Suicidal ideation among racial/ethnic minorities: moderating effects of rumination and depressive symptoms

The mediation effects of nightmares and depression between insomnia and suicidal ideation in young adults

Suicide is prevalent among young adults, and epidemiological studies indicate that insomnia, nightmares, and depression are significantly associated with a high incidence of suicidal ideation (SI). However, the causal relationship between these factors and SI remains unclear. Therefore, the purpose of this study was to examine the association between nightmares and depression and insomnia and SI in young adults, as well as to develop a mediation model to investigate the causal relationship between insomnia, nightmare, depression, and SI. We assessed insomnia, nightmares, depression, and SI in 546 young adults using the Insomnia Severity Scale (ISI), Disturbing Dream and Nightmare Severity Scale (DDNSI), Depression Study Scale (CESD-20), and Columbia-Suicide Severity Rating Scale (C-SSRS). Using the Bootstrap method, the mediation effects of nightmares and depression between insomnia and SI were calculated. The results demonstrated that nightmares and depression fully mediated the relationship between insomnia and SI, including the chain-mediation of insomnia and SI between nightmare and depression with an effect value of 0.02, 95% CI 0.01-0.04, and depression as a mediator between insomnia and SI with an effect value of 0.22, 95% CI 0.15-0.29. This study found that depression and nightmares may be risk and predictive factors between insomnia and SI, which implies that the assessment and treatment of depression and the simple or linked effect of nightmares play crucial roles in preventing SI in young adults.

Informing Equitable Prevention Practices: A Statewide Disaggregated Analysis of Suicide for Ethnoracially Minoritized Adolescents

The increase in adolescent suicide rates in the United States is a pervasive public health issue, and ethnoracial youth with diverse identities are disproportionately impacted, yet less studied. National planning efforts reinforce state-level approaches to suicide prevention through an equitable lens to prevent adolescent suicide. This study examined disaggregated state-level data over time to determine changes to suicide outcomes based on race/ethnicity, sex, sexual orientation, and the intersection of these identities and determined which sub-groups had higher odds of suicide outcomes. Data from the 1991-2019 Centers for Disease Control and Prevention Youth Risk Behavioral Surveillance System were analyzed for 17,419 ethnoracially minoritized high school adolescents in North Carolina. Descriptive analyses and multinominal logistic regression models were employed. Findings indicated that subgroups within categories of ethnoracial populations, specifically Black female adolescents unsure of their sexual orientation, reported higher rates of suicide attempts. Additionally, Multiracial adolescents reported higher means for suicide consideration and attempts over time. Recommendations for investigating state-level suicide data by focusing on diverse intersecting identities to illuminate areas for potential prevention efforts and support health equity are provided.

Campus Racial Climate, Psychological Well-being, and Race-Based Traumatic Stress Symptoms Among Monoracial Black and Biracial Black Students Following Heightened Exposure to Police Brutality

The spring of 2020 was characterized by highly visible acts of police brutality and a heightened attention to systemic racism that created a macro-stressor for Black-identifying individuals. The current study aimed to capture college students' perceptions of campus racial climate, subjective well-being, and race-based trauma symptoms during this time. Results indicated that racial identity was associated with students' mental well-being, perceptions of campus racial climate, and experiences of traumatic stress symptoms. Monoracial Black and biracial Black students differed from non-Black students in their perceptions of campus racial climate and their traumatic stress symptoms. Monoracial Black and biracial Black students differed from one another on reports of subjective well-being. A unique pattern of correlations among the study variables emerged for each group. Our findings document the race-based trauma symptoms experienced by monoracial Black and biracial Black students in the spring of 2020 and provide a foundation for future research to examine factors that uniquely contribute to the well-being of monoracial Black and biracial Black students.

Emotion expressivity, suicidal ideation, and explanatory factors: Differences by Asian American subgroups compared with White emerging adults

OBJECTIVE

The relationship between emotion expressivity and psychological symptoms varies by race/ethnicity, and reduced expression of emotions has been implicated in risk for suicidal ideation. The present study examined differences in the relation between emotion expressivity and suicidal ideation through well-documented correlates of suicide risk (i.e., hopelessness, depressive symptoms) among Asian American subgroups compared with White emerging adults.

