Help-seeking tendencies in Asian Americans with suicidal ideation and attempts.

Among rising concerns surrounding heightened suicide in certain subgroups of Asian Americans, it is important to understand the help-seeking rates and pathways among Asian Americans experiencing suicidality. This study examined perceived need for care, help-seeking behavior, and chosen sources of care among Asian Americans compared with Latinos in the National Latino and Asian American Study who reported a history of lifetime suicidal ideation, suicide attempts, or mental disorders without history of suicide. Consistent with existing literature in Caucasians, suicide attempts in Asian Americans and Latinos were related to greater help seeking and perceived need beyond that of mental disorders only. However, Asian Americans with suicide attempts still reported lower perceived need and help-seeking behaviors compared with Latinos. In contrast to both the existing literature and Latinos in this study, Asian Americans with suicidal ideation were no more likely to perceive a need for help or seek help than Asian Americans with a mental disorder without history of suicide and were less likely to seek and perceive a need for help than Latinos with suicidal ideation. These findings point to the idea that Asian Americans who have serious suicidal ideation or attempts may underestimate the importance of their condition and do not receive the level of attention and support needed. Findings also show that Asian Americans with suicidal ideation and attempts prefer seeking help from nonprofessional rather than professional sources of help, other than medical professionals. Clinical implications for outreach, assessment, and management of suicide are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Do ethnic identity and other-group orientation protect against discrimination for Asian Americans?

Ethnic identity and other-group orientation were examined as possible moderators and mediators on the effects of personal ethnic discrimination and minority group discrimination in 2 studies of Asian Americans. Results demonstrated that discrimination, particularly when directed personally at an individual, correlated negatively with psychological well-being and correlated positively with distress. Ethnic identity and other-group orientation, however, correlated positively with psychological well-being. Contrary to the main hypothesis, ethnic identity did not moderate or mediate the effects of discrimination, although other-group orientation demonstrated a moderator effect on community well-being. More research on ethnic identity and other-group orientation as protective factors that enable Asian Americans to be resilient against discrimination is necessary to clarify the findings from these studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Asian American college students' suicide ideation: A mixed-methods study.

The purpose of this mixed-methods study was to explore the phenomenon of suicide ideation among 293 Asian American college students. Guided by T. Joiner's (2005) interpersonal-psychological theory of suicidal behavior, the authors examined the relationships among perceived burdensomeness, thwarted belongingness, self-construals, and suicide ideation. Compared with thwarted belongingness, perceived burdensomeness was a more robust predictor of suicide ideation. However, thwarted belongingness moderated the positive association between perceived burdensomeness and suicide ideation. Furthermore, interdependent self-construal and independent self-construal both weakened the link between perceived burdensomeness and suicide ideation and between thwarted belongingness and suicide ideation. The authors also conducted a qualitative analysis of participants' open-ended responses about their perceptions of why Asian American college students might consider suicide. The authors identified a core phenomenon of unfulfilled expectations as well as 2 broad themes related to this core phenomenon: unfulfilled intrapersonal expectations and unfulfilled interpersonal expectations, comprising the subthemes of (a) family, (b) relationship, (c) cultural differences, and (d) racism. These findings are discussed in terms of implications for suicide-related clinical interventions and primary prevention efforts among Asian American college students. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization.

Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk for suicidal ideation in the U.S. Air Force: An ecological perspective.

Objective: Suicidal members of the U.S. military often fail to disclose their suicidal urges and behaviors. Military suicide prevention efforts may therefore be enhanced if they also target less stigmatized psychosocial factors that may decrease risk of suicidality. In keeping with Bronfenbrenner's (1977, 1994) model, this study simultaneously examined 4 ecological levels (i.e., individual, family, workplace, and community) of factors variously associated with increased or decreased risk for suicidal ideation. Method: Active-duty U.S. Air Force members (N = 52,780; 79.3% male; 79.2% non-Hispanic White; mean age = 31.78 years, SD = 7.38) completed the 2006 Community Assessment survey (a biennial, anonymous survey conducted at 82 U.S. Air Force bases worldwide), including the Centers for Disease Control and Prevention's (2008) 5-item measure of past-year suicidality along with scales assessing an array of potential predictors. Results: The 1-year rate of suicidal ideation, defined as (a) more than rarely thinking about suicide or (b) ever seriously considering suicide, was approximately 4%. In multivariate models, for men and women, individual- (depressive symptoms and alcohol problems), family- (relationship satisfaction and intimate partner victimization), workplace- (hours worked), and community-level (social support) variables were retained in the final model. However, some sex differences in retained predictors were noted (e.g., men: dissatisfaction with the U.S. Air Force way of life; women: workplace relationship satisfaction and financial stressors). Conclusions: Addressing depressive symptoms and alcohol use, facilitating healthy relationship functioning, and increasing job satisfaction and social support may aid military suicide prevention efforts. These findings illustrate the importance of attending to multiple levels of potential influence when designing integrated suicide prevention and intervention programs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Ethnic Identity and Approach-Type Coping as Moderators of the Racial Discrimination/Well-Being Relation in Asian Americans.

