National Trends in Suicide Among Asian American or Pacific Islander Youth.

This cross-sectional study examines trends in suicide rates among Asian American or Pacific Islander youth by sex from 1999 to 2021.

National trends of suicidality 1999-2020 among Asian American Pacific Islander young adults across sex.

This study analyzes 21 years of suicide trend among Asian American Pacific Islander (AAPI) young adults aged 18-25. Analyzing NCHS data (1999-2020) through the Joinpoint Regression, we examined temporal trends of suicide death across sexes and identified trend shifts. Findings indicate a significant and steady increasing trend in AAPI female suicides from 1999 to 2020. Alarmingly, AAPI males displayed a significant and sharp increasing trend of suicide from 2008 onwards. It is important to consider other risk factors of suicide, including cultural factors and gendered racial experiences, to understand the context of AAPI young adults' suicide patterns.

Associations between vicarious discrimination and mental health among young adult college students: Findings from the 2020-2021 Healthy Minds Study.

BACKGROUND: Poor mental health among young adults in higher education is a growing concern. In recent years, the visibility of racism has sharply risen. Vicarious discrimination is defined as the secondhand witnessing of racism, and given society's increased accessibility to social media and the Internet, addressing indirect violence is urgently needed to inform anti-racism and mental health efforts. The current study examined associations between vicarious discrimination and mental health across a large sample of young college students in the United States. METHODS: We analyzed data from the Healthy Minds Study (HMS; 2020-2021; N=130,566) and used multivariable logistic regression to examine whether past-year vicarious discrimination was associated with various mental health outcomes, adjusting for age, gender, race/ethnicity, and direct discrimination. RESULTS: The sample was predominantly white (n=31,438, 63.66%) and female-identifying (n=34,313, 69.49%) with an average age of 21.1 years. Approximately 35.9% of the sample endorsed experiencing vicarious discrimination. Vicarious discrimination was associated with greater depression (OR:1.97; 95% CI: [1.86,2.09], p< 0.001), anxiety (OR:1.82; 95% CI: [1.72,1.92], p<0.001), languishing (OR:1.75; 95% CI: [1.65,1.87], p<0.001), perceived need for treatment (OR:2.24; 95% CI: [2.10,2.40], p<0.001), suicidal ideation (OR:1.86; 95% CI: [1.73,2.01], p<0.001), suicide plan (OR:1.91; 95% CI: [1.71,2.14], p<0.001), suicide attempt (OR:1.89; 95% CI: [1.51,2.36], p<0.001), self-injurious behavior (OR:2.0; 95% CI: [1.88,2.12], p<0.001), and loneliness (OR:1.67; 95% CI: [1.58,1.77], p<0.001). DISCUSSION: Consistent with growing literature, vicarious discrimination was associated with poorer mental health among young college students. Additional research should investigate moderators, mediators, and interventions to support those who may be impacted indirectly by discrimination.

Online xenophobia and mental health among Venezuelan migrant youth in Colombia: The interplay with "in-person" discrimination.

Emerging research provides insights into migration-related cultural stress experiences and mental health among Venezuelan migrants; however, prior studies have not considered the critical distinction between online xenophobia and in-person discrimination. To address this gap, we assess the psychometric properties of an abbreviated version of the Perceived Online Racism Scale (PORS) with Venezuelan migrant youth and examine the interplay between online xenophobia, in-person discrimination, and mental health. Survey data were collected from Venezuelan migrant youth (N = 319; ages 13-17, 49.5% female) in Colombia in April-July 2023. Confirmatory factor analysis (CFA) was used to examine the PORS, and multiple regression was conducted to examine key associations. The CFA showed excellent model fit: χ²(7) = 13.498, p = .061; comparative fit index = .989; Tucker-Lewis index = .977; root-mean-square error of approximation = .055; standardized root-mean-square residual = .026. Controlling for demographic factors, online xenophobia was associated with depressive symptoms (ß = .253, p < .001) and anxiety (ß = .200, p = .001). The online xenophobia-mental health association weakened when controlling for in-person discrimination but remained nevertheless significant (depression: ß = .181, p = .002, anxiety: ß = .135, p = .026). Interaction effects (Online × In-Person) revealed a pattern in which greater exposure to online xenophobia was associated with greater distress, but only at relatively low levels of in-person discrimination. Findings provide new insights regarding (a) the properties of an increasingly relevant measure of cultural stress, (b) how online xenophobia relates to mental health, and (c) the interplay of online and in-person cultural stressors vis-à-vis mental health among Venezuelan migrant youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Counseling Center and Therapist Effects on Changes in Suicidal Ideation among College Students Receiving Services on Campus: Comparisons across International Status, Race, Gender, and Sexual Orientation.

