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Ellis É, Wieling E, Tate A. Complex Posttraumatic Stress Disorder Links Trauma Exposure and Suicidal Behaviors Among Sexual Minority Populations: A New Target in Suicide Prevention? JOURNAL OF HOMOSEXUALITY 2024; 71:2300-2318. [PMID: 37466931 DOI: 10.1080/00918369.2023.2233654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Exposure to potentially traumatic events and posttraumatic stress are known risk factors for suicidal thoughts and behaviors (STB). Research suggests that sexual minorities are disproportionately exposed to traumatic events and experience greater STB than their heterosexual peers, although few studies have explored connections between these parallel disparities. Further, existing literature may implicate complex posttraumatic stress disorder (CPTSD) as a potential mechanism in the trauma-suicide connection among sexual minorities. This study uses a sample from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; n = 1351) to test structural equation models for associations between trauma exposure, heterosexist discrimination, and CPTSD with suicide attempt status. We found CPTSD mediated associations between exposure to traumatic events and presence of a lifetime suicide attempt among sexual minority male and female samples. Discrimination demonstrated a synergistic effect on the association between trauma exposure and CPTSD, but, among males, CPTSD did not fully explain associations between discrimination and suicide attempts. Our findings suggest that CPTSD should be considered an important mechanism in the trauma-suicide connection for sexual minorities and may be a potentially important target for suicide prevention and that interventions should address the influence of discrimination on traumatic stress in this high-risk population.
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Affiliation(s)
- Émilie Ellis
- College of Public Health, University of Georgia School of Public Health, Athens, Georgia, USA
| | - Elizabeth Wieling
- Human Development and Family Science, University of Georgia Department of Human Development and Family Science, Athens, Georgia, USA
| | - Allan Tate
- College of Public Health, University of Georgia School of Public Health, Athens, Georgia, USA
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Boyd DT, Quinn CR, Durkee MI, Williams EDG, Constant A, Washington D, Butler-Barnes ST, Ewing AP. Perceived discrimination, mental health help-seeking attitudes, and suicide ideation, planning, and attempts among black young adults. BMC Public Health 2024; 24:2019. [PMID: 39075376 PMCID: PMC11285399 DOI: 10.1186/s12889-024-19519-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/18/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Developing an understanding of the negative impact of discrimination is critical when examining the suicidality of Black young adults in the US. Suicide rates among Black young adults have increased at alarming rates. One of the reasons for this increase is the disparities related to access to mental health services, which has long-term health consequences. This study addresses a significant gap in the literature by examining associations between experiences of everyday discrimination, attitudes towards mental health help-seeking attitudes, on the outcomes suicide ideation, planning to die by suicide, and suicide attempts. METHODS The data came from a national study of the experiences of Black young adults regarding mental, physical, and sexual health. Participants were recruited from across the Midwestern region of the United States through Qualtrics Panels, an online survey delivery service used to recruit study participants. The total sample for this study was N = 362, and the average age of the sample was 21 (SD: 1.96). We used a logistic regression analysis to examine the role of everyday discrimination, mental health support-seeking attitudes, and covariates on the outcomes: suicide ideation, planning to die by committing suicide, and suicide attempts. RESULTS Black young adults with positive mental health help-seeking attitudes were 34% less likely to attempt suicide (OR = 0.66; 95% CI: 0.46, 0.96) and 35% less likely to experience suicide ideation (OR = 0.65; 95% CI: 0.47, 0.89). However, those young adults who experienced discrimination daily were more likely to report having attempted suicide (OR = 1.70; 95% CI: 1.34, 2.15). CONCLUSIONS Our findings offer valuable insights into the complex interplay between experiences of discrimination, attitudes toward seeking mental health support, and suicidal behaviors. However, our research also underscores how experiences of discrimination can significantly exacerbate feelings of isolation, hopelessness, and inadequacy, further contributing to suicidal behaviors in this population. By promoting positive mental health help-seeking behaviors, actively addressing discrimination, and applying an intersectional approach to suicide prevention efforts, we can take significant strides towards building a more supportive and inclusive society. This approach aims to empower individuals to seek help, reduce the risk of suicidal behaviors, and create a more welcoming environment for all members of our community.
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Affiliation(s)
- Donte T Boyd
- College of Social Work, The Ohio State University, 1047 College RD, #325K, Columbus, OH, 43215, USA.
- Center for Equitable Family & Community Well-Being, School of Social Work, University of Michigan, Ann Arbor, MI, USA.
| | - Camille R Quinn
- Center for Equitable Family & Community Well-Being, School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Myles I Durkee
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | | | - Andrea Constant
- Department of Sociology, The Ohio State University, Columbus, OH, USA
| | | | | | - Aldenise P Ewing
- College of Public Health, The Ohio State University, Columbus, OH, USA
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Mehari KR, Smith PN, Morton BC, Billingsley JL, Coleman JN, Farrell AD. Challenges in Evaluating a Community-Level Intervention to Address Root Causes of Youth Violence. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:774-785. [PMID: 38733468 PMCID: PMC11321925 DOI: 10.1007/s11121-024-01678-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
Violence disproportionately impacts Black American youth, representing a major health disparity. Addressing the possible root causes of structural inequities to reduce violence may increase the impact of prevention strategies. However, efforts to evaluate the impact of such interventions pose numerous methodological challenges, particularly around selecting an effective evaluation design to detect change at the community level, with adequate power and sampling, and appropriate constructs and measurement strategies. We propose a multiple baseline experimental design to evaluate the impact of a community-level youth violence and suicidality prevention strategy. A multiple baseline experimental design with multiple community units balances the need for scientific rigor with practical and values-based considerations. It includes randomization and plausible counterfactuals without requiring large samples or placing some communities in the position of not receiving the intervention. Considerations related to the conceptualization of the logic model, mechanisms of change, and health disparity outcomes informed the development of the measurement strategy. The strengths and weaknesses of a multiple baseline experimental design are discussed in comparison to versions of randomized clinical trials. Future health disparity intervention evaluation research will benefit from (1) building a shared sense of urgent public need to promote health; (2) respecting the validity of values- and partnership-based decision-making; and (3) promoting community-based and systems-level partnerships in scientific grant funding. The described study has been registered prospectively at clinicaltrials.gov, Protocol Record 21-454.
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Affiliation(s)
- Krista R Mehari
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
| | - Phillip N Smith
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | - Benterah C Morton
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | | | - Jasmine N Coleman
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Albert D Farrell
- Clark-Hill Institute for Positive Youth Development & Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Robison M, Jeon ME, Udupa NS, Potter M, Robertson L, Joiner T. The Self-Dehumanization Scale: Three Studies on Its Development and Validation. J Pers Assess 2024:1-17. [PMID: 38940620 DOI: 10.1080/00223891.2024.2367543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 05/31/2024] [Indexed: 06/29/2024]
Abstract
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.