Ethnic identity, in combination with approach-type coping strategies (i.e., social support seeking, cognitive restructuring, and problem solving), was hypothesized to moderate the effects of perceived racial discrimination on the well-being of Asian American college students. Results found that individuals with a strong ethnic identity were more likely to engage in approach-type coping strategies, but the use of cognitive restructuring and problem solving coping buffered the effects of racial discrimination on well-being only when racial discrimination was low. These results are contrary to the current literature and suggest ethnic identity and approach-type coping strategies may not always protect against discrimination for Asian Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived burdensomeness and suicide ideation in older adults.

Older adults have the highest risk of death by suicide in the United States. Improving our understanding of the factors that lead to increased risk of suicide in older adults will greatly inform our ability to prevent suicide in this high-risk group. Two studies were conducted to test the effect of perceived burdensomeness, a component of the interpersonal-psychological theory of suicide (Joiner, 2005), on suicide ideation in older adults. Further, gender was examined as a moderator of this association to determine if perceived burdensomeness exerted a greater influence on suicide ideation in males. The results of these studies suggest that perceived burdensomeness accounts for significant variance in suicide ideation, even after predictors such as depressive symptoms, hopelessness, and functional impairment are controlled. Gender did not moderate the association. The implications of these findings for treatment of older adults with suicide ideation and elevated suicide risk are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

New data on the nature of suicidal crises in college students: Shifting the paradigm.

This article presents new data on the nature of suicidal crises in college students. Data were collected from over 26,000 undergraduate and graduate students at 70 colleges and universities. An anonymous Web-based survey was designed to provide insight into the full spectrum of suicidal thought, intent, and action among college students. The authors discuss implications of these data and outline a new, problem-focused paradigm for conceptualizing the problem of college student suicidality and for guiding institutional policies and interventions at multiple points along the continuum of suicidal thoughts and behaviors. The proposed paradigm encompasses and expands on the current model of treating individuals in crisis in order to act preventively to reduce both prevalence and incidence of all forms of suicidality among college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive affect and suicide ideation in older adult primary care patients.

Suicide is a significant public health problem for older adults. Identification of protective factors associated with reduced risk is important. The authors examined the association of positive affect and suicide ideation in 462 primary care patients ages 65 and older. Positive affect distinguished suicide ideators from nonideators, after controlling for age, gender, depression, negative affect, illness burden, activity, sociability, cognitive functioning, and physical functioning. There was a trend toward age moderation of this relationship. Clinical and theoretical formulations of late-life suicide should consider the role of positive affect, including the possibility that its protective effects grow more pronounced with age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Where are you really from?: Asian Americans and identity denial.

Five studies investigate identity denial, the situation in which an individual is not recognized as a member of an important in-group. Asian Americans are seen as less American than other Americans (Study 1) and realize this is the case, although they do not report being any less American than White Americans (Studies 2A and 2B). Identity denial is a common occurrence in Asian Americans' daily lives (Study 3). They react to instances of identity denial by presenting American cultural knowledge and claiming greater participation in American practices (Studies 4 & 5). Identity denial furthers the understanding of group dynamics by capturing the experience of less prototypical group members who desire to have their common in-group identity recognized by fellow group members. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial discrimination stress, coping, and depressive symptoms among Asian Americans: A moderation analysis.

The purpose of our study was to explore: (a) the association between racial discrimination stress and depressive symptoms, and (b) how coping (e.g., individualistic/collectivistic and dispositional/situation-specific coping) attenuated or strengthened this association specifically among Asian Americans. Data were collected from 201 Asian Americans in a large Midwestern state university through an online survey. Results from a hierarchical regression indicated that racial discrimination stress significantly predicted depressive symptoms over and beyond perceived general stress and perceived racial discrimination. For the moderation effect, the simple effect analyses indicated that low utilization of reactive coping strategies and a high helpfulness rating of family support reduced the strength of association between racial discrimination stress and depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of suicide ideation and attempts among adolescents using a brief performance-based test.

Suicide is a leading cause of death that is difficult to predict because clinical assessment has relied almost exclusively on individuals' self-report of suicidal thoughts. This is problematic because there often is motivation to conceal such thoughts. The authors tested the ability of the Self-Injury Implicit Association Test (SI-IAT), a reaction-time measure of implicit associations between self-injury and oneself, to detect and predict suicide ideation and attempts. Participants were adolescents who were nonsuicidal (n = 38), suicide ideators (n = 37), or recent suicide attempters (n = 14). Analyses revealed large between-group differences on the SI-IAT, with nonsuicidal adolescents showing large negative associations between self-injury and themselves, suicide ideators showing small positive associations, and suicide attempters showing large positive associations on this performance-based test. The SI-IAT accurately predicted current suicide ideation and attempt status as well as future suicide ideation, and it incrementally improved prediction of these outcomes above and beyond the use of known risk factors. Future research is needed to refine this assessment method and to further develop and examine performance-based assessment of suicide risk in clinical settings (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between level of self-esteem and suicidal ideation with stability of self-esteem as moderator.