METHOD

A sample of 829 emerging adults, Ages 18 to 28 years, identifying as Asian American (27% East Asian, 18% South Asian, 11% Southeast Asian) or White (44%) completed measures of emotion expressivity, hopelessness, depressive symptoms, and suicidal ideation.

RESULTS

Lower emotion expressivity was statistically associated with higher levels of suicidal ideation, via hopelessness and depressive symptoms, among White, East Asian, and South Asian American emerging adults, but not among Southeast Asian Americans, though this difference in mediation was not statistically significant.

CONCLUSION

A focus on Asian Americans as a homogenous group occludes important ethnic differences in the relation between emotion expressivity and vulnerability to suicidal ideation. Ethnic differences in the function of emotion expressivity should be considered in suicide prevention and interventions among Asian American emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Behavioral and psychosocial factors related to mental distress among medical students

Introduction

Physicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre-COVID-19-era.

Methods

Students enrolled in a large California medical school in 2018-2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression.

Results

Elevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings.

Discussion

Higher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.

Role of rumination and hope on negative life events and suicidal ideation under the background of normalization of pandemic prevention and control: A moderated mediation model

Introduction

The study aimed to investigate the impact and mechanism of negative life events on college students' suicidal ideation during the COVID-19 pandemic and the buffering effect of hope under the background of normalization of pandemic.

Methods

A total of 5211 participants took part in this study. Self-reported negative life events, rumination, hope and suicide ideation were measured using a range of questions and scales. Our research demonstrated that the incidence of suicidal ideation among college freshmen in the past week was higher during the COVID-19 pandemic than that before the pandemic. In this study, conditional process model 15 was used to verify the hypothetical model of rumination as a potential mediator and hope as a moderator.

Results

The hypothesized moderated mediation model was verified significant (β = -0.047, 95% CI = [-0.061, -0.035]), and hope was found to moderate the direct effect of negative life events on suicidal ideation (β = -0.039, t = -2.937, 95% CI = [-0.065, -0.013]) as well as the indirect effect of through the mediator rumination (β = -0.134, t = -10.850, 95% CI = [-0.158, -0.110]).

Discussion

We found that rumination partially mediated the effect of negative life events on suicidal ideation, and hope buffered the direct and indirect effect of negative life events on suicidal ideation. The implications of the findings for clinical interventions are discussed, including the importance of hope arousal as a protective factor and rumination as a cognitive mechanism for emotion regulation under the background of normalization of pandemic.

Is rumination associated with psychological distress after a cancer diagnosis? A systematic review

Objective: The aim of this work was to review evidence on the association between psychological rumination and distress in those diagnosed with cancer. Methods: Six databases were searched for studies exploring rumination alongside overall assessments of psychological distress, depression, anxiety, or stress. Results: Sixteen studies were identified. Rumination was associated with distress cross-sectionally and longitudinally. However, once baseline depression was controlled for, the association was no longer seen. The emotional valence of ruminative thoughts and the style in which they were processed, rather than their topic, was associated with distress. Brooding and intrusive rumination were associated with increased distress, deliberate rumination had no association, and reflection/instrumentality had mixed findings. Conclusions: This review highlights that it is not necessarily the topic of content, but the style and valence of rumination that is important when considering its association with distress. The style of rumination should be the target of clinical intervention, including brooding and intrusion.

Rumination mediates the relationship between childhood trauma and depressive symptoms in schizophrenia patients

