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The predictive ability of thwarted belongingness and perceived burdensomeness versus culture-specific indicators of suicidality

Dissertation
Author: Daniel L. Hollar
Abstract:
Introduction: The purpose of this study is to examine the connection between culture and psychopathology to determine if, belongingness and burdensomeness are more predictive of suicidality risk than multicultural inclusiveness, African self-fortification and acculturative stress among college students of African descent from two culturally distinct universities. The main hypothesis is that among individuals of African descent thwarted belongingness, perceived burdensomeness and the interaction between the two will be more significant than multicultural inclusiveness, African self-fortification, acculturative stress, or those two-way interaction combinations. Methods: Approximately 170 consenting African American male and female undergraduate college students from two southeastern State universities participated in this study. Suicidality was assessed using the Beck Suicide Scale and depressive symptoms using the Beck Depression Inventory. Results: Hypotheses were supported. Regression 1 indicated the main effect of ethnicity on suicidality was non-significant and ethnicity did not significantly moderate the relationship between belongingness or burdensomeness and Suicidality. Regression 2 indicated university setting did not significantly moderate the relationship between Suicidality and belongingness or burdensomeness. Regression 3 indicated that the two-way interaction between burdensomeness and belongingness was of greater significance than culture-specific variables in predicting suicidality among individuals of African descent. Conclusions: Perceived burdensomeness and the belongingness X burdensomeness interaction are robust predictors of suicidality among individuals of African descent. Clinical implications are discussed.

TABLE OF CONTENTS

List of Tables ..........................................................................................................……. vii

List of Figures .........................................................................................................……. viii

Abstract ...................................................................................................................……. ix

1. INTRODUCTION ...............................................................................................…… 1 1.1 Suicide and the Importance of Investigating Suicidality Risk 1 1.2 Suicidality Risk Between Ethnic Groups 3 1.3 College Students, Ethnicity, Culture and Suicidality 3 1.4 Interpersonalpsychological Theory and Serious Suicidal Desire/Ideation: Belongingness and Burdensomeness 4 1.5 Theories and Cultural Factors Investigating Suicidality in Individuals of African Descent 6 1.6 Acculturative Stress and its Main and Moderating Effects in Suicidality Risk Assessment 8 1.7 Summary 8 2. THE PRESENT STUDY.......................................................................................... 10 2.1 Predictions 10 2.1.2 Hypotheses 11 3. METHODS ................................................................................................………... 13 3.1 Participants and Procedures 13 3.2 Sample Characteristics 13 3.3 Materials 14 3.4 Sequence of Investigation 18 3.5 Statistical Analyses 18 3.5.1 General Prediction Analyses 21 3.5.2 Main Hypotheses Analyses 21 3.6 Statistical Power 23

4. RESULTS……….................................................................................................. … 24 4.1 Descriptive Statistics 24 4.1.1 Group Comparisons 26 4.1.2 General Analyses: Intercorrelations of Dependent and Independent Variables 30 4.2 Regression Analyses 35 4.2.1 Exploratory Regression Analysis 43 5. Discussion…………………………………………………………………………. 49 6. Conclusion………………………………………………………………………….. 56

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6.1 Implications 56 6.2 Limitations 57 6.3 Summary 57 FOOTNOTES…………………………………………………………………………. 1 2 52 APPENDIX…………………………………………………………………………… 58 A Human Subjects Approval 58 B Informed Consent Form 61

REFERENCES ............................................................................................................. 63

BIOGRAPHICAL SKETCH ........................................................................................ 69

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LIST OF TABLES

1. Demographic Frequencies………………………………………………... 14

2. Variable Descriptives…………………………………………………….. 25

3. Descriptives Individuals of NonAfrican Descent ……………................... 26

4. Descriptives Individuals of African Descent ………………….................... 26

5. Means & Standard Deviations of Dependent Variables, Entire Sample....... 27

6. Means & Standard Deviations of Dependent Variables Between African Descent and NonAfrican Descent Groups………….……........... 28

