Do sociocultural factors predict suicidality among persons of African descent living in the U.S.?

Suicide risk and suicide risk factors among immigrants in Italy: A bi-center matched sample study

Italy has the third-largest immigrant population of European Union countries, but only a few research papers have examined suicide risk in immigrant psychiatric patients in Italy. The main aim of this paper was to compare suicidal ideation and suicide attempts in a sample of 304 psychiatric patients. We included 152 immigrant patients matched with 152 Italian patients admitted to the same wards during the same time period by age, gender, and diagnosis. We also investigated sociodemographic and clinical characteristics of the two samples including psychiatric diagnosis, age of illness onset, duration of illness, previous hospitalizations, length of hospitalization, previous suicide attempts, and substance and alcohol abuse. There were no differences between immigrant and Italian patients in either suicidal ideation (previous or current) or suicide attempts (previous or current). Immigrant patients were more likely to have a shorter duration of illness than the Italian patients and Italian patients were more likely to report substance abuse than were immigrant patients. Despite similar suicide rates between immigrants and Italian psychiatric inpatients, appropriate assessment of suicide risk in these patients is essential in implementing therapeutic suicide prevention strategies.

Confucianism and Gender Ratios of Suicide in the World: A WHO Data-Based Study

This study explores how Confucianism affects suicide rates by gender. Data for the study come from the World Health Organization document "Suicide Worldwide in 2019", which provides frequency and gender ratios for suicide rates in 183 member countries. One-way ANOVA and multiple linear regression analysis were used to examine potential differences in suicide rates and male to female ratio of suicides. Independent variables include region, income level, culture, and Confucian values that may be related to suicide. Suicide rates for Confucian countries do not show significant differences from European countries. However, these countries have lower suicide gender ratios.

Major discriminatory events and suicidal thoughts and behaviors amongst Black Americans: Findings from the National Survey of American Life

BACKGROUND

Risk for suicide is growing among certain groups of Black Americans, yet the topic remains understudied. Discrimination appears to increase risk for suicidal thoughts and behaviors, but the evidence has been mixed for Black Americans. This study aimed to examine the association between major discriminatory events and suicidal thoughts and behaviors among Black American adults.

METHODS

We drew data from the National Survey of American Life, a representative sample of Black Americans, and used multivariable logistic regression to examine the associations between nine major discriminatory events and suicidal thoughts and behaviors (ideation, plan, attempt), adjusting for sociodemographic characteristics and psychiatric disorders.

RESULTS

We found that some major discriminatory events increased odds of reporting suicidal thoughts and behaviors, while others did not. Further, findings suggest the mediating role of psychiatric disorders.

LIMITATIONS

The study drew from cross-sectional data and did not allow for causal inferences.

CONCLUSIONS

Major discriminatory events have important implications for clinical practice, as well as diagnostic criteria when considering race-related stressors as a precipitator of suicidal thoughts and behaviors.

Cultural Identity, Africultural Coping Strategies, and Depression as Predictors of Suicidal Ideations and Attempts Among African American Female College Students

Suicide prevention is a growing health concern in America for many minority groups. Although experts agree suicide is associated with cultural practices and beliefs, there is limited evidence on how African American women cultural values and practices influence their low rates of suicide. This study explores cultural identity, Africultural coping strategies, and depression as predictors of suicidal ideations and attempts among African American female college students. It was hypothesized that suicidal ideations and attempts are negatively related to cultural identity and Africultural coping styles, but positively related to depression. One hundred and thirty-seven African American female students were administered a battery of measures assessing cultural identity, coping strategies, and suicidal ideations and attempts. Results revealed that Africultural coping strategies and depression emerged as significant predictors of suicidal ideation and attempts. Results are discussed in terms of African American culture as a buffer to possible suicidal behavior in African American women.

Suicide Risk among Immigrants and Ethnic Minorities: A Literature Overview

Recent studies have demonstrated that immigrants and ethnic minorities may be at higher risk of suicidal behaviour as compared to the general population. We conducted a literature search to identify studies in English from 1980 to 2017 related to suicide risk among immigrants and ethnic minorities. Six hundred and seventy-eight reports were screened, and 43 articles were included in the qualitative synthesis of the review. Some studies reported lower rates of suicide attempts, while other findings suggested higher rates of suicidal behaviour and deaths among immigrants as compared to the native population. Also, a positive correlation was found between suicidal behaviour and specific countries of origin. Non-European immigrant women were at the highest risk for suicide attempts, a group which included young women of South Asian and black African origin. Risk factors among migrants and ethnic minorities were found to be: language barriers, worrying about family back home, and separation from family. The lack of information on health care system, loss of status, loss of social network, and acculturation were identified as possible triggers for suicidal behaviour. Overall, results suggest that specific migrant populations and ethnic minorities present a higher risk of suicidal behaviour than native populations, as well as a higher risk of death by suicide.

Examining the Complexities of Suicidal Behavior in the African American Community

Once considered a “White thing,” suicide is now the third leading cause of death for African Americans, behind only homicide and unintentional injury. Although the rates of suicide for African American women remain low and relatively unchanged, the rates for African American men have increased dramatically during the past 20 years. The changes in the suicide rates for African American youth have motivated researchers to investigate protective and risk factors associated with suicide. In light of some of the current findings that identify religious participation as a protective factor against suicide for African Americans, an alternative perspective is provided that examines the contribution of spirituality and specific religious practices on gender differences in suicide risk.