Rumination and childhood trauma are related to depressive symptoms in clinical and non-clinical individuals. This is the first study aimed to test the mediating effect of rumination on the relationship between childhood trauma and depressive symptoms in schizophrenia patients. A total of 313 schizophrenia patients were recruited in the present study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, the short-form Childhood Trauma Questionnaire (CTQ-SF) and the 10-item Ruminative response scale (RRS-10) were utilized to assess the childhood trauma and rumination in patients, respectively. Our results showed that 168 schizophrenia patients (53.67%) had comorbid depressive symptoms. These patients with depressive symptoms had higher levels of childhood trauma [both CTQ-SF total scores and emotional abuse (EA), emotional neglect (EN), physical neglect (PN) subscale scores] and rumination (both RRS-10 total scores and brooding, reflection subscale scores) compared to patients without depressive symptoms. The stepwise logistic regression analysis identified that EN (OR 1.196, P = 0.003), PN (OR 1.1294, P < 0.001), brooding (OR 1.291, P < 0.001) and reflection (OR 1.481, P < 0.001) could independently predict the depressive symptoms in schizophrenia patients. Moreover, RRS-10 and its subscale scores could mediate the relationship between depressive symptoms and childhood trauma, especially EA, EN and PN in schizophrenia. Our preliminary findings suggest that the rigorous assessment and psychosocial interventions of rumination are important to alleviate the influence of childhood trauma on depressive symptoms in schizophrenia patients.

Familismo neutralizes the effects of discrimination on suicide-related thoughts and behaviors in Latinx young adults

In recent years, there has been a significant increase in rates of suicide-related thoughts and behaviors among Latinx young adults. Given Latinx young adults are one of the fastest growing subgroups in the United States, this raises significant public health concern. Perceived discrimination has consistently been identified as a risk factor and has been positively associated with depressive symptoms, further exacerbating risk for the development of suicide-related thoughts and behaviors. Critical to understanding Latinx mental health is familismo, a core cultural value that entails connectedness, dedication, commitment, and loyalty to family. Moreover, it involves seeking family for advice and support. The current study sought to examine depressive symptoms as mediator for the relation between perceived discrimination and suicide-related thoughts and behaviors while investigating familismo as a moderator in attenuating these relations within a college aged Latinx sample (N = 1037, 75.3% female, Mage = 21, SD = 4.49). Across models, depressive symptoms explained the relation between perceived discrimination and suicide-related thoughts and behaviors (p ≤0.001-0.024) with familismo significantly acting as moderator (p = .009). In exploring the protective effects of an important Latinx cultural value on a growing public health disparity, the current study provides novel insight that may be used to tailor and adapt current intervention and prevention efforts for Latinx young adults at risk for suicide-related thoughts and behaviors.

Understanding suicide risk for youth who are both Black and Native American: The role of intersectionality and multiple marginalization

INTRODUCTION

Native American and multiracial youth experience elevated risk for suicide ideation (SI) and suicide attempts (SA); however, intersectional identities are often unexamined in suicide research.

METHOD

We examined the prevalence of SI and SA, and the impact of intersectional identities (sex, sexual minority identity, and economic insecurity) on these rates, in 496 biracial Black-Native American, 2,804 Native American, 14,220 Black, 5,569 biracial Native American-White, 4,076 biracial Black-White, and 118,816 White youth who participated in the Minnesota Student Survey.

RESULTS

Black-Native American youth reports of SI and SA resembled other Native American youth and were significantly higher than those reported by Black, White, and Black-White (SA only) youth. While sexual minority youth reported higher rates of SI and SA than heterosexual youth, this difference between sexual minority and heterosexual Black-Native American youth was smaller as compared to their peers.

CONCLUSION

Though they largely resemble their mono/biracial Native American peers, Black-Native American youth show some distinct patterns of SA when accounting for their intersectional identities. Despite presumed similarities in systemic risk factors, Black and Black-Native American youth differ considerably in reported suicidality. The experiences of Black-Native American teens warrant further examination.

Psychological strain and suicidal ideation in young university students during Covid-19 outbreak: the mediating roles of rumination and depression

The link between psychological strain and suicidal ideation is well embedded in literature, however, the underlying mechanism is rarely explored. Therefore, this study aimed to examine the relationship between psychological strain, suicidal ideation, rumination, and depression among Pakistani young adults during the Covid-19 outbreak. In addition, it will also try to determine the mediating role of ruminative subtypes and depression in the relationship between psychological strain and suicidal ideation. The sample consists of 400 university students (83 males and 289 females) with the age range from 18 to 30 years (M = 22.25, SD = 2.40). Psychological strain scale, Suicidal Ideation Scale, Beck Depression Inventory, and Ruminative Response Scale were administered to the participants. Results indicated a significant and positive association between the study variables. Psychological strain positively influenced suicidal ideation both directly, and indirectly via brooding and depression. Both variables were found to be serially mediated by the brooding subtype of rumination and depression and not with the reflective subtype. Strain theory of suicide and response style theory also postulated important insights regarding the association of these variables in young adults, among which, strain is serially related to first brooding and then depression, which is eventually related to suicidal ideation. The present study makes a significant contribution to the literature by providing a unique conceptual and theoretical framework to identify suicide at the ideation level before it proceeds to behavior during this unprecedented time of the pandemic outbreak.

