Intersectional Stigma, Belongingness, and Suicide: A Novel Approach for Minority Mental Health.

项目总结 在自杀研究和少数群体心理健康差距领域取得进展的一个关键障碍是缺乏 对高危群体进行适当的概念化。过去的研究表明，移民一代比 比种族/民族分类更有意义的自杀衡量标准。基于来自 全国拉丁裔和亚裔美国人的研究，自杀是一个日益增长的问题，特别是在第二代人中 移民。在所有第二代移民中，有一半是少数族裔，即拉丁裔和亚裔。 亚洲人是唯一一个自杀是导致早期成年人死亡的主要原因的种族/民族。 18-24。在种族/族裔少数群体中，自杀在55岁之前仍然是前五大死因，只有 亚洲人。尽管存在这种差异，但针对自杀的循证研究项目严重匮乏。 通过在种族/少数民族群体中采取基于身份的方法。来自少数民族应激理论的过去证据 表明基于身份的耻辱和自杀之间存在强烈的关联。然而，少数群体压力理论缺乏 一种融合了多种少数人身份的交叉污名视角。修改这一理论，使之包括 交叉污名增强了它对种族/少数民族的适用性，他们中的许多人认为 污名化的亚群。此外，将自杀的人际关系理论与少数民族压力相结合，使科学家能够 从交叉污名的角度探讨归属感导致自杀的途径。建议数 这项研究意味着一个紧迫的研究机会，可以通过这个发现来发现对自杀的新见解 在一个亚裔群体中的创新理论框架。这将在一项试点研究中实施，该研究使用了一种新的 研究设计综合了来自多层次国家、社区和个人数据的复杂方法。这项研究 目的是更好地理解归属感，因为它与自杀有关，从复杂的 交叉污名，特别是在认同多个污名化亚群的早期成年亚洲人(种族， 移民，信仰)，通过以下目标：目标1：测试归属感对 跨部门污名和自杀相关结果(压力、抑郁、自杀意念)在一项全国性样本中 有多种污名化身份的亚洲人；目标2：确定特定身份(种族、移民、信仰)风险和 亚裔社区自杀倾向的复原力因素；目标3：探索归属感的意义 通过对亚洲人的深入访谈，体验跨界别的耻辱。团契 研究目的是对自杀的风险和复原力因素进行假设生成的初步研究。 使用一种与少数族裔特别相关的新方法。团契培训目标为：(1) 熟练掌握心理健康和健康差距研究的高级方法技能；(2)加强 在移民种族/少数族裔群体中进行自杀和精神健康研究方面的专门知识；以及(3) 出版5篇第一作者同行评议的手稿，以推进独立研究事业。建议数 这项研究响应了NIMHD最近提出的针对少数族裔健康差距的创新方法的呼吁。

PROJECT SUMMARY A critical barrier to progress in the fields of suicide research and minority mental health disparities is the lack of appropriate conceptualization of at-risk groups. Past research indicates that immigrant generation is a more meaningful measure of suicidality than racial/ethnic categorization. Based on comprehensive findings from the National Latino and Asian American Study, suicide is a growing concern particularly among second-generation immigrants. Half of all second-generation immigrants are racial/ethnic minorities, namely Latinos and Asians. Asians are the only racial/ethnic group for which suicide is the leading cause of death among early adults age 18-24. Among racial/ethnic minorities, suicide remains a top five leading cause of death until age 55 only in Asians. Despite this disparity, there is a severe dearth of evidence-based research initiatives targeting suicide through an identity-based approach in racial/ethnic minority groups. Past evidence from minority stress theory suggests strong associations between identity-based stigma and suicide. However, minority stress theory lacks an intersectional stigma perspective incorporating multiple minority identities. Adapting this theory to include intersectional stigma enhances its applicability to racial/ethnic minorities, many of whom identify with multiple stigmatized subgroups. Moreover, merging the interpersonal theory of suicide to minority stress allows scientists to investigate the pathway of belongingness to suicide from an intersectional stigma perspective. The proposed study signifies a pressing research opportunity to uncover new insights on understanding suicide through this innovative theoretical framework in a subgroup of Asians. This will be implemented in a pilot study using a novel study design integrating complex methods from multi-level national, community, and individual data. The study purpose is to better understand belongingness as it relates to suicide from the complex perspective of intersectional stigma, particularly in early adult Asians who identify with multiple stigmatized subgroups (ethnicity, immigrant, faith), through the following aims: Aim 1: To test the potential mediating effect of belongingness to intersectional stigma and suicide-related outcomes (stress, depression, suicidal ideation) in a national sample of Asians with multiple stigmatized identities; Aim 2: Identify identity-specific (ethnicity, immigrant, faith) risk and resilience factors of suicidality in an Asian community; Aim 3: Explore the meaning of belongingness from the lived experience of intersectional stigma through in-depth interviews with Asian individuals. The fellowship research objective is to conduct a hypothesis-generating pilot study on the risk and resilience factors of suicide using a novel approach that is especially relevant to racial minorities. The fellowship training goals are to: (1) gain proficiency in advanced methodological skills for mental health and health disparities research; (2) enhance expertise in conducting suicide and mental health research in immigrant racial/ethnic minority groups; and (3) Publish 5 first author peer-reviewed manuscripts to advance an independent research career. The proposed study responds to NIMHD’s recent calls to produce innovative approaches for minority health disparities.