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Affiliation(s)
| | - Min Eun Jeon
- Department of Psychology, Florida State University
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Kogan SM, Reck AJ, Curtis MG, Oshri A. Childhood adversity and racial discrimination forecast suicidal and death ideation among emerging adult Black men: A longitudinal analysis. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024:2024-50864-001. [PMID: 38330370 PMCID: PMC11306413 DOI: 10.1037/cdp0000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Disproportionate exposure to childhood adversity and the effects of racial discrimination take a toll on Black American men's mental health. Despite increasing rates of suicidal behaviors and thoughts among young adult, Black American men, few longitudinal studies examine their risk for suicidal and death ideation (SDI). We tested a developmental model linking childhood adversity (experiences of deprivation and threatening experiences) and emerging adult exposure to racial discrimination to increases in SDI and examined a potential mechanism for these effects, negative relational schemas. METHOD A sample of 504 Black men (Mage = 20.7) from rural Georgia were recruited with respondent-driven sampling and completed a baseline survey. Men participated in two additional follow-up surveys (Mage = 21.9 and Mage = 23.5). Hypotheses were tested using structural equation modeling. RESULTS Analyses largely supported the proposed model. Childhood adversities were associated directly with reports of SDI. Childhood deprivation indirectly predicted SDI via negative schemas (β = 0.03, 95% CI [.014, .046]). Racial discrimination also indirectly predicted SDI via negative relational schemas (β = 0.01, 95% CI [.001, .018]). CONCLUSION Study results suggest that clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Steven M. Kogan
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Ava J. Reck
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Michael G. Curtis
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
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Kılıçarslan Ş, Çelik S, Güngör AY, Alkan Ö. The role of effective factors on suicidal tendency of women in Turkey. Front Public Health 2024; 11:1332937. [PMID: 38274522 PMCID: PMC10809711 DOI: 10.3389/fpubh.2023.1332937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background/Aim This study aims to identify the variables that influence the suicidal tendency of women who are married, have had a relationship or are currently in a relationship in Turkey. Methods This study uses cross-sectional data from the 2014 Hacettepe University Institute of Population Studies National Research on Domestic Violence Against Women in Turkey. Data from 6,458 women between the ages of 15 and 49 were analyzed in this dataset. Binary logistic regression was used to determine the factors influencing women's suicidal tendencies. Results Based on the analysis's findings, age, education level, health status, number of children, the sector in which the spouse/partner works, the drinking status of the spouse/partner, the situation where the spouse/partner fights with another man in a way that involves physical violence, the cheating status of the spouse/partner, the controlling behaviour of the spouse/partner, exposure to various types of violence by both the spouse/partner and someone other than the partner, and the household income level variables were found to be associated with the suicidal tendency of women. Conclusion Prioritizing women who are, in particular, between the ages of 15 and 24, live in the south of Turkey, have a high school education, are in poor health, are childless, have low household incomes, live with an unemployed spouse or partner, and are exposed to various forms of violence from their partner or other sources can be achieved more effective results in reducing and preventing women's suicidal behaviors.
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Affiliation(s)
- Şerife Kılıçarslan
- Oltu Faculty of Humanities and Social Sciences, Department of Finance and Banking, Ataturk University, Erzurum, Türkiye
| | - Sefa Çelik
- Faculty of Economics and Administrative Sciences, Department of Business Administration, Ataturk University, Erzurum, Türkiye
| | - Abdullah Y. Güngör
- Oltu Faculty of Humanities and Social Sciences, Department of Business Administration, Ataturk University, Erzurum, Türkiye
| | - Ömer Alkan
- Faculty of Economics and Administrative Sciences, Department of Econometrics, Ataturk University, Erzurum, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. Şti., Erzurum, Türkiye
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Joseph VA, Martínez-Alés G, Olfson M, Shaman J, Gould MS, Gimbrone C, Keyes KM. Trends in Suicide Among Black Women in the United States, 1999-2020. Am J Psychiatry 2023; 180:914-917. [PMID: 38037401 PMCID: PMC11205256 DOI: 10.1176/appi.ajp.20230254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Objective: Recent increases in suicide deaths among Black women in the US warrant further investigation. Our objective was to clarify the epidemiology of suicide among Black girls and women, by estimating age-period-cohort effects on suicide rates among decedents coded as female aged 15-84 years. Methods: The present study examined annual time-series data from the National Center for Health Statistics’ Multiple Cause of Death 1999-2020 database. Suicide rates by age, period, and cohort were visualized using hexagonal maps, and estimated using modified Poisson regression to address identifiability. Results: In total, our analysis included 9,271 suicide deaths. Results indicated the presence of all three effects: (i) a clear age effect, with higher rates at younger ages, regardless of cohort and time, (ii) a period effect, with rates generally increasing across time for most ages, and (iii) a cohort effect, with a clustering of increased suicide rates among the youngest cohorts. Across regions, rates were highest among the youngest age groups, concentrated in the West. Conclusion: Suicide is increasing rapidly among Black females – with particularly concerning trends among the youngest Black females born in the most recent birth cohorts. Findings suggest a need for increased mental health access and geographically targeted prevention efforts.
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Affiliation(s)
- Victoria A. Joseph
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Gonzalo Martínez-Alés
- CAUSALab, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States; Mental Health Network Biomedical Research Center (CIBERSAM), Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Mark Olfson
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York, United States; Department of Psychiatry, Columbia University, New York, New York, United States
| | - Jeffrey Shaman
- Department of Environmental Health Sciences (EHS), Columbia University Mailman School of Public Health, Columbia University, New York, New York, United States; Columbia Climate School, Columbia University, New York, New York, United States
| | - Madelyn S Gould
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York, United States; Department of Psychiatry, Columbia University, New York, New York, United States
| | - Catherine Gimbrone
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States
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Floyd LJ, Brown K. Perceived neighborhood disorder as a moderator of the relationship between marijuana use and disinhibition in a sample of emerging adult African American females. J Ethn Subst Abuse 2023:1-15. [PMID: 37270673 PMCID: PMC10694336 DOI: 10.1080/15332640.2023.2195691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Disinhibition is associated with myriad risk-taking behaviors and adverse outcomes. Both marijuana use and poor neighborhood conditions have been associated with disinhibition. However, the extent to which neighborhood disorder interacts with marijuana use to influence disinhibition has not been studied, extensively. A better understanding of these relationships has implications for designing more effective tailored place-based interventions that aim to reduce risk taking behaviors and related adverse social and health outcomes associated with marijuana use. Thus, the purpose of this study was to examine the interactive effects of perceived neighborhood disorder and marijuana use on disinhibition. The sample included 120 African American female residents of disadvantaged neighborhoods (Mage = 23.6 ± 3.46). We employed hierarchical linear regression analysis to examine the interactive effects of marijuana use and perceived neighborhood disorder on disinhibition, while controlling for age and education. The interaction term was marginally significant (b = 5.66; t(109) = 1.72, p = .08). Next, the conditional effects were explored. Results indicated the association of marijuana use with disinhibition was stronger for females in the higher neighborhood disorder group, compared to those in the lower neighborhood disorder group (10.40 and 4.51, respectively). Our findings support the need for more research on the potential of neighborhood disorder to amplify the effects of marijuana use on disinhibition and related neurobehavioral traits. The identification of contextual moderators and high-risk sub-groups will aid in the design of more tailored place-based interventions that aim to reduce risk-taking behavior among those most vulnerable.