Minority status, depression and suicidality among counseling center clients

Objective This study examined race/ethnicity, gender, sexual orientation, and financial stress and their association with depression and suicidality among university counseling center clients. Methods: The sample included 3,189 participants who received services at a university counseling center. Results: Asian American college students reported more depressive symptoms than European American and Hispanic students and were more likely to have a depression diagnosis than European American and African American students. Female and lesbian/gay/bisexual/questioning (LGBQ) individuals had higher depressive symptom scores, were more likely to have a depression diagnosis, and history of suicidal ideation and attempts than male and heterosexual individuals, respectively. Students with high financial stress reported higher depression scores and were more likely to have experienced past and current suicidality. More minority statuses were associated with higher risk for depression and suicidality. Conclusions: Counseling center clients who identified with one or more minority groups had higher risk for depression and suicidality.

Depression and Suicide Ideation: The Role of Self-Acceptance for Black Young Adults

Suicide is a leading cause of death for Black young adults. Though depression is commonly linked to increased risk for suicide, empirical literature examining the depression–suicide association and intrinsic buffers for this association remains limited among Black young adults. This study sought to address this gap in the literature by examining the relationship between depression and suicide ideation among Black young adults. Importantly, this study assessed the moderating role of self-acceptance, an index of how content one is with oneself. Study participants included 123 Black young adults (63.5% female, Mage = 20.91 years, SD = 2.45 years) who completed measures evaluating symptoms of depression, suicide ideation, and psychological well-being. Multivariate regression analyses revealed that self-acceptance moderated the association between depressive symptomatology and suicide ideation ( β = −0.05, p < .01, 95% CI [-1.01, −0.11]), such that the depression–suicide ideation association was not significant for individuals who reported high levels of self-acceptance. These findings suggest that self-acceptance may be an important treatment target for interventions aimed specifically at reducing suicide vulnerability among Black young adults.

Global and reflective rumination are related to suicide attempts among patients experiencing major depressive episodes

BACKGROUND

Recent attention has focused on the role of rumination in suicidality, with evidence indicating that rumination may be positively related to suicidal ideation. There remains disagreement on the nature of the relationship between rumination and suicide attempts, especially in major affective disorders. This study was designed to identify whether rumination is a risk factor for attempted suicide.

METHODS

A total of 309 patients with major depressive episodes were recruited for this study, including 170 patients with major depression and 139 patients with bipolar disorder. All participants were categorized into two groups based on a series of clinical assessments: suicide attempters (n = 87) and non-suicide attempters (n = 222). Rumination was evaluated with the Ruminative Responses Scale. A binary logistic regression analysis was carried out to evaluate the relationship between rumination and suicide attempts.

RESULTS

Both global ruminative levels and the two subtypes of rumination, brooding and reflection, were significantly higher in the suicide attempters than the non-suicide attempters. After controlling for age, current depression and anxiety symptoms, and episode frequency, it was found that global rumination and reflection (but not brooding) were positively associated with suicide attempts.

CONCLUSION

These results suggest that rumination may be a risk factor for suicide attempts and highlight the maladaptive nature of reflection in patients with major depressive episodes.

Perceived burdensomeness and thwarted belongingness influence the childhood polyvictimization and suicide ideation association among Hispanic undergraduates

The present study examined the mediating effect of perceived burdensomeness (PB) and thwarted belongingness (TB) in the association between childhood polyvictimization and suicide ideation (past week) among 528 Hispanic college students. Nearly 10% reported polyvictimization, 19.8% had suicide ideation, and polyvictimization was a risk factor of suicide ideation through PB and TB. The indirect effect through PB was stronger than the indirect effect through TB. Interventions should focus on PB and TB to alleviate suicide ideation among Hispanic undergraduate students.