7. Means & Standard Deviations of Independent Variables for African Descent Only………………………………………………….…............. 29

8. Intercorrelations Between Variables………………………………............ 31

9. Intercorrelations Between Variables Among NonAfrican Descent…........ 32

10. Intercorrelations Between Variables Among African Descent………….. 33

11. Descriptives for TWU vs. HBCU Among Individuals of African Descent……………………………………………………………........ 35 12. Stepwise Multiple Regression Equations with Belongingness, Burdensomeness & Ethnicity Predicting Suicidality for Entire Sample… 37

13. Stepwise Multiple Regression Equations with Belongingness, Burdensomeness & Ethnicity Predicting Suicidality Among African Descent………………………………………………………… 40

14. TwoWay Multiple regression Equations with Burdensomeness, Belongingness, IMCI, ASF, & SAFE Predicting Suicidality Among Individuals of African Descent…………………………………………. 43

15. Exploratory Multiple Regression Equations with Burdensomeness, Belongingness, IMCI, ASF, SAFE, and all ThreeWay Interaction Combinations Predicting Suicidality Among Individuals of African Descent……………………………………………………….... 45

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LIST OF FIGURES

1. Suicidal Thoughts & Behaviors in the Past Year Among Adults, by Age group 2008……………………………………………………….. 2

2. Ethnicity, Burdensomeness, & Belongingness 3Way Interaction…………. 38

3. University, Burdensomeness, & Belongingness 3Way Interaction………… 41

4. Interaction Between Burdensomeness & African Selffortification………… 46

5. Interaction Between Multicultural Inclusiveness & African Selffortification…………………………………………………… 47

6. Burdensomeness, Belongingness, & African Selffortification 3Way Interaction……………………………………………………….…. 48

ix ABSTRACT

Introduction: The purpose of this study is to examine the connection between culture and psychopathology to determine if, belongingness and burdensomeness are more predictive of suicidality risk than multicultural inclusiveness, African selffortification and acculturative stress among college students of African descent from two culturally distinct universities. The main hypothesis is that among individuals of African descent thwarted belongingness, perceived burdensomeness and the interaction between the two will be more significant than multicultural inclusiveness, African selffortification, acculturative stress, or those twoway interaction combinations. Methods: Approximately 170 consenting African American male and female undergraduate college students from two southeastern State universities participated in this study. Suicidality was assessed using the Beck Suicide Scale and depressive symptoms using the Beck Depression Inventory. Results: Hypotheses were supported. Regression 1 indicated the main effect of ethnicity on suicidality was nonsignificant and ethnicity did not significantly moderate the relationship between belongingness or burdensomeness and Suicidality. Regression 2 indicated university setting did not significantly moderate the relationship between Suicidality and belongingness or burdensomeness. Regression 3 indicated that the twoway interaction between burdensomeness and belongingness was of greater significance than culture specific variables in predicting suicidality among individuals of African descent. Conclusions: Perceived burdensomeness and the belongingness X burdensomeness interaction are robust predictors of suicidality among individuals of African descent. Clinical implications are discussed.

