Suicidal behaviors among Latina adolescents: An ecodevelopmental approach and narrative review

INTRODUCTION

For the past several decades, Latina adolescents have consistently shown high rates of suicidal behaviors (i.e., suicidal ideation, planning, and attempts), higher than Latino adolescents and adolescents of most other ethnic groups. Yet, progress toward establishing evidence-based intervention efforts to address this urgent public health issue has been slow. The purpose of this narrative review is to summarize empirical findings on etiological factors associated with Latina adolescent suicidal behaviors using an ecodevelopmental, gender-specific framework that contextualizes Latina adolescent development.

METHODS

To be included, peer reviewed empirical manuscripts had to focus on suicidal behaviors (i.e., suicide attempts, suicide plan, and/or suicidal ideation) of adolescents (ages 11-19 or in grades 7-12) who self-identified as either Latina or Hispanic and a girl in the United States.

RESULTS

A total of 19 studies met review criteria and focused on microsystemic and intrapersonal predictors. Microsystemic predictors included family (i.e., family-adolescent discrepancies in acculturation, family functioning, family-daughter interactions), peer (i.e., victimization, friendships), and school (i.e., functioning, achievement) factors, while intrapersonal predictors were emotional vulnerability, psychosocial functioning, and substance use.

CONCLUSIONS

Family-related phenomena were the most widely studied. Research on school and peer microsystems was comparatively sparse, and several promising intrapersonal development factors have been underexplored. A notable limitation of existing studies is that samples consisted primarily of U.S.-born adolescents living in urban areas. Additional research is needed to characterize factors on other ecodevelopmental levels, identify resilience processes, and examine within-group diversity among Latina adolescents. Implications for intervention and future directions are discussed.

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping

The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers' mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths' attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9-16 years to explore their perspectives on maternal depression. All youth had participated in a 12-week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture-specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.

The Prevalence and Comorbidity Between Delinquency, Drug Abuse, Suicide Attempts, Physical and Sexual Abuse, and Self-Mutilation Among Delinquent Hispanic Females

Representative data show that drug abuse, delinquency, and suicide attempts are major concerns among adolescent Hispanic females. Although comorbidity research indicates that such problems tend to be related to each other, this research largely neglects Hispanic females. Using data from presentence investigations on 141 Hispanic girls sentenced to probation, the present research assesses the prevalence of drug abuse, delinquency, suicide attempts, physical and sexual abuse, and self-mutilation as well as the extent of comorbidity among these problems. Results show very high levels of violent delinquency, marijuana abuse, suicide attempts, and self-mutilation. Comorbidity was also extensive between suicide attempts, self-mutilation, physical and sexual abuse, and between these variables and drug abuse and certain forms of delinquency. This study is among the first to describe the problems of adolescent Hispanic females and highlights the need for additional research to better understand and address the serious issues many of these young women face.

Dysphoria among Hispanic Working Women: A Research Note

The purpose of this study was to examine the extent to which role conflict, life satisfaction, self-esteem, instrumentality, expressiveness, age, and education predicts dysphoria among a community sample of Hispanic working women. The sample consisted of a total of 126 Hispanic women, ranging in age from 18 to 65. Participants completed five instruments assessing gender-related traits of instrumentality and expressiveness, selfesteem, depression, life satisfaction, role conflict, and sociodemographic information. A forced entry stepwise multiple regression was conducted that included all the designated predictor variables with log transformed depression scores as the dependent variable. The significant negative beta in Step 3 indicated that women scoring high on the Masculinity (instrumentality) subscale were less likely to have a high depression score. The prediction of dysphoria by self-esteem was maintained after the masculinity score was added to the equation in Step 3. There was a significant inverse relationship for masculinity (instrumentality) and self-esteem in predicting the criterion variable, dysphoria. In counseling Hispanic women experiencing dysphoria, supporting instrumentality can serve to enhance self-esteem.

A Retrospective on "The Suicidal Fit" in Mainland Puerto Ricans: Research Issues

The so-called "suicidalfit"among Puerto Ricans in New York City was reported by Trautman (1961a, 1961b) over two decades ago. Based on a sample of 93 Puerto Ricans who, under severe emotional stress, attempted suicide in almost identical circumstances, his writings provide an early view of suicidal behavior among Puerto Ricans in the South Bronx during the late-1950s. In the intervening time, very little has appeared further documenting and elucidating suicidal behavior among Puerto Ricans, and other Hispanics, in the mainland United States. The paucity of available knowledge for clinicians and researchers about the nature of suicide among contemporary New York Puerto Ricans poses seriousproblemsfor mental health programs and practice. This article reviews Trautman's research, commenting on methodology and interpretations of findings, and discusses implications for mental health research with mainland Puerto Ricans and other Hispanic groups.

Association between school engagement and disclosure of suicidal ideation to adults among Latino adolescents

We examined associations between Latino adolescents' school engagement and their likelihood of disclosing suicidal ideation (SI) to adults and of asking for help for SI. A first set of analyses was conducted on a total sample of 14 high schools, and a second set of analyses was conducted on 8 "Latino-representative" high schools. The criterion for Latino representation was that ≥10% of the school's total student population was Latino. Across all 14 high schools, 17% (110/663) of Latino students reported SI in the past year, compared to 13% (359/2,740) of non-Hispanic White students and 11% (78/719) of African American students. Of Latino students with SI, 24% (26/110) told an adult and 35% (38/110) sought help. In the 8 Latino-representative schools, higher levels of reported school engagement were associated with a greater likelihood of seeking help (OR = 6.17) and disclosure of SI to an adult (OR = 7.64) for Latino males. For Latinas, however, school engagement was not associated with either disclosure of SI to an adult or seeking help. Additional research is needed to clarify the processes, including social connectedness, that contribute to the disclosure of and help-seeking for SI among Latino adolescents.

