Negative emotional reactivity to minority stress: measure development and testing.

The purpose of the present investigation was to develop and test a measure of negative emotional reactivity to racial/ethnic minoritized stress. In Study 1, we developed item content for a measure of negative emotional reactivity to racial/ethnic minoritized stress. We then evaluated item performance and produced a refined 15-item scale among a large sample of racial/ethnic minority adults (N = 1,343). Results supported a unidimensional construct and high levels of internal consistency. The factor structure and internal consistency were replicated and extended to a sample of Latinx persons who smoke (N = 338) in Study 2. There was evidence of convergent validity of the Emotional Reactivity to Minoritized Stress (ERMS) total score in terms of theoretically consistent and statistically significant relations with indices of mental health problems, social determinants of health, and substance use processes. There was also evidence that the ERMS demonstrated divergent validity in that it was negatively associated with psychological well-being, health literacy, subjective social status in Study 1, and positive abstinence expectancies in Study 2. Overall, the present study establishes the reliability and validity of measuring individual differences in negative emotional reactivity to racial/ethnic minority stress with the ERMS and that such responsivity is associated with behavioral health problems.

Self-reported COVID-19 symptoms and perceived likelihood of suicide attempt among Latinx individuals who experience acculturative stress.

The impact of COVID-19 has led to a substantial economic and psychosocial burden on the Latinx population. However, few studies have evaluated how COVID-19 symptoms may exacerbate suicide risk indicators among Latinx persons, or the particular social determinants of health facilitating such detrimental effects. The present study examined the association between self-reported COVID-19 symptoms and suicide likelihood (i.e., self-reported perceived likelihood that one will attempt suicide in the future) among Latinx individuals within a timeframe involving high COVID-19 contagion before the onset of vaccine dissemination. Further, the possible moderating role of acculturative stress in the association between COVID-19 symptoms and suicide likelihood was examined. The sample included 200 Latinx participants (67.5% male, Mage = 34.67 years, SD = 9.15) who completed self-report measures on COVID-19 symptoms, suicide likelihood, acculturative stress, depressive symptoms, trauma symptoms, somatic symptoms, and general COVID-19 emotional impact. Findings indicated that self-reported COVID-19 symptoms were positively associated with suicide likelihood. Further, the association between COVID-19 symptoms and suicide likelihood was moderated by acculturative stress, such that the association was only statistically significant at mean or higher levels of acculturative stress but was not significant among participants with lower acculturative stress. The moderation effect was statistically significant after controlling for sociodemographic factors, depressive symptoms, trauma symptoms, somatic symptoms, and the general emotional impact of the COVID-19 pandemic. The current findings indicate that, among Latinx individuals, acculturative stress is a key social determinant of health for marked psychological distress in the context of the COVID-19 pandemic.

Mental health services use and social support among Latinx families with adolescents who engage in suicidal behavior.

Latinx communities experience a significant child mental health disparity. Research is needed to examine mental health services use and social support in Latinx adolescents, with particular attention to acculturative factors and youth who have high levels of clinical severity. The current study examined whether acculturation and enculturation, and related proxies, are associated with prior history of services use and social support in Latinx families with adolescents who had a recent suicidal crisis. Participants were 110 youths, recently admitted to psychiatric hospitalization, ages 12 to 17 years and their caregivers. Results indicated that approximately 20% of the overall sample did not access any formal mental health services (e.g., outpatient mental health care, primary care support, school staff support) before high acuity hospital care. First generation status and higher caregiver enculturation were associated with a lower likelihood of formal mental health services use, even when controlling for clinical covariates. Adolescent preference for Spanish was associated with lower social support. Findings suggest that families with higher enculturation and first-generation immigrant families (both caregivers and youth born outside of the U.S.), in the context of severe clinical impairment, experience systemic and sociocultural barriers conducive to limited engagement with mental health support. Implications for improving the accessibility of mental health supports are reviewed.

Assessment and Management of Suicide Risk in Children and Adolescents.

This article presents a pragmatic approach to assessing and managing suicide risk in children and adolescents. We first present general recommendations for conducting risk assessments with children and adolescents, followed by an algorithm for designating risk. Risk assessment and designation should be based on both distal (i.e., a prior history of self-harm behaviors) and proximal (i.e., suicide ideation, plans, intent, and preparations) predictors of suicide attempt. We then discuss safety planning as an easy-to-implement approach for intervening and managing suicide risk when working with children and adolescents. We end with a case example illustrating the implementation of risk assessment, risk designation, and safety planning with an adolescent client and her mother.