A Longitudinal Examination of Cultural Risk Factors of Suicide and Emotion Regulation

The present study is a secondary analysis that tested whether difficulties with emotion regulation (DER) would statistically mediate cultural risk factors of suicide and depression symptoms or suicidal behaviors among (a) Black, Indigenous, and People of Color (BIPOC) and (b) lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. BIPOC (n = 246), and LGBTQ (n = 203) participants completed measures on cultural risk factors of suicide, DER, depression symptoms, and suicidal behaviors at three time points from a larger remote randomized controlled trial (RCT). Simple and parallel mediation explored whether there were indirect effects of cultural risk of suicide on depression or suicidal behaviors via DER. Hypotheses were partially supported: simple mediation revealed that cultural risk factors of suicide at Time 1 predicted only depression symptoms at Time 3 via DER at Time 2 among BIPOC (indirect effect = .09, SE = .04, 95% CI [.01, .17]) and LGBTQ individuals (indirect effect = .05, SE = .02, 95% CI [.02, 08]). Parallel mediation revealed an indirect effect of cultural stressors of suicide and depression via lack of emotional awareness, difficulty with goal-directed behavior, and difficulty accessing emotion regulation strategies for BIPOC, whereas it was via difficulties with goal-directed behavior for LGBTQ persons. With replication, these findings support the importance of cultural risk factors when screening for suicide and inform tailoring of psychosocial interventions targeting emotion regulation with BIPOC and LGBTQ individuals. Public Policy Relevance Statement This longitudinal study provides evidence that difficulties with emotion regulation (DER) linked cultural risk factors of suicide and depression symptoms for BIPOC, as well as depression symptoms and suicidal behaviors for LGBTQ individuals. The study also found that each cultural group had unique DER, which can inform tailoring of evidence-based interventions targeting emotion regulation