Understanding the Suicide Attempts of
Young Latinas
Luis H. Zayas, Ph.D.
Long Island Crisis Center
Breakfast and Educational Forum
March 27, 2015
Not a new phenomenon
 Earliest evidence of Latinas attempting
suicide—late 1950s
 The “Suicidal Fit” South Bronx, NY (Trautman, 1961)






impulsive escapes from stressful situations
ingested pills or household cleansers
disturbances in family relations spouse or mother
no thought of death
not aware of their thoughts
no psychotic symptoms
No public health attention until 1990s
 Research lagged until mid-1980s
 CDC launches Youth Risk Behavior Surveillance
System in 1991
 Proves that Latinas ideate, plan, and attempt more
 Spurred research
 SAMHSA’s National Household Survey on Drug
Abuse (2003)
 Latinas 12-17 at higher risk for attempts than others
 US-born Latinas at higher risk than foreign-born
 Highest risk in small metropolitan areas
% of Adolescent Girls’ Reporting Suicide
Attempts on YRBSS (1995-2013)
19.7
21
18.9
15.9
11.6
10.4
9.4
1991
14.9
15.6
14
15
13.5
11.311.2
1993
10.4
10.8
1995
9
9
1999
White
10.3
7.8
2001
Black
9
10.3
2003
9.9
9.3
9.8
2005
Latinas
7.7
2007
11.1
10.4
10.7
8.8
7.9
8.5
6.5
2009
2011
2013
38.8 million Hispanics in 2010
77% of all Hispanics
Why it Matters:
Core Hispanic States (9)
Emerging Hispanic States (19)
Historical Core: >400,000 in 1990
New Hispanic: >200,000 from1990-10
The Progression:
It starts with sadness or hopelessness, 2013
50
45
40
35
30
25
20
15
10
5
0
White
Black
Hispanic
Female
Both
Genders
Source: CDC, 2014
Then moves to ideation, seriously considering
suicide attempt, 2013
30
25
White
20
15
Black
10
Hispanic
5
0
Female Both Genders
Source: CDC, 2014
Next, making a suicide plan, 2013
25
20
White
15
Black
10
Hispanic
5
0
Female Both Genders
Source: CDC, 2014
Culminating in a suicide attempt, 2013
16
14
12
White
10
Black
8
Hispanic
6
4
2
0
Female Both Genders
Source: CDC, 2012
Suicide Attempts of Adolescent Girls in
Core Hispanic States, 2009
20
10
White
Black
0
Data on California and New Jersey not available
Data on African Americans in Arizona, Colorado, New Mexico not available (insufficient sample)
Latina
Suicide Attempts of Adolescent Girls in
Core Hispanic States, 2011
20
15
10
5
0
Data on California not available
Data on African Americans in Arizona, Colorado, New Jersey New Mexico not available (insufficient sample)
White
Black
Latina
Suicide Attempts of Adolescent Girls in
Core Hispanic States, 2013
25
20
White
15
Black
10
Latina
5
0
Arizona Florida Illinois
New
New
Jersey Mexico
New
York
Texas Puerto
Rico
Data on California not available
Data on African Americans in Arizona, New Jersey New Mexico not available (insufficient sample)
Theoretical Basis to Examine and Treat Latinas
 Adolescent development:
 Autonomy-connection/relatedness
 Need mentors who teach, tutor, guide, inspire
 Development systems theory:
 Reciprocal influence of person and environment
 Family systems theory:
 Cohesion vs. Flexibility
 Communication
 Reciprocal exchange of affection, respect, admiration.
 Emotional attunement to other
 Perspective-taking
Cultural Basis for Research
 Sets variations in family structure, interactions, & childrearing that prime and shape affects
HISPANIC FAMILISM
Obligation to family & individual identity
Enforces traditions, beliefs, family interactions
 Influences psychological representations and affects; sets
limits of tolerance for emotions
 Provides context & rules for interactions (where, when, how,
and how intensely)
 Provides categories & lexicons for emotional expressions
(“idioms of distress”)
Our Research Questions
 Why do some Latinas attempt suicide and others
don’t despite similar characteristics?
 What are the elements in the suicide attempts of
young Latinas?
Our Study
 122 attempters, 88 mothers, 19 fathers
 110 non-attempters, 83 mothers, 17 fathers
 Girls’ average age: 15 years
 Parents’ average education: 10th -11th grade
Familism, Parent-Adolescent Conflict, & Self-Esteem
Total Sample
(N=226)
Attempters
(n=121)
Non-Attempt
(n=105)
SD
M
SD
M
Parent-Adol. Conflict
5.20
4.61
6.59
4.84
3.72
3.85 t(206)=-4.70***
Internalizing
20.67
11.13
25.98
10.70
14.95
8.47 t(212)=-8.31***
Self-Esteem
29.28
5.72
26.85
5.29
31.94
4.95
*p<.05 **p<.01 ***p<.001
SD
t/χ2 Values
M
t(209)=7.20***
Results
 Acculturation
 Attempters and Non-Attempters did not differ
 Teens more acculturated than parents
 Familism
 Attempters and Non-Attempters did not differ
 Teens less familistic than parents
 Affection, Communication, & Support
 Attempters reported lower levels than Non-Attempters
 Attempters rated mothers significantly lower than nonattempters rated their mothers
Mother-Daughter Mutuality/Reciprocity
 Mutuality with mothers
 Attempters lower in mutuality with moms than Non-Attempters
 Girls generally rated mothers lower in mutuality
 Gap greater between attempters/mothers than between nonattempters/mothers
 Attempters’ moms perceive selves to be attuned to
daughters
 Daughters disagree: mothers not attuned
 Non-attempters’ moms perceive selves to be
attuned to daughters
 Daughters agree: mothers pretty much attuned
Why Mother-Daughter Mutuality Matters*
 A one-point increase in measure (MPDQ) of
mutuality is associated with a 57% decrease in the
probability of being an attempter
* insufficient data on fathers
The Crisis Event or Trigger
Prolonged tension between girl and parents
Relations with divorced parents
Household chores; breaking house rules
Perceived favoritism for sibling
 Often about a boyfriend, dating, sexuality—
developmental struggle of autonomy
Privacy and boundaries
Romantic relations
Personal attire
 Intense argument with parents just prior
 Felt guilt at threat to family integrity
Trigger and intense emotional experience
Agitation
Feeling
Trapped
Helpless
Overwhelming, contradictory, emotions
Meaning of the Suicide Act
“I was thinking, ‘Oh, I should just kill myself. I’m not worth it
Self-Punishment anymore.” [16 year-old; blade from a pencil sharpener]
Self-Blame
“I wanted to kill myself. I didn’t want to cause any more
problems. I felt so bad for everything.” [14 year-old; pills]
Emotional
Release
 “I have so much pain inside, it’s kind of like I cry inside…I guess
when I cut myself, I feel like I’m letting endless words or
anything through the blade. I’m taking out my pain.” [16 yearold; razor blade]
Revenge
 “I went to rub it in my mom’s face. I was like, ‘that’s why I
went in to the bathroom and swallowed the bottle of pills.’”
[13 year-old; 11 Tylenol with Codeine]
Control
 “It was like a breath of fresh air for me, cause it’s like my mom
wasn’t the one who was hurting me, like she didn’t have
control over the hurt I felt.” [15 year-old; razor blade]
Simple Conceptual Model for Project
Adolescent
Development
Culture and
Cultural
Traditions
Family
Functioning
Family Sociocultural Environment
Emotional
Vulnerability
Psychosocial
Functioning
Suicide
Attempt
Subjective Experience of
Family Crisis