OBJECTIVE: Examine center- and therapist-level factors that may impact suicide ideation outcomes for college students with minoritized identities. METHOD: Data were drawn from a 2015-2017 data set collected from 136 university counseling centers that were part of the Center for Collegiate Mental Health. This study used a three-level model in hierarchical linear modeling with clients (Level 1; N = 122,212), clients nested in therapists (Level 2; N = 2,574), and therapists nested in counseling centers (Level 3; N = 120). RESULTS: Racially/ethnically minoritized students were 20%, LGBQ + students were 100% more likely, and women students were 20% less likely to have suicidal ideation at the first session, compared to White, male, heterosexual domestic students. LGBQ + students were 20%, and international students were 50% more likely to have suicidal ideation in the last session, compared to White, male, heterosexual domestic students. Cross-level interactions revealed that when therapists had a higher percentage of international students on their caseload, international students had decreased suicidal ideation. Similarly, when therapists had a higher percentage of male students on their caseload, their male students had decreased suicidal ideation. CONCLUSIONS: Findings from this study support the importance of experience and competence in working with minoritized students, as therapists who had more international and men students on their caseload fared better in decreasing the suicide ideation of respective students. This suggests that continued exposure to the unique challenges faced by particular minoritized groups of college students can enhance the quality of care delivered by therapists.

Social support and psychotherapy outcomes for international students in university/college counseling centers.

Objective: To explore the relationship between international students' social support at intake and international student distress at end of treatment. Participants: Data was collected from participants (n = 40,085) from 90 United States universities using the Center for Collegiate Mental Health (CCMH) database. Methods: Participants completed measures of psychological distress and perceived social support. Using multilevel modeling, we predicted participants' distress at end of treatment by international student status, social support, race, and length of therapy. Results: We found that international students who reported lower social support at intake ended treatment with higher levels of psychological distress when distress at intake was controlled compared to United States peers. Conclusions: Understanding the significance of social support for international students can help to inform mental healthcare professionals' approach to psychotherapy.

The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale.

Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.

Racial Hate at the Intersection of Online and Offline Worlds: The Joint Impact of Online and Offline Racism on the Mental Health of Racially Minoritized Individuals.

With the everyday influence of social media and online platforms, racially minoritized individuals face the risk of experiencing racial discrimination in both offline and online contexts. Yet, there is scant research on how online and offline racism could jointly impact the mental health of racially minoritized individuals. Thus, the study examined online racism as a moderator in the link between offline racism and mental health issues. Using data from 651 racially minoritized emerging adults (Mage = 22.15, SD = 3.39), a moderation analysis was conducted using the PROCESS macro with bias-corrected bootstrapping (10,000 resamples). Experiencing more offline racism was significantly associated with greater mental health issues. Online racism was a significant moderator in the link between offline racism and mental health issues. The link between offline racism and mental health issues was not significant at low levels of online racism. However, the link was significant and strengthened at mean to high levels of online racism. The results suggest complex interactions in understanding the compounding impact of online and offline racism on mental health costs among racially minoritized individuals. Implications for future research on understanding the interplay between online and offline racism are discussed.

Impact of online and offline racism on cigarette smoking, marijuana use, and vaping via depressive/anxiety symptoms among racially minoritized emerging adults.

Studies have found that offline and online racism are linked to mental health issues including depressive and anxiety symptoms among racially minoritized emerging adults. To cope with these symptoms, racially minoritized emerging adults may resort to substance use. Thus, we examined the relationship between offline and online racism and recent smoking behaviors (past 30 days), and whether depressive and anxiety symptoms (DAS) mediate this relationship. We hypothesized that offline and online racism would be associated with a greater probability of recent smoking through depressive/anxiety symptoms. With data from 338 participants (Mage = 23.28, SD = 2.38), we conducted a path analysis of offline racism (Everyday Discrimination Scale) and online racism (Perceived Online Racism Scale) predicting recent smoking (recent cigarette smoking, recent marijuana use, recent vaping) via depressive (Patient Health Questionnaire-9)/anxiety (Generalized Anxiety Disorder-7) symptoms. Offline racism was directly associated with recent cigarette smoking while online racism was directly associated with recent vaping. No significant indirect associations were observed with cigarette smoking and vaping. Both online and offline racism were indirectly associated with recent marijuana use via depressive/anxiety symptoms. Our findings suggest that there are nuanced differences between the impact that online and offline racism experiences may have on the DAS, and smoking behaviors of racially minoritized emerging adults. Implications for research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