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Keum BT. Impact of Online Racism on Suicide Ideation Through Interpersonal Factors Among Racial Minority Emerging Adults: The Role of Perceived Burdensomeness and Thwarted Belongingness. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:4537-4561. [PMID: 35942944 PMCID: PMC9900690 DOI: 10.1177/08862605221117247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
While a growing number of studies have documented significant links between online racism (e.g., racist interactions, contents on racial violence) and comorbid factors (e.g., depression) associated with suicide risk, no studies have examined whether online racism predicts suicide ideation and if interpersonal factors can help explain this link. Thus, the current study examined the direct relationship between online racism and suicide ideation among racial minority emerging adults, and the indirect relationships via the interpersonal factors (perceived burdensomeness and thwarted belongingness). Using data from a convenience sample of 338 racial minority emerging adults, we conducted a path analysis with online racism predicting suicide ideation through thwarted belongingness and perceived burdensomeness. Online racism significantly predicted suicide ideation via perceived burdensomeness but not thwarted belongingness. Post hoc multi-group analysis found that this pathway was consistent across Black, Asian, and Latinx groups but was completely mediated for the Asian group. The findings suggest that online racism can increase feelings of being a burden to society, which can trigger thoughts of suicide. This process may be particularly salient among Asian individuals. Implications for future research are discussed.
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Willemen FEM, Heuschen CBBCM, Zantvoord JB, Galenkamp H, de Wit MAS, Zwinderman AH, Denys DAJP, Bockting CLH, Stronks K, Lok A. Perceived ethnic discrimination, suicidal ideation and mastery in a multi-ethnic cohort: the HELIUS study. BJPsych Open 2023; 9:e21. [PMID: 36660955 PMCID: PMC9885336 DOI: 10.1192/bjo.2022.640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The association between perceived ethnic discrimination (PED) and mental health conditions is well studied. However, less is known about the association between PED and suicidal ideation, or the role of positive psychosocial factors in this association. AIMS To examine the association between PED and suicidal ideation among ethnic minority groups in Amsterdam, The Netherlands, and investigate whether ethnicity and mastery (people's extent of feeling in control of their lives and environment) moderate this association. METHOD Cross-sectional data from the multi-ethnic HELIUS study were analysed (n = 17 053) for participants of South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin. PED was measured using the Everyday Discrimination Scale, suicidal ideation using item 9 of the Patient Health Questionnaire-9 and mastery using the Pearlin-Schooler Mastery Scale. RESULTS Logistic regression analyses demonstrated a small positive association between PED and suicidal ideation (OR = 1.068, 95% CI 1.059-1.077), which did not differ among ethnic minority groups. Mastery did not moderate the association between PED and suicidal ideation among the ethnic minority groups. CONCLUSIONS Our findings support the hypothesis that PED is associated with suicidal ideation and this association does not significantly vary between ethnic minority groups. Although higher levels of mastery were associated with lower suicidal ideation, mastery did not moderate the relationship between PED and suicidal ideation. Besides targeting ethnic discrimination as a societal problem, future longitudinal research is needed to investigate whether interventions aimed at improving mastery could reduce suicidal ideation in ethnic minority groups.
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Affiliation(s)
- Fabienne E M Willemen
- Department of Psychiatry, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands
| | - Caroline B B C M Heuschen
- Department of Psychiatry, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands
| | - Jasper B Zantvoord
- Department of Psychiatry, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands; and Department of Child and Adolescent Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands
| | - Matty A S de Wit
- Department of Epidemiology, Health Promotion and Care Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Aeilko H Zwinderman
- Center for Urban Mental health, University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan A J P Denys
- Department of Psychiatry, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands
| | - Claudi L H Bockting
- Department of Psychiatry, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands; and Center for Urban Mental health, University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands; and Center for Urban Mental health, University of Amsterdam, Amsterdam, The Netherlands
| | - Anja Lok
- Department of Psychiatry, University of Amsterdam, Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands; and Center for Urban Mental health, University of Amsterdam, Amsterdam, The Netherlands
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Schouler-Ocak M, Moran JK. Racial discrimination and its impact on mental health. Int Rev Psychiatry 2022:1-9. [PMID: 36519290 DOI: 10.1080/09540261.2022.2155033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There is evidence that racial discrimination at different levels has a major impact on mental health over the whole life span. It is related generally to poor health, with the relationship being particularly strong for mental health. All forms of structural, institutionalised, interpersonal and internalised racism as well as the cumulative impact of intersectional discrimination appear to be linked to mental health and well-being. Studies also show links between effects of racial discrimination and neurophysiology especially on the brain volume. All forms of racism need to be addressed in inter- and transdisciplinary ways in order to dismantle racial discrimination. This review provides an overview of these interconnections.
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Affiliation(s)
- Meryam Schouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital Berlin, Berlin, Germany
| | - James Kenneth Moran
- Department of Psychiatry and Psychotherapy, Multisensory Integration Lab, Charité Universitätsmedizin Berlin, Berlin, Germany
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Meta-analysis of the effect of racial discrimination on suicidality. SSM Popul Health 2022; 20:101283. [PMID: 36387016 PMCID: PMC9646655 DOI: 10.1016/j.ssmph.2022.101283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Racial discrimination (RD) is unfair treatment of individuals based on race or ethnicity. It is a pervasive and increasing phenomenon in the lives of many individuals with deleterious effects on mental health. Research implicates RD in diminished well-being, lower life satisfaction and self-esteem, and mental health disorders. Furthermore, there have been reports that minorities and marginalized groups exposed to RD are at a higher risk of suicide. Given that RD negatively impacts mental health and that suicide is a major public health concern, we meta-analytically reviewed the literature to investigate whether RD is associated with suicidal ideation (SI) and suicide attempt (SA). We identified 43 eligible articles investigating the association between RD and suicidality through PubMed, Embase, PsycINFO and Scopus, from which we pooled 39 effect sizes for SI (58,629 individuals) and 15 for SA (30,088 individuals). Results demonstrated that RD has a small but significant effect both on SI (r = 0.16, 95% CI: 0.12 to 0.19; p < 0.0001) and on SA (r = 0.13, 95% CI: 0.02 to 0.23; p = 0.018). We found no indication of publication bias, and fail-safe tests confirmed the robustness of the results. Furthermore, we tested the moderating effects of several study characteristics (e.g., age, race, RD and SI time frame assessment, and categorization of RD measures). The only study characteristic to moderate the effect of RD on SI was SI time frame assessment (r = 0.07; 95% CI: 0.015 to 0.12; p = 0.01). Our findings suggest that SI and SA are phenomena that may be influenced by exposure to RD. Thus, individuals that are discriminated based on race may develop more suicidal thoughts and an increased likelihood of attempting suicide. These findings underscore the need for more prevention and intervention efforts to attenuate the effect of RD on suicidality. We conducted a meta-analysis of 62,349 individuals. We pooled effect sizes from 43 studies from seven countries. Racial discrimination has a statistically significant effect on suicidal ideation (r = 0.16, p < 0.0001). Racial discrimination has a statistically significant effect on suicide attempt (r = 0.13, p = 0.018).
