Moderators of Depression and Suicidal Ideation Among Latinos in the United States

Moderators of Depression and Suicidal Ideation Among Latinos in the United States | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Moderators of Depression and Suicidal Ideation Among Latinos in the United States Lawrence Watkins, Cory Cobb, Sunghyun Chung, Benjamin Montemayor This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6806639/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Despite increasing rates of mental health challenges among Hispanic populations in the United States, limited research has examined potential circumstances in the depression to suicidal ideation relationship in this demographic. This study investigated the relationship between depression and suicidal ideation, with a specific focus on the moderating roles of adverse childhood experiences (ACEs) and distress tolerance, two particularly impactful factors in suicide risk. Methods: This study included 800 Hispanic adults in Texas who completed measures of depression, suicidal ideation, ACEs, and distress tolerance. A dual-moderation analysis tested the direct and interactive effects of ACEs and distress tolerance on the link between depressive symptoms and suicidal ideation while controlling for age, sex, and acculturative stress. Results : Depression and ACEs showed significant direct effects on suicidal ideation. While ACEs did not moderate the depression-suicidal ideation relationship, distress tolerance did. Notably, the relationship between depression and suicidal ideation was strongest among individuals with low distress tolerance compared to high levels. Acculturative stress was positively associated with suicidal ideation, while age was negatively associated. Discussion : These findings highlight the complex interplay between depression, distress tolerance, and suicidal ideation among Hispanic adults. The unexpected finding that lower distress tolerance strengthened the depression-suicide relationship suggests it may serve as a potential protective factor, warranting further investigation. Results underscore the need to further examine these relationships in a population facing growing mental health concerns. Hispanic mental health depression suicidal ideation adverse childhood experiences distress tolerance acculturative stress Figures Figure 1 Introduction Depression and suicidal ideation are rising at alarming rates among Latinos in the United States and have shown concerning trends in recent years (Cai et al., 2021). Since 2020, the Centers for Disease Control and Prevention (CDC) reported a suicide rate of 7.6 per 100,000 among Latinos, and the Substance Abuse and Mental Health Service Administration (SAMHSA) found that 7.9% of Latino adults report experiencing a major depressive episode in the past year. Additionally, a comprehensive 12-year longitudinal study by Bommersbach et al. (2023) further emphasized this concern, revealing that Latinos experienced the most significant increase in suicidal ideation across all demographic groups. These figures reflect a growing mental health crisis gradually increasing within the Latino community (Moreno, 2017). Growing evidence points to a set of psychological factors that may help explain elevated rates of depression and suicidal ideation among Latino populations, most notably adverse childhood experiences (ACEs) and distress tolerance. ACEs, defined as potentially traumatic events occurring before age 18 such as abuse or household dysfunction (Sahle et al., 2022), and distress tolerance, defined as an individual's perceived ability to endure emotional discomfort (Lass et al., 2020), are common correlates that have been increasingly recognized as key factors influencing mental health outcomes. Specifically, low distress tolerance has been linked to difficulties in coping with stressors, potentially exacerbating symptoms of depression and increasing vulnerability to suicidal ideation (Kratovic et al., 2021). While research has firmly established the strong association between depression and suicidal ideation (e.g., Miret et al., 2013), critical gaps remain in our understanding of factors that may moderate this relationship among Latinos. Identifying such moderating factors is crucial for uncovering potential protective mechanisms and guiding the development of culturally tailored interventions and treatment approaches, ultimately improving mental health outcomes in this population. Latinos, the largest ethnic minority group in the U.S., often occupy a disadvantaged social position that places them at increased risk for depressive symptomatology (Silva et al., 2016). Latinos report among the highest rates of depressive symptoms and suicidal ideation nationally (Silva & Van Orden, 2018), influenced by myriad psychosocial stressors (Cobb et al., 2020). Cultural factors specific to Latinos, such as acculturative stress, can significantly impact mental health outcomes, potentially serving as a risk factor. Additionally, language barriers and experiences of discrimination present unique challenges for Latinos navigating mental health services, further contributing to disparities in care and treatment (Goldstein, 2024). Depression remains a salient predictor of suicidal ideation among the Latino populations, where these sociocultural factors and broader social determinants of health playing crucial roles in shaping outcomes.The present brief report aims to evaluate whether ACEs and distress tolerance significantly moderate the relationship between depression and suicidal ideation, controlling for key sociodemographic factors (i.e. age, gender, acculturative stress; Polanco-Roman et al., 2023). We hypothesize that: (1) depression, distress tolerance, and ACEs will be significantly associated with suicidal ideation; (2) distress tolerance will significantly moderate the depression-suicide relationship, such that higher distress tolerance will mitigate the effects of depressive symptoms on suicidal ideation; and (3) ACEs will moderate the depression-suicide relationship such that greater ACE exposure will exacerbate the effects of depressive symptoms on suicidal ideation. A conceptual model illustrating these hypothesized pathways is presented in Figure 1. [Insert Figure 1] Methods Procedures and Sample Data were collected using a professional research firm (ReconMR) who recruited a panel sample of 800 Latinos across Texas. Participant recruitment was guided by predetermined sub-demographic targets based on Texas population data (Texas Demographic Center, 2024). The final sample closely resembled Texas statewide Latino sub-demographics, the proportion of immigrants (11%) fell short of the target quota of (28%). Frequency weights were applied to adjust the sample to better align with Texas demographics. Measures Depression: The Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001; α = .94) is scored on a 0-27 scale, with each of the 9 items rated from 0-3. Higher scores indicate greater depression severity. Typical severity ranges are: 0-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. Distress Tolerance [Moderating Variable]: The Distress Tolerance Scale (DTS; Simons & Gaher, 2005) is scored on a 1-5 scale across 15 items, with total scores ranging from 15-75. Higher scores reflect greater ability to tolerate distress. Adverse Childhood Experiences [Moderating Variable]: The ACE questionnaire (Felitti et al., 1998) is scored on a 0-10 scale, with each "yes" response counting as 1 point. Higher scores indicate greater exposure to ACEs. Suicidal Ideation: The Frequency of Suicidal Ideation Inventory (FSII; Chang & Chang, 2016; α = .95) is scored on a 1-5 scale across 5 items, with total scores ranging from 5-25. Higher scores reflecting more frequent and intense suicidal ideation. Covariates : Age in years, sex, and acculturative stress were included as covariates. Acculturative stress was measured using the Riverside Acculturative Stress Inventory (RASI; Benet-Martinez, 2003; α = .95), with higher scores indicating greater stress related to cultural adaptation. Data Analysis Plan Using the PROCESS macro in SPSS software (Hayes & Rockford, 2017), we tested our moderation model using nonparametric bootstrapping with ordinary least squares regression. Prior to analysis, we checked for multicollinearity using VIF and tolerance values, linearity through scatterplots, normality using Q-Q plots, and homoscedasticity via residual plots. The analysis employed 10,000 bootstrapped resamples with bias-corrected 95% confidence intervals. Results The final sample consisted of 400 men and 400 women (M_ age = 34.74 years, SD = 11.45). Approximately 89% were born in the U.S., and 78% resided in metropolitan areas. Regarding education, 6.1% had less than an 11th-grade education, 7.1% had a GED, 30.1% held a high school diploma, 29.5% had some college experience, and 27.3% held a college degree. Regarding income, 67% reported a monthly income of less than $2,000. The overall model examining suicidal ideation was significant ( R ² = .58, F (8, 791) = 135.60, p < .0001), accounting for 58% of the variance in suicidal ideation. Depression was positively associated with suicidal ideation ( b = 0.16, p = .04, CI 95 % = 0.01 - 0.31). Adverse Childhood Experiences (ACEs ( b = 0.1920, p = .0286, CI 95 % = 0.02 - 0.36). Distress tolerance, however, did not have a significant direct effect on suicidal ideation ( b = -0.001, p = .95, CI 95 % = -0.034 - 0.04). Among the covariates, acculturative stress was positively associated with suicidal ideation ( b = 0.08, p < .0001, CI 95 % = 0.06 - 0.11), while age was negatively associated ( b = -0.03, p = .05, CI95% = -0.05 - -0.0003), Finally, sex (being male) also emerged as a significant correlate with suicidal ideation ( b = 1.03, p = .0006, CI 95 % = 0.45 - 1.61). The interaction between depression and ACEs in being significant associated with suicidal ideation was not significant ( b = -0.002, p = .78, CI 95 % = -0.01 - 0.01). However, there was a significant interaction between depression and distress tolerance in predicting suicidal ideation ( b = 0.01, p = .001, CI 95 % = 0.0022 - 0.01). The association between depression and suicidal ideation was significant across all levels of distress tolerance, with the strongest effects observed at high distress tolerance levels ( b = 0.47 - 0.48), followed by medium ( b = 0.39 - 0.40) and low levels ( b = 0.33 - 0.34), all ps < .0001. This pattern remained consistent across all levels of ACEs exposure, suggesting that distress tolerance moderates the depression-suicidal ideation relationship regardless of childhood adversity exposure. See Table 1 for bivariate correlations. [Insert Table 1] Table 1 Linear regression analysis predicting suicidal ideation among Latino adults Variable B SE P Covariates Sex (male) 1.030 0.298 < 0.001*** Ageᵃ -0.026 0.013 0.048* Acculturative stressᵃ 0.084 0.014 < 0.001*** Main Effects Depressionᵃ 0.162 0.077 0.035* Adverse childhood experiencesᵃ 0.192 0.088 0.029* Distress toleranceᵃ -0.001 0.019 0.950 Interaction Effects Depression × ACEs -0.002 0.006 0.777 Depression × Distress tolerance 0.005 0.002 < 0.001*** Constant 3.088 1.026 0.003** Model Statistics: R² = .578, F(8, 791) = 135.60, p < .001 p < .05, *** p < .001 ᵃ Variables were centered at their mean to aid interpretations Sex coded as 0 = female, 1 = male; ACEs = Adverse Childhood Experiences Coefficients represent the change in suicidal ideation scores for each unit increase in the predictor, holding all other variables constant Discussion The purpose of this brief report was to examine moderators of the depression-suicidal ideation relationship among Latinos in Texas. Research of this nature is critical for identifying culturally relevant risk and protective factors that can inform more targeted mental health interventions within underserved communities. Findings partially supported our hypotheses. Depression was positively and significantly association with suicidal ideation, consistent with previous research examining this relationship in Latino populations (Chakravarthy et al., 2014). Similarly, ACEs demonstrated a significant direct effect on suicidal ideation, reinforcing existing literature on the long-term impact of childhood adversity on mental health outcomes. Contrary to expectations (see Zhong et al., 2023), distress tolerance did not have a significant direct effect on suicidal ideation. However, it did significantly moderate the relationship depression and suicidal ideation. In contrast, ACEs did not moderate this relationship, diverging from previous research suggesting that childhood adversity amplifies the impact of depressive symptoms on suicidal thoughts (Tegegne et al., 2022). Future research should examine how specific types of ACEs and individual differences in emotion regulation, such as distress tolerance, interact to shape suicide risk among Latino populations. Among covariates, being male was associated with higher levels of suicidal ideation, contradicting earlier findings (e.g. Miranda-Mendizabal et al., 2019; Omary, 2021), but consistent with more recent studies specific to Latino communities (Lucas et al., 2024; Ostanin et al., 2025). The negative association between age and suicidal ideation suggests that younger Latino adults may be particularly vulnerable. Additionally, acculturative stress emerged as a significant predictor of suicidal ideation, highlighting the importance of cultural factors in shaping mental health outcomes. These findings point to the need for future research and interventions that account for gender, age, and culturally specific stressors when addressing suicide risk among Latino adults. Results from this study should be considered in light of several limitations. including the cross-sectional design, reliance on self-report measures, and the sample being limited to Latinos residing in Texas Hispanics. Despite these constraints, our large, demographically representative sample provides valuable insights into an understudied population. The anonymous nature of data collection likely improved self-report accuracy, and findings may generalize to other states with significant Hispanic populations. While longitudinal research is needed to establish causal relationships, this study establishes an important empirical foundation for understanding personality-psychopathology relationships within this community. Overall, these findings highlight the need for culturally responsive interventions that enhance distress tolerance as a potential protective factor while also recognizing the enduring impact of childhood adversity. Given the significant role of acculturative stress, mental health programs should incorporate culturally tailored strategies to mitigate its effects on suicide risk among Latino populations in Texas. Future research should also explore additional cultural moderators, such as familismo and ethnic identity, and examine these relationships across different Latino subgroups in both short- and long-term studies. This brief report lays the groundwork for a more nuanced understanding of these psychosocial and cultural factors, providing a foundation for future longitudinal research that can track how they shape mental health