Greater Minority Stress is Associated with Lower Intentions to Disclose Suicidal Thoughts among LGBTQ + Youth

Sexual Orientation and Disclosure of Suicidal Thoughts Before Suicide Mortality

INTRODUCTION

Disclosure of suicidal thoughts and behaviors represents an opportunity to intervene before suicide mortality, representing a cornerstone for suicide prevention. Sexual minority (e.g., lesbian/gay, bisexual) people experience sharply elevated suicide risk, yet there is scant research on patterns of disclosure of suicidal thoughts and behaviors before suicide that might uncover missed opportunities for suicide prevention. Thus, authors leveraged postmortem suicide data to evaluate associations among sexual orientation, sex, and disclosure of suicidal thoughts and behaviors in the month preceding death.

METHODS

Data on suicides from the 2013-2019 National Violent Death Reporting System (N=155,516) were classified for sexual orientation and denoted disclosure of suicidal thoughts and behaviors and to whom suicidal thoughts and behaviors were disclosed in the month preceding death. Logistic regression models stratified by sex and adjusted for sociodemographic covariates assessed the associations between sexual orientation and suicidal thoughts and behaviors disclosure. Analyses were conducted from October 2022 to February 2023.

RESULTS

Among females, sexual minority decedents were 65% more likely to disclose suicidal thoughts and behaviors than heterosexual decedents (95% CI=37%, 99%, p<0.001). No difference in suicidal thoughts and behaviors disclosure was observed between sexual minority and heterosexual men. Of decedents who disclosed suicidal thoughts and behaviors, one in five sexual minority decedents disclosed to a friend/colleague, whereas fewer than 5% disclosed to a healthcare professional. Among sexual minority females, younger age, intimate partner problems, and physical health problems were positively associated with disclosing suicidal thoughts and behaviors.

CONCLUSIONS

These findings suggest that reducing suicide mortality in sexual minority populations will require considering contexts beyond the healthcare system, including engaging peer networks. Gatekeeper training for suicide prevention may be an especially promising approach for reducing suicide among sexual minority women.

Suicide-related disclosure patterns among culturally minoritized youth: Examining differences across race, ethnicity, gender identity, and sexual orientation

OBJECTIVE

Sharing one's suicidal thoughts and behaviors, or suicide-related disclosure, allows adolescents to recruit help from others. Despite elevated risk among culturally minoritized youth, their suicide-related disclosure remains understudied.

METHODS

191 adolescents (M = 15.98, SD = 1.04, range = 13-17), including minoritized youth (38% racially, 19% ethnically, 40% gender, and 77% sexually), were recruited via social media ads and completed an anonymous online survey on suicide-related disclosure to informal support sources (e.g., family, friends). Disclosure rates, targets, and reasons for disclosure and nondisclosure were compared based on race, ethnicity, gender identity, and sexual orientation.

RESULTS

Racially minoritized adolescents less often disclosed suicidal ideation and more strongly endorsed fear of negative reactions and resistance to intervention as reasons for nondisclosure, and reciprocity as reasons for disclosure, than White adolescents. Cisgender adolescents less often disclosed suicidal ideation and more strongly endorsed dismissal of suicide risk as reasons for nondisclosure than gender minoritized adolescents. Non-Hispanic adolescents more strongly endorsed help-seeking as reasons for disclosure than Hispanic adolescents. While adolescents overall disclosed most often to friends, heterosexual adolescents disclosed more to family than sexually minoritized adolescents.

CONCLUSION

Racial and gender disparities in suicide-related disclosure may occur for distinct reasons among adolescents. Uncovering patterns of disclosure may facilitate detection of suicide risk among minoritized youth.

