Lillian Polanco-Roman

Culturally related stress, hopelessness, and vulnerability to depressive symptoms and suicidal ideation in emerging adulthood

Culturally related experiences are seldom considered in assessing risk for suicidal behavior among emerging adults, despite racial/ethnic differences in suicide attempts. The present study examined the impact of culturally related stressors on hopelessness, symptoms of depression, and suicidal ideation-well-known predictors of suicidal behavior-among emerging adults over time, and whether hopelessness would mediate the relation between culturally related stressors and both depression and ideation. An ethnically diverse sample of 143 emerging adults, ages 18 to 25, completed self-report measures of acculturative stress, perceived discrimination, and depressive symptoms at 1 time point, and self-report measures of ethnic identity, hopelessness, depressive symptoms, and suicidal ideation 2 to 3years later. Higher baseline acculturative stress and perceived discrimination predicted hopelessness, but not symptoms of depression, when entered simultaneously into a regression analysis. However, there was an indirect relation between these culturally related stressors and depressive symptoms through hopelessness. There was also a direct relation between acculturative stress at baseline and suicidal ideation at follow-up, and hopelessness mediated this relation. However, the indirect relations between culturally related stressors and depression and suicidal ideation through hopelessness were only present at low levels of ethnic identity, but not at average or high levels of ethnic identity. Acculturative stress and perceived discrimination may thus increase vulnerability to depression and suicidal ideation to the extent that they increase hopelessness, but a strong ethnic identity may buffer against this relation. This study highlights the need for incorporating culturally related experiences in assessing risk for suicidal ideation and behavior, particularly among emerging adults from diverse backgrounds.

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

Among emerging adults and college students, racial and ethnic minorities experience greater risk for suicidal ideation and behavior than their White counterparts. Research has identified numerous cognitive risk factors for suicidal ideation. However, they have not been well studied among racial and ethnic minorities. The present study examined the association between these factors (brooding rumination, reflective rumination, hopelessness, and depressive symptoms) and suicidal ideation among 690 Black, Latino, and biracial college students. Among all groups, hopelessness was positively associated with suicidal ideation. Brooding was negatively associated with suicidal ideation, after adjusting for reflection and hopelessness, although only at low levels of depressive symptoms. Black race/ethnicity and Latino race/ethnicity, compared with biracial race/ethnicity, each separately interacted with reflection to predict lower levels of suicidal ideation at moderate to high levels of reflection. Furthermore, Latino race/ethnicity, compared with biracial race/ethnicity, interacted with both reflection and depressive symptoms, such that reflection was negatively associated with suicidal ideation among Latino individuals reporting depressive symptoms above the 39th percentile. Biracial race/ethnicity, compared with monoracial race/ethnicity, also interacted with reflection and depressive symptoms, with reflection associated with greater amounts of suicidal ideation at depressive symptom levels above the 39th percentile. Our findings suggest reflective rumination differentially affects racial and ethnic groups and should be considered in conjunction with depressive symptoms among Latino and biracial individuals in suicide risk assessment and treatment.

Brooding, Reflection, and Distraction: Relation to Non-Suicidal Self-Injury versus Suicide Attempts

The present study examined the relation between cognitive response styles (i.e., brooding, reflection, distraction) and cognitive inflexibility in differentially predicting history of non-suicidal self-injury (NSSI) only, suicide attempt (SA) only, or both (NSSI + SA). College students (N = 352) completed self-report measures of rumination, distraction, and self-harm history, a diagnostic interview, and a computerized task measuring cognitive flexibility. Brooding uniquely predicted SA-only history, while reflection uniquely predicted history of NSSI-only and NSSI + SA. Distraction was associated with lower odds of NSSI-only and NSSI + SA. Cognitive inflexibility was not significantly associated with self-harm history. Cognitive vulnerabilities may help identify individuals who are at risk for self-harm and may differentiate between NSSI and SA.