outcomes over time. Conclusion Our findings highlight the complex role of distress tolerance as a moderator and reinforce the persistent impact of ACES on mental health outcomes. The significant associations of demographic and cultural factors underscore the need to consider both individual and sociocultural contexts in understanding suicide risk among Latino populations. These results suggest the importance of comprehensive assessment approaches that consider multiple risk factors and their interactions in clinical practice. Declarations Author Contribution LGW contributed to the conceptualization, methodology, Writing- original draft preparation, and formal analysis. CLC contributed with formal analysis, Data curation, writing- reviewing and editing . SC contributed with writing- original draft preparation, and visualization. BNM contributed to writing- reviewing and editing and methodology. References Akbari, M., Hosseini, Z. S., Seydavi, M., Zegel, M., Zvolensky, M. J., & Vujanovic, A. A. (2022). Distress tolerance and posttraumatic stress disorder: A systematic review and meta-analysis. Cognitive Behaviour Therapy , 51 (1), 42–71. https://doi.org/10.1080/16506073.2021.1942541 Benet-Martínez, V. (2003). The Riverside Acculturation Stress Inventory (RASI): Development and psychometric properties. Technical Report, Department of Psychology, University of California at Riverside. Bommersbach, T. J., Rosenheck, R. A., & Rhee, T. G. (2023). Rising Rates of Suicidal Behaviors and Large Unmet Treatment Needs Among US Adults With a Major Depressive Episode, 2009 to 2020. Mayo Clinic Proceedings , 98 (7), 969–984. https://doi.org/10.1016/j.mayocp.2023.02.012 Brandt, C. P., Zvolensky, M. J., & Bonn-Miller, M. O. (2013). Distress Tolerance, Emotion Dysregulation, and Anxiety and Depressive Symptoms Among HIV+ Individuals. Cognitive Therapy and Research , 37 (3), 446–455. https://doi.org/10.1007/s10608-012-9497-9 Cai, H., Xie, X.-M., Zhang, Q., Cui, X., Lin, J.-X., Sim, K., Ungvari, G. S., Zhang, L., & Xiang, Y.-T. (2021). Prevalence of Suicidality in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Comparative Studies. Frontiers in Psychiatry , 12 , 690130. https://doi.org/10.3389/fpsyt.2021.690130 Cavanagh, J. T. O., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine , 33 (3), 395–405. https://doi.org/10.1017/S0033291702006943 Centers for Disease Control and Prevention (CDC). (2022). Suicide mortality in the United States, 2020 (NCHS Data Brief No. 433). National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db433.htm Chakravarthy, B., Hoonpongsimanont, W., Anderson, C. L., Habicht, M., Bruckner, T., & Lotfipour, S. (2014). Depression, suicidal ideation, and suicidal attempt presenting to the emergency department: Differences between these cohorts. The Western Journal of Emergency Medicine , 15 (2), 211–216. https://doi.org/10.5811/westjem.2013.11.13172 Chang, E. C., & Chang, O. D. (2016). Development of the Frequency of Suicidal Ideation Inventory: Evidence for the Validity and Reliability of a Brief Measure of Suicidal Ideation Frequency in a College Student Population. Cognitive Therapy and Research , 40 (4), 549–556. https://doi.org/10.1007/s10608-016-9758-0 Cobb, C. L., Salas-Wright, C. P., John, R., Schwartz, S. J., Vaughn, M., Martínez, C. R., Awad, G., Pinedo, M., & Cano, M. Á. (2021). Discrimination Trends and Mental Health Among Native- and Foreign-Born Latinos: Results from National Surveys in 2004 and 2013. Prevention Science , 22 (3), 397–407. https://doi.org/10.1007/s11121-020-01186-4 Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine , 14 (4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8 Geyer, R. B., Dreyer-Oren, S. E., Das, A., & Clerkin, E. M. (2023). Distressed drinking: The moderating impact of distress tolerance on the relation between anxiety sensitivity, panic symptoms, and alcohol use and problems. Journal of Studies on Alcohol and Drugs , jsad.22-00353. https://doi.org/10.15288/jsad.22-00353 Goldstein, E. V., Bailey, E. V., & Wilson, F. A. (2024). Poverty and Suicidal Ideation Among Hispanic Mental Health Care Patients Leading up to the COVID-19 Pandemic. Hispanic Health Care International , 22 (1), 6–10. https://doi.org/10.1177/15404153231181110 Gonzales, J. J., & Papadopoulos, A. S. (Eds.). (2010). Mental health services: A public health perspective (3rd ed). Oxford University Press. Hardt, J., & Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence. Journal of Child Psychology and Psychiatry , 45 (2), 260–273. https://doi.org/10.1111/j.1469-7610.2004.00218.x Hayes, A. F., & Rockwood, N. J. (2017). Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. Behaviour Research and Therapy , 98 , 39–57. https://doi.org/10.1016/j.brat.2016.11.001 Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine , 16 (9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x Lass, A. N., & Winer, E. S. (2020). Distress tolerance and symptoms of depression: A review and integration of literatures. Clinical Psychology: Science and Practice , 27 (3). Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. Psychological Bulletin , 136 (4), 576–600. https://doi.org/10.1037/a0019712 Luca, S. D., Yan, Y., Schueller, D., & O’Donnell, K. (2024). Exploring adolescent suicidal trajectories: The intersection of race/ethnicity, gender, and social connectedness. Journal of Adolescence , 96 (8), 1853–1870. https://doi.org/10.1002/jad.12387 Kratovic, L., Smith, L. J., & Vujanovic, A. A. (2021). PTSD symptoms, suicidal ideation, and suicide risk in university students: The role of distress tolerance. Journal of Aggression, Maltreatment & Trauma, 30(1), 82-100. Miranda-Mendizabal, A., Castellví, P., Parés-Badell, O., Alayo, I., Almenara, J., Alonso, I., Blasco, M. J., Cebrià, A., Gabilondo, A., Gili, M., Lagares, C., Piqueras, J. A., Rodríguez-Jiménez, T., Rodríguez-Marín, J., Roca, M., Soto-Sanz, V., Vilagut, G., & Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and young adults: Systematic review and meta-analysis of longitudinal studies. International Journal of Public Health , 64 (2), 265–283. https://doi.org/10.1007/s00038-018-1196-1 Miret, M., Ayuso-Mateos, J. L., Sanchez-Moreno, J., & Vieta, E. (2013). Depressive disorders and suicide: Epidemiology, risk factors, and burden. Neuroscience & Biobehavioral Reviews , 37 (10), 2372–2374. https://doi.org/10.1016/j.neubiorev.2013.01.008 Moreno, E. (2017). Latinos and mental health: Current issues and a reason for hope. American Foundation for Suicide Prevention. https://afsp.org/story/latinos-and-mental-health-current-issues-and-reason-for-hope Omary, A. (2021). National Prevalence Rates of Suicidal Ideation and Suicide Attempts Among Adults With and Without Depression. Journal of Nervous & Mental Disease , 209 (5), 378–385. https://doi.org/10.1097/NMD.0000000000001309 Ostanin, J., Miranda, H., Shugar, S., Abdo, D., Mejia, M. C., Hennekens, C. H., & Kitsantas, P. (2025). Suicidal Behaviors Among United States Adolescents: Increasing Clinical and Public Health Challenges. Children , 12 (1), 57. https://doi.org/10.3390/children12010057 Polanco-Roman, L., Ebrahimi, C. T., Mafnas, K. S. W., Hausmann-Stabile, C., Meca, A., Mazzula, S. L., Duarte, C. S., & Lewis-Fernández, R. (2023). Acculturation and suicide-related risk in ethnoracially minoritized youth in the US: A scoping review and content analysis of the empirical evidence. Social Psychiatry and Psychiatric Epidemiology , 58 (8), 1121–1137. https://doi.org/10.1007/s00127-023-02494-0 Sahle, B. W., Reavley, N. J., Li, W., Morgan, A. J., Yap, M. B. H., Reupert, A., & Jorm, A. F. (2022). The association between adverse