COVID-19 anti-Asian racism, perceived burdensomeness, thwarted belongingness, and suicidal ideation among Asian American Emerging Adults.

Since the start of the COVID-19 pandemic, there has been a significant surge in COVID-19 related anti-Asian racism and hate crimes. Given the ostracising and dehumanising narrative of COVID-19 related anti-Asian hate, we examined whether COVID-19 anti-Asian racism would be associated with suicidal ideation through increased thwarted belongingness and perceived burdensomeness among Asian American emerging adults. With data from 139 participants (Mage = 23.04), we conducted a path analysis of COVID-19 anti-Asian racism (four items) predicting suicidal ideation (item nine; Patient Health Questionnaire-9) via perceived burdensomeness and thwarted belongingness (Interpersonal Needs Questionnaire). COVID-19 anti-Asian racism significantly predicted suicidal ideation. The indirect effect through perceived burdensomeness was significant but not through thwarted belongingness; greater COVID-19 anti-Asian racism was associated with greater perceived burdensomeness, which in turn was associated with greater suicidal ideation. The significance of perceived burdensomeness was substantiated given the non-significant direct effect. The results suggest that the ongoing COVID-19 anti-Asian racism may be an alarming risk factor for suicidal ideation for Asian American emerging adults.

Profiles of online racism exposure and mental health among Asian, Black, and Latinx emerging adults in the United States.

Online racism is a digital social determinant to health inequity and an acute and widespread public health problem. To explore the heterogeneity of online racism exposure within and across race, we latent class modelled this construct among Asian (n = 310), Black (n = 306), and Latinx (n = 163) emerging adults in the United States and analysed key demographic and psychosocial health correlates. We observed Low and Mediated Exposure classes across all racial groups, whereas High Exposure classes appeared among Asian and Black people and the Systemic Exposure classes emerged uniquely in Asian and Latinx people. Generally, the High Exposure classes reported the greatest psychological distress and unjust views of society compared to all other classes. The Mediated and Systemic Exposure classes reported greater mental health costs than the Low Exposure classes. Asian women were more likely to be in the Mediated Exposure class compared to the Low Exposure class, whereas Black women were more likely to be in the Mediated Exposure class compared to both High and Low Exposure classes. About a third of each racial group belonged to the Low Exposure classes. Our findings highlight the multidimensionality of online racism exposure and identify hidden yet divergently risky subgroups. Research implications include examination of class membership chronicity and change over time, online exposure to intersecting oppressions, and additional antecedents and health consequences of diverse forms of online racism exposure.

Resisting and countering online racial hate: Antiracism advocacy and coping online with racism as moderators of distress associated with online racism.

The emerging literature highlights online racism (e.g., racist online interactions, exposure to racially traumatizing content) as a contemporary stressor among racially/ethnically minoritized adults. Thus, identifying factors that can help buffer the harmful impact of online racism are imperative. We examined engagement in antiracism advocacy and online coping as moderators that can potentially buffer the link between online racism and psychological distress. Using data from 395 racially/ethnically diverse adults (Mage = 34.12, SD = 11.19), we conducted latent moderated structural equation modeling to test individual and institutional antiracism advocacy, and online coping as moderators in the link between online racism and psychological distress. Individual antiracism advocacy was not a significant moderator. Both institutional antiracism advocacy and online coping were significant moderators. For both variables, the link between online racism and psychological distress was not significant at 1 SD below the mean but was significant at the mean and 1 SD above the mean. Thus, distress associated with online racism was not significant among those engaging in low levels of institutional antiracism advocacy and online coping but mean to high levels of institutional antiracism advocacy and online coping did not appear to be protective against distress. Implications for advancing the research on coping with online racism are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gendered racism, family and external shame, depressive symptoms, and alcohol use severity among Asian American men.

