties with the technology and the redundancy of the survey questions. Emerging themes also addressed issues such as reduced EMA survey compliance and diminished mood related to deficit-framed questions related to suicide.
Conclusions
Findings from this study will be used to clarify the suitability of EMA for Black men. Overall, our EMA pilot study demonstrated mixed feasibility and acceptability when delivered through smartphone-based apps to Black men. Specific recommendations are provided for managing safety within these study designs and for refinements in future intervention and implementation science research.
International Registered Report Identifier (IRRID)
RR2-10.2196/31241
... A study by Assari et al. (2017) showed that higher perceived discrimination was associated with higher odds of suicidal ideation for Black adolescents. Brooks et al. (2020) report that for Black young adults, perceived discrimination can act as a painful and provocative experience that is associated with increased capability to overcome their own fear of death. This link was previously examined with black adolescents (Arshanapally et al., 2018). ...
... While most often Latina teens who attempt suicide report experiencing detachment or alienation within family relationships (see, for example, Zayas et al., 2009), and even violence and abuse at home (see, for example, Unikel et al., 2006), some adolescents also describe experiences of discrimination and violence in their broader social spheres (see, for example, Gulbas et al., 2019;Prince & References Being bullied and threatened at school increases the risk for suicide attempts Price and Khubchandani (2017) Adolescents who attempted suicide were more likely to interpret academic shortcomings as evidence of their perceived worthlessness Exposure to violence at schools is related to the attempter's "acquired capability" to self-harm Gulbas et al. (2019) Adolescent suicide attempters described few personal, educational, and professional aspirations compared to their non-suicidal peers There was incongruence of academic aspirations between suicidal adolescent and their parents Hausmann-Stabile et al. (2013) Being bullied and threatened at school increases the risk for suicide attempts for LGB youth (including females) Boyas et al. (2019) Positive relationships with adults at school are strongly correlated with reduced odds of suicide attempt A school adult believing they would be successful was protective for Latina girls Hall et al. (2018) Being bullied and cyberbullied increases the likelihood of suicide attempts among Latina teens Romero et al. (2018) Neighborhood Avoiding social connection with others, or experiencing marginalization or discrimination, is related to the attempter's "thwarted belongingness" Exposure to violence in the community is related to the attempter's "acquired capability" to self-harm Gulbas et al. (2019) Khubchandani, 2017). Experiences of discrimination and/or violence in the community may, according to the IPTS (Joiner, 2005;Van Orden et al., 2010) increase an adolescent's sense of alienation and her tolerance of pain, increasing, in turn, the risk for suicide attempts (Brooks et al., 2020). ...
In this chapter, we review and summarize what is known about the familial, cultural, and community protective and risk factors for suicide attempts among Latina adolescents. We begin by describing epidemiological findings about the suicidal behaviors of Latina adolescents living in the United States, then briefly discuss the dominant theoretical frameworks and summarize research findings in this area of scholarship. Research has focused primarily on family functioning, explaining it in terms of culture and acculturation. Family closeness, communication, and harmony reduce the risk of suicide attempts, while family conflicts increase it. Experiences of violence at home (e.g., physical abuse) or at school (e.g., bullying) increase the risk of attempted suicide. The significance of cultural values, such as familism, and the role of acculturation in suicidal behaviors is complex, nuanced, and poorly understood. Despite numerous theoretical suggestions of the cultural basis of this phenomenon, there are no definitive answers about the intragroup dynamics shaping protections and risks for suicide attempts. To move the field forward, interdisciplinary and mixed methods research could compare the suicide attempts of different groups of teens to those of Latinas to identify universal and context-specific intervention targets.
... Exposure to racism and prejudice has been linked to increased suicide risk (Brooks et al., 2020;Rudes and Fantuzzi, 2022), and it follows that the onset of police violence and a culture of sanctioned racism during this period could account for some of the increased suicides in AA and Hispanics. Further research is needed to determine how exposure to racism impacts suicide risk within different age and minority groups. ...
Suicide rates differ over time. Our objective was to determine when significant changes occurred by age, race, and ethnicity in the United States between 1999 and 2020. National Center for Health Statistics WONDER data were used in joinpoint regression. The annual percent change in suicide rate increased for all race, ethnic, and age groups, except for those 65 years and older. For American Indian/Alaska Natives, the largest increase occurred between 2010 and 2020 for those with ages 25 to 34 years. For Asian/Pacific Islander, the largest increase occurred among those 15 to 24 years old between 2011 and 2016. For Black/African-Americans, the largest increases occurred between 2010 and 2020 among 15- to 34-year-olds. For Whites, the largest increase occurred between 2014 and 2017 among 15- to 24-year-olds. Between 2018 and 2020, suicide rates significantly declined among Whites 45 to 64 years of age. Among Hispanics, significant increases in suicide rate occurred between 2012 and 2020 among those with ages 15 to 44 years. Between 1999 and 2020, the contour of suicide burden varied by age groups, race, and ethnicity.
... Furthermore, the danger of suicide among AsAm young adults highlights the relationship between discrimination and suicide ideation or suicide risk factors, specifically perceived burdensomeness (20). Perceived discrimination predicting suicide risk is found among other racially minoritized groups as well (21). Thereby, researchers are becoming more cognizant of the ongoing, pervasive experience of prejudice and discrimination against minoritized people and its effects on mental wellbeing and risk factors. ...
The present study examined the effect of campus racial climate on perceived burdensomeness, a suicide risk factor, among Asian American college students during the COVID-19 pandemic, when anti-Asian racism was present. To disaggregate these data, there was a test of whether Asian American ethnicity subgroup identification as Southeast and South or East Asian changed the association between campus racial climate on perceived burdensomeness. The current sample included 148 college students, 73 Southeast or South Asian Americans, and 75 East Asian American. The study participants were enrolled at a small liberal arts institution located in the Pacific Northwest region of the United States. Researchers collected data across 3 days (9-12 April 2020) via an online questionnaire. Both groups reported similar levels of campus racial climate and perceived burdensomeness. Bivariate correlations indicated that campus racial climate was positively correlated with perceived burdensomeness for Southeast and South Asians only. Moderation analyses revealed that a negative campus racial climate was related to greater perceived burdensomeness among Southeast and South Asian, but not East Asian, American students. This finding supports the need for disaggregation of Asian subgroups in mental health research to understand the diverse experiences within the Asian American community. Furthermore, there is a need for higher education institutions to consider tailoring interventions and tools that fit into the unique cultural and sociohistorical experiences of ethnic and racial subgroups among Asian American students.
... Discrimination was examined in only three articles in this corpus despite the evidence that experiences of discrimination serve as key determinants of health with implications for mental and physical health (Pascoe & Richman, 2009;Schmitt et al., 2014). In the broader suicide literature, experiences of discrimination have been linked with suicide attempts and capability for suicide (Brooks et al., 2020;Gomez et al., 2011). Moreover, qualitative literature suggests the role of bullying (Bell et al., 2014) and discrimination-based bullying as related to youths' suicide (Cwik et al., 2022). ...
American Indian/Alaska Natives (AI/ANs) experience disproportionate rates of suicide, but current strategies for suicide prevention have not reduced these health disparities. Therefore, to gain insight into factors that may affect risk trajectories for suicide attempts (SAs) among AI/ANs, we conducted a systematic review of the literature. Forty-five articles met inclusion criteria for the final corpus. Results demonstrate that substance use, depression/hopelessness, childhood maltreatment, violent victimization, and friend/family-member death by suicide serve as robust predictors for SAs. For AI/AN youths specifically, risk-taking behaviors, family conflict, and school environment were associated with SAs. Notable differences in risk factors were identified across age, sex, and region. Limitations of this body of evidence are described, including heterogeneity in study design, measurement, and sampling. Predicated on these findings and limitations, we suggest four key strategies to advance the study of risk factors for AI/AN communities to prevent AI/AN suicide.