childhood experiences and common mental disorders and suicidality: An umbrella review of systematic reviews and meta-analyses. European Child & Adolescent Psychiatry , 31 (10), 1489–1499. https://doi.org/10.1007/s00787-021-01745-2 Silva, C., & Van Orden, K. A. (2018). Suicide among Hispanics in the United States. Current Opinion in Psychology , 22 , 44–49. https://doi.org/10.1016/j.copsyc.2017.07.013 Silva, M., Loureiro, A., & Cardoso, G. (2016). Social determinants of mental health: A review of the evidence. The European Journal of Psychiatry , 30 (4), 259–292. Simons, J. S., & Gaher, R. M. (2005). The Distress Tolerance Scale: Development and Validation of a Self-Report Measure. Motivation and Emotion , 29 (2), 83–102. https://doi.org/10.1007/s11031-005-7955-3 Stack, S. (2021). Contributing factors to suicide: Political, social, cultural and economic. Preventive Medicine , 152 , 106498. https://doi.org/10.1016/j.ypmed.2021.106498 Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report Tegegne, K. T., Tegegne, E. T., Tessema, M. K., Bagajjo, W. S., Rike, M., Abebe, A. T., & Bifato, B. (2022). The association between depression and suicidal ideation: a systematic review and meta-analysis. J Psychol Mental Health Care , 6 (1), 1-6. Texas Demographic Center (2023). Estimates of the total populations of counties and places in Texas for July 1, 2022 and January 1, 2023 [Methodology]. Retrieved February 21, 2024, from https://demographics.texas.gov/Projections/2022/TotalMethodology.pdf Zhong, J., Huang, X.-J., Wang, X.-M., & Xu, M.-Z. (2023). The mediating effect of distress tolerance on the relationship between stressful life events and suicide risk in patients with major depressive disorder. BMC Psychiatry , 23 (1), 118. https://doi.org/10.1186/s12888-023-04600-7 Zigmond, M. J., Wiley, C. A., & Chesselet, M.-F. (Eds.). (2023). Neurobiology of brain disorders: Biological basis of neurological and psychiatric disorders (Second edition). Academic Press, an imprint of Elsevier. Zvolensky, M. J., Jardin, C., Garey, L., Robles, Z., & Sharp, C. (2016). Acculturative stress and experiential avoidance: Relations to depression, suicide, and anxiety symptoms among minority college students. Cognitive Behaviour Therapy , 45 (6), 501–517. https://doi.org/10.1080/16506073.2016.1205658 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6806639","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":467054162,"identity":"a940ae9d-8acf-40aa-8b5f-fc255ef4c390","order_by":0,"name":"Lawrence Watkins","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzklEQVRIiWNgGAWjYBACPjB5QIKBgb0BKnSAgBY2sCKQFp7DpGkBEhLJxGrhX2P4+cMZizz5me8PfrrZxiDHdyOBgBaJN8YSB25IFBvcTmaWzm1jMJYkrOXsBokDHyQSN0gnM4C0JG4gQsvmHyAt82ceZv4N1FJPWAt/7zaQwxIbbjCzgWxJMCBsC/83izNngA47k2xmnXNOwnDmmQf4tfDzH0u+UXGsLnF++8HHt3PKbOT5jhOwhUECVYEEAeVgaw4QoWgUjIJRMApGNgAA485KXJMq/FkAAAAASUVORK5CYII=","orcid":"","institution":"Texas A\u0026M University","correspondingAuthor":true,"prefix":"","firstName":"Lawrence","middleName":"","lastName":"Watkins","suffix":""},{"id":467054164,"identity":"9b89eb80-38e6-43cc-9e7d-4f9be40dfcc5","order_by":1,"name":"Cory Cobb","email":"","orcid":"","institution":"Texas A\u0026M University","correspondingAuthor":false,"prefix":"","firstName":"Cory","middleName":"","lastName":"Cobb","suffix":""},{"id":467054166,"identity":"f5997714-2917-4e8e-aeda-c6d24544c3a8","order_by":2,"name":"Sunghyun Chung","email":"","orcid":"","institution":"Texas A\u0026M University","correspondingAuthor":false,"prefix":"","firstName":"Sunghyun","middleName":"","lastName":"Chung","suffix":""},{"id":467054167,"identity":"822d2a48-dc8a-4767-97f6-e01bbd74b2bf","order_by":3,"name":"Benjamin Montemayor","email":"","orcid":"","institution":"Texas A\u0026M University","correspondingAuthor":false,"prefix":"","firstName":"Benjamin","middleName":"","lastName":"Montemayor","suffix":""}],"badges":[],"createdAt":"2025-06-03 03:53:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6806639/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6806639/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85668902,"identity":"2cd98cb6-3c8f-4a91-af92-e56da8964666","added_by":"auto","created_at":"2025-06-30 13:17:36","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":21817,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6806639/v1/cb4655f002d07990929270f2.jpg"},{"id":87315259,"identity":"2c8e29ee-4fb8-4092-a416-021d1b4d5cf7","added_by":"auto","created_at":"2025-07-22 15:38:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":496712,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6806639/v1/f89fa8ca-46ec-4abc-9c82-6752188ed050.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Moderators of Depression and Suicidal Ideation Among Latinos in the United States","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDepression and suicidal ideation are rising at alarming rates among Latinos in the United States and have shown concerning trends in recent years (Cai et al., 2021). Since 2020, the Centers for Disease Control and Prevention (CDC) reported a suicide rate of 7.6 per 100,000 among Latinos, and the Substance Abuse and Mental Health Service Administration (SAMHSA) found that 7.9% of Latino adults report experiencing a major depressive episode in the past year. Additionally, a comprehensive 12-year longitudinal study by Bommersbach et al. (2023) further emphasized this concern, revealing that Latinos experienced the most significant increase in suicidal ideation across all demographic groups. These figures reflect a growing mental health crisis gradually increasing within the Latino community (Moreno, 2017).\u003c/p\u003e\n\u003cp\u003eGrowing evidence points to a set of psychological factors that may help explain elevated rates of depression and suicidal ideation among Latino populations, most notably adverse childhood experiences (ACEs) and distress tolerance. ACEs, defined as potentially traumatic events occurring before age 18 such as abuse or household dysfunction (Sahle et al., 2022), and distress tolerance, defined as an individual\u0026apos;s perceived ability to endure emotional discomfort (Lass et al., 2020), are common correlates that have been increasingly recognized as key factors influencing mental health outcomes. Specifically, low distress tolerance has been linked to difficulties in coping with stressors, potentially exacerbating symptoms of depression and increasing vulnerability to suicidal ideation (Kratovic et al., 2021). While research has firmly established the strong association between depression and suicidal ideation (e.g., Miret et al., 2013), critical gaps remain in our understanding of factors that may moderate this relationship among Latinos. Identifying such moderating factors is crucial for uncovering potential protective mechanisms and guiding the development of culturally tailored interventions and treatment approaches, ultimately improving mental health outcomes in this population.