OBJECTIVE: We investigated whether gendered racism predicts depressive symptoms and alcohol use severity among Asian American men (AAM) through indirect relations via culture-specific family and external shame. METHOD: We analyzed convenience data from 409 AAM. Sample age (M = 21.24), nativity, ethnicity, education, income, and self-reported social class were diverse and controlled for. We path modeled direct associations among gendered racism and depressive symptoms and alcohol use severity, and their indirect (mediated) associations through family and external shame. RESULTS: About 21% and 25% of the sample met the clinical cutoffs for depressive symptoms and risky alcohol use, respectively. Gendered racism predicted depressive symptoms indirectly via external shame, and predicted alcohol use severity directly and indirectly via family shame. The hypothesized model fits the data better than an alternative model with shame factors as predictors. CONCLUSION: Gendered racism is an insidious psychiatric risk factor for AAM and appears to exacerbate family and external shame, which may subsequently and divergently increase depressive symptoms and alcohol use severity. Findings highlight the role of cultural factors within gendered racism-related stress processes among AAM. Future research should consider longitudinal designs and additional mediating and outcome variables to examine the behavioral health sequelae of gendered racism among AAM. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gendered racial microaggressions, internalized racism, and suicidal ideation among emerging adult Asian American women.

BACKGROUND: Despite suicide being the leading cause of death among emerging adult Asian American women (AAW), little is known about the risk factors. AIM: We tested whether gendered racial microaggressions stress (GRMS) would be associated with AAW's suicidal ideation, and whether internalized racism (self-negativity, IRSN; weakness stereotypes, IRWS; and appearance bias, IRAB) would exacerbate this link based on self-devaluating implications of internalized racism. METHOD: Using a sample of 309 AAW (Mage = 20.00, SD = 6.26), we conducted a moderated logistic regression with GRMS predicting suicidal ideation (endorsement or no endorsement) and the three internalized racism factors (IRSN, IRWS, and IRAB) as moderators. RESULTS: GRMS significantly predicted suicidal ideation with a threefold increase in the odds of suicidal ideation. Only IRSN significantly exacerbated this link at low to mean levels. CONCLUSION: Gendered racial microaggressions is likely a risk factor for suicidal ideation among AAW, particularly for those who internalize negative images of themselves as Asian individuals.

Online racism, depressive and anxiety symptoms, coping-related drinking motives, and alcohol use severity among Black, Latina/o/x, and Asian emerging adults.

Online racism has been associated with alcohol-related coping, likely to deal with mental health symptoms that arise from experiencing racial discrimination in online settings. Thus, we examined online racism as a risk factor for alcohol-related problems by examining depressive/anxiety symptoms and coping-related drinking motives as mediators among Black, Latina/o/x, and Asian emerging adults in the U.S. We hypothesized that online racism would be associated with greater alcohol use severity through depressive/anxiety symptoms and coping-related drinking motives sequentially. With data from 322 participants (Mage = 23.28; Black, n = 108; Latina/o/x, n = 118; and Asian, n = 96), we conducted a multi-group path analysis of online racism (Perceived Online Racism Scale) linked to alcohol use (Alcohol Use Disorders Identification Test) via depressive (Patient Health Questionnaire-9)/Anxiety (Generalized Anxiety Disorder-7) symptoms and coping-related drinking motives (Drinking Motives Questionnaire-Revised Short Form). The hypothesized indirect pathway was significant in all groups. The direct effect was also significant for Latina/o/x and Asian groups. For the Black group, the direct effect was not significant, highlighting the salience of the mental health symptoms and drinking motives in explaining the link between online racism and alcohol use. Collectively, the results help to contextualize the risks of alcohol-related problems from experiencing contemporary forms of racial trauma such as online racial discrimination and provide implications for intervention development.

Impact of Online Racism on Suicide Ideation Through Interpersonal Factors Among Racial Minority Emerging Adults: The Role of Perceived Burdensomeness and Thwarted Belongingness.

