A mixed methods study of Asian American adolescent suicidality
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Recent national level data have shown higher rates of suicidal ideation and attempt among Asian American adolescents than U.S. adolescents on average. Yet, empirical literature on understanding the phenomenology of Asian American adolescent suicidality is limited, hindering the development of culturally sensitive and appropriate intervention and prevention programs for these youths. Existing theoretical frameworks of suicide are too general to meaningfully inform a complete understanding of suicidality among Asian American adolescents given the complex ways that family, culture, and acculturation processes impact their development. This mixed methods dissertation aimed to understand how socio-cultural/socio-demographic factors(s) and parent-child relationships are associated with suicidality for 1.5/second-generation Asian American adolescents, using a multidimensional conceptual model that integrates factors unique to immigrant/ethnic minority families. Specifically, the three studies examined acculturation, generation, ethnicity, socioeconomic status, parenting practices and values which account for the differential immigration experiences that directly or indirectly impact Asian American adolescents’ mental health and psychological well-being. Three separate studies were conducted using a sample of adolescents who racially identify as Asian/Asian American and who had at least one foreign-born immigrant parent. Study 1 used the California Health Interview Survey data to examine Asian ethnic differences in suicidality and psychological distress. Multiple regression analyses found significant ethnic differences in reports of suicidal ideation and serious psychological distress. Using structural equation modeling and data from the National Longitudinal Study of Adolescent to Adult Health, Study 2 tested whether intergenerational acculturative dissonance (IAD) was associated with adolescent suicidality, and whether the association was mediated by parent-child closeness and parental authoritative decision-making. Results showed that for moderately acculturated parent-child dyads, no IAD was associated with higher odds of adolescent suicidal ideation than highly acculturated dyads with no IAD. There was also a negative association between IAD and parent-child closeness, and no evidence for parent-child closeness or parental authoritative decision-making as mediators. Finally, Study 3 was a qualitative study that used narrative data collected from interviews with young adult Asian American women with self-reported histories of suicidal ideation, attempt, and/or self-harm during adolescence. Thematic analysis using a culturally-informed framework of parent-to-child emotional abuse found several themes describing emotional aggression and neglect. The retrospective accounts of these women also addressed the ways they navigated and coped with these conflictual and difficult relationships with their parents, through acceptance, emotional detachment, and emotional ambivalence. This dissertation highlighted the importance of recognizing the heterogeneity of Asian Americans in research, and the need for better ways to operationalize key constructs such as acculturation and IAD when studying adolescents with immigrant parents. Data that disaggregate Asian American adolescents into ethnic subgroups and additional research are needed to understand the association between IAD and parent-child relationships, and how other types of family processes (e.g., family cohesion) affect Asian American youth mental health. There is a need to expand the mental health workforce with more providers from Asian ethnic backgrounds who must also incorporate a multidimensional framework in their work to increase access to mental health services for Asian American adolescents and their families. It is important for providers, educators, and programs to engage youth early and offer culturally appropriate guidance and coping skills to navigate parent-child relationships and other important developmental contexts.