\u003c/p\u003e\n\u003cp\u003eLatinos, the largest ethnic minority group in the U.S., often occupy a disadvantaged social position that places them at increased risk for depressive symptomatology (Silva et al., 2016). Latinos report among the highest rates of depressive symptoms and suicidal ideation nationally (Silva \u0026amp; Van Orden, 2018), influenced by myriad psychosocial stressors (Cobb et al., 2020). Cultural factors specific to Latinos, such as acculturative stress, can significantly impact mental health outcomes, potentially serving as a risk factor. Additionally, language barriers and experiences of discrimination present unique challenges for Latinos navigating mental health services, further contributing to disparities in care and treatment (Goldstein, 2024). Depression remains a salient predictor of suicidal ideation among the Latino populations, where these sociocultural factors and broader social determinants of health playing crucial roles in shaping outcomes.The present brief report aims to evaluate whether ACEs and distress tolerance significantly moderate the relationship between depression and suicidal ideation, controlling for key sociodemographic factors (i.e. age, gender, acculturative stress; Polanco-Roman\u0026nbsp;et al.,\u0026nbsp;2023). We hypothesize that: (1) depression, distress tolerance, and ACEs will be significantly associated with suicidal ideation; (2) distress tolerance will significantly moderate the depression-suicide relationship, such that higher distress tolerance will mitigate the effects of depressive symptoms on suicidal ideation; and (3) ACEs will moderate the depression-suicide relationship such that greater ACE exposure will exacerbate the effects of depressive symptoms on suicidal ideation. A conceptual model illustrating these hypothesized pathways is presented in Figure 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Insert Figure 1]\u003c/strong\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eProcedures and Sample\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were collected using a professional research firm (ReconMR) who recruited a panel sample of 800 Latinos across Texas. Participant recruitment was guided by predetermined sub-demographic targets based on Texas population data (Texas Demographic Center, 2024). The final sample closely resembled Texas statewide Latino sub-demographics, the proportion of immigrants (11%) fell short of the target quota of (28%). Frequency weights were applied to adjust the sample to better align with Texas demographics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepression:\u0026nbsp;\u003c/strong\u003eThe Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001; \u0026alpha; = .94) is scored on a 0-27 scale, with each of the 9 items rated from 0-3. Higher scores indicate greater depression severity. Typical severity ranges are: 0-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDistress Tolerance [Moderating Variable]:\u0026nbsp;\u003c/strong\u003eThe Distress Tolerance Scale (DTS; Simons \u0026amp; Gaher, 2005) is scored on a 1-5 scale across 15 items, with total scores ranging from 15-75. Higher scores reflect greater ability to tolerate distress.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdverse Childhood Experiences [Moderating Variable]:\u0026nbsp;\u003c/strong\u003eThe ACE questionnaire (Felitti et al., 1998) is scored on a 0-10 scale, with each \u0026quot;yes\u0026quot; response counting as 1 point. Higher scores indicate greater exposure to ACEs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSuicidal Ideation:\u0026nbsp;\u003c/strong\u003eThe Frequency of Suicidal Ideation Inventory (FSII; Chang \u0026amp; Chang, 2016; \u0026alpha; = .95) is scored on a 1-5 scale across 5 items, with total scores ranging from 5-25. Higher scores reflecting more frequent and intense suicidal ideation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCovariates\u003c/strong\u003e: Age in years, sex, and acculturative stress were included as covariates. Acculturative stress was measured using the Riverside Acculturative Stress Inventory (RASI; Benet-Martinez, 2003; \u0026alpha; = .95), with higher scores indicating greater stress related to cultural adaptation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis Plan\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing the PROCESS macro in SPSS software (Hayes \u0026amp; Rockford, 2017), we tested our moderation model using nonparametric bootstrapping with ordinary least squares regression. Prior to analysis, we checked for multicollinearity using VIF and tolerance values, linearity through scatterplots, normality using Q-Q plots, and homoscedasticity via residual plots. The analysis employed 10,000 bootstrapped resamples with bias-corrected 95% confidence intervals.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe final sample consisted of 400 men and 400 women (M_\u003cem\u003eage\u003c/em\u003e = 34.74 years, SD = 11.45). Approximately 89% were born in the U.S., and 78% resided in metropolitan areas. Regarding education, 6.1% had less than an 11th-grade education, 7.1% had a GED, 30.1% held a high school diploma, 29.5% had some college experience, and 27.3% held a college degree. Regarding income, 67% reported a monthly income of less than $2,000.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe overall model examining suicidal ideation was significant (\u003cem\u003eR\u003c/em\u003e\u0026sup2; = .58, \u003cem\u003eF\u003c/em\u003e(8, 791) = \u0026nbsp;135.60, \u003cem\u003ep\u003c/em\u003e \u0026lt; .0001), accounting for 58% of the variance in suicidal ideation. Depression was positively associated with suicidal ideation (\u003cem\u003eb\u003c/em\u003e = 0.16, \u003cem\u003ep\u0026nbsp;\u003c/em\u003e= .04, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u0026nbsp;\u003c/sub\u003e= 0.01 - 0.31). Adverse Childhood Experiences (ACEs (\u003cem\u003eb\u003c/em\u003e = 0.1920, \u003cem\u003ep\u003c/em\u003e = .0286, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u003c/sub\u003e = 0.02 - 0.36). Distress tolerance, however, \u0026nbsp;did not have a significant direct effect on suicidal ideation (\u003cem\u003eb\u003c/em\u003e = -0.001, \u003cem\u003ep\u003c/em\u003e = .95, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u0026nbsp;\u003c/sub\u003e= -0.034 - 0.04). Among the covariates, acculturative stress was positively associated with suicidal ideation (\u003cem\u003eb\u003c/em\u003e = 0.08, \u003cem\u003ep\u003c/em\u003e \u0026lt; .0001, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u0026nbsp;\u003c/sub\u003e= 0.06 - 0.11), while age was negatively associated (\u003cem\u003eb\u003c/em\u003e = -0.03, p = .05, CI95% = -0.05 - -0.0003), Finally, sex (being male) also emerged as a significant correlate with suicidal ideation (\u003cem\u003eb\u003c/em\u003e = 1.03, \u003cem\u003ep\u003c/em\u003e = .0006, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u0026nbsp;\u003c/sub\u003e= 0.45 - 1.61).\u003c/p\u003e\n\u003cp\u003eThe interaction between depression and ACEs in being significant associated with suicidal ideation was not significant (\u003cem\u003eb\u003c/em\u003e = -0.002, \u003cem\u003ep\u003c/em\u003e = .78, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u0026nbsp;\u003c/sub\u003e= -0.01 - 0.01).\u0026nbsp;However, there was a significant interaction between depression and distress tolerance in predicting suicidal ideation (\u003cem\u003eb\u003c/em\u003e = 0.01, \u003cem\u003ep\u003c/em\u003e = .001, \u003cem\u003eCI\u003csub\u003e95\u003c/sub\u003e\u003c/em\u003e\u003csub\u003e%\u0026nbsp;\u003c/sub\u003e= 0.0022 - 0.01). The association between depression and suicidal ideation was significant across all levels of distress tolerance, with the strongest effects observed at high distress tolerance levels (\u003cem\u003eb\u003c/em\u003e = 0.47 - 0.48), followed by medium (\u003cem\u003eb\u003c/em\u003e = 0.39 - 0.40) and low levels (\u003cem\u003eb\u003c/em\u003e = 0.33 - 0.34), all \u003cem\u003eps\u003c/em\u003e \u0026lt; .0001. This pattern remained consistent across all levels of ACEs exposure, suggesting that distress tolerance moderates the depression-suicidal ideation relationship regardless of childhood adversity exposure. See Table 1 for bivariate correlations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Insert Table 1]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 Linear regression analysis predicting suicidal ideation among Latino adults\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eCovariates\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eSex (male)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e1.