Abstract
Death by suicide, and suicidal behaviors, are a significant public mental health problem, and individuals who are lesbian, gay, bisexual, transgendered and questioning (LGBTQ), may be at increased risk. Potential underlying mechanisms of this association are unknown, but may involve the impact of LGBTQ status on future orientation and mood. Our purpose was to determine the influence of sexual identity, sequentially, on cognitive and emotional functioning, and consequent relation to suicidal behavior. In a sample of 349 college students, we used serial mediation models to investigate the relation between self-identification as LGBTQ and suicidal behavior, with hope and hopelessness as first-order mediators and depression as a second order mediator. Supporting hypotheses, we found that LGBTQ status was related to less hope and greater hopelessness and, in serial fashion, to depressive symptoms and consequent suicidal behavior. Our findings may have clinical implications. Resolution of hopelessness and depression, and promotion of hopefulness, perhaps via Motivational Interviewing and Cognitive Behavioral Therapy strategies, such as goal-setting, may reduce suicidal risk in LGBTQ young adults.
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References
Alessi, E. J. (2014). A framework for incorporating minority stress theory into treatment with sexual minority clients. Journal of Gay & Lesbian Mental Health, 18(1), 47–66. doi:10.1080/19359705.2013.789811.
Anestis, M. D., Moberg, F. B., & Arnau, R. C. (2014). Hope and the interpersonal-psychological theory of suicidal behavior: replication and extension of prior findings. Suicide and Life-threatening Behavior, 44(2), 175–187. doi:10.1111/sltb.12060.
Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9, 324–333.
Beck, A. T., Steer, R. A., Kovacs, M., & Garrison, B. (1985). Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. The American Journal of Psychiatry, 142(5), 559–563.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck depression inventory: twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77–100. doi:10.1016/0272-7358(88)90050-5.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II. San Antonio: Psychological Corporation.
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42(6), 861-865.
Beitman, B. D. (1987). The structure of individual psychotherapy. New York: Guilford Press.
Casey, C. M. (2013). A positive psychology intervention for building hope: a case approach. Dissertation Abstracts International: Section B: The Sciences and Engineering, 73(10-B(E)). (UMI No. AAI3509730).
Centers for Disease Control and Prevention (2009). Suicide and self inflicted injuries. Retrieved from http://www.cdc.gov/nchs/fastats/suicide.htm.
Chakraborty, A., McManus, S., Brugha, T. S., Bebbington, P., & King, M. (2011). Mental health of the non-heterosexual population of England. The British Journal of Psychiatry, 198, 143–148. doi:10.1192/bjp.bp.110.082271.
Chang, E. C., Sanna, L. J., Hirsch, J. K., & Jeglic, E. L. (2010). Loneliness and negative life events as predictors of hopelessness and suicidal behaviors in Hispanics: evidence for a diathesis-stress model. Journal of Clinical Psychology, 66(12), 1242–1253. doi:10.1002/jclp.20721.
Cohn, T. J., & Leake, V. S. (2012). Affective distress among adolescents who endorse same-sex sexual attraction: urban versus rural differences and the role of protective factors. Journal of Gay & Lesbian Mental Health, 16(4), 291–305. doi:10.1080/19359705.2012.690931.
Craig, S. L., & McInroy, L. (2013). The relationship of cumulative stressors, chronic illness and abuse to the self-reported suicide risk of black and Hispanic sexual minority youth. Journal of Community Psychology, 41(7), 783–798. doi:10.1002/jcop.21570.
Daniel, S. S., & Goldston, D. B. (2012). Hopelessness and lack of connectedness to others as risk factors for suicidal behavior across the lifespan: implications for cognitive-behavioral treatment. Cognitive and Behavioral Practice, 19(2), 288–300. doi:10.1016/j.cbpra.2011.05.003.
Duggleby, W. D., Degner, L., Williams, A., Wright, K., Cooper, D., Popkin, D., & Holtslander, L. (2007). Living with hope: initial evaluation of a psychosocial hope intervention for older palliative home care patients. Journal of Pain and Symptom Management, 33(3), 247–257. doi:10.1016/j.jpainsymman.2006.09.013.
Fergusson, D. M., Horwood, L. J., & Beautrais, A. L. (1999). Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry, 56, 876–880. doi:10.1001/archpsyc.56.10.876.
Grewal, P. K., & Porter, J. E. (2007). Hope theory: a framework for understanding suicidal action. Death Studies, 31(2), 131–154. doi:10.1080/07481180601100491.
Gutierrez, P. M., Osman, A., Barrios, A. X., & Kopper, B. A. (2001). Development and Initial Validation of the Self-Harm Behavior Questionnaire. Journal of Personality Assessment, 77(3), 475–490.
Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf
Heintzelman, S. J., & King, L. A. (2014). Life is pretty meaningful. American Psychologist, 69(6), 561–574. doi:10.1037/a0035049.
Irwin, J. A., Coleman, J. D., Fisher, C. M., & Marasco, V. M. (2014). Correlates of suicide ideation among LGBT Nebraskans. Journal of Homosexuality, 61, 1172–1191. doi:10.1080/00918369.2014.872521.
