Christman, S. K. (2019). Using sense of coherence to understand suicidality among American Indian and Alaska Native college students (Doctoral dissertation).

Abstract

The American Indian (AI) and Alaska Native (AN) young adult population consistently experiences the highest suicide rate of all ethnic groups in the United States. Unlike other groups, whose suicide rates peak in middle age, suicide among AI/ANs is most common among college-aged individuals. Previous research focusing on suicide among AI/AN populations is limited in its scope and has focused almost exclusively on reservation-based individuals, despite that the vast majority of AI/ANs now live in urban areas. Examining the experience of suicidality among urban AI/AN young people may contribute to a developed understanding of how to prevent suicide among this unique and unstudied population. As such, this dissertation sought to address the gaps in current knowledge of factors that influence suicidality among urban AI/AN college students. Using multiple linear regression analyses, the current study explored the prevalence of distress and suicidality among this group, as well as the prevalence and importance of common suicide risk factors. Additionally, the protective nature of certain malleable psychological factors, including sense of coherence and mental health, was examined. Results indicated that AI/AN participants had significantly higher rates of distress and suicidality as compared to participants of other races. Additionally, it was found that childhood exposure to familial stressors and abuse were important predictors of distress and suicidality and that similar racial disparities in such exposure exist among urban AI/ANs as is true for reservation-based populations. Sense of coherence and mental health were also strong predictors of distress and suicidality but were unable to buffer against the risk that one acquires through increased exposure to adversity. The current study provides important directions for future research as well as implications for suicide prevention among urban AI/ANs that capitalize on the strength and resilience of this population.