Perceived Burdensomeness, Attitudinal Familism and Suicidal Ideation in Hispanic Adolescent Inpatients

Suicidal ideation is alarmingly prevalent in Hispanic adolescents, who report greater rates of ideation than other major ethnoracial same-aged groups in the United States (CDC YRBS, 2015). Elevated prevalence rates in this group remain particularly concerning, given that Hispanic youth have been shown to experience greatest unmet need for mental healthcare, and are under-identified for crisis intervention when suicidal (Kataoka, Zhang, & Wells, 2002; Kataoka, Stein, Lieberman, & Wong, 2003). Perceived burdensomeness, or beliefs that one is a burden or tax on close others and society, is one risk factor for suicidal ideation proposed by the interpersonal theory of suicide (Joiner, 2005), which has been evidenced in Hispanic individuals (Garza & Pettit, 2010; Hill & Pettit, 2012). Little is known about how culturally-relevant factors, such as attitudinal familism, may intersect this known risk relation to mitigate or exacerbate suicidal ideation in Hispanic youth. Understanding how attitudinal familism interacts with the relation between perceived burdensomeness and suicidal ideation in Hispanic adolescents remains of empirical and clinical importance, given that such an investigation would increase understanding of cultural-specific processes impacting interpersonal risk for suicide, and findings may inform the development of culturally-sensitive interventions for suicidal ideation in Hispanic youth. Against this background, the current proposal studied the relation between perceived burdensomeness, attitudinal familism, and suicidal ideation in a psychiatric sample of N = 81 Hispanic adolescent inpatients. The aims of the current proposal were two-fold: 1) Aim 1: To investigate the direct relations between perceived burdensomeness, attitudinal familism, and suicidal ideation in a Hispanic adolescent inpatient sample; and 2) Aim 2: To investigate the moderating effects of attitudinal familism (consistent the conceptualization provided by Lugo Steidel & Contreras, 2003) on the relation between perceived burdensomeness and suicidal ideation in Hispanic adolescent inpatients, while controlling for the effects of potentially relevant covariates (depressive symptoms, gender). Our central interaction hypothesis posited that attitudinal familism would mitigate the impact of perceived burdensomeness on suicidal ideation, above and beyond the effects of gender and depressive symptoms. Results showed a nonsignificant interaction effect for the role of attitudinal familism, which trended towards significance in a mitigating direction at p = .08 with low achieved power. Overall, the current study evidenced a nonsignificant interaction effect for the main study hypothesis, however low achieved power and effect size indicate increased likelihood of type II error and that a true mitigating effect may have been missed. Indeed, the trend towards significance does suggest that a trend for attitudinal familism buffering the impact of perceived burdensomeness on suicidal ideation, consistent with our hypothesis that perceived family support and cohesion may alleviate the effects of perceived burdensomeness in extra-familial relations on subsequent thoughts about suicide.