... In this case, DEI work can be a matter of life and death as loneliness is associated with an increased risk of heart disease, dementia, depression, and even premature death (Murthy 2020). And while people of any age, race, ethnicity, or sex can unfortunately experience suicide risk, we see that sexual and gender minorities are at a higher risk and have substantially higher rates of suicide than the general U.S. population (Brooks et al. 2020), Centers for Disease Control and Prevention 2021). DEI work plays a role in responding to and preventing these issues while helping give people the permission to be their authentic selves in a way that supports belongingness. ...
Initiatives around the world are being implemented in an effort to foster and promote diversity, equity, and inclusion (DEI) in universities, work environments, and beyond. Using DEI as their foundation, courses and studies have been developed which discuss the importance of employee and student engagement and belonging in these settings as well. There are small changes which leaders can implement that may lead to big impacts surrounding DEI, engagement, and belonging both for team members and for the people they serve.
... A primary finding from this research is the higher-thanexpected rate of suicide ideation in the prior two weeks as compared with the rate of 4% reported for adults in the U.S. [73]. This may be a signal of the increased rates of suicide and suicidality recently observed in Black and Latinx communities [74][75][76][77] and reinforces the need for greater attention to research and practice in this area. or PHQ-8 score ≥ 10). ...
Suicide is a critical public health problem. Over the past decade, suicide rates have increased among Black and Latinx adults in the U.S. Though depression is the most prevalent psychiatric contributor to suicide risk, Black and Latinx Americans uniquely experience distress and stress (e.g., structural adversity) that can independently operate to worsen suicide risk. This makes it important to investigate non-clinical, subjective assessment of mental health as a predictor of suicide ideation. We also investigate whether social support can buffer the deleterious impact of poor mental health on suicide ideation.
We analyzed data from 1,503 Black and Latinx participants of the Washington Heights Community Survey, a 2015 survey of residents of a NYC neighborhood. Multivariable logistic regression was conducted to examine the effect of subjectively experienced problems with anxiety and depression on suicide ideation independent of depression diagnosis, and the role of social support as a moderator.
Estimated prevalence of past two-week suicide ideation was 5.8%. Regression estimates showed significantly increased odds of suicide ideation among participants reporting moderate (OR = 8.54,95% CI = 2.44–29.93) and severe (OR = 16.84,95% CI = 2.88–98.46) versus no problems with anxiety and depression, after adjustment for depression diagnosis. Informational support, i.e., having someone to provide good advice in a crisis, reduced the negative impact of moderate levels of anxiety and depression problems on suicide ideation.
Findings suggest that among Black and Latinx Americans, subjective feelings of anxiety and depression account for a significant portion of the suicide ideation risk related to poor mental health. Further, social support, particularly informational support, may provide protection against suicide ideation.
... Apparently, in the context of pandemic conditions, lockdown measures, and the spread of infodemic, the sensitive population groups developed either autoaggressive behavior and suicidality, accumulating in the increased number of mental disturbances over this period, or heteroaggressive actions and protests, when individuals struggled against wearing masks, their rights regarding a choice of vaccination, and even sociopolitical issues, in particular, appealing to conspiracy beliefs about the artifi cial origins of the novel coronavirus, its purposes to provide a control over community, a pathway to arrange the economic crisis, etc. [14,[20][21][22][23][24][25]. These oppositional anti-mask and antivaccine attitudes might be also related to the hypoactive instinct of self-preservation which is also linked to some forms of autoagressive intention ("capability for suicide") due to the lack of self-care, decreased healthy volition to stay safe, not to contract the virus, to prevent severe disease, or cause a death; thus, this behavior also might be explained within the context of self-harm and parasuicidal phenomena arising due to the current pandemic [26][27][28][29]. The increase in suicide rates and suicide-related phenomena within the "dual suicide and COVID- 19 The Risk Assessment Suicidality Scale (RASS) has been developed as a self-report instrument with an emphasis on items describing suicide-related behavior itself [52]. ...
BACKGROUND: Suicidality is a complex clinical phenomenon reflecting vulnerability to suicidal behavior which can be explained via the biopsychosocial paradigm and in relationship with a variety of country-specific factors. Data on suicides within the Russian population are inconsistent (from 11.7 up to 25.1 per 100.000), whereas the population’s suicidality risks have not been investigated in detail. Suicidality estimates during the multifactorial influence of the COVID-19 pandemic could serve as a basis to learn more about this mental health indicator.
METHODS: The current study is a part of the COMET-G international project (40 countries, n=55.589), which represents an analysis of data collected from Russia’s general population (n=7714, 33±12 y.o., 61% female) to estimate suicidality using the Risk Assessment Suicidality Scale (RASS) and its relationships with socio-demographic, clinical, and life-habit characteristics during the COVID-19 pandemic. The evaluation of the statistical data (descriptive statistics, ANOVA, LASSO linear regression, significant at α=0.05) was undertaken using TIBCO Statistica.
RESULTS: According to the RASS, at least 20.68%, and up to 29.15%, of the general population in Russia demonstrated increased risk of suicidality during the pandemic. Modelling these risks pointed to the key vulnerabilities related to mental and behavioral disorders, such as (i) current severe depression and a history of mental disorders, (ii) bipolar disorder, (iii) use of illicit drugs surprisingly outranking the alcohol misuse, and psychiatric compounds (hypnotics), highlighting sleep quality deterioration, (iv) a history of suicide attempts and self-harm — though not self-reported changes in depression — in response were predictors of the risk of suicidality, which can be explained by the phenomenon of “learned suicidality”, a habitual behavioral suicidality pattern completion accumulated over the background. Such (v) socio-demographic indicators as younger age (disregarding the gender factor), a marital status of single, having no children, living with fewer people in the household, a recent increase in family conflicts, increased need for emotional support, decreased need for communication, and not believing in precautionary measures against COVID-19, contributed to the increase of suicidality risk in the context of the pandemic.
CONCLUSIONS: The findings of this study revealed new suicide risk factors that should be taken into account in suicidality risk assessments for the Russian population and in the implementation of suicide prevention programs in the region.
... Over the past decade, suicide rates in the United States have increased dramatically among racial and ethnic minorities, and Black Americans in particular. For Black young adults aged 15 to 24 years, suicide is the third leading cause of death with approximately 3,000 Black Americans dying by suicide each year (Brooks et al., 2020). Not only black Americans but also the Native Americans and Alaskan minorities face a great emergency in terms of suicide ideation and suicide attempts (Suicide Prevention Resource Center, 2018). ...
Introduction
The World Health Organization states that suicide is the second leading cause of death among youngs, and racism has been proven to have detrimental effects on both physical and mental health. These two plagues represent a public health priority, especially for susceptible minorities.
Method
This systematic review analyzed 23 studies from multiple database searches, to understand the relationship between racism and suicidality in young minority groups.
Results
The review demonstrated the correlation between racism and suicidality with the consequent development of mental disorders. There is strong evidence that the main suicide risk factor is acculturation, interpreted as the assimilation of the dominant culture with the loss of values from one’s cultural background.
Discussion
Health care professionals should not underestimate the risk of suicidality associated with racism. Prevention is crucial and it should be implemented from a young age, in schools, through a joint intervention with children and their families, aiming toward integration without acculturation.
... Race and ethnicity are understudied in military suicide. Race-based discrimination has been associated with adverse mental health outcomes and an increased capability for suicide in minority members (Brooks et al., 2020). Some groups with higher suicide rates warrant special concern because they are already at risk when they enter the military. ...
Despite considerable prevention and intervention efforts, military suicide rates have increased. Although most research on active-duty military suicide has focused on combat exposure, evidence shows that bullying, hazing, and race are understudied risk factors for military suicide. According to the interpersonal theory of suicide, thwarted belongingness, perceived burdensomeness, and acquired capability are necessary components for enacting a suicide death. In this theoretically-based interpersonal case analysis of the suicide death of Private Danny Chen, an American soldier of Chinese descent, we explore how bullying, hazing, and race may have intersected with other vulnerabilities to result in his death.