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INTRODUCTION

1.1 Suicide and the Importance of Investigating Suicidality Risk In 2001, the National Institute of Mental Health (NIMH) reported suicide was the eleventh leading cause of death in the United States (US) (Miniño, ACRIS, Kochanek, Murphy, & Smith, 2002.) The report indicated that in the US about 11 of every 100,000 persons die by suicide each year. In 2005, little had changed as the Center for Disease Control reported similar findings 1 . It is estimated that there are anywhere from eight to 25 attempted suicides for every one documented suicide death. In short, the annual number of suicides can be expected to be around 32,000 persons (i.e., 1.2% of all deaths in the US) (NIMH, 2003). This phenomenon has become so problematic that mainstream media has taken a serious interest in understanding, predicting and preventing suicide. For example, documentaries such as The Bridge (2006) 2 have brought the sufferings of suicide victims to the forefront of public discussion. Daytime television and talkshow hosts such as “Dr. Phil” have begun to hold scientific discussions of suicidality, its risk factors and warning signs. These events have helped heighten public and private sector attentiveness to the need for better assessment and prevention models of suicide and its related behaviors. Suicidality involves suicidal ideation, symptoms (e.g., depression) and behaviors such as plans, preparation and attempts. It is associated with multifaceted risk factors such as stress from negative life events and depression (Joiner & Rudd, 2000; Furr, Westefeld, McConnell & Jenkins, 2001; and Kaslow, Thompson, Okum, et al., 2002). These risk factors vary by age, gender and ethnicity. Rates of desire, ideation, attempts and deaths by suicide arise with the greatest frequency among White American and Native American ethnic groups. Approximately onethird of Americans experience some form of suicidal desire or ideation in their lifetime (Witte, Fitzpatrick, Warren, et al., 2006; Paykel, Myers, Lindenthal, & Tanner, 1974). According to the Substance Abuse and Mental Health Services Administration

1 Deaths: Final Data for 2005. National Vital Statistics Reports, 56(10). http:// www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf obtained 16 November 2008. 2 The Bridge (2006). That Beautiful but Deadly San Francisco Span. New York Times. http://movies.nytimes.com/2006/10/27/movies/27brid.html?ex=1162612800&en=ef9e6526364f9 858&ei=5070

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(SAMHSA), in 2008 approximately 8.3 million adults ages 18 and older had serious suicidal thoughts 3 . Roughly, 2.3 million of those individuals developed a specific plan for suicide and about 1.2 million made an actual attempt. On average the highest rates of suicidality were among individuals 1825 years of age. Figure 1 illustrates this point. Much of the current research on suicidality risk prevention focused on deaths. If suicide deaths are to be prevented further the approach cannot continue to focus solely on suicide deaths. Instead, the scope of suicide research should be broadened to include an emphasis on desire and ideation as they are the precipitants of death. Doing so would not only produce results to assist those in early stages of suicide crisis, it would focus efforts on preventing people from progressing along the continuum (Drum, Brownson, Denmark & Smith, 2009).

Figure 1. Suicidal Thoughts and Behaviors in the Past Year, Among Adults, by Age Group, 2008

3 2008 SAMHSA National Survey on Drug Use and Health (NSDUH) http://latimesblogs.latimes.com/booster_shots/2009/09/suicide.html

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1.2 Suicidality Risk Between Ethnic Groups In 2003, the NIMH reported suicidality demographics between ethnic groups from 1999 to 2000. This included 5.6 deaths per 100,000 for African Americans and 12.5 deaths per 100,000 for White Americans (2.0 per 100,000 for Hispanic Americans, Asian/Pacific Islanders, and other ethnicities combined). White women held the highest suicide ideation and attempt rates while White men had the highest death rates (NIMH, 2003). Specifically, White males 65 years and over had the greatest risk. Among African Americans, risk peaked around 2534 years of age. African American females were exceptionally resistant to suicidality risk and experienced the least number of suicides in comparison to other ethnic groups (Garlow et al., 2005). Suicidality generally increases with age for most ethnic groups. However, since 1960, the suicide rate for young African Americans has doubled (Walker, 2002). African American males between 20 and 24 years of age accounted for much of that increase.

