Prospective Risk for Self-Injurious Thoughts and Behaviors among Vulnerable Populations Across the Lifespan
4 - (Sym 3) The Relationship Between Race, Dissociation, and Minority Stressors in Conferring Risk for Suicidal Ideation Among Transgender and Gender Diverse Adults
Friday, November 18, 2022
8:00 AM – 9:30 AM EST
Location: O'Neill, 4th Floor
Keywords: Suicide, Self-Injury, Vulnerable Populations Recommended Readings: Banerjee, D., Kosagisharaf, J. R., & Rao, T. S. (2021). “The dual pandemic” of suicide and COVID-19: A biopsychosocial narrative of risks and prevention. Psychiatry Research, 295, 113577. https://doi.org/10.1016/j.psychres.2020.113577 Lantos, J. D., Yeh, H., Raza, F., Connelly, M., Goggin, K., & Sullivant, S. A. (2022). Suicide risk in adolescents during the COVID-19 pandemic. Pediatrics,149(2): e2021053486. https://doi.org/10.1542/peds.2021-053486
Vullier, L., May, L., Greville-Harris, M., Surman, R., & Moseley, R. L. (2021). The impact of the COVID-19 pandemic on individuals with eating disorders: The role of emotion regulation and exploration of online treatment experiences. Journal of Eating Disorders, 9(10), 1-18. https://doi.org/10.1186/s40337-020-00362-9
Associate Professor Fordham University Bronx, New York
Transgender and gender diverse (TGD) individuals are at high risk for suicide, with TGD people of color (POC) at particularly high risk compared to white TGD individuals (James et al., 2016). Research has not yet examined the role of dissociation in suicidal ideation (SI) among TGD POC, although cisgender POC have higher rates of dissociation than cisgender white individuals (Douglas, 2009) and dissociation is associated with increased risk for suicidality among the general population (Foote et al., 2008). It is also unknown how minority stress impacts the relationship between dissociation and SI among TGD POC, despite minority stress being associated with increased dissociation among POC (Polanco-Roman et al., 2016) and suicidality among TGD people (Wolford-Clevenger et al., 2018). Therefore, the aim of the present research was to investigate whether dissociation mediated the relationship between race and SI severity among a sample of TGD individuals. In addition, the present research examined whether minority stressors (victimization, discrimination, and rejection) served as moderators in the mediation model. TGD adults (n = 180) were recruited online. Participants completed a baseline survey (T1) and one-month follow-up survey (T2). SI severity was measured using the Beck Scale for Suicidal Ideation (Beck & Steer, 1991), minority stress was measured using the Gender Minority Stress and Resilience Measure (Testa et al., 2015), and dissociation was measured using the Dissociative Experience Scale (Bernstein & Putnam, 1986). It was found that T1 dissociation mediated the association between race and T2 SI severity, with POC participants experiencing increased dissociation (a = -.99) and increased dissociation predicting increased T2 SI (b = .43). The direct effect was not significant (c’ = -.35, t = -1.83, p = 0.07); however, the bias corrected bootstrapped indirect effect was significant (ab = -3.84; Bootstrapped 95% CI = -6.52 – (-1.76)). This suggests that TGD POC experience increased dissociation, which subsequently increases SI severity. Furthermore, the minority stressors of victimization, discrimination, and rejection were identified at moderators in the mediation model. Dissociation no longer mediated the relationship between race and SI at low levels of minority stress. These findings have considerable clinical implications, including highlighting the importance of considering how the intersection of race and minority stress may impact suicidality when providing TGD-affirming therapies.