While a growing number of studies have documented significant links between online racism (e.g., racist interactions, contents on racial violence) and comorbid factors (e.g., depression) associated with suicide risk, no studies have examined whether online racism predicts suicide ideation and if interpersonal factors can help explain this link. Thus, the current study examined the direct relationship between online racism and suicide ideation among racial minority emerging adults, and the indirect relationships via the interpersonal factors (perceived burdensomeness and thwarted belongingness). Using data from a convenience sample of 338 racial minority emerging adults, we conducted a path analysis with online racism predicting suicide ideation through thwarted belongingness and perceived burdensomeness. Online racism significantly predicted suicide ideation via perceived burdensomeness but not thwarted belongingness. Post hoc multi-group analysis found that this pathway was consistent across Black, Asian, and Latinx groups but was completely mediated for the Asian group. The findings suggest that online racism can increase feelings of being a burden to society, which can trigger thoughts of suicide. This process may be particularly salient among Asian individuals. Implications for future research are discussed.

Witnessing racism against racial minority individuals online and loneliness among White emerging adults: Anti-racism advocacy as a moderator.

Extant literature suggests that racism is associated with difficult emotional reactions and feelings of social disconnect among White individuals. These feelings of social disconnect may be particularly salient in today's digital era in which racism against racial minority individuals is conveniently and frequently witnessed via online platforms. Thus, we examined whether witnessing racism online may be associated with feelings of loneliness among White emerging adults. We also tested whether anti-racism advocacy buffered loneliness given its potential for relationship building and community organizing to promote racial justice and equity. Using data from 227 White emerging adults (Mage = 20.86, SD = 4.82), we conducted a latent moderated structural equation modeling to test individual and institutional anti-racism advocacy as moderators in the link between witnessing racism online (racial victimization of racial minority individuals in online interactions and online content on cultural devaluation/systemic racism against racial minority individuals) and loneliness. Greater exposure to online content on systemic racism and cultural devaluation of racial minority groups significantly predicted greater loneliness. Engagement in individual anti-racism advocacy (mean to high levels) buffered this link. White allies must engage in anti-racism practice to address racism in our society, and our findings advance our understanding of the associated psychosocial costs. Implications for research and practice are discussed.

Coping with online racism: Patterns of online social support seeking and anti-racism advocacy associated with online racism, and correlates of ethnic-racial socialization, perceived health, and alcohol use severity.

Given the emerging public health concerns of online racism, we examined potential coping approaches for racial/ethnic minority adults. Using a latent class regression model (N = 407), we examined patterns of online social support seeking and anti-racism advocacy engagements that were associated with online racism among racial/ethnic minority adults. We also examined whether these patterns were associated with ethnic-racial socialization messages (cultural socialization, promotion of mistrust, preparation for racial bias), perceived health, and alcohol use severity. Three distinct latent groups were identified with meaningful group differences: triggered/reactive (alcohol use risk, higher promotion of mistrust), moderate engagement (no risk), disengaged/non-reactive (higher promotion of mistrust, higher cultural socialization, alcohol use risk) groups. Online social support seeking and advocacy engagement may have both benefits and costs in coping with online racism. Those who engage at optimal/balanced levels appear to report better well-being. Implications for research and practice are discussed.

Congruence and discrepancy in Asian American women's perception and stress appraisal of gendered racial microaggressions: Relationships with depressive symptoms and internalized racism.

Prior research demonstrates significant links between discrimination and mental health by assessing either encounters with or stress appraisal of discrimination. However, research has yet to examine the dynamic interplay between frequency and stress appraisal (e.g., high frequency-low stress appraisal) and their linkage to depressive symptoms. Using a sample of 309 Asian American women (M age = 22.81, SD = 0.26), we used a polynomial regression and response surface analysis to model the congruence and discrepancy between frequency and stress appraisal of gendered racial microaggressions experienced by Asian American women and how they are related to depressive symptoms and internalized racism. The dynamics between frequency and stress in relation to depressive symptoms were further probed at low, mean, and high levels of internalized racism. Greater congruence between frequency and stress was significantly associated with depressive symptoms (medium to large effect) and internalized racism (small effect). A discrepancy between higher frequency and lower stress was significantly associated with greater internalized racism. Further, when looking across levels of internalized racism, greater congruence between frequency and stress was significantly associated with greater depressive symptoms at low and mean levels of internalized racism but not at high levels. Gendered racial microaggressions are associated with adverse mental health outcomes among Asian American women, contributing to greater depressive symptoms and internalized racism. Further consideration should be given toward how internalized racism shapes differences in the perceptions and stress appraisal of gendered racial microaggressions, and subsequent mental health outcomes among Asian American women.