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JBPXXX10.1177/0095798414525967Journal of Black PsychologyKlibert et al.

Article
Journal of Black Psychology
2015, Vol. 41(3) 272­–295
Cross-Cultural and © The Author(s) 2014
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DOI: 10.1177/0095798414525967
Models of Suicide Risk jbp.sagepub.com

Jeffrey Klibert1, K. Nikki Barefoot1,

Jennifer Langhinrichsen-Rohling2, Jacob C. Warren3,
and K. Bryant Smalley1

Abstract
Only a handful of empirical investigations have identified culturally salient
markers of suicide risk within samples of African American young adults. To
address this gap, our study examined the intercorrelations among cultural
congruity, defectiveness schemas, and multiple indices of suicide risk for African
American (n = 207) and European American (n = 208) students attending a
primary White institution. Cultural congruity was negatively associated with
reports of interpersonal and behavioral suicide risk for both African and
European American students. However, ethnic differences in the magnitude of
these relationships emerged. Specifically, as predicted, for African Americans,
lower levels of cultural congruity were more strongly related to greater
interpersonal factors associated with a desire to die. Finally, the relationships
between cultural congruity and multiple indices of suicide risk were partially
mediated by defectiveness schemas for both African and European American
students, suggesting a useful intervention target for students. These results
also have implications for suicide screening, prevention, and intervention
strategies directed toward African American students.

Keywords
cultural congruity, defectiveness schemas, suicide risk

1GeorgiaSouthern University, Statesboro, GA, USA

2University
of South Alabama, Mobile, AL, USA
3Mercer University, Macon, GA, USA

Corresponding Author:
Klibert, Georgia Southern University, Box 8041, Statesboro, GA 30460, USA.
Email: [email protected]

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Klibert et al. 273

Although theorists strongly assert that the interaction between ethnicity and
environmental stress serves as a trigger for suicide behaviors, few researchers
offer cross-cultural comparisons that delineate how suicide risk varies across
ethnic groups. Instead, the bulk of the suicide literature considers risk from a
European American perspective with little thought directed toward identify-
ing suicide markers unique to predominant ethnic groups in the United States
(Langhinrichsen-Rohling, Friend, & Powell, 2009). Inattention to processes
that consider how the interactive effects of ethnicity and environmental stress
promote suicide has impeded the development of culturally sensitive screen-
ing, prevention, and intervention efforts (Chu, Goldblum, Floyd, & Bongar,
2010), especially in regard to African American youth aged 18 to 24 for
whom suicide is the third leading cause of death (Centers for Disease Control
and Prevention, 2012).
African American suicide remains inadequately understood (Walker,
Wingate, Obasi, & Joiner, 2008) perhaps due to misinterpretations of mortal-
ity statistics and self-report assessments that suggest that African Americans
(5-6/100,000) have a considerably lower rate of suicide compared to European
Americans (12/100,000; American Association of Suicidology, 2011).
Interpreting mortality statistics and self-report ratings as an assessment of
risk can be misleading in two important ways. Namely, the accuracy by
which suicides are recorded is subject to underreporting and misclassifying
errors (Chu et al., 2010; Rockett et al., 2010). For instance, ethnic minorities
are more likely to engage in “hidden ideation,” a concept coined by Chu et al.
(2010) to describe the tendency to conceal the desire and willingness to
engage in suicide behaviors on self-report questionnaires and interviews.
Mortality statistics also offer a restricted definition of suicide that considers
only one outcome, the act of taking one’s own life. Instead recent theory
recommends that suicidal behavior be defined along a continuum (Lewinsohn,
Langhinrichsen-Rohling, Langford, & Rohde, 1995). The continuum begins
with thoughts of death and dying and a desire to engage in risk-taking behav-
iors. It progresses to suicide ideation, plans to attempt suicide, and eventually
suicide attempts. Identifying individuals who are engaging in behaviors at
early points along the continuum (e.g., intervening with risk-taking and inter-
personal correlates of suicide behavior) has been identified as an important
screening and prevention strategy; especially since suicide completion is a
relatively low base rate behavior (Langhinrichsen-Rohling, Klibert, &
Williams, 2011).
Examining risk outcomes at earlier points on the suicidal trajectory is also
consistent with culturally sensitive practices of suicide assessment. According
to Chu et al.’s (2010) cultural model of suicide, consideration for alternative
forms of suicide thought and intent (i.e., social discord, risk-taking behavior)

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274 Journal of Black Psychology 41(3)

is an essential step in explicating cultural variation of suicide risk in and

among different ethnic groups. Few researchers, to date, have investigated
ethnic disparities on interpersonal and risk-taking components of suicide.
Preliminary evidence from these studies indicate that few meaningful differ-
ences exist on interpersonal and behavioral measures of suicide risk between
African American and European American youth (Davidson & Wingate,
2011); however, more research is needed to confirm these findings.

