Examining Suicidality among Multiracial College Students

Table of Content

Suicide is the second leading cause of death among college-aged Americans (CDC, 2016) and has been studied extensively in this demographic (Schwartz, 2006). Suicidal ideation (i.e., “passive thoughts about wanting to be dead or active thoughts about killing oneself;” Bridge et al., 2007, p. 1684) is a phenomenon that has been consistently linked with suicidal behavior (e.g., Beck, Kovacs, & Weissman, 1979; Kessler, Borges, & Walters, 1999; Miranda, Ortin, Scott, & Shaffer, 2014; Reinherz, Tanner, Berger, Beardslee, & Fitzmaurice, 2006) and presents a serious public health concern considering college students endorse suicidal ideation at alarming rates. In a nationally representative study of over 26,000 college students, more than half reported suicidal thinking at some point in their lives (Drum, Brownson, Burton Denmark, & Smith, 2009). As with suicidal behavior, researchers have focused considerable attention on investigating factors associated with suicidal ideation in college-student populations (e.g., Bonner & Rich, 1987; Chochinov, Wilson, Enns, & Lander, 1998; Stephenson, Pena-Shaff, & Quirk, 2006). Unfortunately, racial and ethnocultural elements of suicidality are comparatively understudied (Colucci & Martin, 2007) despite increasing racial and ethnic demographic changes on college campuses (NCES, 2010). One racial minority group that is virtually non-existent in the literature on college-student suicidality is Multiracial Americans.

Multiracial Americans constitute a substantial and rapidly expanding cross-section of the United States population. With this demographic projected to grow by 180% over the next 30 years, Multiracial individuals are now the fastest growing racial/ethnic minority (REM) group in the U.S. (Bernstein & Edwards, 2008). As of the 2010 census, these individuals make up 2.9% of the population, a 32% increase since the year 2000 (U.S. Census, 2011). In fact, a 2015 Pew research study that accounted for differences in racial self-identification not captured by census data estimated the multiracial population at just shy of 7% (Pew Research Center, 2015). Despite this growth, Multiracial individuals are among the most understudied REM groups. What’s more, studies have shown that Multiracial youth report higher rates of health and mental health problems, substance use, and violent behaviors when compared to their monoracial peers (Campbell & Eggerling-Boeck, 2006; Choi, Harachi, Gillmore, & Catalano, 2006; Udry, Li, Hendrickson-Smith, 2003). In light of this disparity, it is imperative that the etiology of such health-risk behaviors among this group be rigorously studied in order to craft culturally-responsive interventions that helping professionals and organizations can begin to implement.

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Suicidal ideation is one such construct that research has consistently shown to be elevated among Multiracial adolescents and emerging adults when compared to their monoracial counterparts (Cheref, Lane, Polanco-Roman, Gadol, & Miranda, 2015; Olvera, 2001; Roberts, Chen, & Roberts, 1997; Udry, Li, & Hendrickson-Smith, 2003; Wong, Sugimoto-Matsuda, Chang, Hishinuma, 2012). However, there is little understanding of the risk factors for suicidal ideation in the Multiracial community, as previous researchers studying this group have relied on speculation to explain heightened risk (i.e., extant scholarship demonstrating Multiracial youths’ struggle with positive identity and sense of belonging). Researchers assert that future work can now assume a greater risk of suicidal ideation among mixed-race youths, but needs to start identifying sources of distress (Udry et al., 2003). Recent scholarship has also called on psychologists to shift toward a strengths-based approach and to begin identifying both malleable risk and protective factors for suicide-related behaviors that may be uniquely predictive for Multiracial populations (Wong et al., 2012). An updated and robust approach calls for an empirical analysis of the relationships between malleable predictors of suicidal ideation and actual suicidal thinking. Such an analysis could inform a more evidence-based understanding of Multiracial individuals and ultimately be translated into culturally-informed suicide prevention strategies.