... 27 Particularly alarming are findings that perceived racial discrimination was associated with increased suicidal ideation among diverse samples of racial and ethnic minority young adults 28,29 and that perceived discrimination was positively associated with capability for suicide in Black Americans while controlling for depressive symptoms, suicide ideation, and painful and provocative events. 23 Not only is the incidence of perceived discrimination linked with greater mental health symptoms, but prior research has found a strong association between the frequency of perceived discrimination and the appraised stress from these experiences. 9 Appraised stress from discrimination has been associated with various psychological and behavioral outcomes, including depression, stress, anxiety, 30 alcohol consumption, 31 and cigarette smoking. ...
Objective/Participants
In a large, diverse sample of college students (N = 2,230), this online study investigated racial/ethnic differences on type of discriminatory event experienced and perceived stress, and whether discrimination-related stress was associated with mental health symptoms. Methods: Prevalence of lifetime/past year discriminatory events was assessed and frequency of discrimination-related stress was compared across racial/ethnic groups. Correlations between discrimination-related stress and mental health symptoms were also examined. Results: All racial/ethnic groups reported experiencing all types of discriminatory events, though prevalence was lowest for White students. Racial/ethnic minority (i.e., Asian, Black, Latinx) students reported greater discrimination-related perceived stress compared to White, non-Hispanics. Across all racial/ethnic groups, discrimination-related stress was positively associated with negative mental health outcomes (e.g., anxiety/depressive symptoms). Conclusions: These results highlight the need to continue efforts to reduce discriminatory experiences of racial/ethnic minority students and to incorporate antiracism interventions in universities to mitigate the pervasive negative experiences of minority students.
... . Brooks et al. (2020) found that perceived discrimination was associated with suicide capability for Black, but not White university students. Black college students also attempt suicide more often, although they disclose suicidality less readily than their White counterparts (Morrison & Downey, 2000;Wang, Lightsey, et al., 2013). ...
Suicide is a leading cause of death for Black young adults. Though depression is commonly linked to increased risk for suicide, empirical literature examining the depression–suicide association and intrinsic buffers for this association remains limited among Black young adults. This study sought to address this gap in the literature by examining the relationship between depression and suicide ideation among Black young adults. Importantly, this study assessed the moderating role of self-acceptance, an index of how content one is with oneself. Study participants included 123 Black young adults (63.5% female, M age = 20.91 years, SD = 2.45 years) who completed measures evaluating symptoms of depression, suicide ideation, and psychological well-being. Multivariate regression analyses revealed that self-acceptance moderated the association between depressive symptomatology and suicide ideation ( β = −0.05, p < .01, 95% CI [-1.01, −0.11]), such that the depression–suicide ideation association was not significant for individuals who reported high levels of self-acceptance. These findings suggest that self-acceptance may be an important treatment target for interventions aimed specifically at reducing suicide vulnerability among Black young adults.
... To date, theories of suicide largely neglect how structural inequality, colonization, and intersecting systems of oppression, privilege, and power shape vulnerability to suicide. Though there have been some exiting new efforts to theorize how structural inequality and intersectionality matter to suicidology (Brooks et al., 2020;Opara et al., 2020;Standley, 2020), much more work is needed. Based on broader research within the sociology of mental healthwhich does take up this issue -the patterns are likely to be complex and again not distillable to individual experiences with discrimination or prejudice (McLeod, 2015;Williams et al., 2019;Laster Pirtle, 2020). ...
The past 20 years have seen dramatic rises in suicide rates in the United States and other countries around the world. These trends have been identified as a public health crisis in urgent need of new solutions and have spurred significant research efforts to improve our understanding of suicide and strategies to prevent it. Unfortunately, despite making significant contributions to the founding of suicidology – through Emile Durkheim’s classic Suicide (1897/1951) – sociology’s role has been less prominent in contemporary efforts to address these tragic trends, though as we will show, sociological theories offer great promise for advancing our understanding of suicide and improving the efficacy of suicide prevention. Here, we review sociological theory and empirical research on suicide. We begin where all sociologists must: with Durkheim. However, we offer a more comprehensive understanding of Durkheim’s insights into suicide than the prior reviews provided by those in other disciplines. In so doing, we reveal the nuance and richness of Durkheim’s insights that have been largely lost in modern suicidology, despite being foundational to all sociological theories of suicide – even those that have moved beyond his model. We proceed to discuss broadly acknowledged limitations to Durkheim’s theory of suicide and review how more recent theoretical efforts have not only addressed those concerns, but have done so by bringing a larger swatch of sociology’s theoretical and empirical toolkit to bare on suicide. Specifically, we review how recent sociological theories of suicide have incorporated insights from social network theories, cultural sociology, sociology of emotions, and sociological social psychology to better theorize how the external social world matters to individual psychological pain and suffering. We conclude by making explicit bridges between sociological and psychological theories of suicide; by noting important limitations in knowledge about suicide – particularly regarding the roles of organizations, inequality, and intersectionality in suicide – that sociology is well situated to help address.
Adolescents involved in the juvenile legal system have suicide rates three times higher than their non-involved peers, and the research-to-practice gap is evident in clinical work with these adolescents. A clinical vignette illustrates the use of a family-based program that incorporates three evidence-based clinical tools: the Columbia Suicide Severity Rating Scale, the Ask Suicide Questions instrument, and the Safety Planning Intervention. Family involvement in restricting lethal means was important to maintain safety during re-entry; however, this aspect of the written safety plan (e.g., “Keeping the Environment Safe”), among others, needed improvement. The case illustrates two key aspects of suicide prevention that can be overlooked in practice: lethal means restriction and social support. Research is warranted to understand the unique needs of juvenile legal system adolescents with suicidality, especially during re-entry.
Suicide is a leading cause of death among Black emerging adults. The concurrent effect of the COVID-19 pandemic and racial discrimination were projected to exacerbate suicide vulnerability for Black Americans. The purpose of the present study was to utilize a risk-resilience model to examine the effects of racial discrimination and COVID-related stress on suicide risk for Black emerging adults, as well as the moderating effect of three central components of radical healing: critical consciousness, resilience, and cultural authenticity. Study participants included 521 Black emerging adults between the ages of 18 and 29 (51.6% male; Mage = 24.6, SD = 2.6) who completed measures evaluating symptoms of racial discrimination, COVID-related stress, suicide risk, and psychological well-being. After controlling for age, gender, socioeconomic status, and general stress, structural equation modeling analyses revealed unique and interactive effects of racial discrimination, COVID-related stress, and culturally relevant protective factors on suicide risk for Black emerging adults. These findings provide preliminary insight into novel risk and protective factors that influence suicide risk for Black emerging adults.
While virtually all suicide attempters experience ideations, not all who think about suicide will attempt or die by suicide. The ideation-to-action framework has led to new theories distinguishing suicide ideators from suicide attempters. The framework suggests that suicide progresses on a spectrum of thoughts and behaviors with different identifiers and explanations. The concept of acquired capability for suicide (ACS), conceptualized by the Interpersonal Psychological Theory of Suicide, is the first to explain the movement from ideation to action. This concept analysis of ACS is timely and relevant for greater clarification of the role ACS has in the movement from ideation to action. Rodgers' evolutionary concept analysis method is used. The six-step evolutionary method highlights the concept's attributes, antecedents, and consequences and provides a basis for further inquiry and development rather than a final definition.
