Augsberger, A., Rivera, A.M., Hahm, C.T., Lee, Y.A., Choi, Y., & Hahm, H.C. (2018). Culturally related risk factors of suicidal ideation, intent, and behavior among Asian American women. Asian American Journal of Psychology, 9(4), 252–261. http://dx.doi.org/10.1037/aap0000146
This study focused on Asian American women—a group often thought to be exempt from racial or cultural struggle due to the pervasive “model minority” myth that portrays Asian Americans as unphased by racism and able to achieve high levels of success (Sue & Morishima, 1982). Researchers specifically examined risk factors of suicidal ideation and intent among young Chinese, Korean, and Vietnamese American women.
Researchers recruited a sample of these women to take part in a culturally informed psychotherapy group called “Asian Women’s Action for Resilience and Empowerment.” Participants were ages 18 to 35, either born outside the United States but raised in the country, or born in the United States to immigrant parents and living in the Greater Boston area. Because the study explored intimate partner violence, being sexually active was also an inclusion criterion.
Out of the 435 women initially screened, 173 met the criteria and responded to the follow-up questions for this study. Participants were screened for any degree of psychological distress, experiences of interpersonal violence in relationships, or other trauma, and were asked about their experiences with suicidal ideation and intent using the Columbia Suicide Severity Rating Scale.
The researchers recorded occurances of suicidal ideation and of specific plans, along with the methods participants planned to use, measured on a scale ranging from “mild lethality” to “extremely high lethality.” The results were analyzed to identify recurring themes.
Of the 173 participants, 110 (64%) reported at least one instance of suicidal ideation in their lifetimes. 101 (58%) reported passive ideation, while 32 (19%) reported experience with suicidal intent. 64 individuals (37%) described a plan for suicide. Of those 64 participants, 36 (56%) described plans of mild lethality, 16 (25%) of moderate lethality, 10 (16%) of high lethality, and two (3%) of extremely high lethality. No significant distinction was found between the different ethnic groups for the severity of ideation or intent.
Researchers identified six precipitants to the women’s suicidal ideation or intent based on the women’s narrative descriptions of their suicidal experiences:
- health concerns
- social isolation
- inability to cope
- pressure to achieve
- controlling parenting
- loss of power in intimate relationships
By analyzing the responses against existing literature, and by consulting Hyeouk Chris Hahm—an expert in Asian American women’s mental health—pressure to achieve, controlling parenting, and loss of power in intimate relationships were each determined to be connected to Asian culture.
Pressure to achieve is often characterized by unrealistic familial or societal expectations and internalization of familial disapproval. Researchers also suggested that it may be linked to an internalization of the model minority myth, though this was not measured.
Controlling parenting often includes parents intensely monitoring the participants’ grades or limiting career options.
Finally, the loss of power in intimate relationships often refers to either parental control over dating or to experiences with abusive or failed relationships in young adulthood. Intimate partner violence was reported among 65% of the women who experienced suicidal ideation or intent.
The researchers concluded that Asian American women exhibiting any of these factors may be at particular risk of suicidal ideation or intent. Given that 64% of participants reported some experience with ideation and 12% reported specific plans or intent (compared with 13.7% and 4.3% of other treatment-seeking Americans, respectively), psychologists may want to carefully assess for these factors when treating Asian American women.
Despite the study’s narrow sample, the researchers recommend active screening for suicidal ideation in young Asian American women and treatment that addresses familial and interpersonal conflict and identity development.