Perceived Discrimination, Ruminative Subtypes, and Risk for Depressive Symptoms in Emerging Adulthood

Perceived discrimination has been found to increase risk for depression in emerging adulthood, but explanatory cognitive mechanisms have not been well studied. We examined whether the brooding and reflective subtypes of rumination would mediate the relation between perceived discrimination and depressive symptoms among racial/ethnic minority, versus White, emerging adults, and whether a strong ethnic identity would buffer against this effect. Emerging adults (N = 709; 70% female; 68% racial/ethnic minority), ages 18-25, completed measures of perceived discrimination, rumination, depressive symptoms, and ethnic identity. Perceived discrimination was positively associated with depressive symptoms among racial/ethnic minority and White participants. Brooding--but not reflection--mediated this relation only among racial/ethnic minorities. Ethnic identity, though negatively associated with depressive symptoms, did not buffer against the mediating effect of brooding on the discrimination-depression relation. Interventions for depression among racial/ethnic minority emerging adults should address maladaptive cognitive responses, such as brooding, associated with perceived discrimination.

Mental Health Treatment Barriers Among Racial/Ethnic Minority Versus White Young Adults 6 Months After Intake at a College Counseling Center.

Abstract Objective: This study examined mental health treatment barriers following intake at a counseling center among racially/ethnically diverse college students. Methods: College students (N = 122) seen for intake at a college counseling center in 2012–2013 completed self-reports of depressive symptoms, suicidal ideation, and mental health treatment barriers 6 months later. Results: Racial/ethnic minority students less often reported previous mental health treatment and treatment after being seen at the counseling center, compared with white students. They also endorsed more treatment barriers—most commonly, financial concerns and lack of time—and more often endorsed stigma-related concerns. Treatment barriers were associated with not following through with counseling center recommendations and with greater depressive symptom severity but not with suicidal ideation during follow-up. Conclusions: Improving mental health treatment seeking among racial/ethnic minority college students should involve decreasing treatment barriers, improving access to affordable options, providing flexible scheduling or time-limited options, and decreasing stigma.,

Ethnic differences in prevalence and correlates of self-harm behaviors in a treatment-seeking sample of emerging adults.

The present study examined differences between White and ethnic minority emerging adults in the prevalence of self-harm behaviors – i.e., non-suicidal self-injury (NSSI) and suicide attempts (SA) – and in well-documented risk (i.e., depressive symptoms, generalized anxiety symptoms, social anxiety symptoms, suicidal ideation (SI), substance use, abuse history) and protective factors (i.e., religiosity/spirituality, family support, friend support) associated with NSSI and SAs. Emerging adults (N=1156; 56% ethnic minority), ages 17–29 (M=22.3, S.D.=3.0), who were presented at a counseling center at a public university in the Northeastern U.S., completed a clinical interview and self-report symptom measures. Univariate and multivariate logistic regression models were used to examine the association between risk and protective factors in predicting history of NSSI-only, any SA, and no self-harm separately among White and ethnic minority individuals. Ethnic differences emerged in the prevalence and correlates of NSSI and SAs. Social anxiety was associated with SAs among White individuals but with NSSI among ethnic minority individuals. Substance use was a more relevant risk factor for White individuals, and friend support was a more relevant protective factor for ethnic minority individuals. These findings suggest differing vulnerabilities to NSSI and SAs between White and ethnic minority emerging adults.

Ethnic Variation in Whether Dissociation Mediates the Relation Between Traumatic Life Events and Attenuated Positive Psychotic Symptoms

The present study sought to determine whether dissociative experiences mediated the relationship between traumatic life events and attenuated positive psychotic symptoms in a non-treatment-seeking sample of racial and ethnic minority young adults. Participants (n = 549) completed a self-report inventory for psychosis risk (i.e., the Prodromal Questionnaire; R. L. Loewy, C. E. Bearden, J. K. Johnson, A. Raine, & T. D. Cannon, 2005), from which a total number of attenuated positive psychotic symptoms was assessed. Participants also completed a checklist of potentially traumatic life events and a traumatic dissociation scale. Hierarchical linear regression models and bootstrapping results indicated that dissociation mediated the relationship between traumatic life events and attenuated positive psychotic symptoms. Stratified analyses of Black, Asian, and Hispanic subgroups revealed that full mediation was only evident in the Black subgroup of young adults. Partial mediation was found among the Hispanic group, and no mediation occurred in the Asian subgroup. For the latter, traumatic life events were not significantly associated with dissociative experiences. A dissociative response style may be particularly relevant to trauma-exposed Black young adults exhibiting subclinical psychotic experiences and less so for Asian young adults. Trauma-induced dissociative experiences should be assessed further in clinical high-risk studies, especially among Black traumatized youth.

