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Mediators of a Culturally-Sensitive Intervention for Suicidal African American Women

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Abstract

This study explored intervention outcomes and mechanisms that could help explain why low-income, African American women with a history of intimate partner abuse and suicide attempt improve in response to a culturally-informed intervention, the Grady Nia Project. Specifically, the investigation examined whether or not the intervention had effects on the women and whether or not spiritual well-being and coping mediated the effects of the intervention on suicidal ideation and depressive symptoms. In this randomized controlled clinical trial, data from 89 women who completed both pre- and post-intervention assessments were analyzed. During the post-intervention follow-up, women in the active intervention group reported lower levels of suicidal ideation and depressive symptoms and higher levels of existential well-being and adaptive coping skills than those women randomized to the treatment as usual group. However, only existential well-being was found to mediate treatment effects on suicidal ideation and depressive symptoms. Religious well-being, as well as adaptive and maladaptive coping, did not serve a mediational function. These findings highlight the importance of designing and implementing culturally-sensitive and evidence-based strategies that enhance existential well-being in this population.

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Acknowledgments

This research was supported by grants from the Centers for Disease Control and Prevention National Center for Injury Prevention and Control (R49 CCR421767-01, Group interventions with suicidal African American women) and the National Institute of Mental Health (1R01MH078002-01A2, Group interviews for abused, suicidal Black women) awarded to the last author (Kaslow).

Conflict of interest

Huaiyu Zhang, Tomina J. Schwenke, Miesha N. Rhodes, and Nadine J. Kaslow, Emory University; Kiranmayi Neelarambam, Georgia State University; Delishia M. Pittman, Lewis & Clark College. None of the authors have any conflicts of interest to report.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Grady Hospital, 80 Jesse Hill Jr. Drive, SE, Atlanta, GA, 30303, USA

    Huaiyu Zhang, Tomina J. Schwenke, Miesha N. Rhodes & Nadine J. Kaslow

  2. Georgia State University, Atlanta, GA, USA

    Kiranmayi Neelarambam

  3. Lewis & Clark College, Portland, OR, USA

    Delishia M. Pittman

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  1. Huaiyu Zhang
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  2. Kiranmayi Neelarambam
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  3. Tomina J. Schwenke
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  6. Nadine J. Kaslow
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Correspondence to Nadine J. Kaslow.

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Zhang, H., Neelarambam, K., Schwenke, T.J. et al. Mediators of a Culturally-Sensitive Intervention for Suicidal African American Women. J Clin Psychol Med Settings 20, 401–414 (2013). https://doi.org/10.1007/s10880-013-9373-0

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