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eAgeᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e-0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.048*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eAcculturative stressᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eMain Effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eDepressionᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.035*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eAdverse childhood experiencesᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.029*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eDistress toleranceᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e-0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eInteraction Effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eDepression \u0026times; ACEs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.777\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eDepression \u0026times; Distress tolerance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e\u0026lt; 0.001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e3.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e1.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.003**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003eModel Statistics: R\u0026sup2; = .578, F(8, 791) = 135.60,\u0026nbsp;\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001\u003cbr\u003e\u0026nbsp;p \u0026lt; .05, *** p \u0026lt; .001\u003c/p\u003e\n\u003cp\u003eᵃ Variables were centered at their mean to aid interpretations\u003c/p\u003e\n\u003cp\u003eSex coded as 0 = female, 1 = male; ACEs = Adverse Childhood Experiences\u003c/p\u003e\n\u003cp\u003eCoefficients represent the change in suicidal ideation scores for each unit increase in the predictor, holding all other variables constant\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe purpose of this brief report was to examine moderators of the depression-suicidal ideation relationship among Latinos in Texas. Research of this nature is critical for identifying culturally relevant risk and protective factors that can inform more targeted mental health interventions within underserved communities. Findings partially supported our hypotheses. Depression was positively and significantly association with suicidal ideation, consistent with previous research examining this relationship in Latino populations (Chakravarthy et al., 2014). Similarly, ACEs demonstrated a significant direct effect on suicidal ideation, reinforcing existing literature on the long-term impact of childhood adversity on mental health outcomes.\u003c/p\u003e\n\u003cp\u003eContrary to expectations (see Zhong et al., 2023), distress tolerance did not have a significant direct effect on suicidal ideation. However, it did significantly moderate the relationship depression and suicidal ideation. In contrast, ACEs did not moderate this relationship, diverging from previous research suggesting that childhood adversity amplifies the impact of depressive symptoms on suicidal thoughts (Tegegne et al., 2022). Future research should examine how specific types of ACEs and individual differences in emotion regulation, such as distress tolerance, interact to shape suicide risk among Latino populations.\u003c/p\u003e\n\u003cp\u003eAmong covariates, being male was associated with higher levels of suicidal ideation, contradicting earlier findings (e.g. Miranda-Mendizabal et al., 2019; Omary, 2021), but consistent with more recent studies specific to Latino communities (Lucas et al., 2024; Ostanin et al., 2025). The negative association between age and suicidal ideation suggests that younger Latino adults may be particularly vulnerable. Additionally, acculturative stress emerged as a significant predictor of suicidal ideation, highlighting the importance of cultural factors in shaping mental health outcomes. These findings point to the need for future research and interventions that account for gender, age, and culturally specific stressors when addressing suicide risk among Latino adults.\u003c/p\u003e\n\u003cp\u003eResults from this study should be considered in light of several limitations. including the cross-sectional design, reliance on self-report measures, and the sample being limited to Latinos residing in Texas Hispanics. Despite these constraints, our large, demographically representative sample provides valuable insights into an understudied population. The anonymous nature of data collection likely improved self-report accuracy, and findings may generalize to other states with significant Hispanic populations. While longitudinal research is needed to establish causal relationships, this study establishes an important empirical foundation for understanding personality-psychopathology relationships within this community.\u003c/p\u003e\n\u003cp\u003eOverall, these findings highlight the need for culturally responsive interventions that enhance distress tolerance as a potential protective factor while also recognizing the enduring impact of childhood adversity. Given the significant role of acculturative stress, mental health programs should incorporate culturally tailored strategies to mitigate its effects on suicide risk among Latino populations in Texas. Future research should also explore additional cultural moderators, such as familismo and ethnic identity, and examine these relationships across different Latino subgroups in both short- and long-term studies. This brief report lays the groundwork for a more nuanced understanding of these psychosocial and cultural factors, providing a foundation for future longitudinal research that can track how they shape mental health outcomes over time.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur findings highlight the complex role of distress tolerance as a moderator and reinforce the persistent impact of ACES on mental health outcomes. The significant associations of demographic and cultural factors underscore the need to consider both individual and sociocultural contexts in understanding suicide risk among Latino populations. These results suggest the importance of comprehensive assessment approaches that consider multiple risk factors and their interactions in clinical practice.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eLGW contributed to the conceptualization, methodology, Writing- original draft preparation, and formal analysis. CLC contributed with formal analysis, Data curation, writing- reviewing and editing . SC contributed with writing- original draft preparation, and visualization. BNM contributed to writing- reviewing and editing and methodology.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAkbari, M., Hosseini, Z. S., Seydavi, M., Zegel, M., Zvolensky, M. J., \u0026amp; Vujanovic, A. A. (2022). Distress tolerance and posttraumatic stress disorder: A systematic review and meta-analysis. \u003cem\u003eCognitive Behaviour Therapy\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e(1), 42\u0026ndash;71. https://doi.org/10.1080/16506073.2021.1942541\u003c/li\u003e\n\u003cli\u003eBenet-Mart\u0026iacute;nez, V. (2003). The Riverside Acculturation Stress Inventory (RASI): Development and psychometric properties. Technical Report, Department of Psychology, University of California at Riverside.