Perez-Rodriguez M Mercedes, Baca-Garcia Enrique, Oquendo Maria A, Wang Shuai, Wall Melanie M, Liu Shang-Min, Blanco Carlos
Mount Sinai School of Medicine Psychiatry Box #1230, 1 Gustave L. Levy Pl, New York, NY 10029
J Clin Psychiatry. 2014 Apr;75(4):399-407. doi: 10.4088/JCP.13m08548.
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.
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 χ(2) tests and logistic regression models to analyze the association between acculturation and risk of suicidal ideation and attempts.
Factors associated with a linear increase in lifetime risk for suicidal ideation and attempts were (1) younger age at migration (linear χ(2)(1) = 57.15; P < .0001), (2) longer time in the United States (linear χ(2)(1)= 36.09; P < .0001), (3) higher degree of English-language orientation (linear χ(2)(1) = 74.08; P <.0001), (4) lower Hispanic composition of social network (linear χ(2)(1) = 36.34; P < .0001), and (5) lower Hispanic racial/ethnic identification (linear χ(2)(1) = 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).
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.
文化适应是移民习得主导社会文化的过程。关于美国西班牙裔人群中文化适应与自杀观念及自杀未遂之间的关系，我们知之甚少。我们的目的是在最大的全国代表性美国西班牙裔样本中，研究5种文化适应指标（移民年龄、在美国的时间、社交网络构成、语言、种族/族裔取向）对自杀观念和自杀未遂的影响。
研究参与者是来自2004 - 2005年全国酒精及相关疾病流行病学调查第二轮（样本量为34,653）的美国西班牙裔（N = 6,359）。我们使用线性χ²检验和逻辑回归模型来分析文化适应与自杀观念及自杀未遂风险之间的关联。
与一生中自杀观念和自杀未遂风险呈线性增加相关的因素有：（1）移民时年龄较小（线性χ²(1)=57.15；P <.0001），（2）在美国时间较长（线性χ²(1)=36.09；P <.0001），（3）英语取向程度较高（线性χ²(1)=74.08；P <.0001），（4）社交网络中西班牙裔构成较低（线性χ²(1)=36.34；P <.0001），（5）西班牙裔种族/族裔认同感较低（线性χ²(1)=47.77；P <.0001）。较高的感知歧视水平与一生中自杀观念风险较高（β = 0.051；P <.001）及自杀未遂风险较高（β = 0.020；P =.003）相关。
文化适应的多个维度与一生中的自杀观念和自杀未遂之间存在线性关联。歧视也与一生中的自杀观念和自杀未遂风险相关。我们的研究结果凸显了传统西班牙裔文化的保护作用，如强大的社会支持、应对策略以及对自杀的道德反对，这些都是可改变的因素，也是旨在降低自杀风险的公共卫生干预措施的潜在目标。需要提供更多具有文化敏感性的心理健康资源，以减少歧视和污名。
