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In order to accurately identify youth at risk for suicide, it remains crucial to explore the interplay of risk factors that predict suicidal behavior. Thus, the purpose of this study was to explore whether social functioning, a putative risk factor, would be positively associated with symptoms of depression and anxiety in youth with a history of suicide attempts. Additionally, it was postulated that poor social functioning would mediate the relation between depression, anxiety symptoms, and a higher frequency of suicidal ideation among this population. A sample of youth (ages 10–17) with a history of suicide attempts was recruited for this study (N = 507) from three behavioral health clinics in Georgia. Data from this study consisted of questionnaires and clinician-based ratings collected on electronic medical records. Results supported the hypothesis that there is a positive correlation between poor social functioning, depressive, and anxiety symptoms. Furthermore, social functioning mediated the relation between these symptoms and a higher frequency of suicidal ideation. Given the findings of this study, it bears importance to explore how social functioning may impact the onset of suicidal ideation and behavior broadly in youth at risk for suicide. Perhaps designing interventions that improve social functioning among youth with symptoms and anxiety and depression will mitigate future suicide risk.

  • Ellen R. Gutowski

  • Stephanie Freitag

  • Shujing Zhang 

  • Martie P. Thompson

  • Nadine J. Kaslow


Although many African American IPV survivors need services, they often do not access care. Hopelessness may partially explain low rates in help-seeking for this population and serve as a significant barrier to care for African American IPV survivors particularly those who have had prior legal system involvement. In a sample of 185 African American women, we first examined whether hopelessness mediated the relation between IPV and barriers to services. If such a mediation effect was found, we then would explore whether legal system involvement moderated the mediated effect of hopelessness on the relation between IPV and barriers to services. As anticipated, hopelessness partially served to explain (i.e., mediated) the relation between IPV and barriers to services. Further, this mediated effect was moderated by legal system involvement such that when legal system involvement was included as a moderator, hopelessness mediated the association between IPV and barriers to services only for those survivors who had been involved with the legal system. These results underscore the critical role of hopelessness as a barrier to accessing services for African American IPV survivors, especially those with prior involvement with the legal system. Recommendations are offered that underscore the importance of interventions that empower African American women who have survived violence instead of penalizing them.


Accurate identification and assessment of suicide risk requires an understanding of the influence of culture, ethnicity, and race in relation to suicidality. This chapter explores culturally relevant risk and protective factors for suicide, and presents epidemiological data and contextual findings on suicidality across cultures and nationalities. It examines international trends regarding suicide prevalence, as well as the impact of immigration, acculturation, and assimilation on suicide risk. The chapter also describes a model of culturally relevant suicide intervention and prevention strategies, and the differences in attitudes toward suicide and suicide acceptability across cultures. Despite improved treatments for the psychiatric illnesses most associated with suicidal behavior, suicide continues to be a growing problem in the United States and the world. Intervention efforts should stem from a culturally competent approach, and prevention efforts should be guided by culturally relevant risk and protective factors for suicide and attitudes toward suicide among the target population.

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