The moderating effect of dispositional forgiveness on perceived racial discrimination and depression for African American adults.

OBJECTIVES: Perceived racial discrimination is associated with depressive symptoms for African American adults; however, insight to protective factors for racism and depression in African Americans is limited. While current research suggests that dispositional forgiveness is an important factor in how people perceive and cope with interpersonal transgressions, few studies have examined its role in the context of racial discrimination. The purpose of this study was to examine the moderating effect of forgiveness (beyond broader internalized religiosity) on the association between perceived racial discrimination and depressive symptoms in African American adults. METHOD: Sample included 101 African American adults (60.2% female; Mage = 21.90 years, SD = 4.93 years) who endorsed experiences of racial discrimination. Participants completed a questionnaire battery consisting of self-report measures of perceived experiences of racial discrimination, depression, dispositional forgiveness, and intrinsic religiosity. RESULTS: Regression analyses showed dispositional forgiveness moderated the association between perceived racial discrimination and symptoms of depression above and beyond intrinsic religiosity (ß = -.05, 95% CI [-.10, -.05], p < .05), such that the racial discrimination-depression association was significant for participants who reported low levels of dispositional forgiveness, but not for individuals who reported higher levels of dispositional forgiveness. CONCLUSIONS: These findings provide insight into the role of dispositional forgiveness in experiences of racial discrimination and suggest that cognitive flexibility serves as an adaptive coping strategy to experiencing discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Refining Psychological, Substance Use, and Sociodemographic Predictors of Suicide Ideation and Attempts in a National Multiethnic Sample of Adults, 2008-2013.

The purpose of this study was to examine psychological, substance use, and sociodemographic predictors of 12-month suicide ideation and attempts across six US racial/ethnic groups-white, Latino/a, Black, Asian or Pacific Islander (A/PI), American Indian or Alaska Native (AI/AN), and multiracial adults. Multiple logistic regression analyses were conducted for 218,765 adults who participated in the 2008-2013 National Survey on Drug Use and Health. Overall, commonly cited factors were associated with increased risk for suicide ideation and attempt for some racial/ethnic groups, but not for others. As one example, 12-month depression was associated with 12-month suicide attempt for A/PI, AI/AN, Latino/a, and white, but not for Black or multiracial adults. Alcohol abuse and dependence were also associated with suicide attempt for AI/AN, Black, and white respondents but not for other racial/ethnic groups. Risk factors for suicide ideation and attempt may not increase risk universally. More theoretically supported research is needed.

Racial differences in adherence and response to combined treatment for full and subthreshold post-traumatic stress disorder and alcohol use disorders: A secondary analysis.

We conducted a secondary data analysis to examine whether there were racial differences in adherence and treatment outcomes for participants with co-occurring full and subthreshold post-traumatic stress disorder (PTSD) and alcohol/substance use disorders (A/SUD) who were treated with Seeking Safety (a cognitive-behavioral therapy) and sertraline or Seeking Safety and placebo as part of a clinical trial. Bivarate analyses examined the association between race and adherence, and generalized estimating equations assessed whether race moderated the effect of combination treatment on PTSD and alcohol use outcomes. Except for education, there were no statistically significant racial differences in baseline demographic and psychiatric characteristics. African Americans and Caucasians were equally adherent in number of psychotherapy and medication sessions attended and medication compliance. After controlling for baseline demographics and psychiatric symptoms, however, a race by treatment condition interaction emerged suggesting that African Americans who received the Seeking Safety and sertraline treatment had significantly lower PTSD symptom severity posttreatment and at six months follow-up compared to their counterparts who received Seeking Safety and placebo. No differential effect of treatment condition was found for Caucasians. Moreover, results indicated that a diagnosis of major depressive disorder negatively impacted PTSD symptom recovery for African American participants but not for Caucasians. In conclusion, no differences emerged between African Americans and Caucasians in adherence to combination treatments for PTSD and A/SUD. Findings also suggest assessment and treatment of MDD among African Americans may improve treatment outcomes. More research is needed to determine whether the differential response to Seeking Safety and sertraline among African Americans compared to Caucasians can be replicated.

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.

At the crossroads: the intersection of substance use disorders, anxiety disorders, and posttraumatic stress disorder.

