title: Cultural identification and attempted suicide in Native Hawaiian adolescents.
abstract: OBJECTIVE
  To determine rates of lifetime suicide attempts in a community sample of Native Hawaiian adolescents and determine the contribution of Hawaiian cultural affiliation, socioeconomic status, and psychiatric symptoms as risk factors for suicide.
  
  
  METHODS
  High school students were surveyed in the state of Hawaii for lifetime suicide attempts, Hawaiian cultural affiliation, socioeconomic status, and symptoms of depression, substance abuse, aggression, and anxiety. Multiple logistic regressions were used on 3,094 subjects to develop prediction models for lifetime suicide attempts.
  
  
  RESULTS
  Native Hawaiian adolescents had significantly higher rates of suicide attempts (12.9%) than other adolescents in Hawaii (9.6%). Hawaiian cultural affiliation rather than ethnicity was uniquely predictive of suicide attempts. Logistic regression indicated that depression, substance abuse, grade level, Hawaiian cultural affiliation, and main wage earner's education best predicted suicide attempts in Native Hawaiian adolescents, while depression, substance abuse, and aggression predicted suicide attempts in non-Hawaiians.
  
  
  CONCLUSIONS
  Native Hawaiian adolescents have higher rates of attempted suicide than non-Hawaiian adolescents. Strong Hawaiian cultural affiliation rather than ethnicity is a risk factor for attempted suicide.
authors.affiliation: Native Hawaiian Mental Health Research Development Program, Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu 96813, USA. yuenn@jabsom.biomed.hawaii.edu
authors.forename: N Y
authors.initials: NY
authors.lastname: Yuen
authors.forename: L B
authors.initials: LB
authors.lastname: Nahulu
authors.forename: E S
authors.initials: ES
authors.lastname: Hishinuma
authors.forename: R H
authors.initials: RH
authors.lastname: Miyamoto
mesh_terms: D000069:Acculturation; D000293:Adolescent; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D012933:Social Identification; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data