1.3 College Students, Ethnicity, Culture and Suicidality Epidemiological studies describe suicide as the second leading cause of death for college students in the United States (Berman & Jobes, 1995). Since the 1970s, approximately, 1,000 college students die by suicide and approximately 100,000 attempt suicide each year (Peck & Bharadwadj, 1980). For the past twentyfive years, there has been a growing interest in the study of suicidality among college students (Drum, Brownson, Denmark, & Smith, 2009). Unfortunately, these efforts are largely based on data generated by deaths. Consequently, there is a strong tendency to focus on White Americans. Typically, investigations into the suicidality of college students have not examined racial or cultural differences. Though there was a recent increase in suicidal behavior among African American youths, it remained unclear if this increase applied to African American college students as well. Theoretical models of suicidality have identified interpersonal variables that seem to accurately assess this phenomenon among college students in general. High rates of chronic stress, financial problems, depression, divorce, and lack of social support have been shown to be strongly related to greater suicide ideation (Berman & Jobes, 1995; Curran, 1987). It has been proposed that these and similar factors lead to lack of belonging and feelings of burden which move a person further along the continuum (Joiner, 2005). One such model that specifically examines failed belonging and perceptions of burden is the Interpersonal

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psychological theory of suicidal behavior (Joiner, 2005). Other theoretical models which investigate suicidality from a cultural standpoint propose that suicidality increases significantly among those who acculturate to a WesternEuropean value system. Those cultural models are largely based on findings from studies evaluating the role of ethnic identification, cultural attitudes or acculturative stress levels among minority groups. Both models were of relevance to the current study and are further explained below.

1.4 Interpersonal-psychological Theory and Serious Suicidal Desire/Ideation: Belongingness and Burdensomeness

The Interpersonalpsychological theory of suicidal behavior (Joiner, 2005) proposes that serious suicidal desire (i.e., ideation) is composed of two interpersonally relevant states of mind known as thwarted belongingness and perceived burdensomeness. The theory defines thwarted belongingness as the experience of feeling alienated from others and not being an integral part of a family, circle of friends, or other valued group. The theory proposes that the need to belong is so fundamental it can buffer against suicide when met or substantially increase risk when thwarted. Support for this position has been found in the literature reviewed below. In 1897, Durkheim proposed that suicide results partly from a failure at social integration or belonging to a larger group. Baumeister and Leary (1995) proposed the need to belong was such a basic human need that feeling disconnected or uncared for by others caused a painful emotional state associated with negative psychological outcomes such as depression. Some of most studied and replicated indicators of suicide have been measures related to belongingness. For example, studies on social isolation, social withdrawal, lack of social support, and intense feelings of loneliness have been found to significantly predict suicidality risk (Bonner & Rich, 1987; Dierserud, Roysamb, Ekberg & Kraft, 2001; Walker, Lester, & Joe, 2006). Higher suicide rates have been reported for single, divorced, and widowed people (e.g., Rothberg & Jones, 1987). According to theory, it is thwarted belongingness that exacerbates suicide risk. A growing body of literature supports this hypothesis (e.g., Hershberger, Pilkington, & D’Augelli, 1997; Joiner, Hollar, & Van Orden, 2006; KoivumaaHonkanen et al., 2001; & Van Orden, Witte, Gordon et al., 2008). These studies suggest that individuals with the greatest suicidality risk may report a low need to belong compared to those whose need to belong is high.

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The current study investigates the role of the need to belong in suicidality among African Americans. Perceived burdensomeness is the second component of this theory. Perceived burdensomeness is described as the perception that one’s existence burdens family, friends, and/or society (Joiner, 2005). The theory states that this belief produces a misperception that one’s death will be more valuable to family, friends or society than one’s life. Through the analyzed statements of persons who completed or attempted suicide, Joiner, et. al, (2002) provided anecdotal support of perceived burdensomeness being associated with desire for suicide. He and his colleagues found the statements in the notes tended to indicate that these persons ended their life because they did not want to be a burden on others. Studies of community samples by DeCantanzaro (1995) found among highsuiciderisk groups that the belief one was a burden to family correlated with suicidal ideation. Empirical studies have reported findings that perceived burdensomeness was a strong predictor of current suicidal ideation even when controlling for powerful covariates such as depression and hopelessness (Van Orden, Lynam, Hollar & Joiner, 2006). Van Orden et al. (2008) reported that the interaction between thwarted belongingness and perceived burdensomeness significantly predicted current suicide ideation . The interpersonalpsychological theory of suicidal behavior further suggested thwarted belongingness and perceived burdensomeness were proximal, causal and interactive risk factors of suicidality. The theory implied that thwarted belongingness and perceived burdensomeness are universal indicators of suicidality because they are associated with fundamental human needs (i.e., belonging and effectiveness). According to Baumeister and Leary (1995) emotional and psychological drives that are limited to certain individuals, groups or which only occur under certain circumstances cannot be regarded as fundamental; instead, they suggest that universality can only be indicated by transcending cultural boundaries. Though the studies mentioned above provide evidence that both thwarted belongingness and perceived burdensomeness predict suicidality, to date there have been no studies directly examining this construct among a large sample of African American participants in distinct cultural environments nor in relation to culturespecific indicators of suicidality. The current study attempts to address the gap in this literature by