Integrative Theory of Suicide Risk

Suicide risk consists of a constellation of factors that increase the willingness
by which an individual will consider and engage in suicide attempts
(Langhinrichsen-Rohling et al., 2011). Based on the recommendations of
Klibert, Langhinrichsen-Rohling, Luna, and Robichaux (2011), it is impor-
tant to assess suicide risk from an integrative perspective that considers con-
structs related to suicidal desire and the capability to enact self-injury.
Joiner’s (2005) Interpersonal Theory of Suicide and Lewinsohn et al.’s
(1995) Suicide Proneness Model work in concert to produce a robust means
of assessing suicide risk, especially for ethnically diverse groups (Davidson
& Wingate, 2011). Joiner’s Interpersonal Theory is a tripartite model of the
processes underlying the development and maintenance of suicidal behavior
(Van Orden, Cukrowicz, Witte, & Joiner, 2012). According to Joiner’s the-
ory, sustained co-occurrence of two core interpersonal factors, thwarted
belongingness and perceived burdensomeness, contribute to the development
of a desire for death by suicide. Thwarted belongingness represents an unmet
need related to a person’s sense of connectedness to familial, social, and cul-
tural groups, whereas perceived burdensomeness represents failed attempts
to achieve a sense of effectiveness or social competence in one’s primary
support network (Van Orden et al., 2012). Although these factors are salient
features in a moderate proportion of suicide notes (Joiner et al., 2002) and
demonstrate the capability to predict suicide ideation (Christensen, Batterham,
Soubelet, & Mackinnon, 2013), they are not thought to be sufficient to pro-
voke lethal suicide behavior (Van Orden et al., 2012).
Instead, interpersonal factors only contribute to lethal suicide behavior
when they simultaneously occur with Joiner’s (2005) third component to sui-
cide risk, an acquired capability to enact self-injury. An acquired capability
is characterized by a heightened degree of pain tolerance and fearlessness
that work in tandem to deactivate preservation instincts and perceptions of
alarm associated with suicide behavior (Van Orden, Witte, Gordon, Bender,
& Joiner, 2008). Joiner posits that prolonged exposure to painful (physical
and emotional) and provocative events over time can habituate an individual

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Klibert et al. 275

to the necessary levels of pain tolerance and fearlessness to initiate and com-
plete a lethal suicide attempt. Painful behaviors directly affiliated to suicide,
such as self-injury and previous suicide attempts, are the most efficient means
of cultivating an acquired capability; however, indirect risky behaviors (e.g.,
violence, sensation seeking) that occur with greater frequency are also impor-
tant in the development of an acquired capability (Smith & Cukrowicz,
2010). For instance, substance use, often a same day correlate of suicide, may
facilitate the necessary fearlessness to attempt to end one’s life.
The latter position mirrors the work of Lewinsohn et al. (1995), who theo-
rized and empirically investigated an individual’s propensity to engage in
future suicide behavior. According to Rohde, Lewinsohn, Seeley, and
Langhinrichsen-Rohling (1996), most instruments assess suicide behaviors
that occur at a high threshold of severity (e.g., suicide attempts). Such focus
often neglects consideration of life-threatening/risky behaviors (e.g., sub-
stance abuse, self-injury, social deviance), all of which are salient factors in
the etiology of youth suicide (Esposito, Spirito, & Overholser, 2003). These
behaviors may also be important prevention targets. In addition, most assess-
ments possess strong associations with cognitive, affective, and interpersonal
components of suicide, overlooking research suggesting that these compo-
nents are neither necessary nor sufficient in predicting actual suicide attempts
(Holden, Mendonca, & Serin, 1989). In response to these limitations,
Lewinsohn et al. (1995) developed the Life Attitudes Schedule (LAS) and
Life Attitudes Schedule–Short Form (LAS-SF) as a means to capture unique
components of suicide behavior not otherwise accounted for by cognitive,
affective, and interpersonal components. Item content of the LAS and
LAS-SF was designed to extract clusters of subtle or covert life-threatening
behaviors, as well as behaviors that are overtly suicidal (Rohde, Seeley,
Langhinrichsen-Rohling, & Rohling, 2003). Included within these clusters
are a number of behaviors (e.g., smashing a fist into a window, going on
drinking sprees) that are known to promote associated features (e.g., greater
levels of pain tolerance and fearlessness; Joiner, 2005) of an acquired capa-
bility to enact self-injury. In support of this theory, suicide prone behaviors
have been shown to correlate with recent suicide ideation and a history of
suicide ideation and attempts (Langhinrichsen-Rohling & Lamis, 2008).
Traditional symptoms of suicide (e.g., hopelessness, depression, etc.) are
not as salient in the prediction of future suicide behaviors among African
Americans when compared to European Americans (Abe, Mertz, Powell, &
Hanzlick, 2006), making it difficult to use most existing assessment strate-
gies aimed at identifying risk. In addition, differing expressions of suicide
may be steeped in unique cultural dynamics, intentions, and motivations
(Klibert et al., 2011), which in turn, may contribute to complications in risk

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276 Journal of Black Psychology 41(3)

assessment strategies. Thus, it is important to examine interpersonal (desire

to die) and behavioral (suicide proneness) components of suicide behavior in
conjunction with one another to generate a more robust and culturally sensi-
tive assessment of suicide risk.