The persistence of extreme suicide disparities in American Indian and Alaska Native (AI/AN) youth signals a severe health inequity with distinct associations to a colonial experience of historical and on-going cultural, social, economic, and political oppression. To address this complex issue, we describe three AI/AN suicide prevention efforts that illustrate how strengths-based community interventions across the prevention spectrum can buffer suicide risk factors associated with structural racism. Developed and implemented in collaboration with tribal partners using participatory methods, the strategies include universal, selective, and indicated prevention elements. Their aim is to enhance systems within communities, institutions, and families by emphasizing supportive relationships, cultural values and practices, and community priorities and preferences. These efforts deploy collaborative, local approaches, that center on the importance of tribal sovereignty and self-determination, disrupting the unequal power distribution inherent in mainstream approaches to suicide prevention. The examples emphasize the centrality of Indigenous intellectual traditions in the co-creation of healthy developmental pathways for AI/AN young people. A central component across all three programs is a deep commitment to an interdependent or collective orientation, in contrast to an individual-based mental health suicide prevention model. This commitment offers novel directions for the entire field of suicide prevention and responds to calls for multilevel, community-driven public health strategies to address the complexity of suicide. Although our focus is on the social determinants of health in AI/AN communities, strategies to address the structural violence of racism as a risk factor in suicide have broad implications for all suicide prevention programming.
Research among adults reveals robust associations between discrimination and suicidality. The relationship between discrimination and suicidality is understudied in youth. Participants in the Adolescent Brain Cognitive Development (ABCD) study completed a measure of discrimination based on multiple attributes. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) was administered one-year later to assess depressive disorders and suicidality (ideation and behavior). Logistic regressions, adjusting for age, sex, race/ethnicity, family income, lifetime depressive disorders, and body composition were conducted. Adjusting for covariates, discrimination based on weight (OR: 2.19), race/ethnicity/color (OR: 3.21), and sexual orientation (OR: 3.83) were associated with greater odds of reporting suicidality one year later (ps < 0.025). Nationality-based discrimination was not significantly associated with suicidality. Compared with those reporting no discrimination, youths reporting discrimination based on two or more attributes had nearly five times greater odds of recent suicidality (OR: 4.72; p<0.001). The current study highlights the deleterious impacts of discrimination on mental health among youths reporting multiple forms of discrimination.
Objectives
Impulsivity is one factor that is associated with increased risk for suicide ideation and suicidal risk. However, limited studies have examined the association between impulsivity and suicidal risk, or clinically relevant protective factors, for Black Americans. While mindfulness is a robust coping mechanism and facilitator of psychological well-being, few studies have examined its role in the context of impulsivity and suicidal risk for Black Americans. The purpose of this study was to examine the mediating role of mindfulness on the association between impulsivity and suicidal risk within a university sample of Black emerging adults.
Method
Data from 332 Black emerging adults (79.2% female; mean age = 22.4, SD = 5.6) were used to examine the indirect effect of impulsivity on suicide ideation and elevated suicide risk through mindfulness. Participants completed an online questionnaire battery that included measures of impulsivity, mindfulness, suicide ideation, and elevated suicide risk.
Results
After controlling for age and gender, mediation analyses revealed that impulsivity was directly and indirectly associated with suicide ideation and elevated suicide risk via lower levels of mindfulness.
Conclusions
This study provides preliminary insight into novel risk and protective factors that influence suicide ideation and elevated suicide risk among Black emerging adults. Further, these findings support the clinical utility of mindfulness as a potential buffer to the negative consequences of impulsivity for Black Americans.
Preregistration
This study is not preregistered.
Objective:
The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk.
Methods:
Two samples were utilized in this study. The first was a subsample of those who identified as Black from a nationally representative sample (N = 502) seeking to understand firearm ownership within the United States. The second used a subsample of those who identified as Black (N = 1086) from a representative sample from New Jersey, Minnesota, and Mississippi. Variables related to safety and threat concerns were included in the second sample.
Results:
In both samples, multiple demographic variables, such as being a woman and having higher education, predicted firearm ownership. In the second sample, experiences of everyday discrimination and crime experiences were associated with firearm ownership. Additionally, Black firearm owners reported significantly more suicidal ideation than Black nonfirearm owners.
Conclusion:
The findings demonstrate the unique characteristics and experiences of Black firearm owners and show that firearm ownership is associated with increased suicide risk factors for Black adults. Findings should be used to advocate for the creation of more culturally relevant suicide prevention and firearm means safety strategies.
Black women’s rates of suicide ideation have risen steadily, and this increase may be due to socioecological factors such as race-related stress. Experiences of race-related stress may be associated with feelings of defeat and entrapment, significant predictors of suicide ideation, as studies have identified that race-based rejection may be humiliating and cause feelings of defeat. Black women may experience race-based rejection sensitivity (RRS) because of historical inequities and discrimination. The current study examined relationships among defeat, entrapment, RRS, and suicide ideation in Black women. Mediation analysis indicated direct associations between defeat and suicide ideation and indirect associations by way of entrapment in Black women. Results indicated that RRS did not significantly moderate the relationship between defeat and entrapment, defeat and suicide ideation, or entrapment and suicide ideation. The current study advances research on mental health equity and suicide by adding to the scant work conducted on risk factors for suicide in Black women.
Objective:
Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed.
Method:
A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (N = 263) from three suicide-focused publications were screened and then coded (n = 131) to identify reporting of procedures for the ethical conduct of research and suicide risk management steps taken by the research teams.
Results:
The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention.
Conclusion:
As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.
Parenting is a demanding task made more difficult for families facing multiple forms of oppression. Undocumented parents are part of this group. They grapple with the challenges of protecting their families and keeping their children safe within a context of racism, nativism, and anti-immigrant sentiment which are experienced simultaneously by members of this community. This paper focuses on the interplay between parenting and documentation status within an anti-immigrant political environment. A brief review of the literature on the challenges experienced by undocumented parents in the United States and the connection to their children’s socialization is provided as a prelude to the Intersectional Socialization Framework (ISF) introduced and described by the authors. The ISF focuses on the role that race, ethnicity, gender, and documentation status likely play in the socialization process of children of undocumented parents. The paper concludes with ten recommendations for childhood socialization that undocumented parents can utilize.
Background:
The COVID-19 pandemic has dramatically altered the way of life in the United States, which may be linked to self-injurious behaviors.
Methods:
We conducted a secondary analysis of data from the Fall 2020 Cohort of the Healthy Minds Survey, a non-probability sample of students enrolled at one of 28 universities across the United States. Participants completed an online survey during the COVID-19 pandemic (September-December, 2020).
Results:
Nearly a quarter of the sample (n = 6999) reported engaging in non-suicidal self-injury (NSSI), 12.41% (n = 3819) reported suicidal ideation, 4.98% (n = 1531) reported making a suicide plan, and 1.09% (n = 334) reported a suicide attempt over the past 12 months. When accounting for all COVID-19 factors in the same model, COVID-19 related concern, COVID-19 related discrimination, financial distress, and infection were significantly associated with NSSI, suicidal ideation, and suicide plan; caregiving was significantly associated with lower odds of engaging in non-suicidal self-injury. None of the factors were associated with suicide attempt.
Conclusions:
This study showed that various COVID-19 factors were related to SIB. Interventions may consider multiple dimensions of COVID-19 and their specific impacts.
Suicide is the second leading cause of death among adolescents and young adults. Historically, Black youths have experienced lower rates of suicide; however, recent data point to significant racial disparities. In this article, the authors review current suicide rates, including alarming new data suggesting that suicide rates are two times higher among Black children ages 5-12 compared with White children in that age range. A clinically focused summary of socioecological risk and protective factors associated with suicide among Black youths, with particular attention on structural drivers and culturally relevant factors, is provided. Current evidence-based reviews suggest that dialectical behavior therapy is the only well-established treatment against self-harm and suicide among youths. However, it is unknown whether current established treatments work for Black youths, because Black youths are rarely included in randomized controlled trials. The authors conclude by reviewing emerging treatments developed and tested specifically for Black youths.