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Kreniske P, Morrison C, Spencer BH, Levine A, Liotta L, Fisher PW, Nguyen N, Robbins RN, Dolezal C, Kluisza L, Wiznia A, Abrams EJ, Mellins CA. HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area. J Int AIDS Soc 2022; 25 Suppl 4:e25984. [PMID: 36176026 PMCID: PMC9522633 DOI: 10.1002/jia2.25984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/01/2022] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV-exposed but uninfected (AYAPHEU). METHODS Data come from an ongoing longitudinal New York City-based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12-18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first-reported suicide attempt. Generalized estimating equations were used to examine associations between first-reported suicide attempt and socio-demographic, contextual and psychosocial correlates measured concurrently across six timepoints. RESULTS At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21-33%) compared to AYAPHEU (16%, CI 10-22%), with an OR of 1.74 (CI 1.04-2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46-4.85), mood (OR 3.62, CI 1.49-8.81) and behaviour disorders (OR 5.05, CI 2.15-11.87) and past-year arrest (OR 3.05, CI 1.26-7.4), negative life events (OR 1.27, CI 1.11-1.46), city stress (OR 2.28, CI 1.46-3.57), pregnancy (OR 2.28, CI 1.08-4.81) and HIV stigma (OR 2.46, CI 1.27-4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14-0.52), higher personal (OR 0.45, CI 0.26-0.80) and family self-concept (OR 0.36, CI 0.22-0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. CONCLUSIONS AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Corey Morrison
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Bailey Holmes Spencer
- Department of Population and Family HealthMailman School of Public HealthColumbia UniversityNew York CityNew YorkUSA
| | - Alina Levine
- Mental Health Data ScienceResearch Foundation for Mental HygieneNew York CityNew YorkUSA
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Prudence W. Fisher
- Child and Adolescent PsychiatryNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Nadia Nguyen
- The Aaron Diamond AIDS Research CenterNew York CityNew YorkUSA
| | - Reuben N. Robbins
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
| | - Andrew Wiznia
- Jacobi Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Elaine J. Abrams
- ICAP at Columbia UniversityMailman School of Public Health and Vagelos College of Physicians & SurgeonsColumbia UniversityNew York CityNew YorkUSA
| | - Claude A. Mellins
- HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew York CityNew YorkUSA
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Hoffmire CA, Borowski S, Griffin BJ, Maguen S, Vogt D. Trajectories of suicidal ideation following separation from military service: Overall trends and group differences. Suicide Life Threat Behav 2022; 52:413-426. [PMID: 35067967 DOI: 10.1111/sltb.12831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although the transition out of military service is a high-risk time for suicidal ideation (SI), a paucity of research examines the development of SI during this transition process and veteran subgroups at risk for SI as they readjust to civilian life. METHODS A population-based, longitudinal post-9/11 veteran cohort reported SI frequency at 3, 9, 15, 21, and 27 months post-separation using the Patient Health Questionnaire-9. We identified distinct trajectories of SI over time (i.e., classes) using latent class growth analysis and examined demographic and military service predictors of class membership overall and by gender using multinomial logistic regression. RESULTS Four SI trajectories that were similar across genders were identified: resilient (90.1%), delayed onset (5.0%), remitting (2.7%), and chronic (2.2%). Younger age, minority race/ethnicity, medical and other (vs. honorable) separation types, and Veterans Health Administration service utilization were associated with increased odds of assignment to a higher-risk trajectory (delayed onset, remitting, and/or chronic vs. resilient), whereas continued service in the National Guard/Reserves and officer rank was associated with lower odds of assignment to a higher-risk trajectory. CONCLUSIONS Findings regarding veterans at greatest risk for SI following military separation can inform targeted assessment and early intervention efforts.
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Affiliation(s)
- Claire A Hoffmire
- Rocky Mountain MIRECC for Suicide Prevention, Department of Veterans Affairs, Aurora, Colorado, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shelby Borowski
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Brandon J Griffin
- Central Arkansas VA Health Care System, Department of Veterans Affairs, Little Rock, Arkansas, USA.,Department of Psychiatry, University of Arkansas for Medical Services School of Medicine, Little Rock, Arkansas, USA
| | - Shira Maguen
- San Francisco VA Health Care System, Department of Veterans Affairs, San Francisco, California, USA.,Department of Psychiatry, University of California - San Francisco, San Francisco, California, USA
| | - Dawne Vogt
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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Milam AJ, Brown I, Edwards-Johnson J, McDougle L, Sousa A, Furr-Holden D. Experiences of Discrimination, Institutional Responses to Seminal Race Events, and Depressive Symptoms in Black U.S. Medical Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:876-883. [PMID: 35703911 PMCID: PMC9204755 DOI: 10.1097/acm.0000000000004638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students. METHOD This study collected data from a convenience sample of Black U.S. medical students via an anonymous electronic questionnaire in August 2020 that was distributed through the Student National Medical Association and Organization of Student Representatives listservs and an author's social media accounts. It included questions on demographics, institutional responses to seminal race events, experiences of discrimination, and symptoms of depression. Path models were used to examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students. RESULTS Of the 750 students completing the survey, 733 (97.7%) were Black. Experiences of discrimination and a lack of institutional responses to seminal race events were associated with more depressive symptoms (b = 0.19, 95% CI: 0.11, 0.26; P < .001 and b = 0.12, 95% CI: 0.04, 0.20; P = .01). After controlling for gender and clinical diagnosis of depression or anxiety before medical school, there was a relationship between experiences of discrimination and institutional responses to seminal race events such that students who reported more experiences of discrimination were more likely to report that their institution did not respond to seminal race events (b = 0.41, 95% CI: 0.34, 0.48; P < .001). Experiences of discrimination moderated the relationship between institutional responses to seminal race events and depressive symptoms (i.e., the relationship between a lack of institutional responses to seminal race events and depressive symptoms was stronger among students who reported more frequent experiences of discrimination). CONCLUSIONS Institutions dedicated to supporting Black medical student wellness must be diligent in cultivating a culture intolerant of discrimination and deft in their responses to seminal race events in the larger culture.