Identifying Culturally Salient Markers to Suicide Risk

For African Americans, quality of life is often determined by perceptions of
cultural fit between individuals’ personal values and the values espoused
within the environment they operate (also known as cultural congruity;
Gloria & Robinson-Kurpius, 1996). Many challenges exist for African
Americans seeking high levels of cultural congruity in the United States, as
institutions prevalent in U.S. society often endorse a monocultural frame-
work that is consistent with European American, masculine, and middle-
class values (Gloria, Hird, & Navarro, 2001). Notably, microaggressions,
marginalization, and acculturation difficulties are all prominent stressors that
African Americans disproportionally encounter in their attempts to adapt to
majority dynamics (Constantine, Smith, Redington & Owens, 2008; Venzant-
Chambers, 2009). Prolonged exposure to such challenging stressors facili-
tates a sense of cultural incongruity marked by feelings of underappreciation
and lower levels of cultural, social, and psychological wellness (Constantine
& Watt, 2002; Pieterse, Todd, Neville, & Carter, 2011), which has the poten-
tial to generate interpersonal and behavioral risk to suicide.
Specifically, dissonance between cultural values and environmental pres-
sures to assimilate may engender overwhelming emotional distress high-
lighted by a sense of isolation or burdensomeness (e.g., De Hoyos & Ramirez,
2007; Walker, 2007). Some previous work has supported this position. For
instance, Chao, Mallinckrodt, and Wei (2012) examined co-occurring pre-
senting problems in 1,777 African American counseling center clients.
Results indicated that ethnically induced distress was positively related to a
number of interpersonal concerns associated with thwarted belongingness,
including difficulties connected with familial relationships, peer relation-
ships, forming new friendships, and homesickness. Similarly, Constantine,
Robinson, Wilton, and Caldwell (2002) found that cultural incongruity was
positively associated with burdensomeness features including perceptions of
ineffectiveness regarding membership in social groups.
Similarly, an inhospitable and unwelcoming environment may also foster
engagement in life-threatening and risky behaviors common among individu-
als with an acquired capability to die by suicide. Psychosocial detriments
associated with cultural incongruity (e.g., discrimination) have been shown

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Klibert et al. 277

to consistently predict increases in unhealthy behaviors over time for African

Americans (Gibbons, Gerrard, Cleveland, Wills, & Brody, 2004). Gibbons et
al. (2012) extended our understanding of these associations by experimen-
tally examining the relationships among racial discrimination, impulse con-
trol, and features of substance use. Their results highlighted an indirect
relationship between racial discrimination and substance use through reduced
impulse control, suggesting that the cumulative effects of discrimination
reduce the potential to employ effective self-control strategies, which in turn
precipitates a greater proclivity to engage in more risky and life-threatening
behaviors (e.g., substance use). Taken as a whole, these results suggest that
operating in a culturally incongruent environment may have detrimental
effects that may increase risk to suicide. However, direct relationships
between cultural congruity and indices of suicide risk have yet to be estab-
lished for African American adults.

Defectiveness as a Potential Mediator

Multicultural theories posit that the relationship between cultural stressors
and psychopathological outcomes may be mediated through cognitive-
affective variables (Pyke, 2010; Szymanski, Kashubeck-West, & Meyer,
2008). The literature on internalized oppression supports this position, citing
the insidious effects hostile environments have on an individual’s percep-
tion of self and how these perceptions provoke negative psychological out-
comes (Szymanski et al., 2008). Culturally incongruent environments may
contribute to and perpetuate chronic feelings of self-blame, disgust, and dis-
respect that distort one’s self-concept (Pyke, 2010). Interestingly, similar
clusters of cognitive-affective variables underlie Young, Klosko, and
Weishaar’s (2003) defectiveness schema, which reflects broad and perva-
sive themes of insecurity and inferiority. Considering that the common esti-
mates of self-worth (e.g., self-esteem measures) do not consider a diverse
range of cognitive and affective components associated with perceptions of
self-concept, defectiveness schemas may be a more robust mechanism to
explain the relationship between cultural incongruity and psychological dif-
ficulties among African Americans. Moreover, Klibert, Barefoot, Smalley,
and Warren (2014) found evidence suggesting that defectiveness schemas
predict moderate to large amounts of variance in both interpersonal and
behavioral components of suicide risk over time. In combination, these find-
ings provide theoretical evidence for the potential mediational role of defec-
tiveness schemas in explaining the relationships between cultural congruity
and indices of suicide risk.

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278 Journal of Black Psychology 41(3)

Current Study
The purpose of the current study was to investigate gender and cross-cultural
differences (African American vs. European American students) in suicide
risk. Research citing gender and ethnic differences in suicide rates has been
hampered by underreporting errors (Rockett et al., 2010). To address this
limitation, researchers (i.e., Chu et al., 2010) have endorsed conducting stud-
ies to examine gender and ethnic differences on alternative measures of sui-
cide desire and intent that may more accurately capture culturally sensitive
expressions of risk. As a result, the first goal of the current study was to
examine gender and ethnic differences on two unique measures of suicide
risk (interpersonal factors associated with a desire to die and suicide prone-
ness). Additionally, an emerging line of research has focused on the identifi-
cation of culturally salient correlates of suicide risk across ethnic groups.
Classic correlates of suicide risk (e.g., depression, hopelessness) appear less
predictive of future suicide behavior for African American versus European
American students (Abe et al., 2006). As a result, it is important that research-
ers identify culturally salient correlates to African American risk so that more
culturally sensitive practices associated with suicide prevention and interven-
tion can be developed and refined. Given this need, the second goal of the
current study was to examine the relationships between cultural congruity
and two measures of suicide risk for African American as well as European
Americans students. Also considering the large percentage of African
Americans students who report experiencing a discriminating event (98.5%;
Prelow, Mosher, & Bowman, 2006) and the deleterious effects of accultura-
tive stress on mental health (Walker, 2007), there may be some ethnic varia-
tion by which cultural congruity is related to indices of suicide risk. As a
result, the third goal of the study was to examine ethnic differences in the
associations between cultural congruity and indices of suicide risk. Finally,
theorists suggest that models of suicide have not been framed from a multi-
cultural context (Chu et al., 2010), which again limits the development of
culturally sensitive prevention and assessment strategies to suicide.
Multicultural theories (i.e., Pyke, 2010) posit that culturally incongruent
environments may influence the development of cognitive-affective themes
of inferiority and insecurity, which in turn may promote negative psychologi-
cal outcomes. To date, no known study has examined the fit of this model to
predict suicide risk in a sample of ethnically diverse students. To address this
gap, the fourth goal of the current study was to examine cultural congruence-
suicide risk relationships in the context of a third mediating variable, defec-
tiveness schemas, in a sample of African American students.

