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Relationship Between Acculturation, Discrimination, and Suicidal Ideation and Attempts Among US Hispanics in the National Epidemiologic Survey of Alcohol and Related Conditions

J Clin Psychiatry 2014;75(4):399-407
10.4088/JCP.13m08548

Objective: Acculturation is the process by which immigrants acquire the culture of the dominant society. Little is known about the relationship between acculturation and suicidal ideation and attempts among US Hispanics. Our aim was to examine the impact of 5 acculturation measures (age at migration, time in the United States, social network composition, language, race/ethnic orientation) on suicidal ideation and attempts in the largest available nationally representative sample of US Hispanics.

Method: Study participants were US Hispanics (N = 6,359) from Wave 2 of the 2004–2005 National Epidemiologic Survey of Alcohol and Related Conditions (N = 34,653). We used linear χ2 tests and logistic regression models to analyze the association between acculturation and risk of suicidal ideation and attempts.

Results: Factors associated with a linear increase in lifetime risk for suicidal ideation and attempts were (1) younger age at migration (linear χ21 = 57.15; P < .0001), (2) longer time in the United States (linear χ21 = 36.09; P < .0001), (3) higher degree of English-language orientation (linear χ21 = 74.08; P < .0001), (4) lower Hispanic composition of social network (linear χ21 = 36.34; P < .0001), and (5) lower Hispanic racial/ethnic identification (linear χ21 = 47.77; P < .0001). Higher levels of perceived discrimination were associated with higher lifetime risk for suicidal ideation (β = 0.051; P < .001) and attempts (β = 0.020; P = .003).

Conclusions: There was a linear association between multiple dimensions of acculturation and lifetime suicidal ideation and attempts. Discrimination was also associated with lifetime risk for suicidal ideation and attempts. Our results highlight protective aspects of the traditional Hispanic culture, such as high social support, coping strategies, and moral objections to suicide, which are modifiable factors and potential targets for public health interventions aimed at decreasing suicide risk. Culturally sensitive mental health resources need to be made more available to decrease discrimination and stigma.

J Clin Psychiatry 2014;75(4):399–407

Submitted: April 22, 2013; accepted December 18, 2013 (doi:10.4088/JCP.13m08548).

Corresponding author: M. Mercedes Perez-Rodriguez, MD, PhD, Mount Sinai School of Medicine Psychiatry Box #1230, 1 Gustave L. Levy Pl, New York, NY 10029 (mercedes.perez@mssm.edu).