Predictors of suicidal ideation among "at risk" cocaine-using African American women

The focus of this study was to identify factors that differentiate women drug abusers who had experienced suicidal ideation from those who did not. Face-to-face interviews were conducted with 221 cocaine-using women in Atlanta, GA, 88 (39.8%) of whom reported thinking about committing suicide at least once during the 90 days prior to interview and 133 (60.2%) of whom did not. Multivariate logistic regression was used to identify predictors of suicidal ideation, and post hoc goodness-of-fit tests were conducted to assess the robustness of final models derived. Model 1 excluded all psychosocial functioning measures and Model 2 included these items. Both models showed that suicidal ideation was more common among women who were unemployed, had been abused sexually, engaged in sexual relations to cope with stresses, or had less helpful relatives. In addition, Model 1 revealed a heightened risk for women experiencing financial problems and those who had a previous mental health diagnosis, whereas Model 2 showed an elevated risk among women who experienced anxiety and those who had lower levels of self-esteem. These findings suggest the need for prevention and intervention programs that target at-risk women, and for such programs to include an emphasis on suicidal ideation in addition to focusing on risk factors that are addressed more commonly.     

Prevalence of suicidal ideation and associated factors among postpartum HIV-positive women in health facilities,South Africa

The goal of this study was to investigate the prevalence of suicidal ideation and its associated factors in postpartum HIV-positive women in South Africa . A cross-sectional survey was carried out on 580 HIV positive postnatal women (M = 28 .5 years; SD = 5 .8) in 48 health facilities in Nkangala district, Mpumalanga, South Africa . Results indicate that 41 .2% of women reported suicidal ideation in the postnatal period . In multivariate analysis, receiving money from the family, having been diagnosed with a sexually transmitted infection (STI) (other than HIV) in the past year, and lack of social support were found to be associated with suicidal ideation . In conclusion, suicidal ideation is common among HIV positive postpartum women, which calls for inclusion of suicidality risk assessment and management protocols in interventions targeting postpartum women living with HIV .     

Acculturative stress, depression, and suicidal ideation in Mexican immigrants

This study examined the relationship among acculturative stress, depression, and suicidal ideation in a sample of Mexican immigrants. Also examined were variables that predict depression and suicidal ideation. Multiple regression analyses revealed that acculturative stress significantly predicted depression and suicidal ideation and that family support, social support, religiosity, agreement with the decision to migrate, and expectations for the future were significant predictors of depression and suicidal ideation. The overall findings suggest that adult Mexican immigrants who experience elevated levels of acculturative stress may be at risk for experiencing critical levels of depression and suicidal ideation. The findings highlight the importance of using culturally relevant clinical methods when assessing and treating the depressed and potentially suicidal acculturating individual.     

Perceived racism, discrimination, and acculturation in suicidal ideation and suicide attempts among black young adults

During young adulthood the suicide rate among Blacks rises dramatically and approaches that of the U.S. general population, requiring that prevention efforts include a focus on Black young adults. Although most research on suicidality among Blacks has focused on risk factors observed in the dominant culture, in this study the authors examined associations between perceived discrimination, racism, and acculturation with lifetime suicidal ideation (SI) and suicide attempt (SA) among Black young adults. Two hundred fifty Black or African American individuals aged 18-24 residing in a midsize northeastern city were recruited to participate through advertisements. Participants filled out self-report questionnaires. Logistic regressions were used to examine the association of each predictor with SI and SA. Greater perceived acculturation was associated with SI in univariate and multivariate models. There were no other statistically significant results concerning the predictors of interest. The link between perceived acculturation and SI is consistent with limited available data, indicating the need for further study including the potential mechanism(s) for the association. Limitations include the cross-sectional design and reliance on subjective measures.     