The co-occurrence of substance use disorders with anxiety disorders and/or posttraumatic stress disorder has been widely documented and when compared to each disorder alone, consistently linked to increased risk for a host of negative outcomes including greater impairment, poorer treatment response, and higher rates of symptom relapse. This article focuses on recent advances in the understanding and effective treatment of this common and highly complex comorbidity. Prevalence and epidemiological data are introduced, followed by a review of contemporary models of etiology and associative pathways. Conceptualizations of effective treatment approaches are discussed alongside evidence from the past decade of clinical research trials. Highlighted are ongoing questions regarding the benefit of sequential, parallel, and integrated approaches and the necessity of further investigation into the mechanisms underlying treatment efficacy. Lastly, recent contributions from neuroscience research are offered as a promising bridge for the development and testing of novel, interdisciplinary treatment approaches.

Capability for suicide: Discrimination as a painful and provocative event.

OBJECTIVE: Developing the capability to die by suicide, and overcoming one's natural instinct of self-preservation, is thought to occur as a result of habituation to the fear and pain surrounding suicide. However, investigations of suicide capability have yet to examine whether perceived discrimination serves as a painful and provocative event that contributes to capability for suicide. The purpose of the current study was to examine the association of perceived discrimination and suicide capability for Black and White adults. METHOD: The study sample included 173 Black adults (67.6% female; Mage  = 23.18, SD = 5.74) and 272 White adults (60.7% female; Mage  = 22.80, SD = 5.90). Participants completed a questionnaire battery that included measures of perceived discrimination, depression, and suicide ideation. RESULTS: Regression analyses revealed for Black adults (but not White adults), perceived discrimination was associated with an increased capability for suicide after accounting for depressive symptomatology, suicide ideation, non-discriminatory painful and provocative events experienced, age, and gender (ß = .226, t = 3.154, p = .002). CONCLUSIONS: These findings provide preliminary evidence that perceived discrimination may play a role in suicide capability for Black adults and highlight the importance of considering contextual experiences when examining suicidality in underserved groups.

Perceived Discrimination and Suicide Ideation: Moderating Roles of Anxiety Symptoms and Ethnic Identity among Asian American, African American, and Hispanic Emerging Adults.

Suicide is a leading cause of death for vulnerable ethnic minority emerging adults in the United States (Web-based injury statistics query and reporting system [WISQARS], 2015). Perceived discrimination (Journal of Youth and Adolescence, 40, 2011, 1465) and anxiety symptoms (Asian American Journal of Psychology, 1, 2010, 18) are two predictors that are theoretically and conceptually related, but have yet to be examined in a simultaneous model for suicide ideation. Existing theory and research suggest that these variables activate similar pathways (American Behavioral Scientist, 51, 2007, 551). This study sought to address this gap in the literature by examining the simultaneous relationship between perceived discrimination and anxiety symptoms as predictors of suicide ideation. The moderating effect of anxiety symptoms on the relationship between perceived discrimination and suicide ideation was examined in a multiethnic sample of emerging adults. Results indicated that anxiety symptoms moderated the perceived discrimination-suicide ideation relationship for Hispanic emerging adults, but not for their Asian American and African American counterparts. Furthermore, ethnic identity has been shown to mitigate suicide risk in the face of other stressors (Cultural Diversity and Ethnic Minority Psychology, 14, 2008, 75). Ethnic identity emerged as a protective factor for Hispanic emerging adults by further interacting with perceived discrimination and anxiety symptoms to negatively predict suicide ideation. The implications of these findings are discussed.

Ethnic Differences in Suicidal Ideation and its Correlates among South Asian American Emerging Adults.

Prior research on suicidal ideation and its correlates among South Asian American individuals has been limited. Given that South Asian American individuals are a burgeoning ethnic subgroup in the United States population, research regarding these factors is necessary to inform culturally competent suicide screening, prevention, and intervention among this increasingly prominent group. We examined depressive symptoms, hopelessness, and suicidal ideation among a sample of 204 undergraduate South Asian American (96 Bangladeshi American, 67 Asian Indian, and 41 Pakistani American) emerging adult students (66% female), ages 18 to 24 (M = 18.52, SD = 0.93). Participants completed measures of hopelessness, depressive symptoms, and suicidal ideation. Bangladeshi American ethnicity was associated with significantly lower levels of suicidal ideation than Asian Indian ethnicity. There was a non-significant trend for Pakistani American ethnicity to be associated with lower levels of suicidal ideation than Asian Indian ethnicity. Additionally, Bangladeshi American ethnicity and Pakistani American ethnicity each interacted with hopelessness, such that hopelessness was associated with lower levels of suicidal ideation among these groups than among their Asian Indian peers. Being of Asian Indian ethnicity may deleteriously influence vulnerability to suicidal ideation, while being of other South Asian American ethnicities may buffer against suicidal ideation, both independently and in interaction with hopelessness. Such contingencies should be considered during suicide screening, prevention, and intervention.