131 undergraduate university students (aged 18-24 yrs) participated in a study of the relationship between suicidal ideation and level and (in)stability of self-esteem, while controlling for the possible effect of depression. Level of self-esteem and (in)stability of self-esteem, suicidal ideation, and depression were measured using M. Rosenberg's (1965) Self-Esteem Scale, the scale for Suicidal Ideation, and the Beck Depression Inventory (A. T. Beck et al., 1961), respectively. Results of correlation analyses and an analysis of covariance show that suicidal ideation was significantly related to level of self esteem, but not to (in)stability of self-esteem. An interaction effect shows that for individuals with high self-esteem, variation in self-esteem stability did not have a significant moderating influence, whereas for those with low self-esteem, stable self-esteem appeared to be a protective factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

East meets West: Ethnic identity, acculturation, and conflict in Asian Indian families.

This study examined the influence of the family on adolescents' acculturation, ethnic identity achievement, and psychological functioning. One hundred eighty American-born Asian Indian adolescents and one of their immigrant parents completed questionnaires assessing their acculturation, ethnic identity, and family conflict. Adolescents also completed anxiety and self-esteem measures. The results showed that parents' and adolescents' ratings of their self-identification and ethnic identity were positively associated. Parents who had a separated or marginalized style of acculturation reported higher family conflict than those who had an integrated or assimilated acculturation style. Adolescents reported higher self-esteem, less anxiety, and less family conflict when there was no acculturation gap between them and their parents. The findings suggest that how parents relate to their natal, as well as to the host, culture has direct effects on adolescents' ethnic identity achievement and their psychological functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resilience Against Discrimination: Ethnic Identity and Other-Group Orientation as Protective Factors for Korean Americans.

This study investigated the resilience of 84 Korean American college students in the context of perceived ethnic discrimination. Two cultural resources, multidimensional ethnic identity and other-group orientation, were hypothesized as protective factors that moderate the negative effects of discrimination. Only 1 aspect of ethnic identity was found to have a moderation effect. Specifically, ethnic identity pride operated as a protective-reactive factor that moderated the effects of discrimination on depressive symptoms and social connectedness but not on self-esteem. Ethnic identity pride and perceived discrimination had first-order effects on self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rigid thinking in suicidal individuals.

The folklore hypothesis that suicidal individuals think in a rigid manner was evaluated by the California F Scale and the Rokeach Map Test. They were administered to a suicidal attempt group, a group of psychosomatic patients, and to hospitalized normal Ss. It was found that the suicidal group earned significantly higher California F Scale scores (p     

Social connections and suicidal thoughts and behavior.

Disrupted social connectedness is associated with suicidal thoughts and behaviors among individuals with substance use disorders (SUDs). The current study sought to further characterize this relationship by examining several indices of social connectedness—(a) living alone, (b) perceived social support, (c) interpersonal conflict, and (d) belongingness. Participants (n = 814) were recruited from 4 residential substance-use treatment programs and completed self-report measures of social connectedness as well as whether they had ever thought about or attempted suicide. Multivariate results indicated that interpersonal conflict and belongingness were significant predictors of a history of suicidal ideation, and that belongingness, perceived social support, and living alone were significant predictors of suicide attempt. These results indicate the most consistent support for the relationship between suicidality and thwarted belongingness, and also support the clinical utility of assessing whether individuals live alone. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

From abandonment to symbiosis: A developmental reversal in suicidal adolescents.

This article presents the abandonment-symbiosis hypothesis. This hypothesis pertains to the dynamics of suicide in youngsters who experience difficulties in separation from their symbiotic families. It is suggested that such youngsters have experienced various types of rejection and abandonment in early childhood and have developed insecure attachment styles and insufficient ego functions in order to cope with difficulties. It is also suggested that these youngsters have become scapegoats by their dysfunctional families and that they are held in a symbiotic grip in order to continue to bear the negative projections of their families. As such, they are prevented from developing a proper sense of individuation and autonomy. The sequence that begins with abandonment and continues with symbiosis is a reversal of normal development is critical for the emergence of suicidal behavior. The various aspects of the abandonment-symbiosis hypothesis are demonstrated by case studies and empirical data. A combination of individual and family treatment is recommended as the best approach for the treatment of such youngsters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults.

The interpersonal-psychological theory of suicidal behavior (T. E. Joiner, 2005) proposes that an individual will not die by suicide unless he or she has both the desire to die by suicide and the ability to do so. Three studies test the theory's hypotheses. In Study 1, the interaction of thwarted belongingness and perceived burdensomeness predicted current suicidal ideation. In Study 2, greater levels of acquired capability were found among individuals with greater numbers of past attempts. Results also indicated that painful and provocative experiences significantly predicted acquired capability scores. In Study 3, the interaction of acquired capability and perceived burdensomeness predicted clinician-rated risk for suicidal behavior. Implications for the etiology, assessment, and treatment of suicidal behavior are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)