Perceived burdensomeness, fearlessness of death, and suicidality among deployed military personnel

The interpersonal-psychological theory of suicide posits that the interaction of three elements is required for lethal suicidal behaviors: the perception that one is a burden on others, the perception that one does not belong, and fearlessness about death combined with high pain tolerance (termed “acquired capability” for suicide). Although an ever expanding research base supports the theory, very limited data exist supporting the theory among military personnel, a group that has experienced a rapid increase in suicides during the past several years. The current study tests the interpersonal-psychological theory in two clinical samples of military personnel while deployed to Iraq: those seeking treatment for mild traumatic brain injury, and those seeking outpatient mental health treatment. In both samples, perceived burdensomeness and acquired capability were significantly associated with suicidality, as was their interaction term. Results partially support the interpersonal-psychological theory of suicide, and indicate that perceptions of burdensomeness combined with fearlessness about death are associated with increased suicidality among deployed military personnel.     

Emotions and suicidal ideation among depressed women with childhood sexual abuse histories

Depressed women with sexual abuse histories have a heightened risk of suicidal ideation (SI), which may be only in part attributable to psychiatric symptoms of depression and posttraumatic stress disorder (PTSD). Emotions and SI were studied among 106 women with histories of childhood sexual abuse enrolled in treatment trials for major depression. Assessments were conducted at baseline, 10, 24, and 36 weeks. Sadness, guilt, and shame-proneness were associated with self-reported and observer-rated SI across time after adjusting for depressive and PTSD symptoms, suicide attempt history, and sociodemographic characteristics associated with SI. These findings highlight the need for clinical attention to self-directed negative emotions to potentially reduce suicide-related risk.     

Acculturative stress, depression, and suicidal ideation among Central American immigrants

No previous studies have examined suicide risk among Central American immigrants. The present study explored the relationship between acculturative stress, depression, and suicidal ideation among Central American immigrants. Also examined were variables that predict depression and suicidal ideation. Elevated levels of acculturative stress were significantly correlated with high levels of depression and suicidal ideation. Family dysfunction, ineffective social support, nonpositive expectations concerning the future, low levels of religiosity, low levels of education and income, and lack of agreement with the decision to immigrate were significantly associated with high levels of depression and suicidal ideation. The overall findings suggest that Central American immigrants who experience elevated levels of acculturative stress may be at risk for experiencing heightened levels of depression and suicidal ideation. The findings highlight the importance of using culturally relevant clinical methods when assessing and treating depressed and potentially suicidal acculturating individuals.     

AIDS-related factors predictive of suicidal ideation of low and high intent among gay and bisexual men.

AIDS-related stressors were studied in relationship to suicidal ideation and suicide intent among 778 gay and bisexual men (none with AIDS). Over the previous six months, 27% (n = 212) reported suicidal ideation. Subjects who reported suicidal ideation (compared to those who did not) were more likely to report recent (last 6 months) bereavement of partner, recent ARC diagnosis, and multiple close friends with ARC. Suicide ideators were divided by a median split on a self-report scale of suicide intent into low (n = 105) and high (n = 107) intent suicide ideators. News of HIV seropositivity was specifically related to low intent suicidal ideation. High intent suicidal ideation was associated with having a partner with AIDS or ARC, or multiple close friends with AIDS, or having ARC. Generally speaking, while temporally discrete AIDS-related events were associated the report of suicidal ideation, ongoing stressors which may more greatly challenge adaptational capacities were more associated with high intent suicidal ideation.     

The relationships among gratitude,self‐esteem,depression, and suicidal ideation among undergraduate students

The main purpose of this study was to examine the relationships among gratitude, self‐esteem, depression, and suicidal ideation. In total, 814 undergraduate participants (259 males and 555 females with mean age of 20.13 years) completed four inventories measuring the variables of interest. Analyses of structural equation modeling found that gratitude had direct effects on individuals' self‐esteem, depression, and suicidal ideation. In addition, gratitude had indirect effects on individuals' suicidal ideation via self‐esteem and depression, and self‐esteem had direct effects on individuals' depression. These results support the proposed model of suicidal ideation and contribute to the understanding of how gratitude influences individuals' suicidal ideation via psychological and physical variables.     

Perceived racial/ethnic discrimination, posttraumatic stress symptoms, and health risk behaviors among Mexican American adolescents

Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact.     