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Klibert et al. 279

Given the current literature, the hypotheses for the current study were the
following: (a) minimal differences in self-reported measures of suicide risk
(i.e., interpersonal factors associated with a desire to die, suicide proneness)
would be reported between African American and European American col-
lege students; (b) cultural congruity would be inversely related to reports of
interpersonal and behavioral risk for both African American and European
American students; (c) the relations between cultural incongruity and suicide
risk would be stronger for African Americans as compared to European
Americans; and (d) defectiveness schemas would at least partially mediate
the relationships between cultural congruity and the indices of suicide risk,
especially for African American students.

Method
Participants
Participants included 487 (293 women and 194 men) students from a Primary
White Institution (PWI) in the southeastern region of the United States. All
interested students were invited to participate in the study through the univer-
sity’s subject pool and received one course credit for their time. The age of
the participants ranged from 18 to 26, with an average age of 19.55 (SD =
1.46). In terms of ethnicity, only participants who self-identified as European
American and African American were included in the analyses. Two hundred
and eight participants self-identified as European American (57.5%), and 207
participants self-identified as African American (42.5%). These characteris-
tics, including the preponderance of women, are similar to the demographics
of this university’s psychology participation pool.

Measures
Life Attitudes Schedule–Short Form (LAS-SF). The LAS-SF (Lewinsohn, Lang-
hinrichsen-Rohling, Rohde, & Langford, 2004) is a 24-item true-false ques-
tionnaire designed to measure behaviors known to increase the likelihood of
future suicide ideation, attempts, and completions. Total LAS-SF scores
range from 0 to 24, with higher scores indicating greater suicide proneness.
The LAS-SF total score has demonstrated solid internal consistency (α = .78)
with college student samples (Lewinsohn et al., 2004) and high construct
validity as evidenced by moderately high relationships with measures of
risky behaviors and reports of previous suicide attempts among college stu-
dents (Rohde et al., 2003). Similarly, in the current study, the LAS-SF total
score (α = .74) demonstrated adequate internal consistency.

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280 Journal of Black Psychology 41(3)

Interpersonal Needs Questionnaire (INQ). The INQ (Van Orden et al., 2008) is
a 12-item questionnaire. It was designed to measure an individual’s desire to
die as reflected by a perceived lack of connection to others as well as by
overwhelming feelings of burdensomeness. Participants were asked to indi-
cate the extent to which each statement was recently true for them using a
7-point Likert-type scale (1 = Not at all true for me to 7 = Completely true for
me). INQ total scores range from 0 to 84, with higher scores indicating greater
interpersonal factors associated with a desire for death by suicide. Consider-
ing that the most dangerous form of suicide desire arises from the simultane-
ous presence of thwarted belongingness and perceived burdensomeness (Van
Orden et al., 2012), an INQ total score was calculated and used within the
current study. Klibert et al. (2014) found high internal consistency (α = .92)
and test-retest reliability (α = .68) for the INQ total score in college student
samples. In addition, the INQ total score has demonstrated excellent con-
struct validity with measures of perceived stress and suicide proneness across
time (Klibert et al., 2014). In the current study, the INQ total score (α = .92)
demonstrated high internal consistency.

Cultural Congruity Scale (CCS). The CCS (Gloria & Robinson-Kurpius, 1996)
is a 13-item measure designed to assess for the perceived fit between an indi-
vidual’s cultural values and traditions and the cultural climate of the environ-
ment in which he/she operates. The CCS asks participants to rate their
perceptions of cultural fit with their campus climate (e.g., “I feel that my
language and/or appearance make it hard for me to fit in with other students”)
on a 7-point Likert-type scale (1 = Not at all, 7 = A great deal). Total scores
on the CCS range from 13 to 91, with higher scores indicating greater per-
ceived cultural congruity. The CCS has been shown to have adequate reli-
ability (α =.82) and excellent construct validity with measures of help-seeking
behavior (Gloria et al., 2001; Gloria, Robinson Kurpius, Hamilton, & Will-
son, 1999) among diverse samples of college students. In the current sample,
the CSS total score demonstrated solid internal consistency (α = .79).