Measurement Invariance of the Ruminative Responses Scale Across Gender

Although women demonstrate higher levels of rumination than men, it is unknown whether instruments used to measure rumination have the same psychometric properties for women and men. To examine this question, we evaluated measurement invariance of the brooding and reflection subscales from the Ruminative Responses Scale (RRS) by gender, using data from four samples of undergraduates from three universities within the United States (N = 4,205). A multigroup confirmatory factor analysis revealed evidence for configural, metric, and scalar invariance of the covariance structure of the 10-item version of the RRS. There were statistically significant latent mean differences between women and men, with women scoring significantly higher than men on both brooding and reflection. These findings suggest that the 10-item version of the RRS provides an assessment of rumination that is psychometrically equivalent across gender. Consequently, gender differences in brooding and reflection likely reflect valid differences between women and men.

A multi factorial model of self-harm behaviors in Anorexia-nervosa and Bulimia-nervosa

BACKGROUND

Co-existence of eating disorders and NSSI, suicide attempts and ideations is well established yet much is not known about the personality traits and behavioral tendencies that maintain this relationship. To this date no empirical work has been produced that offers a multifactorial view on the contributing variables to the occurrence of self-harm behaviors in EDs.

METHOD

Binge eating, depression, impulsivity, ruminations and loss aversion were assessed in a sample of 93 patients diagnosed with Anorexia-Nervosa and Bulimia-Nervosa and other EDs with a history of NSSI and suicide attempts.

RESULTS

Binge eating was found to be a predictor of depression, which in turn was found to be related to NSSI frequency, suicide attempts and suicide ideations. Ruminations were found to mediate a relationship between depression and suicide ideations. Trait impulsivity predicted suicide attempts, while the attentional construct of impulsivity was associated to suicide ideations as well as attempts. Higher loss aversion was positively associated with NSSI frequency and suicide ideations.

CONCLUSION

Our findings suggest that trait and state aspects of impulsivity are related to different self-harm behaviors in EDs. Exploring these differences is potentially of great value in understanding the process of transition from suicidal ideation to suicide attempt and the process of NSSI and may assist clinicians formulate better interventions for patients with EDs at risk. Ways in which individual findings in our model correspond with previous research and future implications are discussed.

Suicidal Thoughts and Behaviors Among Transgender Adults in Relation to Education, Ethnicity, and Income: A Systematic Review

Introduction: This systematic review assessed the impact of race/ethnicity, education, and income on transgender individual's lifetime experience of suicidal thoughts and behaviors (SITB) in gray and published literature (1997-2017). Methods: Sixty four research projects (108 articles) were identified in WorldCat, PubMed, and Google Scholar. Articles were included if they were published in Canada or the United States, included original quantifiable data on transgender SITBs, and had ≥5 participants, at least 51% of whom were ≥18 years. Results: Across all projects suicide ideation averaged 46.55% and attempts averaged 27.19%. The majority of participants were Caucasian, whereas the highest rate of suicide attempts (55.31%) was among First Nations, who accounted for <1.5% of participants. Caucasians, by contrast, had the lowest attempt rate (36.80%). More participants obtained a bachelor's degree and fewer an associate or technical degree than any other level of education. Suicide attempts were highest among those with ≤some high school (50.70%) and lowest among those with an advanced degree (30.25%). More participants made an income of $20-$50,000/year and less $10-$20,000 than any other income bracket. Conclusion: SITBs, among the transgender population, are both universally high and impacted by race/ethnicity, educational attainment, and income. These findings may be useful in creating culturally and factually informed interventions for transgender individuals experiencing SITBs and in informing future research on this topic.