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investigating the role of belongingness and burdensomeness among individuals of African descent.

1.5 Theories and Cultural Factors Investigating Suicidality in Individuals of African Descent Concern for cultural considerations arose, in part, from findings that African Americans as a group, tended to describe specific psychological symptoms associated with depression and anxiety as “stress” or in somatic terms (e.g., headache, chest pains, and upset stomach) (Hollar, D.L., Buckner, J.D., HolmDenoma, J.M., et al.; 2007). This occurrence was so common that, at times, it became difficult to discriminate between mental illness and physical ailment. Since these findings and similar ones emerged, there has been speculation about the possible role of ethnicity and culture in the assessment of psychopathology. Researchers have theorized that factors related to ethnic identity and cultural attitudes influence the mental health of African Americans more than White Americans (Akbar, 1996; Estell, 1994; Johnson, 1990; Landrum Brown, 1990; Utsey & Ponterotto, 1996). The primary reason for this occurrence seems to be that individuals of African descent tend to be more collectivist in their worldview than individuals of European descent (Goodstein & Ponterotto, 1997). The nigrescence theory (Cross, 2001) states that African American’s ethnic identity attitudes change over time. Cross, Parham, and Helms (1991) proposed that the internalization attitudinal stage would be related to better psychological wellbeing. This stage was composed of two factors; Afrocentricity and multicultural inclusiveness. According to the theory, a person in the internalization attitudinal stage had developed a personal identity and sought to incorporate this identity into behavior that was important to the goals of his/her own group (i.e., Afrocentricity). Once that individual became additionally concerned with the goals of the outgroup, he/she was said to have moved into a multicultural inclusive attitudinal phase. It is the multicultural inclusive phase that is considered to be the healthiest phase of identity development associated with the best psychological wellbeing for African Americans. This position has been supported by several studies (Carter, 1991; Spencer, Cunningham & Swanson, 1995; Pierre & Mahalik, 2005; Hollar, 2006). Preliminary evidence reported by Hollar (2006) indicated support for a significant relationship between multicultural

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inclusiveness scores and suicide ideation among African Americans (r = 0.32, p<.001). As such, the current study characterizes multicultural inclusiveness as a culturespecific indicator and further investigates how well it predicts suicidality among individuals of African descent. According to Baldwin (1984), one of the earliest and most comprehensive theories on cultural attitudes and African American psychopathology was in presented in 1979, when Akbar proposed a classification system to explain the mental disorders and pathological behaviors occurring in the African American community. One aspect of this system described individuals who had rejected fundamental cultural aspects of their identity, namely the expression of their African selfconsciousness. Consistent with this theory, Baldwin (1981, 1984) proposed an African SelfConsciousness (ASC) scale in order to help identify and describe the degrees to which one identified and was conscious of his/her African self. According to Baldwin (1984), the components of African selfconsciousness are thought to generate selfaffirming behaviors which help resist against oppressive and discriminatory forces that create psychologically unhealthy conditions for individuals of African descent. Of particular interest is the African selffortification component. The theory contended that the African selffortification (selfknowledge and selfaffirmation related to Africentric values, customs, and institutions) relates negatively to indices of psychological distress because consciousness about one’s cultural heritage, attitudes and beliefs about one’s race serve as coping mechanisms, which buffer against many forms of psychological distress. Research by Pierre & Mahalik (2005) found evidence that scoring high on the African selffortification component of the ASC is predictive of less psychological distress and depression for African American men. Preliminary investigations conducted by Hollar (2006) indicated support for a significant relationship between low African selffortification scores and increased suicide ideation (r = 0.29, p<.01). As such, the current study specifically investigated the role of African selffortification as a culturespecific indicator of suicidality for use among individuals of African descent.