Young Schema Questionnaire–Long Form 2nd Revision (YSQ-L2). The YSQ-L2

(Young, 2005) consists of 205 items that measure pervasive and debilitative
themes of cognitive-affective functioning. In total, the YSQ-L2 contains 15
early maladaptive schema subscales. However, for the purposes of this study,
only the defectiveness schema subscale score (n = 15) was calculated. Indi-
viduals were asked to respond to a series of statements by rating their agree-
ment/disagreement using a 6-point Likert-type scale. Total scores on the
defectiveness schema subscale range from 15to 90, with higher scores indicat-
ing greater adherence to cognitive-affective themes associated with insecurity

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Klibert et al. 281

and inferiority. The defectiveness schema subscale has demonstrated solid

internal consistency (α = .84) and high construct validity with academic,
social, and emotional adjustment difficulties in college students (Cecero, Bei-
tel, & Prout, 2008). In the current sample, the defectiveness schema demon-
strated high internal consistency (α = .92).

Procedure
Data were collected anonymously through an online survey. Undergraduates
voluntarily provided their informed consent before responding to the set of
questionnaires. Participants took approximately 50 minutes to complete the
online survey. On completion of the survey, all participants were taken to a
debriefing page where they were offered free to low cost mental health ser-
vices and thanked for their participation. Ethical guidelines were followed in
the collection of these data, and institutional review board approval was
obtained prior to data collection.

Data Analytic Plan

To test our hypotheses, the following data analytic strategies were executed.
First, a 2 (gender) × 2 (ethnicity) factorial MANOVA was conducted to
determine if there were group differences on the two measures of suicide risk.
Next, tests of zero-order correlations were examined to determine the rela-
tionships among the study’s variables separately by ethnic group (African
American vs. European American). Zero-order correlations were then ana-
lyzed using Fisher’s r to z analyzes to determine significant differences in the
strength of the obtained relationships for African American versus European
American students. Finally, a series of ordinary least square multiple regres-
sions were analyzed to assess the mediating effects of defectiveness schemas
on the cultural congruity-suicide risk relationships for African American and
European American students separately. In total, four mediation models were
evaluated based on the general guidelines outlined by Baron and Kenny
(1986). Specifically, mediation is established when four conditions are met:
(a) the predictor variable (cultural congruity) must be significantly related to
the outcome variable (suicide risk); (b) the predictor variable (cultural con-
gruity) must be significantly related to the proposed mediating variable
(defectiveness schemas); (c) the proposed mediating variable (defectiveness
schemas) must be related to the outcome variable (suicide risk) when control-
ling for the predictor variable (cultural congruity); and (d) the significant
relationship between the predictor variable (cultural congruity) and the out-
come variable (suicide risk) must be attenuated by the proposed mediating

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282 Journal of Black Psychology 41(3)

variable (defectiveness schemas). If these conditions are met, two types of

mediating effects are possible, full and partial mediation. Full mediation is
indicated when a proposed mediating variable completely attenuates the rela-
tionship between the predictor and outcome variable. Alternatively, partial
mediation occurs when the presence of the proposed mediator accounts for a
significant portion, but not all, of the covariance between the predictor and
outcome variables. As a supplement to the regression models, Sobel’s z tests
(1982) were conducted to determine if the proposed mediator accounted for
a significant portion of the covariance between the predictor and outcome
relationships.

Results
Mean Difference and Correlational Analyses
Mean Differences on Suicide Risk. A 2 gender (women vs. men) × 2 ethnicity
(African American vs. European American) MANOVA was conducted to
investigate ethnic differences among the two suicide indices (i.e., interper-
sonal factors associated with a desire to die and suicide proneness). Results
yielded a significant overall main effect for ethnicity Wilks’s Λ(1, 480) =
3.31, p = .037, η2 = .02. However, nonsignificant effects for gender, Wilks’s
Λ(1, 480) = .92, p = .14, η2 = .01, and the gender by ethnicity interaction,
Wilks’s Λ(1, 480) = .99, p = .791, η2 = .01, were revealed. For ethnicity, there
was significant main effect on suicide proneness, F(1, 482) = 5.47, p< .05,
η2 = .01, such that African American students (M = 5.22, SD = 3.31) reported
engaging in less life-threatening behaviors than did European American stu-
dents (M = 5.98, SD = 3.65). Overall, ethnicity main effects were not obtained
for self-reported interpersonal factors associated with a desire to die.

Univariate Correlations. Zero-order correlations were computed to examine

the relationships among cultural congruity, defectiveness schemas, and indi-
ces of suicide risk for African American and European American students
independently. Means, standard deviations, and the intercorrelations among
the study’s main variables are presented in Table 1. Intercorrelations revealed
medium effect sizes for both African American and European American stu-
dents. All of the intercorrelations examined were in the expected directions.

Ethnic Differences Among Univariate Correlations. Based on the literature, it

was expected that lower rates of cultural congruity would be associated with
greater reports of insecurity and inferiority and higher levels of suicide risk
for African American students more than for European American students.

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Klibert et al. 283

Table 1. Means, Standard Deviations, and Intercorrelations Among Measures

of Cultural Congruity, Defectiveness Schemas, and Suicide Risk in European and
African Americans Students.

Variable 1 2 3 4 M SD
1. Cultural Congruity — −.55** −.44** −.60** 75.75 12.64
2. Desire to Die −.37** — .55** .64** 20.34 11.46
3. Suicide Proneness −.32** .50** — .51** 5.22†† 3.31
4. Defectiveness Schemas −.36** .60** .45** — 28.29 12.42
M 75.28 20.33 5.98†† 28.98
SD 10.45 10.98 3.65 11.91

Note: Mean scores and correlations in bold represent data for African American students.
**Correlation is significant at the .01 level.
††Significant mean differences between African American and European American students at

.05 level.