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Affiliation(s)
- Adam J Milam
- A.J. Milam is associate professor of anesthesiology, Mayo Clinic, Phoenix, Arizona; ORCID: https://orcid.org/0000-0001-9306-1598
| | - Italo Brown
- I. Brown is assistant professor of emergency medicine, Stanford University School of Medicine, Stanford, California
| | - Jennifer Edwards-Johnson
- J. Edwards-Johnson is associate professor and community assistant dean, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Leon McDougle
- L. McDougle is professor of family medicine and associate dean for diversity and inclusion, The Ohio State University College of Medicine, Columbus, Ohio; ORCID: https://orcid.org/0000-0003-2400-8763
| | - Aron Sousa
- A. Sousa is interim dean, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Debra Furr-Holden
- D. Furr-Holden is the C.S. Mott Endowed Professor of Public Health and associate dean for public health integration, College of Human Medicine, Michigan State University, East Lansing, Michigan; ORCID: https://orcid.org/0000-0002-9337-9886
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16
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Argabright ST, Visoki E, Moore TM, Ryan DT, DiDomenico GE, Njoroge WFM, Taylor JH, Guloksuz S, Gur RC, Gur RE, Benton TD, Barzilay R. Association Between Discrimination Stress and Suicidality in Preadolescent Children. J Am Acad Child Adolesc Psychiatry 2022; 61:686-697. [PMID: 34425231 PMCID: PMC8917360 DOI: 10.1016/j.jaac.2021.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/17/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). METHOD We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. RESULTS Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). CONCLUSION Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.
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Affiliation(s)
- Stirling T Argabright
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Elina Visoki
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Tyler M Moore
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dallas T Ryan
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Grace E DiDomenico
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Wanjikũ F M Njoroge
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jerome H Taylor
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Sinan Guloksuz
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, the Netherlands; Yale University School of Medicine, New Haven, Connecticut
| | - Ruben C Gur
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raquel E Gur
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tami D Benton
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ran Barzilay
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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Opara I, Assan MA, Pierre K, Gunn JF, Metzger I, Hamilton J, Arugu E. Suicide Among Black Children: An Integrated Model of the Interpersonal-Psychological Theory of Suicide and Intersectionality Theory for Researchers and Clinicians. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:232-240. [PMID: 37153126 PMCID: PMC10153497 DOI: 10.1176/appi.focus.22020003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 05/09/2023]
Abstract
Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States. Reprinted with permission of SAGE Publications; Opara et al. J Black Stud (51:611-631), copyright 2020.
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Affiliation(s)
- Ijeoma Opara
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Maame Araba Assan
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Kimberly Pierre
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - John F Gunn
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Isha Metzger
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Jahi Hamilton
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Eileen Arugu
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
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Meza JI, Patel K, Bath E. Black Youth Suicide Crisis: Prevalence Rates, Review of Risk and Protective Factors, and Current Evidence-Based Practices. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:197-203. [PMID: 37153125 PMCID: PMC10153500 DOI: 10.1176/appi.focus.20210034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
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.
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Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Meza, Bath); Graduate School of Psychology, California Lutheran University, Thousand Oaks (Patel)
| | - Katie Patel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Meza, Bath); Graduate School of Psychology, California Lutheran University, Thousand Oaks (Patel)
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Meza, Bath); Graduate School of Psychology, California Lutheran University, Thousand Oaks (Patel)
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Argabright ST, Visoki E, Moore TM, Ryan DT, DiDomenico GE, Njoroge WFM, Taylor JH, Guloksuz S, Gur RC, Gur RE, Benton TD, Barzilay R. Association Between Discrimination Stress and Suicidality in Preadolescent Children. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:252-262. [PMID: 37153135 PMCID: PMC10153507 DOI: 10.1176/appi.focus.22020005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 05/09/2023]
Abstract
Objective Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). Method We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. Results Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). Conclusion Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.Reprinted from J Am Acad Child Adolesc Psychiatry, Argabright et al., Association Between Discrimination Stress and Suicidality in Preadolescent Children, S0890-8567(21)01355-1, copyright 2021, with permission from Elsevier.
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Eisenlohr-Moul T, Divine M, Schmalenberger K, Murphy L, Buchert B, Wagner-Schuman M, Kania A, Raja S, Miller AB, Barone J, Ross J. Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder. BMC Psychiatry 2022; 22:199. [PMID: 35303811 PMCID: PMC8933886 DOI: 10.1186/s12888-022-03851-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/02/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among Americans ages 10 to 34, with alarming recent increases in suicide rates among those assigned female at birth. A large body of evidence points to menstrual cycle influences on self-injurious thoughts and behaviors (STBs), suggesting that neurobiological hormone sensitivities, such as in premenstrual dysphoric disorder (PMDD), may drive suicide risk in females. However, existing studies of STBs in PMDD use cross-sectional self-report measures of PMDD with poor validity. As a first step to establish accurate prevalence rates of STBs in PMDD, we examined the lifetime prevalence of STBs in a large global survey of patients reporting a diagnosis of PMDD based on daily ratings. METHOD Individuals with self-reported PMDD symptoms were invited to an online survey through online support groups for PMDD and social media posts from PMDD awareness accounts. Participants reported demographics, whether they had been diagnosed with PMDD by a healthcare provider using daily ratings, STBs using the Columbia Suicide Severity Rating Scale, and history of lifetime comorbid psychiatric diagnoses. RESULTS Of 2,689 survey completers, 599 (23%) reported a diagnosis with PMDD based on two months of daily ratings and were included in analyses. We observed high rates of lifetime active suicidal ideation (72%), planning (49%), intent (42%), preparing for an attempt (40%), and attempt (34%), as well as non-suicidal self-injury (51%). The majority (70%) of the sample reported at least one lifetime comorbid psychiatric diagnosis. Predictors of lifetime active suicidal ideation included nulliparity, low-to-moderate (vs. high) income, and history of diagnosis with major depression or post-traumatic stress disorder. Predictors of lifetime attempts among those reporting lifetime active ideation included older age, nulliparity, lower income, and history of diagnosis with post-traumatic stress disorder or borderline personality disorder. CONCLUSIONS These data indicate high rates of STBs among those reporting prospective diagnosis of PMDD and highlight the need for prospective research on mechanisms and prevention of STBs in PMDD. Clinical practice guidelines for PMDD should accommodate comorbidities and recommend frequent screenings for STB risk. STBs should be considered for inclusion in future iterations of the DSM PMDD diagnostic criteria.
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Affiliation(s)
- Tory Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA.