Are suicide attempts by young Latinas a cultural idiom of distress?

The high rates of suicide attempts among adolescent Hispanic females in the United States have been well established by epidemiological and clinical studies. In this paper, we review the research history of Latina suicide attempts and their characteristics. Then we apply multi-faceted conceptual and empirical criteria found in the anthropological and psychiatric literature about cultural idioms of distress to the suicide attempts of young Latinas. We contrast the suicide-attempt phenomenon to the well-known ataque de nervios and propose that the phenomenon may reflect a developmental or cultural variant of the ataque. The attempt-as-idiom proposition is intended to invite discussion that can deepen our understanding of the cultural roots of the suicide attempts and their possible designation as cultural idiom. Establishing the meaning of suicide attempts within a cultural perspective can assist psychological and psychiatric research and clinical interventions.

Suicidal Ideation and Alcohol Use Among Ethiopian Adolescents in Israel

Recent figures point to alarming rates of suicidal tendencies and risk behaviors among Ethiopian adolescents (first and second generation) in Israel. This study tries to understand this phenomenon through an examination of the relationship between ethnic identity (Israeli and Ethiopian) and parental support with suicidal ideation and alcohol use. Two hundred adolescents aged 15–18 years from the Ethiopian community in Israel completed questionnaires examining the degree to which they felt a sense of (positive) Israeli and Ethiopian identity and parental support as well as suicidal ideation, drinking behavior, and depression. Results showed significant correlations between both Israeli and Ethiopian identities and suicidal ideation and alcohol use and a significant relationship between suicidal ideation and parental support. Regression analysis highlighted the pivotal role of a strong and positive heritage (Ethiopian) identity in lower levels of suicidal ideation and alcohol use. Results suggest the important role of ethnic identity for well-being among immigrant and minority youth, in particular in the ability of minority youth to consolidate a coherent ethnic identity incorporating a positive connection to their heritage culture as providing a protective role against suicidal tendencies and risk behaviors.

Suicidal behavior inLatinas: explanatory cultural factors and implications for intervention

We posit that the high rates of suicidal behavior by teenage Hispanic females reported in large-scale surveys can be understood as a cultural phenomenon, a product of specific elements of the history, tradition, ideology, or social norms of a particular society, and that treatment interventions must take family and cultural factors into consideration. For over a decade, surveys have reported that among ethnic and racial minority youth in the United States, Latinas have the highest rates of suicidal behavior compared to African American and non-Hispanic White adolescent females. However, other research shows that the psychological profiles of suicidal Latina adolescent girls and the risk factors for Latina suicidal behavior may not be that different from non-Hispanic suicidal adolescent females. The unique situation of adolescent Latinas involves the convergence of cultural and familial factors (i.e., familism, acculturation, relatedness, autonomy, etc.) with the developmental, social, and individual factors frequently associated with suicidal behaviors. Based on this background, family-oriented interventions appear to be the most appropriate approach to the prevention and treatment of Hispanic suicidal girls. Factors implicated in Latina suicidal behavior and community-based interventions that include the adolescent and her family are suggested.

Why do so many latina teens attempt suicide? A conceptual model for research

Rates of suicide attempts among adolescent Latinas have been reported to be higher than for their non-Hispanic counterparts. Yet researchers know very little about the attempts, their antecedents, and why the girls attempt suicide. Latina girls have been included in research on suicidal adolescents and typically show higher rates of attempts relative to similar psychopathology when compared with other young women. A few small studies have focused on Latinas, but none have explored why suicide attempt rates are higher. The authors constructed a conceptual model to provide a formulation of this phenomenon on the basis of a review of the literature on suicide attempts among Latinas and their clinical experience. This model can serve as a framework to guide research on the unique sociocultural processes present in Latina adolescent suicide attempts and may also benefit the work of clinicians.

Prevention programs and special education: Considerations related to risk, social competence, and multiculturalism

As one reviews the literature on culture-related factors influencing behavioral outcomes and responsiveness to preventive programs, it becomes clear that in addition to the more traditionally defined risk factors, "special education status" itself can be considered an at-risk cultural designation. Despite this additional vulnerability to failure, primary prevention programs for special education (SE) populations are found to be both underdeveloped and understudied. The authors discuss how issues of multiculturalism and cross-cultural competence can be understood and used to enhance the education of SE students. Recommendations are made to enhance the design and delivery of multiculturally sensitive health promotion and problem prevention programs for SE.

Suicidality correlates in Mexican American teens

This study was conducted to determine the relationships between suicidality and life stress, coping, depression, and family dysfunction in Mexican American teens. The research question was: What are the magnitude of the relationships between suicidality and life stress, coping, depression, and family dysfunction in Mexican American teenagers? The investigators discuss the findings of the study from the perspective of the Mexican American culture, followed by specific conclusions and recommendations drawn from the results of the study. In this article, the term teen is used interchangeably with the terms teenager, youth, and adolescent; suicidality is used interchangeably with suicide risk.