Table 2. Comparison of Correlational Coefficients Between Cultural Congruity

and Measures of Suicide Risk and Defensiveness by Ethnic Group.

European
African American American cultural
Correlations cultural congruity congruity r to z score p Value
Desire to Die −.55 (n = 203) −.37 (n = 277) 2.44 <.05
Suicide Proneness −.44 (n = 204) −.32 (n = 279) 1.49 >.05
Defectiveness Schemas −.60 (n = 204) −.36 (n = 279) 3.30 <.01

To test these hypotheses, Fisher’s r to z analyses were performed to deter-

mine if significant differences existed in the magnitude of these relationships
between ethnic groups. Results are presented in Table 2. Of note and as pre-
dicted, lower rates of cultural congruity were more strongly related to greater
reports of interpersonal factors associated with a desire to die and cognitive-
affective themes of insecurity and inferiority for African American as com-
pared to European American students. There was no difference in the strength
of the cultural congruity-suicide proneness relationship between ethnic
groups.

Mediation Models
All variables were associated to a significant degree, meeting Baron and
Kenny’s (1986) four conditions to construct mediation models. As a result,
four series of ordinary least square multiple regressions were conducted to
examine the potential mediating effects of defectiveness schemas on the

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284 Journal of Black Psychology 41(3)

Figure 1. Results of indirect and direct paths for African Americans in Models 1(a)
and 1(b). Results of indirect and direct paths for European Americans in Model 2(a)
and 2(b).
Note: Defectiveness schema is the potential mediator in the association between cultural
congruity and two indices of suicide risk. All numbers reflect standardized beta weights
(**p< .01). The beta weight in the parentheses reflects the direct path between cultural
congruity and measures of suicide risk.

relationships between cultural congruity and indices of suicide risk for

African American and European American students. Considering that two
indices of suicide risk (interpersonal factors associated with a desire to die
and suicide proneness) were under investigation, two separate mediation
models were constructed for each ethnic group. The results of the path analy-
ses are presented in Figure 1.

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Klibert et al. 285

For African American respondents, the inclusion of the defectiveness

schema attenuated (Δβ = .31; Sobel’s Z = 7.83, p< .01) the relationship
between cultural congruity and interpersonal factors associated with a desire
to die by suicide. However, even after considering the impact of defectiveness
schemas, the relationship between cultural congruity and interpersonal factors
associated with a desire to die was still significant (β = −.24, p< .01), suggest-
ing partially mediated effects. The linear combination of cultural congruity
(b = −.24, p< .01) and defectiveness schemas (b = .51, p< .01) predicted 47%
of the variance in interpersonal factors associated with a desire to die by sui-
cide in the final step of the path model, F(2, 200) = 88.78, p< .01. Similar
results were revealed in examining the relationship between cultural congruity
and suicide proneness in African American students. Notably, defectiveness
schemas significantly reduced the strength of the path between cultural con-
gruity and suicide proneness (Δβ = .24; Sobel’s Z = 6.64, p< .01). Again,
defectiveness schemas only partially mediated this relationship as the direct
path between cultural congruity and suicide proneness remained significant
(β = −.20, p< .01) even after accounting for the mediating effects. The linear
combination of cultural congruity (b = −.20, p< .01) and defectiveness sche-
mas (b = .40, p< .01) predicted 30% of the variance in suicide proneness
scores in the final step of the path model, F(2, 201) = 42.89, p< .01.
Defectiveness schemas also attenuated the path between cultural congru-
ity and interpersonal factors associated with a desire to die by suicide (Δβ =
.19; Sobel’s Z = 5.73, p<.01) for European American students. Likewise,
considering that the direct path between cultural congruity and interpersonal
factors associated with a desire to die by suicide (β = −.18, p< .01) was sig-
nificant after controlling for the mediated effects, only partial mediation was
obtained. The linear combination of cultural congruity (b = −.18, p< .01) and
defectiveness schemas (b = .54, p< .01) predicted 39% of the variance in
interpersonal factors associated with a desire to die by suicide in the final step
of the path model, F(2, 274) = 86.74, p< .01 (as compared to 47% of the vari-
ance for African American students). Last, the direct path between cultural
congruity and suicide proneness was also significantly reduced in the path
analysis (Δβ = .14; Sobel’s Z = 5.11, p< .01) after controlling for the effects
of defectiveness schemas. However, the model only revealed partially medi-
ated effects as the relationship between cultural congruity and suicide prone-
ness (β = −.18, p< .01) was still significant after accounting for defectiveness
schemas. The linear combination of cultural congruity (b = −.18, p< .01) and
defectiveness schemas (b = .38, p< .01) predicted 23% of the variance in
suicide proneness scores in the final step of the path model for European
American students, F(2, 276) = 41.43, p< .01 (as compared to 30% of the
variance for African American students).