Hope Springs: Moderating the Link Between Racial Discrimination and Depressive Symptoms for African American Emerging Adults

To better understand the moderating effect of coping mechanisms (distraction and rumination) and internal assets (hope) on the relationship between perceived discrimination and depressive symptoms, a sample of 363 African American students (65.3% female; mean age = 20.25 years; SD = 2.39) from two large Midwestern universities were surveyed using self-report measures. Hierarchical multiple regressions were used to explore the relationships among the variables and depressive symptoms. Results indicated that discrimination (B = 0.10, p < .001) and ruminative coping (B = 1.05, p < .001) were positively related to depressive symptoms, while hope was negatively related to depression (B = −0.33, p < .001). Further, the relationship between discrimination and depressive symptoms was moderated by hope (B = 0.01, p = .02). The interaction between discrimination and depressive symptoms suggested that participants who reported low levels of hope also reported more depressive symptoms regardless of level of discrimination, compared with those who reported high hope. For these African American emerging adults, the results bring to light the potential of an internal asset that aids in reduction of depressive symptoms in response to constant, potential harm such as racial discrimination.

Perceived Discrimination and Suicide Ideation: Moderating Roles of Anxiety Symptoms and Ethnic Identity among Asian American, African American, and Hispanic Emerging Adults

Suicide is a leading cause of death for vulnerable ethnic minority emerging adults in the United States (Web-based injury statistics query and reporting system [WISQARS], 2015). Perceived discrimination (Journal of Youth and Adolescence, 40, 2011, 1465) and anxiety symptoms (Asian American Journal of Psychology, 1, 2010, 18) are two predictors that are theoretically and conceptually related, but have yet to be examined in a simultaneous model for suicide ideation. Existing theory and research suggest that these variables activate similar pathways (American Behavioral Scientist, 51, 2007, 551). This study sought to address this gap in the literature by examining the simultaneous relationship between perceived discrimination and anxiety symptoms as predictors of suicide ideation. The moderating effect of anxiety symptoms on the relationship between perceived discrimination and suicide ideation was examined in a multiethnic sample of emerging adults. Results indicated that anxiety symptoms moderated the perceived discrimination-suicide ideation relationship for Hispanic emerging adults, but not for their Asian American and African American counterparts. Furthermore, ethnic identity has been shown to mitigate suicide risk in the face of other stressors (Cultural Diversity and Ethnic Minority Psychology, 14, 2008, 75). Ethnic identity emerged as a protective factor for Hispanic emerging adults by further interacting with perceived discrimination and anxiety symptoms to negatively predict suicide ideation. The implications of these findings are discussed.

Discrimination and suicidality among racial and ethnic minorities in the United States

BACKGROUND

Over the past decade, suicide rates have increased among certain racial/ethnic minority groups in the United States. To better understand suicide vulnerability among people of color, studies have examined the relations between social risk factors-such as discrimination-and suicidal thoughts and behaviors. However, the literature has been inconsistent, calling for more population studies.

METHODS

This study analyzed data from two surveys: (1) The National Survey of American Life; and (2) The National Latino and Asian American Survey, which taken together are representative of Black, Latino, and Asians in the United States. Multivariable logistic regression models were used to examine the association between levels of discrimination on the Everyday Discrimination Scale and suicidal thoughts and behaviors. Additional models tested for effect modification by race and by psychiatric diagnosis.

RESULTS

We found that individuals who reported the highest levels of discrimination had greater odds of reporting lifetime suicidal thoughts, plans, and attempts, when compared with people who did not report discrimination, after adjusting for socio-demographic characteristics. Notably, discrimination increased odds of reporting an unplanned suicide attempt and a suicide attempt without the intent to die. Adjusting for psychiatric diagnoses attenuated these effects. We found no evidence of effect modification by race or by psychiatric diagnosis.

LIMITATIONS

Data were cross-sectional, which did not allow for causal inferences.

CONCLUSIONS

Future translational research can explore how screening for discrimination may help identify individuals and groups of racial/ethnic minorities at risk for suicidal thoughts and behaviors.

Depression, Loneliness, and Suicide Risk among Latino College Students: A Test of a Psychosocial Interaction Model

This study tested a psychosocial model of suicide risk in a sample of 156 Latino college students. Specifically, depression and loneliness were hypothesized to be important predictors of suicide risk (namely, hopelessness and suicidal behaviors) in Latino students. Results of conducting regression analyses indicated that, independent of age and gender, depression and loneliness were significant predictors of both indices of suicide risk examined in the present study. It is noteworthy that within the psychosocial predictor set of depression and loneliness, depression was consistently found to be nearly twice as strong a predictor than was loneliness. Moreover, we found evidence for a significant depression-loneliness interaction effect in predicting suicide risk. That is, the highest level of suicide risk was found among dysphoric Latino students who were also socially isolated. Our findings indicate that depression and loneliness are important factors to consider in understanding suicide risk among Latino college students.