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1.6 Acculturative Stress and its Main and Moderating Effects in Suicidality Risk Assessment Acculturative stress is a welldocumented indicator of psychopathology in minority group members. Specifically, it refers to the negative psychological impact of adapting to a new culture. It is the psychological distress associated with feelings of marginality, isolation, anxiety, lowered selfconcepts (Thompson, Anderson, & Bakeman, 2000), and identity confusion (Berry et al., 1987). Anderson (1991) proposed that acculturative stress is greater for those African Americans who have low scores on the African selfconsciousness (ASC; Baldwin, 1984) scale. Berry et al. (1987) found evidence that African American individuals who experience low levels of acculturative stress have lower levels of anxiety and depression than those who have higher acculturative stress levels. Acculturative stress is one of the most well studied culturespecific indicators of psychological wellbeing among individuals of African descent. It is specifically relevant to the identification of suicide risk factors among individuals of African descent. A review of the literature revealed African American males who did not identify with their ethnic group or participate in its traditions, reported higher acculturative stress scores and suicide ideation scores (Walker, 2002). Hollar (2006) found acculturative stress was positively correlated (r = .26, p<.001) with suicide ideation in African American college students from two culturally distinct universities. That study also indicated a significant interaction effect between low African selffortification and high acculturative stress in the prediction of suicide ideation among African American men. These findings highlight the relationship between culture and suicide; and provide evidence of specific cultural indicators worthy of further investigation.

1.7 Summary A review of the literature indicates many of the current theories and measures of suicidality were developed and normed on individuals mainly from one ethnic group. There has been little investigation into whether such theories and measures are generalizable to a large sample of individuals of African descent. It is unknown whether certain instruments developed from theories absent of cultural influence are able to accurately assess the suicidality of individuals of African descent or if they do so better than culturespecific indicators. Considering

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the growing number of young African Americans at risk for suicide, utilizing such tools may produce an incomplete understanding of risk and prevention among individuals of African descent. In the field of suicide risk assessment, such an approach could be fatal. Recently, research has been aimed at finding universally applicable indicators of suicidality. Two such indicators proposed in The Interpersonal-Psychological Theory of Serious Suicidal Behavior (Joiner, 2005) are related to an individual’s selfreport of belongingness and burdensomeness. According to the theory, belongingness and burdensomeness are factors associated with suicidality, fundamental to all individuals, regardless of ethnicity or culture related variables. As such, these variables may provide an accurate assessment of suicidality for use across cultural and ethnic boundaries. A universal theoretical approach to suicidality would increase both the effectiveness and efficiency of suicide risk assessment. Most importantly, it will help save more lives. For a theory to be universally applicable, it is important that the components of the theory first be tested and retested between differing ethnic groups, cultural contexts and in comparison to unique culturespecific indicators. Given the relative newness of the Interpersonal- Psychological Theory of Serious Suicidal Behavior and its potential to be widely generalizeable, it is the aim of the current study to examine the predictive ability of belongingness and burdensomeness among a group of individuals of African descent. To our knowledge, the current study is the first of such investigations. The purpose of the current study was to describe the predictability of thwarted belongingness and perceived burdensomeness on suicidality between individuals of African descent and nonAfrican descent. Secondly, the study intended to investigate claims that the need to belong and perceived burdensomeness will remain significant indicators of suicidality among individuals of African descent from two culturally distinct university environments (i.e., HBCU vs. TWI). Third, given the limited research, the current study hoped to provide data to clarify and explain the role of culturespecific indicators in suicidality and their utility in light of newer theories that have been proposed.