Purpose of Review
Exposure to trauma accelerates during the adolescence, and due to increased behavioral and psychiatric vulnerability during this developmental period, traumatic events during this time are more likely to cause a lasting impact. In this article, we use three case studies of hospitalized adolescents to illustrate the application of trauma-informed principles of care with this unique population.
Recent Findings
Adolescents today are caught in the crosshairs of two syndemics—racism and other structural inequities and the COVID-19 pandemic. Increased hospitalizations and mental health diagnoses during the past two years signal toxic levels of stress affecting this group. Trauma-informed care promotes health, healing, and equity.
Summary
This concept of the “trauma-informed approach” is still novel; through examples and practice, providers can learn to universally apply the trauma-informed care framework to every patient encounter to address the harmful effects of trauma and promote recovery and resilience.
Despite well-documented disparities by sexual and gender minority (SGM) status in suicide attempt and mortality rates, few studies have investigated the lived experiences that contribute to SGM's disproportionate risk of suicide. Having a history of at least one near-fatal (or medically serious) suicide attempt serves as a proxy for suicide mortality, but no known study has involved SGM who have made such an attempt. Ideation-to-action theories of suicide posit that individuals acquire the capability for suicide through repeated exposure to painful and provocative events – namely, traumatic, threatening, and risky experiences – that can diminish the pain and fear of death. Yet whether identity-specific features of acquired capability for suicide contribute to SGM people's disproportionate risk of suicide remains unknown. Drawing upon interviews with 22 SGM people who experienced a recent near-fatal suicide attempt, the current study sought to identify specific determinants of how SGM acquire the capability to kill themselves, a potentially powerful, and modifiable, pathway to suicide. Results identified three SGM-specific contributors to the acquired capability for suicide: (1) identity invalidation during developmentally sensitive periods of childhood and adolescence that left participants feeling erased, invisible, and, in some cases, non-existent; (2) normalization of suicide within SGM social networks that increased acceptability and reduced the fear of suicide; and (3) structural stigma and SGM community trauma as habituating sources of pain that engendered feelings of exhaustion and positioned suicide as a reprieve from pervasive anti-SGM norms. This study demonstrates that dominant suicidology theories might need to be refined to account for the stigma-related determinants of SGM suicide. Further, this study reinforces the importance of qualitative methods for understanding the lived experience of suicide and calls for SGM-specific suicide prevention efforts to respond to stigma to support those SGM who contemplate suicide.
The purpose of this chapter is to shed light on the psychological, interpersonal, and social reality of Black Americans and how they relate to manifestations of psychological distress by situating the lived experiences of Black people in a racial and sociocultural context. In doing so, we advance an understanding of mental health and treatment considerations for Black Americans who are experiencing increasing rates of psychiatric disturbance. We begin with an overview of unique experiences and stressors for Black Americans, highlighting the importance of utilizing an intersectional lens when examining Black mental health. We follow with a discussion of differences in clinical presentation and somatization of mental health disorders for Black Americans, contextualizing the role of racism, cultural worldview, and racial identity development. Finally, we identify barriers to treatment and conclude with opportunities for theory, research, and interventions in order to better meet the mental health needs of Black Americans.
Using an interpersonal theory of suicide and affect regulation framework, we investigated the relationships between perceived burdensomeness, thwarted belongingness, weight stigmatization, emotion dysregulation, eating pathology, and suicide risk. Three main hypotheses were investigated. First, we predicted a positive linear relationship between weight stigmatization and risk. Second, an indirect effect of weight stigmatization on risk via perceived burdensomeness and thwarted belongingness was posited. Third, we hypothesized that weight stigmatization would indirectly affect suicide risk via emotion dys-regulation and eating pathology. Undergraduates (N = 156) completed online surveys. Linear regressions and indirect effect analyses were performed. Weight stigmatization was directly, positively associated with increased suicide risk. Weight stigmatization indirectly affected suicide risk via perceived burden-someness but not thwarted belongingness. Higher stigmatization was associated with higher levels of perceived burdensomeness, which was associated with higher risk. An indirect effect of weight stigma-tization on suicide risk through emotional dysregulation emerged. Higher weight stigmatization was associated with higher emotional dysregulation, which was associated with higher suicide risk. When all models were combined, only an indirect effect via perceived burdensomeness remained. Our findings may have clinical and public health implications for suicide prevention among people with weight stigma-related risk factors.
Background
: Anxiety sensitivity (AS), defined as the fear of anxiety-related sensations, is associated with increased risk for suicide and related behavior. However, investigations of AS have centered on primarily non-Hispanic White men and women and with limited attention to clinically relevant underlying factors.
Methods
: The purpose of this preliminary study was to examine the indirect effect of AS on suicide ideation and elevated suicide risk through mindfulness in a sample of 307 Black adults (79.2% female; Mage = 22.4, SD = 5.6). Participants completed an online questionnaire battery that included measures of AS, mindfulness, suicide ideation, and elevated suicide risk.
Results
: After controlling for age and gender, results indicated that AS was directly and indirectly associated with suicide ideation and elevated suicide risk via lower levels of mindfulness.
Limitations
: Limitations include using a cross-sectional methodological design and exclusive reliance on self-report measures.
Conclusions
: These findings provide preliminary insight into novel risk and protective factors that influence suicide ideation and elevated suicide risk among Black Americans.
Background
: To examine the association between skin tone discrimination and lifetime suicidal ideation among Black Americans.
Methods
: We analyzed the National Survey of American Life (NSAL), which national probability sample of Black American adults residing general population of the United States. Using multivariable logistic regression, we examined the associations between skin tone discrimination (from Blacks and from whites) and suicidal ideation and suicide attempt, adjusting for sociodemographic characteristics.
Results
: While respondents on average reported higher frequency of inter-group skin tone discrimination, only intra-group skin tone discrimination was significantly associated with greater odds of lifetime suicidal ideation [aOR: 1.21; 95% CI: 1.08-1.36] and suicide attempt [aOR: 1.22; 95% CI: 1.22; 95% CI: 1.04-1.44] adjusting for sociodemographic characteristics. Inter-group skin tone discrimination was not significantly related to suicidal ideation or suicide attempt. When stratifying by ethnicity, the effect of intra-group skin tone discrimination on suicidal ideation and attempt was stronger among Caribbean Black Americans than it was for African Americans.
Limitations
: All measures in the sample were self-reported and thus vulnerable to recall bias.
Conclusions
: Intra-group skin tone discrimination is a risk factor for suicidal ideation among Black Americans, and especially among Caribbean Black Americans.
Objective: Black Americans are at high risk for HIV disease and associated morbidity. However, we know little about the neuropsychological impact and correlates of HIV disease among Black Americans. Methods: Participants included 40 Black persons with HIV (PWH), 83 White PWH, 28 Black HIV- and 64 White HIV- individuals. Neurocognition was measured with raw, sample-based z-scores from a clinical battery. Everyday functioning was assessed using self- and clinician-rated measures of cognitive symptoms and activities of daily living. HIV-associated neurocognitive disorders were classified using the Frascati criteria. Results: We observed a significant three-way interaction between HIV, race, and domain on neurocognitive z-scores. This omnibus effect was driven by large effect size decrements in semantic memory and processing speed in Black PWH compared to the other groups. Black PWH participants also demonstrated higher frequencies of HIV-associated neurocognitive disorders as compared to White PWH. Unexpectedly, global neurocognition was negatively related to everyday functioning for White PWH, but not for Black PWH. Conclusions: Systemic disadvantages for Black Americans may combine with HIV disease to compound some neurocognitive impairments in this vulnerable population. Prospective studies are needed to identify better ways to prevent and manage HIV-associated neurocognitive disorders among Black Americans.
