The Role of Intersectionality on Suicidal Ideation in Younger Adulthood
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THE ROLE OF INTERSECTIONALITY ON SUICIDAL IDEATION IN YOUNGER ADULTHOOD David Snoberger III A Thesis Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS December 2020 Committee: Danielle Kuhl, Advisor John Boman IV Jenjira Yahirun © 2020 David Snoberger III All Rights Reserved iii ABSTRACT Danielle Kuhl, Advisor The aim of this study is to provide a comprehensive picture of younger adults and their risks with suicidal ideation, in order to develop more thoughtful interventions. Using Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health, I examined the association between intersectional statuses, discrimination, and suicidal ideation. In addition to using intersectional theory, I draw on minority stress theory to motivate my study. I incorporated a measure of discrimination to accurately examine how endorsing one or more intersectional statuses changes the variation in suicidal ideation of younger adults. I found that sexual minorities, those who are discriminated against, and those who are nonwhite and female report a higher odds of expressing suicidal ideation compared to sexual majorities, those who are not discriminated against, and those who are white and male. I found that discrimination did not moderate or mediate the relationship between intersectional statuses and suicidal ideation. This study underscores the challenges intersectional individuals face when it comes to how discrimination negatively impacts mental health, and specifically, suicidal ideation. iv To the LGBTQ+ community, thank you. v ACKNOWLEDGEMENTS I would like to briefly thank the women in my life that have gotten me to this point. To start, I would like to thank my mom, Jennifer Snoberger, for supporting my dreams beginning at a young age, and giving me the tools to be successful and make this thesis happen in the first place. I would like to thank the amazing professors I had in undergrad, Dr. Laura Lansing, Dr. Elizabeth Mansley, Dr. Julie Smith, and Dr. Mary Shuttlesworth for guiding me through my undergrad journey, for giving me the courage to speak out in class, and to help me grow as a human being. I would like to thank my grad school professors, Dr. I-Fen Lin, Dr. Kara Joyner, Dr. Jenjira Yahirun, and Dr. Danielle Kuhl for helping me to navigate graduate schooling, proofreading my papers, and giving me the confidence to defend my thesis. Finally, I would like to thank my wonderful support system, Brianna Ports, Jordan Morrison, Corrine Wollet, Cheyanne Marsh, Miranda Sweetman, Justina Beard, Brittany Ganser, Marisa Guido, and Taylor Kotsur for being there for me during my highs and lows in my time as a graduate student thus far. I would not be here if it weren’t for the strong women in my life. vi TABLE OF CONTENTS Page INTRODUCTION .................................................................................................................... 1 Early Diagnostic Research on Suicidal Ideation ........................................................... 2 Minority Stress Theory and Suicidal Ideation .............................................................. 3 Intersectionality and Suicidal Ideation.......................................................................... 5 Other Minority Statuses and Intersectionality .............................................................. 8 Current Study ................................................................................................................ 10 HYPOTHESES ......................................................................................................................... 11 DATA AND METHODS ......................................................................................................... 12 MEASURES ............................................................................................................................. 14 Dependent Variable ...................................................................................................... 14 Suicidal Ideation ............................................................................................... 14 Key Independent Variables ........................................................................................... 14 Discrimination................................................................................................... 14 Sexual Minority ................................................................................................ 14 Immigrant Status ............................................................................................... 14 Religious Minority ............................................................................................ 15 Gender Minority................................................................................................ 15 Racial Minority ................................................................................................. 15 Education .......................................................................................................... 15 Control Variables .......................................................................................................... 15 ANALYTIC STRATEGY ........................................................................................................ 17 vii RESULTS ................................................................................................................................. 18 DISCUSSION AND CONCLUSIONS .................................................................................... 20 REFERENCES ......................................................................................................................... 24 APPENDIX A. TABLES .......................................................................................................... 32 Running head: INTERSECTIONALITY AND SUICIDAL IDEATION 1 INTRODUCTION Suicidal ideation (SI) has become an increasingly pervasive issue for younger adults in the United States, with nearly 15 out of every 100,000 25-34 year olds in the United States having thought about suicide beginning in 2009, and this rate has been climbing throughout the decade (American Foundation for Suicide Prevention, 2020). Younger adults face extensive challenges throughout this stage in life, such as the completion of collegiate studies and entering the work force for the first time in their field, raising a family, etc. For many, these challenges come with discrimination and abusive behavior in institutions such as the work force and in neighborhoods, which are strongly associated with negative mental health outcomes such as suicidal behavior (Sutter & Perrin, 2016). For instance, lesbian, gay, bisexual, and transgender (LGBT) younger adults are at increased risk of expressing suicidal behavior compared to their non-sexual minority counterparts (Irwin, et al., 2014), and racial minorities experience microaggressions and other implicit forms of discrimination which are associated with higher rates of suicidal behavior (O’Keefe, et al, 2014). Less known, however, are the mechanisms of SI risk for younger adults ascribing to multiple minority statuses at once. Minority stress theory (Meyer, 2003) argues that negative health outcomes are linked to experiences of prejudice and stigma associated with membership in a minority group. More recent examinations of the plurality of minority statuses, to which many younger adults increasingly belong, reveal how common discriminatory behaviors are (Garnett, et al., 2014), and how these behaviors disproportionately affect LGBT and other minority younger adults. Past research that has examined intersectionality and its relationship with SI has used inaccurate measures of minority status such as additive intersectionality, or simply looking at demographic characteristics of respondents to determine patterns of inequality, which in some ways may be an incorrect marker INTERSECTIONALITY AND SUICIDAL IDEATION 2 of the true experiences that intersectional adults face in the real world (Bowleg, 2008). Additionally, trends of the relationship between younger adult membership in multiple minority statuses and SI have not been explored in a nationally representative sample of younger adults. The aim of this study is to provide a more comprehensive picture of younger adults and their risks with SI in the framework of minority stress and intersectionality to develop more thoughtful interventions. Early Diagnostic Research on Suicidal Ideation The examination of SI, or the wish to commit suicide even though an attempt may not have happened, began with the realization that warning signs existed for individuals who attempted suicide (Beck, et al., 1979). The focus on psychometric instrumentation to examine suicidal behaviors focused on psychological variables associated with suicidality, even acknowledging that, “Although demographic variables are useful to demarcate groups of individuals at high risk for suicide, they have little practical utility in the assessment of a specific individual.” (Beck, et al., p. 344) Thus, one of the most widely used tools to screen individuals at risk of SI could not adequately explore key social or structural correlates that could be related to SI. At around this time, other disciplines began to examine the role that socialization played in SI. Sociologists continued to build on Durkheim’s original (1897) framework of social integration, or the idea that individuals are