Brooding and reflective rumination among suicide attempters: Cognitive vulnerability to suicidal ideation

Previous research suggests that the brooding subtype of rumination is associated with increased suicidal ideation, but findings are inconsistent with respect to reflection, considered to be the more adaptive form of rumination. This study investigated the circumstances under which reflective rumination might be associated with increased suicidal ideation by examining whether a suicide attempt history moderated the relationship between the ruminative subtypes and current suicidal ideation. Thirty-seven young adults who reported a past suicide attempt and fifty-nine young adults without a suicide attempt history completed measures of rumination and depression symptoms in an initial study session. They then completed a measure of suicidal ideation and hopelessness during a second study session. Overall, brooding was associated with higher self-reported suicidal ideation, whereas reflection was not significantly associated with ideation. However, reflection - but not brooding - interacted with suicide attempt history to statistically predict suicidal ideation, even after adjusting for symptoms of depression and hopelessness, whereas brooding no longer predicted ideation after adjusting for these symptoms. These findings qualify earlier suggestions that reflection is a more adaptive form of rumination by indicating that among vulnerable individuals - in particular those with a history of a suicide attempt - a higher degree of reflective rumination is associated with increased suicidal ideation.     

Health-risk behaviors and suicidal ideation: a preliminary study of cognitive and developmental factors

Various theorists have suggested that unhealthy behaviors such as cigarette smoking and problem drinking may be subtle forms of suicidality. Consistent with this view, prior research has shown an association between health risk behaviors and suicidal ideation. In the present study we examined relationships among suicidal ideation, health-related attitudes and behaviors, and adverse childhood events. We hypothesized that unhealthy attitudes, perhaps shaped by adverse childhood events, would help explain the association between suicidal phenomena and unhealthy behaviors. Three-hundred eighteen college students completed surveys covering health risk behaviors, depression, suicidal ideation, and health-related attitudes. Results supported the hypothesized associations among these variables. However, contrary to our hypotheses, the association between suicidal ideation and health-compromising behaviors was limited largely to substance-related behaviors. Moreover, the association between suicidal ideation and health-related attitudes was mediated by depression. Adverse childhood events were associated with health-related attitudes, but this relationship was mediated by depression. These results are less suggestive of the notion of unhealthy behaviors as subtle suicidality than a model in which suicidality associates specifically with psychopathological states such as depression and substance abuse. Implications for treatment and prevention programs are discussed.     

The socialization of prosocial behavioral tendencies among Mexican American adolescents: The role of familism values

This study investigates the role of familism values in fostering socialization experiences that promote prosocial behavioral tendencies among Mexican American adolescents. Two hundred and four Mexican American mothers and their adolescent children (104 girls, age M = 10.91 years) completed measures of familism values, prosocial parenting practices, and prosocial behavioral tendencies. Structural equation modeling tests indicated that mothers' familism values are related to parenting behaviors that promote prosocial behavioral tendencies, which in turn are related to adolescents' perception of prosocial parenting practices. Furthermore, adolescents' perception of prosocial parenting practices is related to familism values and prosocial behavior tendencies. Last, the relation between adolescents' perception of prosocial parenting practices and prosocial behavioral tendencies is partially mediated by familism values. These findings are consistent with the theoretical suggestion that the transmission of traditional familism values may serve as a social medium through which prosocial behavioral tendencies are fostered among Mexican American adolescents.     

Person factors associated with suicidal behavior among African American women and men

This study compared person risk factors among the following groups of low-income, African American adults in an urban, public hospital: (a) suicide attempters and nonattempters, (b) male and female attempters, and (c) all 4 groups (50 female attempters, 50 female nonattempters, 50 male attempters, and 50 male nonattempters). Participants completed psychological distress, aggression, substance use, cognitive processes, religiosity/spirituality, and ethnic identity measures. Compared with nonattempters, attempters reported more psychological distress, aggression, substance use, and maladaptive coping strategies; less religiosity/spirituality; and lower levels of ethnic identity. Male attempters endorsed more substance use than female attempters. No person risk factors differentiated among the 4 groups. Assessment of person risk factors and implementation of commensurate culturally competent interventions are recommended.