Acculturation and quality of life in urban, African American caregivers of children with asthma

OBJECTIVE

Racial/ethnic minority caregivers of children with asthma are at risk for low levels of quality of life (QOL). Limited research has identified factors that contribute to lower QOL among African American caregivers. This study examined associations between acculturation (e.g., engaging in values/beliefs traditional of one's culture versus adopting mainstream cultural views) and caregiver QOL in low-income, urban African American families of children (7-12 years) with persistent asthma. We also investigated the association between caregiver QOL and child emergency department (ED) use.

METHODS

Fifty-five caregivers and their children completed interview-based questionnaires in a single research session. Caregivers completed the Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ), the African American Acculturation Scale-Revised (AAAS-R), and reported on child asthma variables. Children completed items assessing asthma control.

RESULTS

Higher overall QOL and emotional function subscale scores were associated with more traditional African American religious beliefs/practices (r = .288, p = .033; r = .333, p = .013). Higher emotional function subscale scores were associated with more traditional values of African American families (r = .306, p = .023). Lower QOL was found among caregivers of children who had visited the ED three or more times in the last year.

CONCLUSIONS

Less acculturation tied to religious beliefs/practices and family values (as measured by the AAAS-R) may serve a protective role in reducing the burden low-income, urban African American caregivers experience in managing child asthma. This study is the first of its kind to study acculturation in African American caregivers of children with asthma.

Religion and Suicide Risk: A Systematic Review

Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

African Americans' perceived sociocultural determinants of suicide: afrocentric implications for public health inequalities

The cultural values of African Americans have not been adequately incorporated as a theoretical base to develop new public health models. The major objectives of this study were to explore, with a purposive sample, via seven focus groups, 40 African American college students, the following: How do (a) ethnic culture and (b) a "minoritized" status influence perceptions of sociocultural determinants in explaining increases in the incidence of suicide among African Americans? Thematic results of focus group discussions including the following: (a) racism, discrimination, and stereotyping; (b) U.S. individualism; (c) integration and cultural assimilation; and, (d) the prison industrial complex.

The Racial-Cultural Framework

Suicide-related outcomes are a major public health challenge in communities of color in the United States. To address these challenges, this Major Contribution makes theoretical, empirical, and practice-related contributions to scholarship on suicide-related outcomes among people of color. In this article, the authors present a new framework to conceptualize previous suicidology scholarship, address existing literature gaps, and inform counseling psychologists’ future work on suicide-related outcomes in U.S. communities of color. The framework consists of three components and nine principles that highlight the types of constructs, populations, and preventive interventions that should be emphasized in theory, research, and practice addressing suicide-related outcomes in communities of color. The authors explain why suicide-related outcomes in communities of color deserve attention, describe the framework, and discuss implications of the framework for future practice and training. It is hoped that this framework can serve as a resource and impetus for new paradigms of suicidology work in communities of color.

Health Behavior Theories and Research: Implications for Suicidal Individuals' Treatment Linkage and Adherence

Treatment linkage and adherence to psychotherapeutic interventions can be challenging with suicidal individuals. Health behavior theories, specifically the Health Belief Model, Stages of Change, and Theory of Planned Behavior, focus on individuals' beliefs, their readiness to change, their perceptions of illness severity and "threat," their perceptions of significant others' attitudes toward illness and treatment, and their behavioral intentions to change. These constructs have relevance both for understanding suicidal individuals' behaviors related to treatment utilization and for understanding cultural variations in these behaviors. Furthermore, these theories have implications for clinical practices aimed at facilitating improved treatment follow-through and adherence. After describing the theories and their constructs, clinical examples are provided to illustrate applications to practice with suicidal individuals.

A re-examination of cultural factors that mitigate risk and promote resilience in relation to African American suicide: a review of the literature and recommendations for future research

Suicide among African Americans has been acknowledged by the U.S. Surgeon General as a growing crisis. However, suicide remains understudied in this population. In this article, the authors examine the literature related to cultural protective factors that buffer African Americans from suicide risk. They present an overview of suicide among African Americans, review the culture and world-view of African Americans, and examine the degree to which these cultural variables protect against suicide risk. Finally, they discuss the limitations of the extant research on African American suicide, set an agenda for future research, and discuss its implications for clinical practice and public policy.

Lay Theories of Suicide: An Examination of Culturally Relevant Suicide Beliefs and Attributions Among African Americans and European Americans

The purpose of this study was to examine African Americans' lay beliefs and attributions toward suicide. The Attitudes Toward Suicide Scale, Life Ownership Orientation Questionnaire, Stigma Questionnaire, and Suicide Ideation Questionnaire were administered to 251 undergraduate college students. Beliefs about stigma associated with suicide were comparable across ethnic groups. However, African American college students were significantly less likely than European American college students were to attribute suicide to interpersonal problems and to report that the individual or government is responsible for life. African American students were significantly more likely to report that God is responsible for life. These findings have important implications for suicide risk and also for developing culturally appropriate interventions.