Objectives: Perceived racial discrimination is associated with depressive symptoms for African American adults; however, insight to protective factors for racism and depression in African Americans is limited. While current research suggests that dispositional forgiveness is an important factor in how people perceive and cope with interpersonal transgressions, few studies have examined its role in the context of racial discrimination. The purpose of this study was to examine the moderating effect of forgiveness (beyond broader internalized religiosity) on the association between perceived racial discrimination and depressive symptoms in African American adults. Method: Sample included 101 African American adults (60.2% female; Mage = 21.90 years, SD = 4.93 years) who endorsed experiences of racial discrimination. Participants completed a questionnaire battery consisting of self-report measures of perceived experiences of racial discrimination, depression, dispositional forgiveness, and intrinsic religiosity. Results: Regression analyses showed dispositional forgiveness moderated the association between perceived racial discrimination and symptoms of depression above and beyond intrinsic religiosity (β = −.05, 95% CI [−.10, −.05], p < .05), such that the racial discrimination-depression association was significant for participants who reported low levels of dispositional forgiveness, but not for individuals who reported higher levels of dispositional forgiveness. Conclusions: These findings provide insight into the role of dispositional forgiveness in experiences of racial discrimination and suggest that cognitive flexibility serves as an adaptive coping strategy to experiencing discrimination.
Suicidal thoughts and behaviors (STBs) are major public health problems that have not declined appreciably in several decades. One of the first steps to improving the prevention and treatment of STBs is to establish risk factors (i.e., longitudinal predictors). To provide a summary of current knowledge about risk factors, we conducted a meta-analysis of studies that have attempted to longitudinally predict a specific STB-related outcome. This included 365 studies (3,428 total risk factor effect sizes) from the past 50 years. The present random-effects meta-analysis produced several unexpected findings: across odds ratio, hazard ratio, and diagnostic accuracy analyses, prediction was only slightly better than chance for all outcomes; no broad category or subcategory accurately predicted far above chance levels; predictive ability has not improved across 50 years of research; studies rarely examined the combined effect of multiple risk factors; risk factors have been homogenous over time, with 5 broad categories accounting for nearly 80% of all risk factor tests; and the average study was nearly 10 years long, but longer studies did not produce better prediction. The homogeneity of existing research means that the present meta-analysis could only speak to STB risk factor associations within very narrow methodological limits-limits that have not allowed for tests that approximate most STB theories. The present meta-analysis accordingly highlights several fundamental changes needed in future studies. In particular, these findings suggest the need for a shift in focus from risk factors to machine learning-based risk algorithms. (PsycINFO Database Record
Background:
The interpersonal theory of suicide has gained empirical support as a conceptualization of suicide risk; however, little research has examined the role of individual traits, such as trait hope, within the interpersonal theory of suicide.
Aims:
The purpose of this study was to further investigate the role of trait hope components (i.e., pathways and agency) in acquired capability for suicide.
Method:
Participants were 711 college students who completed measures of acquired capability for suicide, painful and provocative events, and trait hope (i.e., pathways and agency). Linear regression was used to test the hypotheses.
Results:
As hypothesized, there was a positive relation between pathways and acquired capability. Contrary to our hypotheses, after controlling for gender there was a significant relation between agency and acquired capability. In addition, after controlling for gender, pathways did not moderate the relation between painful and provocative events and acquired capability, whereas agency did moderate this relation.
Conclusion:
Painful and provocative events should be assessed as a risk factor for acquired capability for suicide, and this may be more salient for individuals higher in the agency component of trait hope. Future research should consider examining the role of other traits within the interpersonal theory of suicide.
Despite recent findings that nonsuicidal self-injury (NSSI) is a strong predictor of suicide attempts, little empirical attention has been given to the mechanism through which NSSI increases suicide risk. The present 2-wave longitudinal study represents the first critical test of Joiner’s (2005) hypothesis that NSSI is linked to lower pain sensitivity and fear of death over time (i.e., NSSI leads to acquired capability for suicide). Undergraduate students (N = 782) at a midsized Canadian university completed measures of NSSI and acquired capability for suicide at 2 time points (1 year apart). Path analyses revealed that higher frequency of NSSI engagement in the past year was associated with greater acquired capability for suicide 1 year later, and that this link was unidirectional. This study provides the first longitudinal evidence that a potential mechanism for the link between NSSI and suicide attempts may be acquired capability for suicide, and suggests that targeting NSSI engagement could help to prevent individuals from acquiring the ability to enact more lethal forms of self-injury.
This study examines the relationship between facets of religious behavior, religious identity, and church-based social support with strategies used for coping with racial discrimination. Data come from the National Survey of American Life and includes separate representative samples of African Americans (n = 2,032) and Caribbean Blacks (n = 857). Binary logistic regression was used to determine the relationship between 8 religion variables and the likelihood of using each of 7 coping strategies. Among African Americans, religious factors were related to greater likelihood of coping by using prayer, working harder, and talking the situation over with others, and had mixed effects on seeking to resolve the problem. Among Caribbean Blacks, religious factors were related to greater likelihood of coping by using prayer, seeking resolution, and working harder, with mixed effects on coping with passive acceptance, self-blame, and anger. Consumption of religious media, strength of identification with the Black church, and spirituality played the largest roles, with religiosity, church-based social support, and negative church interaction also related to coping outcomes. Results indicate that religious involvement may be associated with some potentially negative coping styles, especially among Caribbean Blacks, in addition to some positive ones. They also suggest that there may be ethnic group differences among Black Americans in terms of the influence of religion on some potentially important coping outcomes.
The Outline for Cultural Formulation (OCF) introduced with DSM-IV provided a framework for clinicians to organize cultural information relevant to diagnostic assessment and treatment planning. However, use of the OCF has been inconsistent, raising questions about the need for guidance on implementation, training, and application in diverse settings. To address this need, DSM-5 introduced a cultural formulation interview (CFI) that operationalizes the process of data collection for the OCF. The CFI includes patient and informant versions and 12 supplementary modules addressing specific domains of the OCF. This article summarizes the literature reviews and analyses of experience with the OCF conducted by the DSM-5 Cross-Cultural Issues Subgroup (DCCIS) that informed the development of the CFI. We review the history and contents of the DSM-IV OCF, its use in training programs, and previous attempts to render it operational through questionnaires, protocols, and semi-structured interview formats. Results of research based on the OCF are discussed. For each domain of the OCF, we summarize findings from the DCCIS that led to content revision and operationalization in the CFI. The conclusion discusses training and implementation issues essential to service delivery.
This study was aimed to investigate the main and buffering effects of positive religious coping on the association between the number of chronic medical conditions and major depressive disorder (MDD) among African Americans, Caribbean Blacks and Non-Hispanic Whites.
This cross-sectional study used data from the National Survey of American Life, 2001 and 2003. This study enrolled 3,570 African Americans, 1,438 Caribbean Blacks and 891 Non-Hispanic Whites. Number of chronic conditions and positive religious coping were independent variables, 12-month MDD was the outcome and socio-economic characteristics were controls. We fitted the following three ethnic-specific logistic regressions for data analysis. In Model I, we included the number of chronic conditions and controls. In Model II, we added the main effect of religious coping. In Model III, we included an interaction between religious coping and number of chronic conditions.
Based on Model I, number of chronic conditions was associated with higher odds of 12-month MDD among all race/ethnic groups. Model II showed a significant and negative association between religious coping and MDD among Caribbean Blacks (odds ratio [OR] =0.55, 95% confidence Interval [CI] =0.39-0.77), but not African Americans or Hispanic Whites. Model III suggested that, only among Caribbean Blacks, the effect of chronic medical conditions on MDD is smaller in the presence of high positive religious coping (OR for interaction = 0.73, 95% CI = 0.55-0.96).
Although the association between multiple chronic conditions and MDD may exist regardless of race and ethnicity, race/ethnicity may shape how positive religious coping buffers this association. This finding sheds more light onto race and ethnic differences in protective effects of religiosity on mental health of populations.