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286 Journal of Black Psychology 41(3)

Discussion
The current literature reports mixed findings regarding variation in self-
reported suicide risk between African American and European American col-
lege students. As a result, the current study examined mean differences
between African American and European American students on two highly
regarded indices of suicide risk. Overall, on a positive note, both African
American and European American students reported low levels of interper-
sonal factors associated with a desire to die and suicide proneness. Moreover,
only minimal differences in suicide risk emerged between African American
and European American students. For instance, African Americans expressed
similar levels of interpersonal factors (thwarted belongingness and perceived
burdensomeness) when compared to European Americans, confirming previ-
ous findings (Davidson & Wingate, 2011). In addition, African American
students (M = 5.22) reported significantly lower suicide proneness scores
compared to European American students (M = 5.98), though the difference
may not hold much practical significance (η2 = .01). Taken as a whole, these
findings suggest that African Americans express suicide risk almost as fre-
quently as European Americans among samples of college students and sup-
port Davidson and Wingate’s (2011) empirical results suggesting that few, if
any, meaningful differences in self-reported suicide risk exist between
African American and European American students.
However, these findings stand in contrast to a large body of literature sug-
gesting that African Americans are at a decreased risk for suicidal behavior
(e.g., attempts, completions; Wenzel et al., 2011). How researchers measure
suicide risk may be an important factor in explaining these discrepancies. It
is important to note that in our study and other similar studies (e.g., Davidson
& Wingate, 2011) suicide risk was measured by more subtle and indirect
assessments. This is an important contribution to the literature as most empir-
ical investigations of ethnic disparities in suicide assess risk examine more
direct behaviors (e.g., suicide ideation and attempts). According to Chu et al.
(2010), use of direct suicide assessments may underdetect risk for ethnic
minorities because such practices engender little consideration for cultural
sanctions (e.g., shame) that might influence willingness to disclose. Instead,
ethnic minorities may be more willing to express symptoms of suicide risk on
indirect and subtle measures because these assessment strategies may help
minimize potential stigma, shame, and/or embarrassment. In keeping with
this position, our findings provide support for diversifying the means by
which clinicians assess suicide in African Americans to include subtle and
indirect measures.

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Klibert et al. 287

Correlates of Suicide Risk by Ethnic Group

Another limitation in the suicide literature is the lack of empirical attention
toward identifying culturally salient correlates of suicide risk for ethnically
diverse populations (Walker et al., 2008). To address this gap, the current
study examined associations between cultural congruity and two indices of
suicide risk in a sample of African American and European American stu-
dents. As expected, perceptions of cultural incongruity within one’s social
environment were significantly related to estimates of interpersonal (e.g.,
thwarted belongingness and perceived burdensomeness) and behavioral (e.g.,
engaging in life-threatening behaviors) risk for both African American and
European American students. These findings are consistent with previous
research (e.g., Pieterse et al., 2011; Walker, 2007) suggesting that African
Americans students are at a greater risk to engage in life-threatening behav-
iors when they perceive their environment as culturally restrictive and
oppressive. Moreover, if African American students experience prolonged
exposure to culturally unwelcoming and hostile conditions, they may increase
the frequency and intensity by which they engage in life-threatening behav-
ior, which may then amplify the probability of engaging in risk behaviors
(e.g., fearlessness and pain tolerance) needed to enact lethal self-injury.
Continued research in this area will be important in order to identify the
impact of prolonged exposure to culturally incongruent environments on the
relationship between life-threatening behaviors and the ability to enact a
lethal suicide attempt.
Interestingly, perceptions of cultural incongruity were also related to
higher estimates of suicide risk for European American students. While esti-
mates of cultural congruity have been traditionally collected from samples of
ethnic minorities, this finding suggests that cultural congruity may also be
important in understanding the development and exacerbation of mental
health difficulties for European American students. Rather than comparisons
of fit based on race, cultural congruity examines fit based on ethnicity, a
concept that includes many cultural aspects (nationality, language, ancestry,
etc.) along which European Americans may vary considerably. In keeping
with this position, it is recommended that cultural congruity be considered in
future research designed to predict mental health difficulties in European
American students.

Ethnic Variation in Correlates to Suicide Risk

Culturally incongruent environments often exert their influence on behav-
ioral and emotional health outcomes. However, the insidious effects of

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288 Journal of Black Psychology 41(3)

cultural incongruity may fluctuate based on minority group status—with

individuals self-reporting as members of a minority group experiencing
greater consequences in comparison to majority group members. Consistent
with this position, the obtained findings revealed some ethnic group differ-
ences in the relationships among cultural congruity, defectiveness schemas,
and indices of suicide risk. For instance, relationships between cultural
incongruity and interpersonal factors associated with a desire to die were
stronger for African Americans students than for European American stu-
dents. This same pattern was obtained for the relationship between cultural
incongruity and defectiveness schemas. In combination, these results sug-
gest that unstable perceptions of cultural fit may be more detrimental in
terms of cultivating a sense of belongingness, social competence, and posi-
tive self-image for African American students as compared to European
American students enrolled at a PWI. One potential explanation for these
differences is fluctuations in cognitive appraisal processes. According to
Lazarus and Folkman (1984), secondary appraisal processes associated with
the identification and implementation of coping resources are crucial in the
development of interpersonal and affective outcomes. Unfortunately,
African American students may experience more difficulties in accumulat-
ing culturally salient coping resources (e.g., social support) to endure unwel-
coming and inhospitable climates compared to European American students.
Thus, when faced with stressors associated with cultural incongruity,
African American students may experience more decrements in interper-
sonal and affective components known to buffer suicide risk because of
restricted opportunities to identify and implement effective coping resources
on college campuses.