Racial discrimination as race-based trauma, coping strategies, and dissociative symptoms among emerging adults.

OBJECTIVE The race-based traumatic stress theory (Carter, 2007) suggests that some racial- and ethnic-minority individuals experience racial discrimination as psychological trauma, as it may elicit a response comparable to posttraumatic stress. In the present study, we examined this further by determining the relation between racial discrimination and dissociation, a common response to trauma exposure. Further, we examined whether active coping strategies specifically employed to cope with racial discrimination related to less dissociative symptomatology. METHOD The predominant racial- and ethnic-minority sample (N = 743) of emerging adults, ages 18-29, recruited from a public university in northeastern United States completed a battery of self-report measures on racial discrimination, responses to racial discrimination, traumatic life events, and dissociative symptoms. RESULTS Frequency of racial discrimination was positively associated with dissociative symptoms in regression analyses adjusted for demographics and other traumatic life events. In addition, more active coping strategies in response to racial discrimination were negatively associated with dissociative symptoms. CONCLUSION Racial- and ethnic-minority emerging adults who experience racial discrimination, possibly as traumatic, may be more vulnerable to dissociative symptoms. However, different strategies of coping with racial discrimination may differentially impact risk for dissociation. (PsycINFO Database Record

The future-oriented repetitive thought (FoRT) scale: A measure of repetitive thinking about the future

BACKGROUND AND OBJECTIVES Repetitive thinking about the future has been suggested as one way in which individuals may become hopeless about the future. We report on a new scale assessing future-oriented repetitive thinking, termed the Future-Oriented Repetitive Thought (FoRT) Scale. METHODS In Study 1, an exploratory factor analysis was conducted with data from 1071 individuals who completed the scale. Study 2 describes a confirmatory factor analysis with a revised version of the scale on a sample of 612 individuals, a subsample of whom (N=99) also completed measures of repetitive thought (rumination, worry), hopelessness-related cognitions, and symptoms of depression and generalized anxiety disorder in order to examine evidence for the measures convergent, discriminant, and concurrent validity. Study 3 examined the scales concurrent validity in distinguishing between individuals with and without a history of suicidal ideation and attempts. RESULTS A three-factor solution emerged in Study 1, and this solution was confirmed in Study 2. In addition, the FoRT scale demonstrated moderate associations with other measures of repetitive thought (rumination, worry), with hopelessness-related cognitions, and with symptoms of depression and generalized anxiety. Finally, the FoRT scale distinguished between individuals with and without a history of suicidal ideation and attempts. LIMITATIONS Cross-sectional data limit conclusions that can be drawn about directionality. CONCLUSIONS These findings suggest that the newly developed FoRT scale is a reliable and valid measure of future-oriented repetitive thought.

Emotion Reactivity, Comfort Expressing Emotions, and Future Suicidal Ideation in Emerging Adults

OBJECTIVE Emotion reactivity and difficulties in expressing emotions have been implicated in risk for suicidal behavior. This study examined comfort in expressing emotions (positive vs. negative) and depressive symptoms as mediators of the prospective relation between emotion reactivity and suicidal ideation. DESIGN Emerging adults (N = 143; 72% female; 28% White) completed measures of emotion reactivity, comfort expressing emotions, and suicidal ideation at baseline and of depressive symptoms and suicidal ideation 12 months later. RESULTS Emotion reactivity predicted suicidal ideation at follow-up through depressive symptoms. Difficulty expressing love-but not happiness, sadness, and anger-partially mediated the relationship between emotion reactivity and suicidal ideation at follow-up before but not after adjusting for baseline ideation. CONCLUSION The relation between high emotion reactivity and suicidal ideation may be explained by discomfort in the expression of positive emotions and by depressive symptoms. Promotion of comfort in positive emotion expression may reduce vulnerability to suicidal ideation.