- International Association for Premenstrual Disorders, Boston, MA, USA.
| | - Madeline Divine
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
- University of Texas at Austin, Austin, TX, USA
| | - Katja Schmalenberger
- International Association for Premenstrual Disorders, Boston, MA, USA
- Heidelberg University, Heidelberg, Germany
| | - Laura Murphy
- International Association for Premenstrual Disorders, Boston, MA, USA
| | - Brett Buchert
- International Association for Premenstrual Disorders, Boston, MA, USA
| | - Melissa Wagner-Schuman
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
- University of Cincinnati, Cincinnati, OH, USA
| | - Alyssa Kania
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
| | - Sabina Raja
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
| | - Adam Bryant Miller
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- RTI International, Raleigh, NC, USA
| | - Jordan Barone
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
| | - Jaclyn Ross
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
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Quist AJL, Han X, Baird DD, Wise LA, Wegienka G, Woods-Giscombe CL, Vines AI. Life Course Racism and Depressive Symptoms among Young Black Women. J Urban Health 2022; 99:55-66. [PMID: 35031943 PMCID: PMC8760080 DOI: 10.1007/s11524-021-00574-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/25/2022]
Abstract
The objective of this study is to evaluate the life course effects of racism on depressive symptoms in young Black women and to identify particularly sensitive periods. Guided by life-course theory and using logistic regression, we analyzed baseline data on racism frequency and stress from racism at two time periods (before age 20 and during the 20s) and follow-up data (at approximate 20-month intervals) on depressive symptoms (using a modified 11-item Center for Epidemiologic Studies Depression Scale, CES-D) among 1612 Black women participants aged 23-34 years living in Detroit, MI. Of the 1612 women, 65% reported experiencing some racism at baseline, and 36.5% had high depressive symptoms at follow-up. Those who experienced high frequency of racism before age 20 had an increased risk for high depressive symptoms (RR = 1.26, 95% CI: 1.07, 1.46) compared to participants in the low racism frequency group. We observed similar associations for high vs. low stress from racism (RR = 1.30, 95% CI : 1.06, 1.54) and high vs. low combination of racism frequency and stress (RR = 1.38, 95% CI: 1.13, 1.64). These findings did not hold or were weaker when assessing racism during the 20s. Among women who experienced high racism across the two time periods, the risk of high depressive symptoms was higher than those who experienced low racism during both periods (RR = 1.49, 95% CI: 1.14, 1.86). The slightly stronger associations between racism and depressive symptoms in childhood and adolescence than in young adulthood suggest that early life might be a sensitive period for experiencing racism.
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Affiliation(s)
- Arbor J L Quist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xiaoxia Han
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Donna D Baird
- Epidemiology Branch, Women's Health Group, National Institute for Environmental Health Sciences, Research Triangle, NC, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Anissa Irvin Vines
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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22
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Marraccini ME, Lindsay CA, Griffin D, Greene MJ, Simmons KT, Ingram KM. A Trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-Informed Approach to Suicide Prevention in School: Black Boys' Lives Matter. SCHOOL PSYCHOLOGY REVIEW 2022; 52:292-315. [PMID: 37484214 PMCID: PMC10358449 DOI: 10.1080/2372966x.2021.2010502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/23/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Black boys have been dying by suicide at an increasing rate. Although the reasons for this increase are unknown, suicide in Black boys is likely influenced by multiple, intersecting risk factors, including historical and ongoing trauma. Schools can serve as an important mechanism of support for Black boys; however, without intentional anti-racist frameworks that acknowledge how intersecting identities can exacerbate risk for suicide, schools can overlook opportunities for care and perpetuate a cycle of racism that compromises the mental health of Black youth. By recognizing their own implicit biases, modeling anti-racist practices, listening to and recognizing the strengths and diversity of Black youth, and fostering school-family-community partnerships, school psychologists can help transform the school environment to be a safe and culturally affirming place for Black youth. This paper outlines how school psychologists can apply a trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-informed approach to suicide prevention in order to more holistically support Black boys, disrupt patterns of aggressive disciplinary procedures, and improve school-based suicide prevention programs. By applying this lens across a multitiered systems of support (MTSS) framework, school psychologists can help to prevent the deaths of Black boys and begin to prioritize the lives of Black boys.
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Affiliation(s)
| | | | - Dana Griffin
- School of Education, University of North Carolina at Chapel Hill
| | - Meghan J Greene
- School of Education, University of North Carolina at Chapel Hill
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23
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Kreniske P, Mellins CA, Dolezal C, Morrison C, Shea E, Fisher PW, Kluisza L, Robbins RN, Nguyen N, Leu CS, Wiznia A, Abrams EJ. Predictors of Attempted Suicide Among Youth Living With Perinatal HIV Infection and Perinatal HIV-Exposed Uninfected Counterparts. J Acquir Immune Defic Syndr 2021; 88:348-355. [PMID: 34406984 PMCID: PMC8693508 DOI: 10.1097/qai.0000000000002784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Suicide is a leading cause of death among adolescents and young adults (AYA). AYA living with perinatally acquired HIV infection (AYALPHIV) are at higher risk of attempted suicide when compared with AYA who were perinatally HIV-exposed but uninfected (AYAPHEU). To inform interventions, we identified risk and protective factors of attempted suicide among AYALPHIV and AYAPHEU. SETTING Data were obtained from a longitudinal New York City-based study of AYALPHIV and AYAPHEU (n = 339; enrollment age 9-16 years) interviewed approximately every 12-18 months. METHOD Our main outcome was suicide attempt at any follow-up. The DISC was used to assess psychiatric disorder diagnoses and attempted suicide and the Child Depression Inventory to assess depressive symptoms. Psychosocial and sociodemographic risk factors were also measured. Analyses used backward stepwise logistic regression modeling. RESULTS At enrollment, 51% was female individuals, 49% Black, 40% Latinx, and 11% both Black and Latinx. Attempted suicide prevalence was significantly higher among AYALPHIV compared with AYAPHEU (27% vs 16%, P = 0.019), with AYALPHIV having 2.21 times the odds of making an attempt [95% confidence interval: (1.18 to 4.12), P = 0.013]. Higher Child Depression Inventory scores were associated with an increased risk of attempted suicide in both groups and the total sample. The presence of DISC-defined behavior disorder increased the risk of attempted suicide in the total sample and the AYALPHIV subgroup. Religiosity was protective of attempted suicide in AYALPHIV. CONCLUSIONS AYALPHIV had increased suicide attempts compared with AYAPHEU. Religiosity was protective in AYALPHIV. Highlighting a need for prevention of early mental health challenges was associated with risk.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Claude Ann Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Eileen Shea
- Department of Psychiatry, Mental Health Data Science, Columbia University Medical Center, New York, NY
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Nadia Nguyen
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Cheng-Shiun Leu
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY; and
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
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24
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Clayton MG, Pollak OH, Owens SA, Miller AB, Prinstein MJ. Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:1068-1096. [PMID: 34820949 DOI: 10.1111/jora.12614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Suicide is the second leading cause of death for adolescents in the United States, yet remarkably little is known regarding risk factors for suicidal thoughts and behaviors (STBs), relatively few federal grants and scientific publications focus on STBs, and few evidence-based approaches to prevent or treat STBs are available. This "decade in review" article discusses five domains of recent empirical findings that span biological, environmental, and contextual systems and can guide future research in this high priority area: (1) the role of the central nervous system; (2) physiological risk factors, including the peripheral nervous system; (3) proximal acute stress responses; (4) novel behavioral and psychological risk factors; and (5) broader societal factors impacting diverse populations and several additional nascent areas worthy of further investigation.