This article describes two separate studies that were conducted to developand validate a measure of the prolonged stress activation andanticipatory race-related stress response in African American adults (Prolonged
Activation and Anticipatory Race-Related Stress Scale [PARS]). InStudy 1, an exploratory factor analytic procedure (N = 292) resulted in a17-item measure with four underlying factors: (a) Perseverative Cognition,
(b) Secondary Appraisal, (c) Anticipatory Race-Related Stress Scale–Psychological, and (d) Anticipatory Race-Related Stress Scale–Physiological.In Study 2 (N = 227), a confirmatory factor analytic procedure was
conducted to evaluate and compare the underlying factor structure forseveral competing models of the PARS. This procedure supported a fourfactoroblique solution as having the best fit to the data. Study 2 also
provided evidence for the convergent validity of the PARS in that its factorscores correlated, in the anticipated direction, with scores on measuresof related constructs
Ostracism means being ignored and excluded by one or more others. Despite the absence of verbal derogation and physical assault, ostracism is painful: It threatens psychological needs (belonging, self-esteem, control, and meaningful existence); and it unleashes a variety of physiological, affective, cognitive, and behavioral responses. Here we review the empirical literature on ostracism within the framework of the temporal need-threat model.
A topic of long-standing interest in racial attitudes research is whites’ support for principles of racial equality on one hand coupled with their intransigence on policies designed to redress that inequality on the other. Much has been written on possible explanations of this “principle-policy gap” and what the gap reveals about the state of contemporary American race relations. In this article, the authors provide an update and partial replication of their 1996 study of whites’ views of racial policies in what has been referred to as our post-racial society. Using both General Social Survey and American National Election Survey data, the authors assess the current state of whites’ racial policy attitudes and the factors that shape those attitudes and consider whether any meaningful change has occurred in recent decades. Among the explanations of the principle-policy gap that the authors examine, one stands out as especially powerful: racial resentment, a variant of stratification ideology that focuses on the role of racial individualism in shaping white resistance to meaningful policy change. Moreover, the authors find no evidence that whites’ racial policy views have changed since the 1980s.
The goal of the current report was to (1) theoretically and empirically integrate interpersonal theories addressing depression, social anxiety, and suicide and (2) document the interpersonal mechanisms through which social anxiety and depression increase risk for suicidal ideation. The authors examined the influence of depression and social anxiety on the interpersonal aspects of the interpersonal- psychological theory of suicide (Joiner, 2005) and suicidal ideation using structural equation modeling among 269 undergraduates. Results suggested that social anxiety was associated with thwarted belongingness, whereas depression was associated with burdensomeness and thwarted belongingness. These findings suggest potential pathways through which social anxiety and depression lead to increased suicide risk. In addition to clinical implications, ramifications for interpersonal theories of depression, anxiety, and suicide are discussed.
This study tested a sociocultural model of stress and coping in a sample of 215 African Americans. Psychological resources (optimism, ego resilience) were modeled as a “nested self” (S. E. Hobfoll, 2001), supported by social resources (family adaptability and cohesion) and cultural resources (racial pride, religiosity). Race-related stress was a significantly more powerful risk factor than stressful life events for psychological distress. Structural equation modeling results confirmed the hypotheses that psychological resources had a significant direct effect in minimizing psychological distress, and social resources had a significant stress-suppressing effect on race-related stress. Theoretical and practical implications for counseling psychologists are discussed.
The association between racial discrimination and mental health was examined using Wave 2 (1987–1988) and Wave 3 (1988–1989) panel data from the National Survey of Black Americans (NSBA). Mental health status was assessed by psychological distress and depression. In cross-sectional analyses, the perception of racial discrimination was related to high levels of psychological distress at Waves 2 and 3. Experiencing racial discrimination was marginally related to a high likelihood of depression at Wave 2. In longitudinal analyses, reports of racial discrimination at Wave 2 were associated with high levels of psychological distress at Wave 3. High psychological distress or depression at Wave 2 was not associated with reports of racial discrimination at Wave 3—indicating that poor mental health did not predict subjective reports (perceptions) of discrimination. The Discussion focused on possible directions for a more comprehensive program of research on mental health, stress, and experiences of racially based discrimination.
The literature indicates that perceived racism tends to be associated with adverse psychological and physiological outcomes; however, findings in this area are not yet conclusive. In this meta-analysis, we systematically reviewed 66 studies (total sample size of 18,140 across studies), published between January 1996 and April 2011, on the associations between racism and mental health among Black Americans. Using a random-effects model, we found a positive association between perceived racism and psychological distress (r = .20). We found a moderation effect for psychological outcomes, with anxiety, depression, and other psychiatric symptoms having a significantly stronger association than quality of life indicators. We did not detect moderation effects for type of racism scale, measurement precision, sample type, or type of publication. Implications for research and practice are discussed.
One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for 8 standard statistical tests: (1) the difference between independent means, (2) the significance of a product-moment correlation, (3) the difference between independent rs, (4) the sign test, (5) the difference between independent proportions, (6) chi-square tests for goodness of fit and contingency tables, (7) 1-way analysis of variance (ANOVA), and (8) the significance of a multiple or multiple partial correlation.
A functional model of the acquired capability for suicide, a component of Joiner's (2005) Interpersonal-Psychological Theory of Suicide, is presented. A component of Joiner's (2005) Interpersonal-Psychological Theory of Suicide a functional model of the acquired capability for suicide is presented. The model integrates the points discussed by Joiner into a unified and specific conceptualization of acquired capability. Several points are elaborated on, such as the interaction between specific diatheses with life events, the role of short-term bolstering of the capability for suicide, and how contextual factors moderate the experience of painful and provocative life events; thereby leading to fearlessness and pain insensitivity to the actions and ideas involved in suicide.
Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs-thwarted belongingness and perceived burdensomeness (and hopelessness about these states)-and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory's hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory's hypotheses.
Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.
The unique and combined effects of chronic and daily racial discrimination on psychological distress were examined in a sample of 174 African American doctoral students and graduates. Using a daily process design, 5 models of the stress process were tested. Multilevel random coefficient modeling analyses revealed that chronic exposure to racial discrimination predicted greater daily discrimination and psychological distress. Further, results show that differences in daily discrimination and negative events accounted for meaningful variation in daily distress responses. Finally, findings indicate that daily discrimination and negative events mediated the relationship between chronic discrimination and psychological distress. The study provides support for the need to measure chronic strains as distinctive from daily stressors in the lives of African Americans.
This study explores the relationship of the accumulative effect of gendered racism, the discrimination felt by African American women, on psychological distress. The study also explores whether coping serves as a mediating variable between gendered racism and psychological distress. Over 300 African American women participated in the study and were administered the Symptoms Checklist 90, a revised version of the Schedule of Sexist Events, and the Africultural Coping Styles Inventory. A positive significant relationship between global psychological distress was found with experiences of gendered racism. Regression analyses suggest some degree of partial mediation on the relationship between gendered racism and global psychological distress via cognitive–emotional coping styles, but no mediating effects with spiritual-centered, collective, and ritual-centered coping. Suggestions for future research and implications are discussed.
There is a growing concern for identifying individuals at risk for suicidal behaviors. Suicidal ideation, that is, the thoughts and cognitions one has about suicidal behaviors and intent, may be considered a primary marker for the risk of more serious suicidal behaviors. This investigation examined the reliability and validity of the Adult Suicidal Ideation Questionnaire (ASIQ; Reynolds, in press-a), a 25-item self-report suicidal ideation measure designed for adults. Subjects were 474 college students from two Midwestern universities. Results indicated high internal consistency (r alpha = .97) and test-retest (rtt = .86) reliability of the ASIQ with college students. Significant correlations (rs = .38 to .60) were found with measures of depression, hopelessness, anxiety, and self-esteem. For the total sample, a multiple correlation of .67 was found between the ASIQ, the independent variables just noted, and history of prior suicide attempt. Factor analysis of the ASIQ produced a four-factor solution. Psychometric support for the utilization of the ASIQ in clinical and research settings is presented and discussed.
