The University of Toledo The University of Toledo Digital Repository Theses and Dissertations 2013 Risk and protective factors for suicidal behaviors in Mexican youth : evidence for the interpersonal theory of suicide Maria Gabriela Alvarado The University of Toledo Follow this and additional works at: http://utdr.edu/theses-dissertations Recommended Citation Alvarado, Maria Gabriela, "Risk and protective factors for suicidal behaviors in Mexican youth : evidence for the interpersonal theory of suicide" (2013). Theses and Dissertations. This Thesis is brought to you for free and open access by The University of Toledo Digital Repository. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of The University of Toledo Digital Repository.
For more information, please see the repository's About page. A Thesis entitled Risk and Protective Factors for Suicidal Behaviors in Mexican Youth: Evidence for the Interpersonal Theory of Suicide by Maria Gabriela Hurtado Alvarado Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Arts Degree in Psychology _________________________________________ Dr. Hovey, Committee Chair _________________________________________ Dr. Jon Elhai, Committee Member _________________________________________ Dr.
Seligman, Committee Member _________________________________________ Dr. Komuniecki, Dean College of Graduate Studies The University of Toledo May, 2013 Copyright 2013, Maria Gabriela Hurtado Alvarado This document is copyrighted material. Under copyright law, no parts of this document may be reproduced without the expressed permission of the author. An Abstract of Risk and Protective Factors for Suicidal Behaviors in Mexican Youth: Evidence for the Interpersonal Theory of Suicide by Maria Gabriela Hurtado Alvarado Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Arts Degree in Psychology The University of Toledo May, 2013 According to the 2009 Youth Risk Behavior Survey, Latino youth reported engaging in suicidal ideation and attempts more frequently when compared to African American and Caucasian youth.
These findings have remained a consistent trend in epidemiological studies for the past 15 years (Duarte-Velez & Bernal, 2007). Building on this knowledge base, it is important to examine specific factors related to suicidal behaviors in Latino youth. The main focus of this study was twofold. First, we aimed to examine suicidal behavior among Mexican youth in the context of well-established predictors of suicide, as well as cultural risk and protective factors that are relevant to their experience.
Second, we aimed to examine suicidal behavior among Mexican youth within the framework of the interpersonal theory of suicide (Joiner, 2005). This theory is particularly relevant to Mexican youth. For example, in the presence of the high levels of family conflict Mexican youth may experience a lack of belongingness and an increased sense of perceived burdensomeness. Family cohesion is a core-value of the Latino culture, and thus, family conflict can lead to the loss of important social support systems for Mexican youth.
iii A total of 152 Mexican adolescents participated in the study. The participants completed a questionnaire packet containing a demographic questionnaire; the Family Environment Scale (Moos & Moos, 1993), the Personal Resources Questionnaire (Weinert, 1987), the Coping Competence Questionnaire (Schroder, 2004), the Interpersonal Needs Questionnaire (Van Orden , Witte, Gordon, Bender, & Joiner, 2008), the Beck Hopelessness Scale (Beck, Weissman, Lester & Trexler, 1974), the Reynolds Adolescent Depression Scale-2 (Reynolds, 1987), and the Suicidal Behaviors Questionnaire-Revised (Osman, Bagge, Gutierrez, Konick, Kopper, & Barrios, 2001). Family conflict, perceived burdensomeness, thwarted belongingness, hopelessness and depression had a positive association with suicidal behaviors. On the other hand, coping competence and social support were negatively associated with suicidal behaviors.
Furthermore, those individuals that reported at least one previous suicide attempt reported greater levels of depressive symptomatology, hopelessness, and perceived burdensomeness. Hierarchical regression analyses revealed that family conflict and depression were significant predictors of suicidal behaviors. In addition, perceived burdensomeness and thwarted belongingness were significant moderators in the relationship between depression and suicidal behaviors. The findings of this study can aid in the understanding of factors that are relevant to the experience of Latino youth, and may contribute to suicidal behaviors in this group.
