10 Suicidality Among Acculturating Mexican Americans: Current Knowledge and Directions for Research

Despite the dramatic increase in Mexican-American immigration over the past two decades, the acculturative experience and its relationship to suicide risk have received little attention within the field of suicidology. This paper summarizes findings from community-based studies that have explored suicide and risk factors among immigrant and Mexican-American groups, and suggests directions for future research. Most of these studies have been epidemiologic, and relatively few have addressed risk and protective factors within well-defined acculturating groups. Further study of the full continuum of suicidal thoughts and behaviors that examines precise cultural risk factors, and uses methodologies that combine quantitative and qualitative data, may improve our understanding of suicide risk among acculturating Mexican Americans.     

Spiritual health locus of control and breast cancer beliefs among urban African American women.

The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted.     

Self‐Efficacy to Avoid Suicidal Action: Factor Structure and Convergent Validity among Adults in Substance Use Disorder Treatment

Individuals with substance use disorders (SUDs) are at high risk of suicidal behaviors, highlighting the need for an improved understanding of potentially influential factors. One such domain is self‐efficacy to manage suicidal thoughts and impulses. Psychometric data about the Self‐Efficacy to Avoid Suicidal Action (SEASA) Scale within a sample of adults seeking SUD treatment (N = 464) is provided. Exploratory factor analysis supported a single self‐efficacy construct. Lower SEASA scores, or lower self‐efficacy, were reported in those with more severe suicidal ideation and those with more suicide attempts, providing evidence for convergent validity. Implications of measuring self‐efficacy in the context of suicide risk assessment are discussed.     

Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force

Abstract

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.