Utilizing the 2016 Understanding Student Distress and Academic Success (USDAS) survey collected by the National Research Consortium of Counseling Centers in Higher Education (housed at the University of Texas Counseling and Mental Health Center), the current study examines relationships between malleable measures of well-being and measures of suicidality among Multiracial college students. The USDAS survey contains a nationally representative sample of 12,010 undergraduate and graduate students from 18 universities across 12 states, 1,231 of whom are Multiracial. Participants completed measures assessing malleable psychological factors thought to protect college students against suicidality (i.e., resilience, grit, meaning in life, perfectionism, sense of coherence, perceived burdensomeness, social connectedness, and coping self-efficacy), as well as an outcome measure assessing suicidality along a spectrum of experience. The following sections briefly discuss these risk and protective factors.

Resilience

Resilience is a construct that has received increasing attention over the past 15 years (Hu, Zhang, & Wang, 2015) and has proven useful in understanding and conceptualizing mental health among marginalized groups (e.g., racial/ethnic minority groups; Ungar, 2004). Resilience can be defined as “the potential to exhibit resourcefulness by using available internal and external resources in response to different contextual and developmental challenges” (Pooley & Cohen, 2010, p. 34). In the context of racial/ethnic minority mental health, researchers often measure resilience in an effort to understand how individuals respond to and develop within adverse environments (Coll et al., 1996). Unfortunately, only one study to date has investigated resilience factors among Multiracial individuals. Salahuddin and O’Brien (2011) identified two Multiracial-specific resilience factors (i.e., appreciation of human differences and Multiracial pride) and demonstrated their positive associations with social connectedness as well as ethnic identity, the former being a protective factor assessed in the current study and discussed briefly in the following section. Resilience has been linked to better mental health in undergraduate college students (Hartley, 2011), and resilience-oriented constructs such as optimism have been shown to mitigate suicidal ideation among young adult college students (Hirsch, Conner, & Duberstein, 2007).

Social Connectedness

Social connectedness measures sense of belongingness and has been defined as “an aspect of the self that reflects subjective awareness of interpersonal closeness with the social world in toto” (Lee & Robbins, 2000, p. 78). The construct was conceptualized by Richard Lee and Steven Robbins in 1995 and has been implicated in the relationship between stigmatization and belonging uncertainty for underrepresented and negatively stereotyped racial minority college students studying computer science (Walton & Cohen, 2007). As previously mentioned, positive relationships between Multiracial-specific resilience factors and social connectedness have been demonstrated. Similarly, negative relationships between social connectedness and Multiracial-specific challenge factors (i.e., others’ surprise and disbelief regarding racial heritage, lack of family acceptance, Multiracial discrimination, and challenges with racial identity) have also been shown. These associations make sense considering Multiracial individuals’ documented struggles with sense of belonging (Bowles, 1993; Deters, 1997; Root, 1994). As it relates to college students, a study by Van Orden et al. (2008) found that belongingness mediated the relationship between semester and suicidal ideation such that increases in suicidal ideation were due largely to decreased belongingness during the summer months (Van Orden et al., 2008). Moreover, in their work on suicidal ideation among college students in the United States, Brener and colleagues found that college students who belonged to a sorority or fraternity reported less suicidal ideation than their unaffiliated peers (Brener, Hassan, & Barrios, 1999).

Grit

Grit is the “perseverance and passion for long-term goals” (Duckworth, Peterson, Matthews, & Kelly, 2007, p. 1087) and represents one of two elements of human ability (the other being type of ability) described by William James in the early 20th century (James, 1907, pp. 322–323). The construct is rooted in the field of positive psychology which focuses primarily on the positive qualities of life and discerning the elements necessary for humans to thrive and flourish (Seligman & Csikszentmihalyi, 2000). As with resilience, grit is a personal characteristic that researchers in cultural diversity and ethnic minority psychology have set out to understand and investigate in the context of oppressive societal forces that compel marginalized people to develop specific protective attributes such as grit in order to survive (Anderson, Turner, Heath, & Payne, 2016). Though related, grit can be distinguished from resilience in that grit is less about “bouncing back” in the face of adversity, and more so defined by “deep commitments that you remain loyal to over many years” (Duckworth as quoted in Perkins-Gough, 2013, p. 16). To the author’s knowledge, no studies to date have examined grit in a Multiracial sample. Among college students, higher levels of grit have been shown to reduce suicidal ideation by increasing meaning in life, a construct discussed in the following section, and lessening the impact of negative life events (Blalock, Young, & Kleiman, 2015; Kleiman, Adams, Kashdan, & Riskind, 2013).