The primary implication of these findings is to inform the development of appropriate suicide prevention efforts. iv Table of Contents Abstract iii Table of Contents v List of Tables vii List of Figures viii I. Interpersonal Theory of Suicide 3 B. Risk and Protective Factors in Mexican Youth 5 a.
Family and Social Support 5 b. Depression in Mexican Youth 8 d. Hopelessness in Mexican Youth 10 C. Mexican Adolescent Suicide Studies 11 a.
Limitations of Previous Studies 12 D. The Present Thesis Study 12 a. Exploratory Data Analysis 21 III. Multiple Regression Analysis of Suicidal Behaviors 23 c.
Moderation Analyses of Interpersonal Needs 23 d. Logistic Regression Analyses of Suicidal Behaviors 24 IV. Interpersonal Theory of Suicide 27 b. Future Directions 29 References 31 Appendices A.
Handout: Suicide and Depression in Latino Adolescents 61 vi List of Tables Table 1 Means, Standard Deviations, and Correlations.49 Table 2 Means and standard deviations of mental health measures in attempters compared to non-attempters………………………….……50 Table 3 Means and standard deviations of low level intent compared to moderate to high level of intent among attempters.……51 Table 4 Multiple Regression Analysis Predicting Suicidal Behaviors.52 Table 5 Logistic Regression Analyses Predicting Suicide Attempts.53 Table 6 Logistic Regression Analyses Predicting Level of Intent Among Attempters.54 vii List of Figures Figure 1 Interaction between Perceived Burdensomeness and Depression in Suicidal Behaviors.55 Figure 2 Interaction between Thwarted Belongingness and Depression in Suicidal Behaviors.56 viii Chapter One Introduction According to the 2010 Fatal Injury Reports and Violent Death (NVDRS) from the Center for Disease Control and Prevention (CDC) (Fatal Injury Reports and Violent Death [NVDRS], 2010), suicide is the second leading cause of death in individuals between the ages of 15 to 24 in the United States. The Youth Risk Behavior Survey (YRBS), a national survey of high school students, provides detailed information of suicidal behaviors among adolescents. The results of the survey show that 6.3% of adolescents reported having attempted suicide one or more times within the last 12 months; 1.9% of the participants reported having a suicide attempt that required serious medical attention; and 10.9% reported having made a specific suicide plan (Youth Risk Behavior Survey [YRBS], 2009). These data suggest that adolescents appear to be at an increased risk for suicide.
There are important differences in suicidal behaviors among ethnic groups. In 2009, 8% of Latino youth engaged in suicidal ideation compared to 7% of African American and 5% of Caucasian youth. In particular, Latina adolescents reported the highest rates of suicide attempts (11. To further highlight the high prevalence of suicidal ideation and attempts among Latino adolescents, Garcia and colleagues (2008) conducted a study with Puerto Rican and Mexican high school students (N = 3178) derived from the Minnesota Student Survey (MSS).
The MSS is a population-based study that includes almost all 6th, 9th, and 12th graders in the school districts of Minnesota. In this study, one in five Latino adolescents reported having experienced suicidal ideation within the past year.5% of Latino adolescents reported suicidal attempts within the past year. The prevalence of suicidal behaviors was higher among females such that 30% to 40% reported experiencing suicidal ideation; and 14% to 19% reported a suicide attempt within the past year. The high rates of suicidal behaviors among Latino youth in the U.
are consistent with suicidal behaviors among adolescents in Mexico (Instituto Nacional de Estadistica y Geografía [INEGI], 2010). A few epidemiological studies have revealed that suicide rates have consistently increased among adolescents in Mexico (Borges, Benjet, Medina-Mora, Orozco, Familiar, Nock, & Wang, 2010). For example, suicidal behaviors increased from 3. Unfortunately, there are only a few available studies that have examined suicidal behavior among Mexican youth (e., Guiao & Esparza, 1995; Hovey & King, 1996, 1997; Hovey, 1998, 1999a, 1999b; Locke & Newcomb, 2005; Queralt, 1993).
