Faculty Proceedings, Presentations, Speeches and Lectures


Multiple Mediation of Theory-based Suicide Risk Factors in College Students with Multiple Marginalized Identities

Event Title

Association for Behavioral and Cognitive Therapies (ABCT) 2021 Virtual Convention

Event Location


Document Type


Presentation Date


Date Range

2021-11-16 to 2021-11-21


Social marginalization leads to mental health disparities, including higher rates of suicidality. Most research on the effects of marginalization focus on one identity without considering the adversity and intersectional complexity of living in potentially heterosexist, sexist, racist, and fatphobic environments. This study focuses on marginalization during a critical period of identity development and increased suicidal ideation (SI). We hypothesized that 1) students with more marginalized identities would report more severe SI and theory-based suicide risk factors, and 2) these factors would mediate associations between marginalized identities and SI severity.

A sample of 265 college students (18-25 years) completed an online survey assessing SI severity and constructs related to the Interpersonal Psychological Theory (IPT; i.e., burdensomeness, thwarted belonging, and hopelessness; Joiner, 2005; Van Orden et al., 2010) and Three Step Theory (3ST; i.e., pain, hopelessness, social connection, and meaning in life; Klonsky & May, 2015). Number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index > 30, sexual attraction to same sex but identified as heterosexual, and gender fluid identity.

Greater number of marginalized identities was related to higher SI severity (r=.23) and worse IPT and 3ST variables (rs = -.17-.24). In IPT multiple mediation analyses, more marginalized identities was related to SI severity through burdensomeness (β=.10, p< .01) and hopelessness (β=.15, p< .001), but not belonging (β=-.004, p=.88). In 3ST analyses, more marginalized identities was related to SI severity through hopelessness (β=.07, p< .05) and psychological pain (β=.22, p< .001), but not social connection (β=.01, p=.45) or meaning in life (β=.01, p=.73).

Emerging adult college students with more marginalized identities experienced greater SI severity and theory-based SI risk factors, yet only burdensomeness, hopelessness, and pain accounted for relationships between marginalized identities and SI severity. Students with more marginalized identities reported lower social connection and meaning in life, yet these factors did not explain associations between identities and SI severity. Future research should consider intersectional identities in assessing suicide risk and test mechanisms by which multiply marginalized college students may be resilient to some suicide risk factors, such as support within their marginalized groups.