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THE PRESENT STUDY

The current study investigated the predictability of thwarted belongingness and perceived burdensomeness by directly assessing their role in the prediction of suicidality as indicated by BSS scores (controlling for depression and gender effects) among individuals of African descent compared to individuals of nonAfrican descent. The second aim was to investigate this effect, explicitly among individuals of African descent by comparing two historically different cultural institutions (i.e., a historically black university and a traditionally white university) to determine if effects related to cultural environment influence the predictability of thwarted belongingness and perceived burdensomeness. The third aim of this study was to investigate specifically among individuals of African descent whether thwarted belongingness, perceived burdensomeness and the interaction between them are more significant in the prediction of suicidality than main and interaction effects of culture specific indicators (i.e., multicultural inclusiveness, Africanself fortification, and acculturative stress).

2.1 Predictions In accordance with the norms reported in the literature, it was generally predicted that the sample would reveal greater reports of suicidality (and depression) for women versus men, among the youngest age group, and for those from a low socioeconomic background. Based on past research investigating the role of cultural and ethnic related variables in psychopathology, it was predicted that there would be greater reports of suicidality (and depression) among the non African descent group versus the African descent group and among individuals of African descent who attend a traditionally white university (TWU) versus a Historically Black College or University (HBCU). In accordance with current trends in the literature, it was predicted that females of African descent would have the lowest suicidality scores. It was further predicted that among males of African descent this correlation would be more similar to individuals of non African descent than to females of African descent given current rates among young African American men who die by suicide currently match those of young European American men. In accordance with cultural theories of psychological wellbeing, among individuals of African descent it was predicted that multicultural inclusiveness (IMCI, subscale of CRIS; Cross

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et al. 2001), African selffortification (ASF, subscale of ASC; Baldwin 1984), and acculturative stress (SAFE; Mena et al., 1987) scores would be significantly correlated with suicidality (BSS, Beck & Steer, 1991) controlling for depression (BDI, Beck et al., 1979) and gender effects. Among individuals of African descent, IMCI, ASF, SAFE and the twoway interaction effect scores between ASF and IMCI, ASF and SAFE, IMCI and SAFE would be predictive of suicidality (controlling for depression and gender). ASF and IMCI scores will be inversely related to suicidality as indicated by a decrease in severity of BSS scores. SAFE scores will have a positive correlation with suicidality as indicated by an increase in severity of BSS scores. It was predicted that the mean ASF and IMCI scores would be greater for those who attended a HBCU versus those who attended a TWU. Accordingly, the mean SAFE scores would be greater for individuals of African descent who attended a traditionally white university. These hypotheses are in accordance with (Baldwin, Duncan, & Bell,1987; Hollar, 2006; Walker, 2002). Based on the interpersonal theory of suicidal behavior, several specific hypotheses were made.

2.2 Main Hypotheses Hypothesis1: Thwarted belongingness (low scores on the Need To Belong scale, NTBS), perceived burdensomeness (low scores on the Beliefs About Self and Others scale, BASO), and the interaction effect scores would be positively related to suicidality as indicated by more severe scores on the Beck Suicide Scale (BSS). This effect is expected even when controlling for depression (as indicated by Beck Depression Inventory, BDI) and gender effects. There will be no moderating effect of ethnicity (i.e., African descent versus nonAfrican descent) which would partially support the claim that thwarted belongingness and perceived burdensomeness are universal indicators predicting suicidality. If so, this would provide evidence that thwarted belongingness and perceived burdensomeness are universal indicators of suicidality devoid of influence from ethnic related variables.