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25
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Odrovakavula L, Mohammadnezhad M. "Everything else is going to be ok if your spiritual wellness is well". A qualitative exploration of wellness amongst secondary school students in Fiji. Int J Qual Stud Health Well-being 2021; 16:2001895. [PMID: 34806562 PMCID: PMC8843379 DOI: 10.1080/17482631.2021.2001895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Purpose Adolescent wellness over the years has been a major public health concern. The adolescent period is stated to be a critical phase as developments occur in all areas of the individual. This study aims to explore secondary school students’ perceptions on knowledge of wellness, influences of wellness, prioritization of wellness dimensions and ideal adolescent wellness programmes in Fiji. Method This study qualitatively investigates adolescents in four purposively selected schools in Suva, Fiji. 31 students who enrolled into years 11 to 13 in the selected schools were interviewed in-depthly using a semi-structured, open-ended questionnaire. Data was transcribed and classified into categories, sub-themes and major themes. Results Participants’ responses indicated wellness perceived as multidimensional with no regard to dimensional balance. Family, peers and school support, social media, nutrition and physical activities are factors perceived to influence wellness. The availability of school counsellors, facilitation of effective school health programmes, and incorporation of wellness into the school curriculum were perceived as ideal ways to increase adolescent wellness. Conclusions This study provides important research findings of adolescent wellness for Fiji’s health sector, its policymakers and programme developers. Further studies are needed to understand the broad concept of wellness and its several dimensions.
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Affiliation(s)
- Latileta Odrovakavula
- Public Health, School of Public Health and Primary Care, Fiji National University, Suva Fiji Islands
| | - Masoud Mohammadnezhad
- Public Health (Health Promotion), School of Public Health and Primary Care, Fiji National University, Suva Fiji Islands
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26
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Demographic risk factors for co-occurring suicidality and cannabis use disorders: Findings from a nationally representative United States sample. Addict Behav 2021; 122:107047. [PMID: 34284313 DOI: 10.1016/j.addbeh.2021.107047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/18/2021] [Accepted: 07/08/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Burgeoning research suggests a link between suicidality (i.e., ideation, attempts) and cannabis use; however, little is known about which demographic groups are at increased risk of co-occurring suicidality and cannabis use disorders (CUD). This study tested differences in suicidality, CUD, and their co-occurrence by gender, age, race/ethnicity, and sexual orientation in a nationally representative U.S. SAMPLE METHOD Five years (2015-2019) of National Survey of Drug Use and Heath surveys were combined. Multinomial logistic regressions tested demographic differences in odds of suicidality only, CUD only, and co-occurring CUD and suicidality, relative to neither suicidality nor CUD. Covariates included survey year, major depressive episode, and other substance use disorders. RESULTS Men had higher odds of co-occurring suicidal ideation and CUD than women (AOR = 2.06). All older age groups reported lower odds of co-occurring suicidal ideation and CUD and co-occurring suicide attempts and CUD than emerging adults (AORs = 0.06-0.39). Black/African American (AOR = 1.42) and Native (AOR = 2.16) adults reported higher odds of co-occurring suicidal ideation and CUD than White adults. Black/African American (AOR = 4.05) and Hispanic/Latinx (AOR = 2.49) adults reported higher odds of co-occurring CUD and suicide attempts than White adults. Gay/lesbian (AOR = 2.04) and bisexual (AOR = 3.16) adults reported higher odds of co-occurring suicidal ideation and CUD than heterosexual adults. CONCLUSIONS Men, emerging adults, Black/African American, Native, and sexual minority groups had elevated risk of co-occurring suicidal ideation and CUD. Emerging adults, Black/African American, and Hispanic/Latinx groups had elevated risk of co-occurring suicide attempts and CUD.
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27
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Polanco-Roman L, Miranda R, Hien D, Anglin DM. Racial/ethnic discrimination as race-based trauma and suicide-related risk in racial/ethnic minority young adults: The explanatory roles of stress sensitivity and dissociation. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2021; 13:759-767. [PMID: 34264740 PMCID: PMC8563437 DOI: 10.1037/tra0001076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Drawing on race-based trauma models, the present study examined common reactions to trauma exposure (i.e., stress sensitivity, dissociative symptoms, depressive symptoms), as potential explanatory factors in the relation between racial/ethnic discrimination and suicide-related risk among racial and ethnic minority young adults. Method: A group of racial and ethnic minority (N = 747; 61% women; 63% U.S.-born; 34% Asian American) young adults, ages 18-29 (M = 19.84; SD = 2.22), completed a battery of self-report measures online. Accounting for demographics and other trauma exposures, direct and indirect associations between racial/ethnic discrimination and suicide attempt (SA) through stress sensitivity, dissociative symptoms, depressive symptoms, and suicide ideation (SI) were examined using hierarchical linear regression models and bootstrapping methods. Results: There was a direct association between racial/ethnic discrimination and stress sensitivity, dissociative symptoms, and depressive symptoms, but not SI or SA, after accounting for demographics and trauma exposures. There was also an indirect association between racial/ethnic discrimination and SI and SA through stress sensitivity, dissociative symptoms, and depressive symptoms. Conclusion: Experiences of racial/ethnic discrimination may function as a source of traumatic stress in racial and ethnic minority young adults to confer risk for SI and SA via stress sensitivity, dissociation, and depressive symptoms. Addressing racial/ethnic discrimination may help reduce suicide-related risk by targeting stress-related exposures particularly relevant to racial and ethnic minority young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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28
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Rudes G, Fantuzzi C. The Association Between Racism and Suicidality Among Young Minority Groups: A Systematic Review. J Transcult Nurs 2021; 33:228-238. [PMID: 34551644 DOI: 10.1177/10436596211046983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Giorgia Rudes
- IRCCS Burlo Garofolo Pediatric Institute, Trieste, Italy
| | - Claudia Fantuzzi
- School of Nursing, University of Trieste, Italy.,Azienda Sanitaria Universitaria Integrata, Trieste, Italy
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29
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Jelsma EB, Goosby BJ, Cheadle JE. Do trait psychological characteristics moderate sympathetic arousal to racial discrimination exposure in a natural setting? Psychophysiology 2021; 58:e13763. [PMID: 33462861 PMCID: PMC10624514 DOI: 10.1111/psyp.13763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
Personality and psychological traits are known to influence how individuals react to and cope with stress, and thus, have downstream health and aging consequences. However, research considering psychological health traits as individual-level difference factors moderating the links been racism-related stress and health for racial and ethnic minorities in the United States is rare. Using intensive daily diaries and a wearable sensor that continuously recorded sympathetic nervous system arousal in a sample of racial and ethnic minority college students (80% African American, first-generation Black, or African; 20% Latinx), we linked arousal to racism-related experiences dynamically throughout the day as participants naturally went about their lives. Findings suggest that multiple traits are associated with increased arousal in real time when interpersonal discrimination is perceived, but that only anger and anxiety also predicted increased arousal during moments of rumination and reflection on race-related inequities. Vicarious discrimination exposure moments were also linked to suppressed arousal in general, but particularly for more anxious individuals. We use a stress appraisal and coping framework to elucidate the ways in which individual psychological differences may inform physiological responses to race-related stress. The biopsychosocial pathways by which cognitive appraisal and interpersonal race-related stress contribute to racial health disparities are also discussed.