The available research has identified some potential risk and protective factors associated with suicidal behaviors among Mexican adolescents in the U., social support, family conflict, depression, hopelessness). A few of these studies have been replicated with adolescents in Mexico and obtained similar findings (e., Borges et al., 2008; Gonzales-Forteza, Ramos-Lira, Caballero-Gutierrez, Wagner-Echeagarray, 2003). However, it is essential to bridge culturally-centered research and suicide research, as well as available theoretical frameworks in order to comprehensively examine the complexity of suicidal behaviors in Mexican youth. Thus, the main purpose of this study is to examine cultural and psychological risk, as well as protective factors that are 2 relevant to the experience of Mexican youth within the framework of the interpersonal theory of suicide.
The introduction to this thesis project includes a description of methodological issues associated with the available research focused on Mexican youth, followed by a description of the risk and protective factors, hopelessness, depression, and suicidal behaviors. Additionally, this thesis project evaluates the available research on suicidal behavior among Mexican adolescents. Lastly, the hypotheses that guided the present study are discussed. Interpersonal Theory of Suicide Suicide is a complex phenomenon influenced by multiple interactions between social and cognitive factors.
Researchers have attempted to explain the mechanisms underlying suicide through several different theories. For the purpose of this study, we will use the interpersonal-theory of suicide as a theoretical framework to examine the factors that contribute to suicidal behaviors in Latino youth. The interpersonal-psychological theory of suicide states that an individual is at an increased risk for suicide when (1) perceived burdensomeness (2) thwarted belongingness are experienced concurrently. Perceived burdensomeness refers to the perception of oneself as a strain for family and friends.
Furthermore, thwarted belongingness refers to feelings of alienation from a desired social group. However, in order for suicide to occur, an individual must overcome the need to self-preserve. In this theory, the author refers to this notion as an acquired capacity to die. An individual acquires a capacity to die through repeated exposure and habituation to painful experiences.
This subsequently increases tolerance to pain and decreases one’s fear of death. This is a solid theory as it 3 considers those predictors of suicidal behaviors that have been well-established through previous research (i., impulsivity, prevalence of suicidal attempts and behaviors) with the assumption that similar mechanisms underlie all suicidal behaviors (Van Orden, Witte, Cukrowicz, Braithwaite, Selby, & Joiner, 2010). A handful of studies have examined the different components of the interpersonal theory of suicide. In sum, the findings of these studies suggested that perceived burdensomeness and thwarted belongingness are critical predictors of suicide attempts and suicidal ideation (Conner, Britton, Sworts, & Joiner, 2007; Joiner et al., 2002; Van Orden, Lynam, Hollar & Joiner, 2002).
Additionally, one study has shown that acquired capability has a strong relationship with previous suicide attempts (Van Orden, Witte, Gordon, Bender, & Joiner, 2008). To our knowledge, there has only been one previous study that has examined the interpersonal theory of suicide among Latinos (i., Garza and Pettit, 2010). The main focus of this study was to investigate the role of familismo and perceived burdensomeness on suicidal ideation in a sample of Mexican women (n = 61) at a community health center in the Southwest area of the U. The participants completed measures of familismo, depression, suicidal ideation, and perceived burdensomeness.
The findings revealed that perceived burdensomeness was the only significant predictor of suicidal ideation. Specifically, women with high levels of perceived burdensomeness were 96% more likely to engage in suicidal ideation than those with low levels of perceived burdensomeness. It is important to note that this study was conducted with adult women. The experience of these women may be qualitatively different from that of adolescents.
For example, Latina women experience unique stressors due to traditional 4 gender and family roles. In fact, previous research suggests that women rank their family role as a main stressor in their daily life (Hovey and Seligman, 2006). Thus, as noted by the authors, these findings might reflect the notion that family conflict and reduced cohesion create a higher sense of perceived burdensomeness among adult women due to the saliency of these traditional roles. Risk and Protective Factors in Mexican Youth Family and social support.