\u003c/li\u003e\n\u003cli\u003eBommersbach, T. J., Rosenheck, R. A., \u0026amp; Rhee, T. G. (2023). Rising Rates of Suicidal Behaviors and Large Unmet Treatment Needs Among US Adults With a Major Depressive Episode, 2009 to 2020. \u003cem\u003eMayo Clinic Proceedings\u003c/em\u003e, \u003cem\u003e98\u003c/em\u003e(7), 969\u0026ndash;984. https://doi.org/10.1016/j.mayocp.2023.02.012\u003c/li\u003e\n\u003cli\u003eBrandt, C. P., Zvolensky, M. J., \u0026amp; Bonn-Miller, M. O. (2013). Distress Tolerance, Emotion Dysregulation, and Anxiety and Depressive Symptoms Among HIV+ Individuals. \u003cem\u003eCognitive Therapy and Research\u003c/em\u003e, \u003cem\u003e37\u003c/em\u003e(3), 446\u0026ndash;455. https://doi.org/10.1007/s10608-012-9497-9\u003c/li\u003e\n\u003cli\u003eCai, H., Xie, X.-M., Zhang, Q., Cui, X., Lin, J.-X., Sim, K., Ungvari, G. S., Zhang, L., \u0026amp; Xiang, Y.-T. (2021). Prevalence of Suicidality in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Comparative Studies. \u003cem\u003eFrontiers in Psychiatry\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e, 690130. https://doi.org/10.3389/fpsyt.2021.690130\u003c/li\u003e\n\u003cli\u003eCavanagh, J. T. O., Carson, A. J., Sharpe, M., \u0026amp; Lawrie, S. M. (2003). Psychological autopsy studies of suicide: A systematic review. \u003cem\u003ePsychological Medicine\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(3), 395\u0026ndash;405. https://doi.org/10.1017/S0033291702006943\u003c/li\u003e\n\u003cli\u003eCenters for Disease Control and Prevention (CDC). (2022). Suicide mortality in the United States, 2020 (NCHS Data Brief No. 433). National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db433.htm\u003c/li\u003e\n\u003cli\u003eChakravarthy, B., Hoonpongsimanont, W., Anderson, C. L., Habicht, M., Bruckner, T., \u0026amp; Lotfipour, S. (2014). Depression, suicidal ideation, and suicidal attempt presenting to the emergency department: Differences between these cohorts. \u003cem\u003eThe Western Journal of Emergency Medicine\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(2), 211\u0026ndash;216. https://doi.org/10.5811/westjem.2013.11.13172\u003c/li\u003e\n\u003cli\u003eChang, E. C., \u0026amp; Chang, O. D. (2016). Development of the Frequency of Suicidal Ideation Inventory: Evidence for the Validity and Reliability of a Brief Measure of Suicidal Ideation Frequency in a College Student Population. \u003cem\u003eCognitive Therapy and Research\u003c/em\u003e, \u003cem\u003e40\u003c/em\u003e(4), 549\u0026ndash;556. https://doi.org/10.1007/s10608-016-9758-0\u003c/li\u003e\n\u003cli\u003eCobb, C. L., Salas-Wright, C. P., John, R., Schwartz, S. J., Vaughn, M., Mart\u0026iacute;nez, C. R., Awad, G., Pinedo, M., \u0026amp; Cano, M. \u0026Aacute;. (2021). Discrimination Trends and Mental Health Among Native- and Foreign-Born Latinos: Results from National Surveys in 2004 and 2013. \u003cem\u003ePrevention Science\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(3), 397\u0026ndash;407. https://doi.org/10.1007/s11121-020-01186-4\u003c/li\u003e\n\u003cli\u003eFelitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., \u0026amp; Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. \u003cem\u003eAmerican Journal of Preventive Medicine\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(4), 245\u0026ndash;258. https://doi.org/10.1016/S0749-3797(98)00017-8\u003c/li\u003e\n\u003cli\u003eGeyer, R. B., Dreyer-Oren, S. E., Das, A., \u0026amp; Clerkin, E. M. (2023). Distressed drinking: The moderating impact of distress tolerance on the relation between anxiety sensitivity, panic symptoms, and alcohol use and problems. \u003cem\u003eJournal of Studies on Alcohol and Drugs\u003c/em\u003e, jsad.22-00353. https://doi.org/10.15288/jsad.22-00353\u003c/li\u003e\n\u003cli\u003eGoldstein, E. V., Bailey, E. V., \u0026amp; Wilson, F. A. (2024). Poverty and Suicidal Ideation Among Hispanic Mental Health Care Patients Leading up to the COVID-19 Pandemic. \u003cem\u003eHispanic Health Care International\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 6\u0026ndash;10. https://doi.org/10.1177/15404153231181110\u003c/li\u003e\n\u003cli\u003eGonzales, J. J., \u0026amp; Papadopoulos, A. S. (Eds.). (2010). \u003cem\u003eMental health services: A public health perspective\u003c/em\u003e (3rd ed). Oxford University Press.\u003c/li\u003e\n\u003cli\u003eHardt, J., \u0026amp; Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence. \u003cem\u003eJournal of Child Psychology and Psychiatry\u003c/em\u003e, \u003cem\u003e45\u003c/em\u003e(2), 260\u0026ndash;273. https://doi.org/10.1111/j.1469-7610.2004.00218.x\u003c/li\u003e\n\u003cli\u003eHayes, A. F., \u0026amp; Rockwood, N. J. (2017). Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. \u003cem\u003eBehaviour Research and Therapy\u003c/em\u003e, \u003cem\u003e98\u003c/em\u003e, 39\u0026ndash;57. https://doi.org/10.1016/j.brat.2016.11.001\u003c/li\u003e\n\u003cli\u003eKroenke, K., Spitzer, R. L., \u0026amp; Williams, J. B. W. (2001). The PHQ-9. \u003cem\u003eJournal of General Internal Medicine\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(9), 606\u0026ndash;613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x\u003c/li\u003e\n\u003cli\u003eLass, A. N., \u0026amp; Winer, E. S. (2020). Distress tolerance and symptoms of depression: A review and integration of literatures. \u003cem\u003eClinical Psychology: Science and Practice\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(3).\u003c/li\u003e\n\u003cli\u003eLeyro, T. M., Zvolensky, M. J., \u0026amp; Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. \u003cem\u003ePsychological Bulletin\u003c/em\u003e, \u003cem\u003e136\u003c/em\u003e(4), 576\u0026ndash;600. https://doi.org/10.1037/a0019712\u003c/li\u003e\n\u003cli\u003eLuca, S. D., Yan, Y., Schueller, D., \u0026amp; O\u0026rsquo;Donnell, K. (2024). Exploring adolescent suicidal trajectories: The intersection of race/ethnicity, gender, and social connectedness. \u003cem\u003eJournal of Adolescence\u003c/em\u003e, \u003cem\u003e96\u003c/em\u003e(8), 1853\u0026ndash;1870. https://doi.org/10.1002/jad.12387\u003c/li\u003e\n\u003cli\u003eKratovic, L., Smith, L. J., \u0026amp; Vujanovic, A. A. (2021). PTSD symptoms, suicidal ideation, and suicide risk in university students: The role of distress tolerance. Journal of Aggression, Maltreatment \u0026amp; Trauma, 30(1), 82-100.\u003c/li\u003e\n\u003cli\u003eMiranda-Mendizabal, A., Castellv\u0026iacute;, P., Par\u0026eacute;s-Badell, O., Alayo, I., Almenara, J., Alonso, I., Blasco, M. J., Cebri\u0026agrave;, A., Gabilondo, A., Gili, M., Lagares, C., Piqueras, J. A., Rodr\u0026iacute;guez-Jim\u0026eacute;nez, T., Rodr\u0026iacute;guez-Mar\u0026iacute;n, J., Roca, M., Soto-Sanz, V., Vilagut, G., \u0026amp; Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and young adults: Systematic review and meta-analysis of longitudinal studies. \u003cem\u003eInternational Journal of Public Health\u003c/em\u003e, \u003cem\u003e64\u003c/em\u003e(2), 265\u0026ndash;283. https://doi.org/10.1007/s00038-018-1196-1\u003c/li\u003e\n\u003cli\u003eMiret, M., Ayuso-Mateos, J. L., Sanchez-Moreno, J., \u0026amp; Vieta, E. (2013). Depressive disorders and suicide: Epidemiology, risk factors, and burden. \u003cem\u003eNeuroscience \u0026amp; Biobehavioral Reviews\u003c/em\u003e, \u003cem\u003e37\u003c/em\u003e(10), 2372\u0026ndash;2374. https://doi.org/10.1016/j.neubiorev.2013.01.008\u003c/li\u003e\n\u003cli\u003eMoreno, E. (2017). Latinos and mental health: Current issues and a reason for hope. American Foundation for Suicide