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Affiliation(s)
- Elizabeth B Jelsma
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA
- Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Bridget J Goosby
- Population Research Center, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
| | - Jacob E Cheadle
- Population Research Center, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
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30
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Nomura K, Minamizono S, Maeda E, Kim R, Iwata T, Hirayama J, Ono K, Fushimi M, Goto T, Mishima K, Yamamoto F. Cross-sectional survey of depressive symptoms and suicide-related ideation at a Japanese national university during the COVID-19 stay-home order. Environ Health Prev Med 2021; 26:30. [PMID: 33673802 PMCID: PMC7934991 DOI: 10.1186/s12199-021-00953-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background We aimed to estimate the prevalence of depressive symptoms as well as suicide-related ideation among Japanese university students during the stay-home order necessitated by the coronavirus disease 2019 pandemic in Japan, and offer evidence in support of future intervention to depression and suicide prevention strategies among college and university students. Methods The data for this cross-sectional study were derived from the Student Mental Health Survey conducted from May 20 to June 16, 2020 at a national university in Akita prefecture. Among the 5111 students recruited, 2712 participated in this study (response rate, 53%; mean age ± standard deviation, 20.5 ±3.5 years; men, 53.8%). Depressive symptoms were identified by using the Patient Health Questionnaire-9 (PHQ-9). Results The prevalence of moderate depressive symptoms based on a PHQ-9 score ≥10 and suicide-related ideation based on question 9 of PHQ-9 ≥1, which encompasses thoughts of both suicide and self-harm, was 11.7% and 6.7%, respectively. Multivariable logistic regression analyses showed that risk factors for depression included being a woman, smoking, alcohol consumption, and social network communication using either video or voice. For suicide-related ideation, alcohol consumption was the only risk factor. Exercise and having someone to consult about worries were associated with decreased risk of both depressive symptoms and suicide-related ideation. Conclusions Negative lifestyles of smoking and drinking, and being a woman, may be important risk factors for depressive symptoms, whereas exercise and having someone to consult about worries may be protective factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00953-1.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan.
| | - Sachiko Minamizono
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Roseline Kim
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Toyoto Iwata
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Junko Hirayama
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kyoichi Ono
- Department of Cell Physiology, Akita University Graduate School of Medicine, Akita, Japan
| | | | | | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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31
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Sileo KM, Kershaw TS. Dimensions of Masculine Norms, Depression, and Mental Health Service Utilization: Results From a Prospective Cohort Study Among Emerging Adult Men in the United States. Am J Mens Health 2021; 14:1557988320906980. [PMID: 32079448 PMCID: PMC7036518 DOI: 10.1177/1557988320906980] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to examine the role of multidimensional masculine
norms (“status,” “toughness,” “anti-femininity”) on depression and mental health
service utilization among emerging adult men in the Northeast United States.
This study examines substance use and hostility as secondary outcomes and
depression status as an effect moderator on the relationship between masculine
norms and mental health service utilization. This study used data from a
prospective cohort study that followed 18- to 25-year-old heterosexual men over
6 months. At baseline and 6 months, approximately 29% and 25% of the sample met
the criteria for depression. The results of multivariate linear and logistic
regression models found that greater endorsement of masculine status was
associated with less depressive symptoms at baseline and 6 months, masculine
toughness was associated with more substance use at baseline, and masculine
anti-femininity was associated with greater hostility at baseline and 6 months.
The multivariate Poisson model found that greater endorsement of status was
associated with greater mental health service utilization in the prior year,
especially for men not meeting the criteria for depression. In contrast, greater
endorsement of anti-femininity and toughness norms was associated with less
mental health service utilization; for men endorsing toughness norms, this
effect was greater for those who were depressed. This study sheds light on the
harmful and protective effects of masculine norms on depression, related mental
health outcomes, and mental health service utilization, with implications for
gender-tailored approaches to engage and retain young men in mental health
services.
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Affiliation(s)
- Katelyn M Sileo
- The University of Texas at San Antonio, TX, USA.,The Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
| | - Trace S Kershaw
- The Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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32
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Sex matters: stress perception and the relevance of resilience and perceived social support in emerging adults. Arch Womens Ment Health 2021; 24:403-411. [PMID: 33057788 PMCID: PMC8116239 DOI: 10.1007/s00737-020-01076-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022]
Abstract
The emerging adulthood represents a vulnerable and critical turning point for the beginning of mental illnesses and is therefore of particular interest for the study of risk and resilience. The present survey investigated the impact of sex on the associations between resilience and the perception of social support and stress in students. The Resilience Scale was used to assess resilience. Stress perception and social support perception were measured using the Perceived Stress Scale and the Social Support Questionnaire FSozU k-22, respectively. Between the ages of 18 and 30, 503 subjects (59.6% female) were included into the study. We detected a significant effect of sex with markedly lower resilience and a more pronounced perception of stress and social support among females. Significant correlations between resilience, stress perception, and social support perception were found in both sexes with women showing a stronger interrelationship between stress perception and both resilience and social support perception. Mediation analysis revealed that the relationship between the perception of social support and stress was fully mediated by resilience among men and partly mediated by resilience among women. Of note, the mediation of resilience on the interrelationship between the perception of social support and stress was much stronger in women than in men. These findings suggest that sex-specific, customized interventions focusing on the strengthening of resilience and the claiming of social support are needed to promote mental health in emerging adults.
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33
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Opara I, Assan MA, Pierre K, Gunn JF, Metzger I, Hamilton J, Arugu E. Suicide among Black Children: An Integrated Model of the Interpersonal-Psychological Theory of Suicide and Intersectionality Theory for Researchers and Clinicians. JOURNAL OF BLACK STUDIES 2020; 51:611-631. [PMID: 34305168 PMCID: PMC8301214 DOI: 10.1177/0021934720935641] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States.
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Affiliation(s)
- Ijeoma Opara
- Stony Brook University School of Social Welfare, Stony Brook, NY, USA
| | | | - Kimberly Pierre
- School of Public Health, Rutgers University, Newark, NJ, USA
| | - John F. Gunn
- Center on Gun Violence Research, Rutgers University, Newark, NJ, USA
| | - Isha Metzger
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Jahi Hamilton
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Eileen Arugu
- School of Social Work, Columbia University, New York, NY, USA
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