Kisch, J., Leino, V., & Silverman, M. M. (2005). Aspects of suicidal behavior, depression, and treatment in college students: results from the spring 2000 National College Health Assessment Survey. Suicide and Life-threatening Behavior, 35(1), 3–13. doi:10.1521/suli.35.1.3.59263.
Kwon, P., & Hugelshofer, D. S. (2010). The protective role of hope for lesbian, gay, and bisexual individuals facing a hostile workplace climate. Journal of Gay & Lesbian Mental Health, 14(1), 3–18.
Lamis, D. A., & Malone, P. S. (2011). Alcohol-related problems and risk of suicide among college students: the mediating roles of belongingness and burdensomeness. Suicide and Life-threatening Behavior, 41(5), 543–553. doi:10.1111/j.1943-278X.2011.00052.x.
LeVassseur, M. T., Kelvin, E. A., & Grosskopf, N. A. (2013). Intersecting identities and the association between bullying and suicide attempt among New York City youths: results from the 2009 New York City youth risk behavior survey. American Journal of Public Health, 103(6), 1082–1089. doi:10.2105/AJPH.2012.300994.
Linehan, M. M., & Nielsen, S. L. (1981). Assessment of suicide ideation and parasuicide: Hopelessness and social desirability. Journal of Consulting and Clinical Psychology, 49(5), 773-775.
Liu, R. T., & Mustanski, B. (2012). Suicidal ideation and self-harm in lesbian, gay, bisexual, and transgender youth. American Journal of Preventive Medicine, 42(3), 221–228. doi:10.1016/j.amepre.2011.10.023.
Rojas, S. M., Leen-Feldner, E. W., Blumenthal, H., Lewis, S. F., & Feldner, M. T. (2014). Risk for suicide among treatment seeking adolescents: the role of positive and negative affect intensity. Cognitive Therapy and Research. doi:10.1007/s10608-014-9650-8.
Safren, S. A., & Heimberg, R. G. (1999) Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents.. Journal of Consulting and Clinical Psychology, 67(6), 859–866.
Savin-Williams, R. C., & Ream, G. L. (2003). Suicide attempts among sexual-minority male youth. Journal of Clinical Child and Adolescent Psychology, 32(4), 509–522. doi:10.1207/S15374424JCCP3204_3.
Scourfield, J., Roen, K., & McDermott, L. (2008). Lesbian, gay, bisexual, and transgender young people’s experiences of distress: resilience, ambivalence, and self-destructive behaviors. Health and Social Care in the Community, 16(3), 329–336. doi:10.1111/j.1365-2524.2008.00769.x.
Snyder, C. R. (1994). The psychology of hope: you can get there from here. New York: Free Press.
Snyder, C. R. (1995). Conceptualizing, measuring, and nurturing hope. Journal of Counseling & Development, 73, 355–360.
Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., et al. (1991). The will and the ways: development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570–585. doi:10.1037/0022-3514.60.4.570.
Snyder, C. R., LaPointe, A. B., Crowson Jr., J. J., & Early, S. (1998). Preferences of high- and low-hope people for self-referential input. Cognition and Emotion, 12(6), 807–823. doi:10.1080/026999398379448.
Steen, J. H. (2004). Measuring the efficacy of the Snyder hope theory as an intervention with an inpatient population (C. Richard Snyder). Dissertation Abstracts International Section A: Humanities and Social Sciences, 65(6-A), 2103. (UMI No. AAI3136238).
Stone, D., Luo, F., Ouyang, L., Lippy, C., Hertz, M. F., & Crosby, A. E. (2014). Sexual orientation and suicide ideation, plans, attempts, and medically serious attempts: evidence from local youth risk behavior surveys, 2001-2009. American Journal of Public Health, 104(2), 262–271. doi:10.2105/AJPH.2013.301383.
Troister, T., & Holden, R. R. (2010). Comparing psychache, depression, and hopelessness in their associations with suicidality: a test of Shneidman’s theory of suicide. Personality and Individual Differences, 49(7), 689–693. doi:10.1016/j.paid.2010.06.006.
Valle, M. F., Huebner, E. S., & Suldo, S. M. (2006). An analysis of hope as a psychological strength. Journal of School Psychology, 44(5), 393–406. doi:10.1016/j.jsp.2006.03.005.
Vincent, P. J., Boddana, P., & MacLeod, A. K. (2004). Positive life goals and plans in parasuicide. Clinical Psychology & Psychotherapy, 11, 90–99.
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Hirsch, J.K., Cohn, T.J., Rowe, C.A. et al. Minority Sexual Orientation, Gender Identity Status and Suicidal Behavior: Serial Indirect Effects of Hope, Hopelessness and Depressive Symptoms. Int J Ment Health Addiction 15, 260–270 (2017). https://doi.org/10.1007/s11469-016-9723-x
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DOI: https://doi.org/10.1007/s11469-016-9723-x