Hypothesis2: Specifically among individuals of African descent, thwarted belongingness, perceived burdensomeness and the interaction between them would significantly predict suicidality for individuals of African descent who attended a TWU as well as those who attended a HBCU. Evidence of no effect for university environment would support the opinion that

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thwarted belongingness and perceived burdensomeness are universal indicators of suicidality devoid of influence from differing cultural environments. Hypothesis3: Specifically among individuals of African descent, thwarted belongingness, perceived burdensomeness, and the interaction effect would be better predictors of suicidality than ASF, IMCI, SAFE and the interactions between ASF and IMCI, ASF and SAFE, IMCI and SAFE. If this is the case, it would provide additional evidence that thwarted belongingness and perceived burdensomeness are universal indicators of suicidality.

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METHODS

3.1 Participants and Procedures Overall, two hundred and seventysix (n=276) college students participated in this study. One hundred and seventy (n=170) were individuals of African descent and 106 were of non African descent. The participants were university college students from two southeastern state universities in close proximity but with two distinct historical and cultural backgrounds; a TWU and a HBCU. The students participated in this study to fulfill, partially, a requirement for their introductory psychology class or to gain some other academic credit. For the purposes of this study, participants who indicated that at least one of their biological parents was Black, African American and/or of African descent were classified as an individual of African descent. All other participants were classified as individuals of nonAfrican descent.

3.2 Sample Characteristics The specific ethnicities reported for individuals of African descent included 5.3% who identified themselves as Africans, 55.3% African Americans, 14.7% Black, 11.2% West Indian/Caribbean, 5.3% Black Hispanic, 4.1% Mixed Race, and 3.5% Other. The specific ethnicities reported for those included in the nonAfrican American group (n=106) included 88.6% who identified themselves as Caucasian, 5.7% Hispanic, 0.9% Mixed Race, and 4.7% Other. Table 1 indicates that of the 276 participants, 70% of the participants attended a TWU and 30% attended a HBCU. Of those who attended a traditionally White university, 45% comprised the African descent group (55% nonAfrican descent). There were more females (68%) than males. The age range of the sample was 17years old to 31years old with the average age being approximately 18years for both groups. The majority of participants reported they were of a middle/working class socioeconomic background.

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TABLE 1 Demographic Frequencies (N=276)

African Descent Non-African Descent Total n = 170 (62%) n = 106 (38%) n = 276 (100%) University TWU 88 106 194 HBCU 82 0 82 Gender Male 61 26 87 Female 109 80 189 Age 17 4 5 9 18 54 61 115 19 57 20 77 20 22 8 30 21 16 9 25 22 8 3 11 23 3 0 3 24 5 0 5 31 1 0 1 SES Low 40 4 44 Mid 127 70 197 High 3 32 35

Full document contains 78 pages
Abstract: Introduction: The purpose of this study is to examine the connection between culture and psychopathology to determine if, belongingness and burdensomeness are more predictive of suicidality risk than multicultural inclusiveness, African self-fortification and acculturative stress among college students of African descent from two culturally distinct universities. The main hypothesis is that among individuals of African descent thwarted belongingness, perceived burdensomeness and the interaction between the two will be more significant than multicultural inclusiveness, African self-fortification, acculturative stress, or those two-way interaction combinations. Methods: Approximately 170 consenting African American male and female undergraduate college students from two southeastern State universities participated in this study. Suicidality was assessed using the Beck Suicide Scale and depressive symptoms using the Beck Depression Inventory. Results: Hypotheses were supported. Regression 1 indicated the main effect of ethnicity on suicidality was non-significant and ethnicity did not significantly moderate the relationship between belongingness or burdensomeness and Suicidality. Regression 2 indicated university setting did not significantly moderate the relationship between Suicidality and belongingness or burdensomeness. Regression 3 indicated that the two-way interaction between burdensomeness and belongingness was of greater significance than culture-specific variables in predicting suicidality among individuals of African descent. Conclusions: Perceived burdensomeness and the belongingness X burdensomeness interaction are robust predictors of suicidality among individuals of African descent. Clinical implications are discussed.