Mediation Models of Suicide Risk

Consistent with our hypothesis, defectiveness schemas emerged as a signifi-
cant mediator in the relationships between cultural congruity and indices of
suicide risk for African American students. These findings are consistent
with internalized oppression models (Pyke, 2010) and suggest that feelings of
insecurity and inferiority partially account for the detrimental effects of low
cultural congruity on suicide risk. For example, an African American student
who perceives that he/she must alter his/her cultural values to achieve the
resources needed to excel in college may be at a greater risk to cultivate and
exacerbate feelings of insecurity around others and hypersensitivity to rejec-
tion. These feelings of insecurity and inferiority, in turn, may increase inter-
personal (e.g., low belongingness and social competence) and behavioral
(e.g., alcohol consumption) risks to suicide. These findings are comparable to

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Klibert et al. 289

other studies investigating the link between cultural-related stressors and sui-
cide (Davidson, Wingate, Slish, & Rasmussen, 2010). Our results extend pre-
vious research on culturally relevant theories of suicide by highlighting the
role of cognitive-affective variables as a salient factor in explaining the rela-
tionships between cultural congruity and suicide risk, especially among
African American students. However, it is important to note that defective-
ness schemas only partially mediated the relationships between cultural con-
gruity and suicide risk indices; suggesting that other factors may be equally
important in understanding how perceptions of cultural congruity are related
to a diverse range of suicide markers for African American students.
Identifying other factors that mediate or moderate these relationships will be
important in future studies.

Practical Implications Regarding Suicide Prevention and

Intervention
In light of these findings, the current study offers practical implications that
have the potential to promote higher levels of well-being, particularly among
African American students attending a PWI. Most important, university offi-
cials must recognize that effective suicide prevention requires proactive
investment from all levels of administration and staff. There are a diverse
range of activities and experiences that are specifically designed to facilitate
cultural congruence that administrative officials can integrate into the fabric
of the core curriculum and the health resources offered to enrolled students.
One way to promote cultural appreciation at the university level is to ensure
that the adopted core curriculum and first-year educational experiences are
culturally inclusive. Researchers have concluded that the development and
adoption of required multicultural and social justice training leads to increases
in self-exploration through the context of cultural identity and the expansion
of personal relevance of multicultural principles (Iijima-Hall, 1997; Warren,
2006). In addition, teaching student service workers how to promote and
advocate for psychological well-being through sociocultural contexts may
increase cultural congruity among African American students, as well as
among European American students who perceive themselves as incongruent
with their environment. As an example, teaching effective and culturally sen-
sitive practices associated with mentoring, coping with discrimination, career
counseling, and accumulating social support resources may help residence
hall advisors, academic counselors, and other student support workers meet
the diverse needs of African American students.

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290 Journal of Black Psychology 41(3)

Our results also offer some unique insights into the assessment of suicide
risk and provision of therapeutic services to African American students. First,
screening and evaluation of suicide risk needs to consider the interactive
effects of unwelcoming social climates and resulting internalized self-attribu-
tions in the expression of suicide risk. Second, our results highlight the
importance of adopting culturally congruent practices to treatment. We cau-
tion against the exclusive use of traditional psychotherapeutic approaches in
treatment because they often fail to consider culturally salient experiences
associated with the presenting problem (Bernal & Sáez-Santiago, 2006).
Instead, it may be useful to implement postmodern practices as a culturally
sensitive method of reducing risk. For instance, narrative practice is a client-
led approach that is designed to examine the intersection between prominent
life experiences and the formation of identity conclusions. In this way,
African American students are offered opportunities to gain insights on how
oppressive experiences have altered their perceptions of self. Clinicians can
use the insights gained to flush out unique outcomes, neglected aspects of the
individuals’ cultural identity, and reinvigorate cultural supports that may
help buffer against the desire and/or ability to enact suicide behaviors.

Limitations and General Conclusions

It is important to note the potential limitations of this research. First, our find-
ings were generated through an evaluation of self-report measures, which are
susceptible to social desirability demands and response biases. To increase
the validity in the obtained relationships, it will be important for researchers
to reexamine the connection between cultural congruity and suicide risk
using behavioral measures. Second, few of the participants in this sample
reported experiencing interpersonal processes associated with a desire to die
and engaging in suicide prone behavior, limiting the ability to generalize
these findings to other populations. Investigations of these models would
benefit from research efforts directed toward more clinical samples of col-
lege students (e.g., students receiving services from university counseling
centers). Finally, the current project used a cross-sectional design that, over
time, did not consider the relationships between cultural congruity and sui-
cide risk. Longitudinal research will be needed to consider the degree to
which cultural congruity is predictive of suicide risk over time.
Nonetheless, our findings highlight some unique insights concerning
suicide risk for African American students. This is important because cul-
tural processes associated with African American risk are not well repre-
sented in conventional models of suicide. Our findings highlight mediated,

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Klibert et al. 291

via defectiveness, associations between cultural processes and indices of

suicide risk for both groups of college students, although more strongly for
African American students. Overall, consideration for the interaction
between cultural experiences and negative self-attributions may enhance
the utility in ongoing suicide prevention and intervention efforts, especially
among African American students.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding
The authors received no financial support for the research, authorship, and/or publica-
tion of this article.

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