The survey data presented here are on the national prevalences of major life-time perceived discrimination and day-to-day perceived discrimination; the associations between perceived discrimination and mental health; and the extent to which differential exposure and differential emotional reactivity to perceived discrimination account for the well-known associations between disadvantaged social status and mental health. Although more prevalent among people with disadvantaged social status, results show that perceived discrimination is common in the total population, with 33.5 percent of respondents in the total sample reporting exposure to major lifetime discrimination and 60.9 percent reporting exposure to day-to-day discrimination. The associations of perceived discrimination with mental health are comparable in magnitude to those of other more commonly studied stressors, and these associations do not vary consistently across subsamples defined on the basis of social status. Even though perceived discrimination explains only a small part of the observed associations between disadvantaged social status and mental health, given its high prevalence, wide distribution, and strong associations with mental health, perceived discrimination needs to be treated much more seriously than in the past in future studies of stress and mental health.
Various authors have noted that interethnic group and intraethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research.
Offers conceptualization of racism-related stress and its impact on well-being that integrates existing theory and research on racism, multicultural mental health, and the stress process. The conceptualization is relevant to diverse racial/ethnic groups, considers the larger social and historical context, and incorporates attention to culture-based variables that may mediate the relationship between racism and well-being. The topics covered include: (1) a definition and conceptualization of racism-related stress, (2) the stress process (racism–related stress and well-being and internal and external mediators), and (3) implications for intervention.
This study explored associations between racism, social class, and health among ethnic minority people in England and Wales.
We conducted a series of regression analyses on cross-sectional data from the Fourth National Survey of Ethnic Minorities to explore the relation between different indicators of racism and health and household occupational class.
Marked independent associations existed between reported experience of racism and perceptions of Britain as a "racist society," household social class, age, sex, and various mental and physical health indicators. These associations showed reasonable consistency across the different ethnic groups.
The different ways in which racism may manifest itself (as interpersonal violence, institutional discrimination, or socioeconomic disadvantage) all have independent detrimental effects on health, regardless of the health indicator used.
This research builds on a series of recent studies that have reported independent effects of personal experiences of racial discrimination on poor mental health outcomes. We suggest that for one mental health outcome, problem drinking, discrimination experiences have an impact not only via abridged socioeconomic attainment and the frustrations associated with institutionally limited opportunity structures, but also by directly increasing the likelihood of problem drinking. Moreover, we argue that personal experiences with discrimination help to foster a set of beliefs about the utility of drinking as a means of reducing stress that in the alcohol literature is referred to as "escapist" drinking. Escapist drinking is proposed as an intervening mechanism that is associated with a higher probability of alcohol-related mental health problems. Using data from the 1999-2000 National Survey of Black Workers, we find that, independent of socioeconomic attainment, personal reports of discriminatory experiences have direct influences on problem drinking. Consistent with our hypotheses, we also find that the effects of personal reports of discrimination are at least partially mediated by the endorsement of beliefs that drinking provides an effective coping mechanism. We conclude that racial impacts on mental health outcomes reflect more than the "simple" effects of constrained socioeconomic attainment.
Background: Research has demonstrated the adverse impact that discrimination has on physical and mental health. However, few studies have examined the association between discrimination and symptoms of posttraumatic stress disorder (PTSD). There is evidence that African Americans experience higher rates of PTSD and are more likely to develop PTSD following trauma exposure than Whites, and discrimination may be one reason for this disparity.
Purpose: To examine the association between discrimination and PTSD among a cross-sectional sample largely comprising African American women, controlling for other psychosocial stressors (psychological distress, neighborhood safety, crime).
Methods: A sample of 806 participants was recruited from two low-income predominantly African American neighborhoods. Participants completed self-report measures of PTSD symptoms, perceived discrimination, perceived safety, and psychological distress. Information on neighborhood crime was obtained through data requested from the city. Multivariate linear regression models were estimated to assess adjusted relationships between PTSD symptoms and discrimination.
Results: Discrimination was significantly associated with PTSD symptoms with a small effect size, controlling for relevant sociodemographic variables. This association remained consistent after controlling for psychological distress, perceived safety, and total neighborhood crime. There was no evidence of a gender by discrimination interaction. Participants who experienced any discrimination were significantly more likely to screen positive for PTSD.
Conclusions: Discrimination may contribute to the disparate rates of PTSD experienced by African Americans. PTSD is associated with a range of negative consequences, including poorer physical health, mental health, and quality of life. These results suggest the importance of finding ways to promote resilience in this at-risk population.
Objectives
A lifecourse framework was used to examine the association between major and everyday measures of perceived discrimination and depressive symptoms among African American men and to evaluate whether these relationships differed for young, middle-aged, and older men.
Method
The association between both major and everyday discrimination and depressive symptoms, as measured by the Center for Epidemiologic Studies Depression (CES-D) scale, was assessed among 296 African American men in the 2011–2014 Nashville Stress and Health Study (NSAHS) using ordinary least squares regression. Interactive associations between major and everyday discrimination and age patterns in the discrimination–depressive symptoms relationship were also investigated.
Results
Everyday, but not major discrimination was associated with depressive symptoms among African American men. This relationship was stronger among middle-aged men and diminished among older men. However, major discrimination, but not everyday discrimination, was associated with depressive symptoms of older men (age 55+), with greatest depressive symptomatology among those reporting both forms of discrimination.
Discussion
Everyday discrimination is a more consistent predictor, relative to major discrimination, of depressive symptoms among African American men across the lifecourse, although there were age and/or cohort differences. Findings also demonstrate the synergistic, or additive, impact of multiple forms of discrimination on mental health.
Past research has identified a link between discrimination and health outcomes among people of color. Perceptions of the cause of discrimination (racial versus other) seem to be important for mental health; however, this relationship has not been fully examined for physical health. Using data from the National Survey of American Life, we find that, among African-Americans, racial discrimination and overall discrimination regardless of attribution are associated with negative health outcomes while non-racial discrimination is not. The results suggest that racial discrimination has a unique adverse effect on physical health for African-Americans that practitioners need to better understand.
Various authors have noted that interethnic group and intraethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research.
Suicide is a public health problem for African Americans who are young and of working age. The purpose of this study was to examine mediated and moderated effects of perceived racism on suicide ideation in a community sample of 236 African American men and women. Measures of suicide ideation, depression symptoms, intrinsic/extrinsic religiosity, and perceived racism were administered. Perceived racial discrimination was directly and indirectly associated with suicide ideation. For participants who reported low levels of extrinsic religiosity, the mediated effect of perceived racism (via depression symptoms) was significant. These findings provide some insight into suicide vulnerability for specific subgroups of African Americans.
G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
Although some have heralded recent political and cultural developments as signaling the arrival of a postracial era in America, several legal and social controversies regarding "reverse racism" highlight Whites' increasing concern about anti-White bias. We show that this emerging belief reflects Whites' view of racism as a zero-sum game, such that decreases in perceived bias against Blacks over the past six decades are associated with increases in perceived bias against Whites-a relationship not observed in Blacks' perceptions. Moreover, these changes in Whites' conceptions of racism are extreme enough that Whites have now come to view anti-White bias as a bigger societal problem than anti-Black bias.
© The Author(s) 2011.
Individuals who experience repeated stressful events are at risk for developing physical and psychological illnesses. African Americans are an ethnic group that is exposed to a range of stressors over time, including racism which leads to discrimination. African Americans also suffer disproportionately from hypertension, cardiac disease, obesity, and drug and alcohol abuse—all illnesses that have been linked to stress. This paper describes a model to guide nursing practice, research, and education about the influence of racism on the cognitive appraisal, stress, and coping of African Americans. Lazarus and Folk man's (1984) phenomenological approach to cognitive appraisal, stress, and coping is the theoretical framework on which the model is based.