Prevention. https://afsp.org/story/latinos-and-mental-health-current-issues-and-reason-for-hope\u003c/li\u003e\n\u003cli\u003eOmary, A. (2021). National Prevalence Rates of Suicidal Ideation and Suicide Attempts Among Adults With and Without Depression. \u003cem\u003eJournal of Nervous \u0026amp; Mental Disease\u003c/em\u003e, \u003cem\u003e209\u003c/em\u003e(5), 378\u0026ndash;385. https://doi.org/10.1097/NMD.0000000000001309\u003c/li\u003e\n\u003cli\u003eOstanin, J., Miranda, H., Shugar, S., Abdo, D., Mejia, M. C., Hennekens, C. H., \u0026amp; Kitsantas, P. (2025). Suicidal Behaviors Among United States Adolescents: Increasing Clinical and Public Health Challenges. \u003cem\u003eChildren\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(1), 57. https://doi.org/10.3390/children12010057\u003c/li\u003e\n\u003cli\u003ePolanco-Roman, L., Ebrahimi, C. T., Mafnas, K. S. W., Hausmann-Stabile, C., Meca, A., Mazzula, S. L., Duarte, C. S., \u0026amp; Lewis-Fern\u0026aacute;ndez, R. (2023). Acculturation and suicide-related risk in ethnoracially minoritized youth in the US: A scoping review and content analysis of the empirical evidence. \u003cem\u003eSocial Psychiatry and Psychiatric Epidemiology\u003c/em\u003e, \u003cem\u003e58\u003c/em\u003e(8), 1121\u0026ndash;1137. https://doi.org/10.1007/s00127-023-02494-0\u003c/li\u003e\n\u003cli\u003eSahle, B. W., Reavley, N. J., Li, W., Morgan, A. J., Yap, M. B. H., Reupert, A., \u0026amp; Jorm, A. F. (2022). The association between adverse childhood experiences and common mental disorders and suicidality: An umbrella review of systematic reviews and meta-analyses. \u003cem\u003eEuropean Child \u0026amp; Adolescent Psychiatry\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e(10), 1489\u0026ndash;1499. https://doi.org/10.1007/s00787-021-01745-2\u003c/li\u003e\n\u003cli\u003eSilva, C., \u0026amp; Van Orden, K. A. (2018). Suicide among Hispanics in the United States. \u003cem\u003eCurrent Opinion in Psychology\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e, 44\u0026ndash;49. https://doi.org/10.1016/j.copsyc.2017.07.013\u003c/li\u003e\n\u003cli\u003eSilva, M., Loureiro, A., \u0026amp; Cardoso, G. (2016). Social determinants of mental health: A review of the evidence. \u003cem\u003eThe European Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e30\u003c/em\u003e(4), 259\u0026ndash;292.\u003c/li\u003e\n\u003cli\u003eSimons, J. S., \u0026amp; Gaher, R. M. (2005). The Distress Tolerance Scale: Development and Validation of a Self-Report Measure. \u003cem\u003eMotivation and Emotion\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e(2), 83\u0026ndash;102. https://doi.org/10.1007/s11031-005-7955-3\u003c/li\u003e\n\u003cli\u003eStack, S. (2021). Contributing factors to suicide: Political, social, cultural and economic. \u003cem\u003ePreventive Medicine\u003c/em\u003e, \u003cem\u003e152\u003c/em\u003e, 106498. https://doi.org/10.1016/j.ypmed.2021.106498\u003c/li\u003e\n\u003cli\u003eSubstance Abuse and Mental Health Services Administration (SAMHSA). (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report\u003c/li\u003e\n\u003cli\u003eTegegne, K. T., Tegegne, E. T., Tessema, M. K., Bagajjo, W. S., Rike, M., Abebe, A. T., \u0026amp; Bifato, B. (2022). The association between depression and suicidal ideation: a systematic review and meta-analysis. \u003cem\u003eJ Psychol Mental Health Care\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(1), 1-6.\u003c/li\u003e\n\u003cli\u003eTexas Demographic Center (2023). Estimates of the total populations of counties and places in Texas for July 1, 2022 and January 1, 2023 [Methodology]. Retrieved February 21, 2024, from https://demographics.texas.gov/Projections/2022/TotalMethodology.pdf\u003c/li\u003e\n\u003cli\u003eZhong, J., Huang, X.-J., Wang, X.-M., \u0026amp; Xu, M.-Z. (2023). The mediating effect of distress tolerance on the relationship between stressful life events and suicide risk in patients with major depressive disorder. \u003cem\u003eBMC Psychiatry\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 118. https://doi.org/10.1186/s12888-023-04600-7\u003c/li\u003e\n\u003cli\u003eZigmond, M. J., Wiley, C. A., \u0026amp; Chesselet, M.-F. (Eds.). (2023). \u003cem\u003eNeurobiology of brain disorders: Biological basis of neurological and psychiatric disorders\u003c/em\u003e (Second edition). Academic Press, an imprint of Elsevier.\u003c/li\u003e\n\u003cli\u003eZvolensky, M. J., Jardin, C., Garey, L., Robles, Z., \u0026amp; Sharp, C. (2016). Acculturative stress and experiential avoidance: Relations to depression, suicide, and anxiety symptoms among minority college students. \u003cem\u003eCognitive Behaviour Therapy\u003c/em\u003e, \u003cem\u003e45\u003c/em\u003e(6), 501\u0026ndash;517. https://doi.org/10.1080/16506073.2016.1205658\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hispanic mental health, depression, suicidal ideation, adverse childhood experiences, distress tolerance, acculturative stress","lastPublishedDoi":"10.21203/rs.3.rs-6806639/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6806639/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Despite increasing rates of mental health challenges among Hispanic populations in the United States, limited research has examined potential circumstances in the depression to suicidal ideation relationship in this demographic. This study investigated the relationship between depression and suicidal ideation, with a specific focus on the moderating roles of adverse childhood experiences (ACEs) and distress tolerance, two particularly impactful factors in suicide risk.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This study included 800 Hispanic adults in Texas who completed measures of depression, suicidal ideation, ACEs, and distress tolerance. A dual-moderation analysis tested the direct and interactive effects of ACEs and distress tolerance on the link between depressive symptoms and suicidal ideation while controlling for age, sex, and acculturative stress.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Depression and ACEs showed significant direct effects on suicidal ideation. While ACEs did not moderate the depression-suicidal ideation relationship, distress tolerance did. Notably, the relationship between depression and suicidal ideation was strongest among individuals with low distress tolerance compared to high levels. Acculturative stress was positively associated with suicidal ideation, while age was negatively associated.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e: These findings highlight the complex interplay between depression, distress tolerance, and suicidal ideation among Hispanic adults. The unexpected finding that lower distress tolerance strengthened the depression-suicide relationship suggests it may serve as a potential protective factor, warranting further investigation. Results underscore the need to further examine these relationships in a population facing growing mental health concerns.\u003c/p\u003e","manuscriptTitle":"Moderators of Depression and Suicidal Ideation Among Latinos in the United States","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-30 13:17:32","doi":"10.21203/rs.3.rs-6806639/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"60f7529b-8b65-4504-9c2f-880917aa7df6","owner":[],"postedDate":"June 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-22T15:38:42+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-30 13:17:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6806639","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6806639","identity":"rs-6806639","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}