Sociocultural Influences on the Association Between Negative Romantic Experiences and Psychological Maladjustment in Mexican Adolescents

The goal of this study was to examine whether cultural values (familismo, female virginity) and gender moderated the associations between negative romantic experiences and psychological maladjustment (depressive, anxiety symptoms) in a sample of Mexican adolescents. Self-report survey data were collected from 973 adolescents (M = 15.14 years old; 56% girls) in Mexico. Findings revealed more depressive and anxiety symptoms among adolescents who reported more negative romantic experiences. These associations were stronger for female adolescents reporting greater beliefs of familismo and female virginity. Mental health practitioners may consider negative romantic experiences and cultural values when working with Mexican adolescents.

Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality?

BACKGROUND

Rumination, particularly brooding rumination, is associated with suicide risk, ideation and attempts; however, findings are inconsistent with respect to reflective rumination. Recent research suggests reflective rumination might be associated with increased suicide risk specifically among vulnerable individuals. Poor sleep quality is related to both suicide risk and rumination, yet no research has examined whether reflective rumination and sleep quality interact in relation to suicidal risk. This study, therefore, examined whether sleep quality moderates the link between ruminative subtypes and (a) suicide risk overall, and (b) suicidal ideation and (c) history of suicide attempts, specifically.

METHODS

Participants were 1696 college students (ages 18-29 years; 65% female) who completed measures assessing rumination, sleep, and suicidal ideation and behavior. Hierarchical linear and logistic regressions were performed regressing overall suicide risk (linear), suicidal ideation (linear) and history of attempts (logistic) on ruminative subtypes controlling for demographics. Sleep quality was examined as a moderator of the rumination-suicide risk/ideation/attempts link.

RESULTS

Brooding rumination was significantly associated with increased suicide risk, ideation, and attempts but these associations were not moderated by sleep quality. Sleep quality exacerbated the association of reflective rumination with overall suicide risk and suicidal ideation specifically. Reflective rumination was not itself, or in interaction with sleep quality, significantly associated with a history of suicide attempts.

LIMITATIONS

The study is cross-sectional and utilizes a college student sample.

CONCLUSIONS

This study adds to the literature that suggests reflective rumination is associated with suicide risk and ideation in certain cases, such as in individuals with lower sleep quality. In addition, the study adds continued support for an association between brooding rumination and suicidal behaviors. More studies that examine the relations between ruminative subtypes and attempts are needed. Interventions that target sleep problems and rumination may be beneficial for suicide prevention and intervention.

The Relationship Between Regulatory Emotional Self-Efficacy and Core Self-Evaluation of College Students: The Mediation Effects of Suicidal Attitude

This study analyzed the mediation effect of a suicidal attitude from regulatory emotional self-efficacy to core self-evaluation. A measurement study was conducted among 438 college students using the Regulatory Emotional Self-Efficacy Scale, the Core Self-Evaluation Scale, and the Suicide Attitude Questionnaire. Results from the plug-in process in SPSS and the bootstrap method showed that the attitude toward suicidal behavior and the attitude toward family members of an individual who has committed suicide played a double-mediation role, from perceived self-efficacy in managing happiness to core self-evaluation. The results also showed that the attitude toward a person who committed suicide or attempted suicide played a mediation effect from perceived self-efficacy in managing curiousness to core self-evaluation. This research has great significance for improving the understanding of college students' sense of happiness and prevention for self-evaluation.

Microsystem and Macrosystem Predictors of Latinx College Students’ Depression and Anxiety

Latinx college students experience depression and anxiety similarly to other groups. Systemic factors (e.g., discrimination, family support) may exacerbate or protect from symptoms. We incorporated an ecological framework to assess family cohesion, social networks, acculturative stress, perceived discrimination, and foreigner objectification as predictors of depression and anxiety for Latinx students at a Hispanic Serving Institution (HSI). Only discrimination predicted depression and anxiety after controlling for age, gender, and birthplace. Educational and counseling implications are addressed.