Meaning in Life

The systematic study of meaning in life has its roots in existential philosophy (Kotchen, 1960) whereby “the basic striving of man [is] to find and fulfill meaning and purpose” (Frankl, 1966, p. 98). As it relates to racial and ethnic minorities, the construct has been utilized to understand the ways in which individuals respond to racial and discriminatory adversity through meaning-making (Ryff, Keyes, & Hughes, 2003). For Multiracials specifically, a “disconnect between culturally defined and individually determined notions of self” (Taylor & Nanney, 2011, p. 199), can hamstring the pursuit of meaning and leave these individuals vulnerable to heightened existential anxiety. Additionally, perceived lack of meaning in life has been identified as a cultural factor that contributes to suicide risk among college students from diverse cultural backgrounds (Wong, 2013), and both the search for as well as presence of meaning in life has been shown to predict lower suicidal ideation over time for college students generally (Kleiman, & Beaver, 2013).

Perfectionism

Perfectionism is a multifaceted construct linked to a wide range of factors associated with mental health including depression, anxiety, stress, fear of negative evaluation, positive affect, and symptoms associated with eating disorders (DiBartolo, Li, & Frost, 2008). According to Cokley et al. (2018; as cited in Hamachek, 1978) perfectionistic standards refer to those “virtually unattainable standards that lack context-specific flexibility” (p. 293), while perfectionistic discrepancy refers to the discrepancy individuals perceive between their standards and performance (Slaney, Rice, Mobley, Trippi, & Ashby, 2001). Adaptive perfectionists are those who hold high standards for themselves but do not perceive a large discrepancy between those standards and their actual performance, whereas maladaptive perfectionists are those with high standards but also the perception that their performance falls short of those standards (Slaney et al., 2001). Among African-American college students, maladaptive perfectionism has been linked with early stages of racial identity development characterized by self-hatred and anti-White attitudes (Elion, Wang, Slaney, & French, 2012). A study conducted with Asian international students found that maladaptive perfectionism significantly predicted suicidal ideation, and amplified the relationship between perceived burdensomeness (a construct included in the current study and discussed in the following section) and suicidal ideation (Wang, Wong, & Fu, 2013). The perfectionism scale utilized in the current study has demonstrated some cultural validity through its applicability with African American college students, however, no studies to date have explicitly investigated perfectionism with Multiracial individuals. For college students more broadly, perfectionism has been consistently demonstrated as a factor linked with suicidal ideation (e.g., Bell, Stanley, Mallon, & Manthorpe, 2010; Chang, 1998; Hewitt, Flett, & Turnbull‐Donovan, 1992).

Perceived Burdensomeness

Perceived burdensomeness is a construct rooted in the interpersonal theory of suicide (Joiner, Van Orden, Witte, & Rudd, 2009), and refers to “an unmet need for social competence” (Van Orden, Cukrowicz, Witte, & Joiner, 2012, p. 2). Few studies have investigated burdensomeness in minority samples, however, a study assessing the relationship between perceived burdensomeness and suicidal ideation in an all Black college student sample found that burdensomeness uniquely predicted suicidal ideation. Moreover, research examining the phenomena in a sample of Black and White college students found no significant differences between the two groups (Davidson & Wingate, 2011). For sexual minority college students, perceived burdensomeness has been shown to partially mediate the relationship between sexual orientation and suicidal ideation (Hill & Pettit, 2012). To the author’s knowledge, there is no published work on perceived burdensomeness in Multiracial individuals. With regards to college students generally, burdensomeness has been shown to partially mediate the relationship between alcohol-related problems and suicide proneness (Lamis & Malone, 2011), as well as predict suicidality directly (Joiner et al., 2009; Lamis & Lester, 2013).