An Integrated Conceptual Model to Understand Suicidality among Queer Youth to Inform Suicide Prevention

In this article, we apply and combine elements from four theoretical frameworks (i.e., Minority Stress Theory, Person-in-Environment and Risk and Resilience Framework, Interpersonal-Psychological Theory of Suicide, and Intersectionality) to explain the problem of queer youth suicide through our integrated conceptual model, Queer Prevention of Youth Suicidality Model (Queer-PRYSM). The need for this conceptual model is based on the current state of the literature, including mixed empirical findings on factors related to queer youth suicidality, no scholarly consensus on specific contributing factors regarding high rates of suicidality among queer youth (including queer youth subgroups), and the absence of a unifying theory to explain the queer youth suicide risk. To address these limitations in theory, evidence, and scholarship explaining suicidality among queer youth we present our integrated model with growing, current, relevant research with queer youth. Queer-PRYSM includes minority stressors specific to queer youth, mental health problems, interpersonal-psychological factors, socioecological factors (i.e., family, school, peers, and community), and intersectionality concepts. Queer-PRYSM is essential to understanding the relationship of distal and proximal risk and protective factors in queer youth suicide and developing evidence-informed suicide preventive interventions that can be incorporated into practice, policy, and system structures.

Health and Social Inclusion: The Impact of Psychological Well-Being and Suicide Attempts Among Older Men Who Have Sex With Men

Older adults' mental health and suicidal tendencies have garnered much attention because of their vulnerability. Few studies have examined the impact of psychological well-being and suicide attempts among older men who have sex with men (OMSM). This study examines the levels of depression and suicidal tendencies among OMSM, factors impacting their mental health, and their likelihood of committing suicide. Descriptive statistics are used to analyze the correlation between depression and suicidal tendencies among OMSM in the United States. We constructed a regression model using relevant data, and scales were selected based on a literature review. The validity and relevance of the control variables were considered. Depression and suicidal tendencies were dependent variables. Data were obtained from the U.S. General Social Survey and analyzed with an ordinary least squares model. There were significant differences between MSM and general groups in depression and suicidal tendency scores (t = 67.084, 58.193, p < .01). Compared with general groups, MSM scored significantly higher on depression and suicidal tendencies. The regression analysis revealed that sex with men was associated with depression and suicidal tendencies (p < .01) among older men. This indicates that OMSM generally have higher levels of depression and suicidal tendencies than the general population. Finally, in the intermediary test, the level of depression had a significant mediating effect on the relationship between homosexuality and suicidal tendencies (p < .01). This suggests that depression intervention can help reduce suicidal tendencies among OMSM.

Family Rejection During COVID-19: Effects on Sexual and Gender Minority Stress and Mental Health Among LGBTQ University Students

This study examines the relationship between family rejection and moderate to severe psychological distress during COVID-19 among LGBTQ university students. Data were obtained from a national cross-sectional electronic survey of LGBTQ university students (N = 565) collected in the summer of 2020. Hierarchical logistic regression models were used to examine the predictive association between increased family rejection and moderate to severe psychological distress. Respondents who reported increased rejection were more than twice as likely to report moderate to severe psychological distress, with social isolation and LGBTQ identity concealment being significant covariate predictors in the model. These results demonstrate the importance of public health, medical, mental health, and higher education stakeholders understanding the significance of LGBTQ-identity related family rejection when addressing the mental health and well-being of LGBTQ young people.

Exposure to Self-Directed Violence: Understanding Intention to Help and Helping Behaviors among Adolescents and Emerging Adults

Exposure to self-directed violence (SDV) is a public health issue. Prevention trains third parties to identify SDV risk and provide help. However, we know little about the range of help provided to those who engage in SDV. The current study used a cross-sectional online survey of 1031 adolescents and emerging adults to learn about their SDV exposure, intent and attempts to help, and barriers to helping. Most participants reported SDV exposure, commonly by a peer, and provided help. Regression analyses showed that intent to help was predicted by social norms and having knowledge of resources, and such knowledge (but not social norms) was also related to actual helping behaviors. Qualitative analysis of short open-ended questions on the survey documented a range of barriers to helping. Findings support but also encourage revision of theoretical models of helping upon which prevention programs are based.