Rumination, Suicidal Ideation, and Suicide Attempts: A Meta-Analytic Review

Rumination has been implicated as a risk factor for suicidal ideation and attempts, yet the literature to date has not been synthesized. We conducted a meta-analysis of the association between rumination and both suicidal ideation and attempts to consolidate the existing literature ( k = 29). Results indicated that the relationships between global rumination ( k = 13; Hedge's g = .74, p < .001, 95% CI [.45, 1.04]), brooding ( k = 12; Hedge's g = .63, p < .001, 95% CI [.35, .90]), and reflection ( k = 12; Hedge's g = .38, p = .002, 95% CI [.10, .65]) with suicidal ideation were significant. Associations between global rumination ( k = 3; Hedge's g = .26, p < .001, 95% CI [.08, .44]) and brooding ( k = 4; Hedge's g = .47, p = .004, 95% CI [.02, .91]) and suicide attempts were significant, but reflection ( k = 4; Hedge's g = .09, p = .646, 95% CI [−.54, .72]) was unrelated. However, given the limited studies included in suicide attempt analyses—and the exclusive use of cross-sectional designs and heterogeneity with regard to samples and measures—these parameters should be taken with caution. Generally, age, gender, race/ethnicity, and year of publication were not moderators, and there was little evidence for publication bias across effects, with the exception of the effect of global rumination on suicidal ideation. Several future research directions are discussed.

Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model

Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes.

Ethnic and Gender Differences in Additive Effects of Socio-economics, Psychiatric Disorders, and Subjective Religiosity on Suicidal Ideation among Blacks

BACKGROUND

This study aimed to investigate the additive effects of socio-economic factors, number of psychiatric disorders, and religiosity on suicidal ideation among Blacks, based on the intersection of ethnicity and gender.

METHODS

With a cross-sectional design, data came from the National Survey of American Life, 2001-2003, which included 3570 African-American and 1621 Caribbean Black adults. Socio-demographics, perceived religiosity, number of lifetime psychiatric disorders and lifetime suicidal ideation were measured. Logistic regressions were fitted specific to groups based on the intersection of gender and ethnicity, while socioeconomics, number of life time psychiatric disorders, and subjective religiosity were independent variables, and lifetime serious suicidal ideation was the dependent variable.

RESULTS

Irrespective of ethnicity and gender, number of lifetime psychiatric disorders was a risk factor for lifetime suicidal ideation (odds ratio [OR] ranging from 2.4 for Caribbean Black women to 6.0 for Caribbean Black men). Only among African-American men (OR = 0.8, 95% confidence interval = 0.7-0.9), perceived religiosity had a residual protective effect against suicidal ideation above and beyond number of lifetime psychiatric disorders. The direction of the effect of education on suicidal ideating also varied based on the group.

CONCLUSIONS

Residual protective effect of subjective religiosity in the presence of psychiatric disorders on suicidal ideation among Blacks depends on ethnicity and gender. African-American men with multiple psychiatric disorders and low religiosity are at very high risk for suicidal ideation.

Normative Data on the Beck Depression Inventory--Second Edition (BDI-II) in College Students

OBJECTIVE

This study was conducted to provide normative data on the Beck Depression Inventory--Second Edition (BDI-II) in college students.

METHOD

Data were obtained from 15,233 college students drawn from 17 universities in the United States, weighted to match the gender and race/ethnicity of enrollment in degree-granting institutions.

RESULTS

Descriptive statistics, point prevalence of individuals exceeding cutoff scores, and mean differences by gender and race/ethnicity were provided. Because the distribution of BDI-II scores was not normal, percentile ranks for raw scores were provided for the total sample and separately by gender and race/ethnicity for the total sample and by race/ethnicity for men and women. Normative data were used to calculate the Reliable Change Index on the BDI-II for college students.

CONCLUSION

Because the distribution of BDI-II scores demonstrated significant skewness and non-normal kurtosis, percentile ranks are important to consider in interpreting scores on the measure, in addition to descriptive statistics.