Sense of Coherence

Sense of coherence is a construct developed by sociologist Aaron Antonovsky and borne from his theory on salutogenic health which assumes living to mean being “inherently flawed” and vulnerable to environmental stressors which place all living organisms at various points on a continuum of well-being, rather than in discrete health or illness categories (Antonovsky, 1993; Antonovsky, 1996, pp. 13-14). Antonovsky identified factors that allow individuals to move toward the health end of the well-being continuum, and in doing so, determined that these factors were all unified by the criterion that they “all fostered repeated life experiences which…helped one to see the world as ‘making sense’, cognitively, instrumentally and emotionally” (Antonovsky, 1996, p. 15). Sense of coherence is the construct that emerged from this observation and can be defined as the extent to which one feels confident that their environment is structured, predictable, explicable, manageable, and worthy of investment and engagement (Antonovsky, 1987).

Antonovsky contended that sense of coherence could be applied cross-culturally and a handful of studies have lent credence to this assertion (see Ben-David, 1996; Bowman, 1996; Glanz, Maskarinec, & Carlin, 2005; Lee, Jones, Mineyama, & Zhang, 2002; Ying, Lee, & Tsai, 2000). As relative to racial and ethnic minority communities in the U.S., the sense of coherence construct has been utilized primarily in examining mental health among Asian Americans and challenging the “model minority” stereotype (Wong & Halgin, 2006; Ying et al., 2001). Ying et al. (2001) found that Asian American college students demonstrated the lowest cross-racial engagement of any racial group and that this low cross-racial engagement along with being Asian was associated with lower sense of coherence in comparison to White, Black, Hispanic, and Multiracial college students. The same study found no significant differences in sense of coherence between Multiracial college students and other racial groups despite Multiracial students reporting the highest levels of cross-racial engagement.

Turning toward the relationship between sense of coherence and suicidality in college students, Drum and colleagues (2017) demonstrated sense of coherence as a buffer against the effect of pre-existing suicide risk factors on suicidal ideation in a sample of over 26,000 undergraduate students and suggested that the construct be integrated into suicide prevention frameworks.

Coping Self-Efficacy

Coping Self-Efficacy is a construct developed by influential social cognitive psychologist Albert Bandura who suggested that confidence in one’s ability for success is essential to that individual’s actual success (Bandura, 1977). Coping self-efficacy is thus “a measure of a person’s perceived ability to cope effectively with life challenges” (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006, p. 1) and consists of three dimensions: problem-focused, emotion-focused, and support-seeking coping self-efficacy. Problem-focused self-efficacy refers to an individual’s perceived ability to cope using problem-solving strategies aimed at diminishing or eliminating a stressor. Emotion-focused self-efficacy deals with an individual’s perceived ability to manage the emotional distress associated with a life stressor. Lastly, support-seeking self-efficacy describes an individual’s perceived ability to cope by reaching out and getting support from friends and family. Adaptive coping occurs when individuals tend to respond to alterable stressors with problem-focused coping but utilize emotion-focused coping to respond to stressors of which they have no control over. When this fit is achieved, individuals tend to experience fewer negative psychological symptoms (Park, Folkman, & Bostrom, 2001). Very few studies have assessed the applicability of the coping self-efficacy construct with racial minority groups, however, a 2011 measurement invariance study found that the coping self-efficacy scale utilized in the current study demonstrated adequate measurement invariance with an African American sample (MacNeil, Esposito-Smythers, Mehlenbeck, & Weismoore, 2012). As with the majority of constructs measured in the current study, no research has investigated coping self-efficacy in Multiracial samples. Relative to suicidal ideation, coping self-efficacy has been shown to correlate negatively with ideation among high school students (Valois, Zullig, & Hunter, 2015), and in diverse cross-cultural samples, an inverse relationship between general self-efficacy and suicidal ideation has been demonstrated (Feng, Li, & Chen, 2015; Kobayashi, Fujita, Kaneko, & Motohashi, 2015; Rothmann & Van Rensburg, 2002). Interestingly, researchers have not investigated the relationship between coping self-efficacy and suicidal ideation in college student populations, however, the construct has been linked to psychological distress in this group (Byrd & McKinney, 2012.)

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