Suicide in African American Adolescents: Understanding Risk by Studying Resilience

Examining the integrated model of the interpersonal-psychological theory of suicide and intersectionality theory among Black male adolescents

INTRODUCTION

Guided by Opara et al.'s (2022), Integrated Model of the Interpersonal Psychological Theory of Suicide and Intersectionality Theory, the current study examined contextual stressors experienced disparately by Black youth (racial discrimination, poverty, and community violence) as moderators of the association between individual motivating factors for suicidal thoughts and behaviors (perceived burdensomeness, thwarted belongingness, and hopelessness) and active suicidal ideation.

METHOD

Participants were 457 Black adolescent boys (mean age = 15.31, SD = 1.26) who completed self-report surveys.

RESULTS

As predicted, the association between perceived burdensomeness and active suicidal ideation was significantly moderated by economic stress. In addition, the association between peer belongingness and suicidal ideation was significantly moderated by racial discrimination, but there were no moderating effects for school belongingness. Finally, the association between hopelessness and suicidal ideation was significantly moderated by both racial discrimination and witnessing community violence.

CONCLUSION

These findings highlight the need for research, interventions, and policy work devoted to using integrated approaches of individual and socioeconomically relevant patterns of suicidal thoughts and behaviors to support Black youth exposed to various forms of structural oppression.

Profiles of Suicidal Ideation Among Black Male Adolescents: Examination of Individual and Socioecological Predictors

OBJECTIVE

The current study utilized latent profile analysis to identify distinct profiles of suicidal ideation among Black male adolescents and compared profiles on socioecological determinants of suicide and psychological symptoms.

METHOD

A sample of 457 Black male adolescents (mean age = 15.31, SD = 1.26) completed self-report measures of suicidal ideation, racial discrimination, community violence exposure, anxiety symptoms, depressive symptoms, and posttraumatic stress symptoms.

RESULTS

Results of the latent profile analysis revealed a three-profile model: a low ideation profile, with low levels of all forms of suicidal ideation; a general death ideation profile with elevated general thoughts of death and dying; and a high, concealed ideation profile with high levels on all suicidal ideation items, except communicating the ideation to others. ANOVAs revealed that levels of psychological symptoms were significantly different for each profile, with the high, concealed ideation profile showing the highest levels. The low ideation profile had significantly lower scores than the two other profiles on community violence exposure, but the other two profiles did not differ significantly from one another. Further, the general death ideation profile had significantly higher scores on racial discrimination than the other two profiles, but the other two profiles did not differ significantly from one another.

CONCLUSIONS

The current study supports recent socio-cultural theories of suicidal ideation and behavior in Black youth and highlights the need for increased access to care and services for Black boys who are exposed to socioecological factors that heighten suicidal ideation.

Reappraisal Mitigates, While COVID-19 Burnout Exacerbates the Impact of Depressive Symptoms on Suicidal Ideation Among Chinese College Students

Background

Suicide is a global public health issue. This study examined the role of COVID-19 burnout and reappraisal in suicidal ideation caused by depressive symptoms among Chinese college students.

Methods

587 students (261 boys, M age = 19.53, SD = 1.42) were assessed using the Short Depression-Happiness Scale (SDHS), Positive and Negative Suicide Ideation (PANSI) inventory, and Emotion Regulation Scale (ERS).

Results

Correlation analysis indicated depressive symptoms were negatively correlated with reappraisal and positively correlated with suicidal ideation and COVID-19 burnout. Reappraisal was negatively correlated with suicidal ideation and COVID-19 burnout. The moderated mediation model showed COVID-19 burnout enhanced the direct effect of depressive symptoms on suicidal ideation and indirectly enhanced this effect by weakening the protective role of reappraisal.

Conclusion

These finding show that reappraisal acts as a protective factor against suicidal ideation in individuals with depressive symptoms, while COVID-19 burnout exacerbates this effect by weakening reappraisal's protective role.

Masculinity and Afrocentric Worldview: Assessing Risk and Protective Factors of Self-Reliance and Ubuntu on Young Black Men's Suicide Ideation

OBJECTIVE

Over the past three decades, there has been a disproportionate increase in premature deaths among young Black Males (YMBs) in the US. This devastating trend has been largely driven by suicide in YBMs. Ecological and interpersonal psychological theories can be leveraged to understand the etiology of premature death in YBMs through both risk and protective factors. This cross-sectional study assessed the influence of depression, self-reliance, Ubuntu (a commonly noted feature of the Afrocentric worldview), and attitudes toward mental health help-seeking behaviors on suicidal ideation among YBMs.

METHOD

Participants (n = 422) who were identified as male, Black American, or African American and aged 18-29 years old completed an online survey between June and July 2022. Ordinal logistic regression correctly classified 76.5% of cases and found a statistically significant difference between observed and expected values.

RESULTS

The odds of reporting suicidal ideation were higher among those with more symptoms of depression and self-reliance and lower among participants who reported more compassion compared to the reference group.

CONCLUSION

These findings suggest that compassion, an important aspect of Ubuntu, may have a protective effect against suicidal ideation, whereas high levels of depression and self-reliance may be linked to a greater vulnerability to suicidal ideation. As such, the current study recommends that interventions should reduce suicidal ideation and increase mental well-being among YBMs.

Sociodemographic Factors Associated with Suicide Outcomes in Transgender and Gender Diverse Young Adults

OBJECTIVE

Transgender and gender diverse (TGD) populations have a higher prevalence of suicide outcomes compared to cisgender peers. Further, among TGD groups, young adults frequently demonstrate a higher risk compared to other age cohorts. While evidence supports sociodemographic differences in suicide risk, these relationships are not well-established for TGD young adults.

METHOD

A secondary data analysis of the young adult (18-24 years) subpopulation of the 2015 U.S. Transgender Survey was conducted. Predicted probabilities of 12-month and lifetime suicide outcomes by gender identity, sexual orientation, race/ethnicity, homelessness, and poverty were estimated comparing fully adjusted models.

RESULTS

Gender identity, race/ethnicity, and homelessness were significantly associated with all suicide outcomes. Comparisons of gender identities were significant for all outcomes and varied based on the outcome. American Indian/Alaska Native TGD young adults had the highest predicted probabilities compared to other race/ethnicity groups. Further, having a heterosexual/straight sexual identity was among the lowest predicted probabilities for suicide outcomes and significantly differed from several of the other sexual identities.

CONCLUSIONS

Findings underscore the importance of heterogeneity among TGD young adults and the need for intersectional research within this population. Elucidating sociodemographic characteristics that contribute to differential suicide risk is necessary for effective intervention strategies and policy advocacy.

Suicide Methods and Trends Across Race/Ethnicity, Age, and Sex Groups in Chicago, Illinois, 2015-2021

Objectives. To measure differences in suicide rates across race/ethnicity, age, and sex groups in Chicago, Illinois, from 2015 to 2021. Methods. We calculated the incidence rate and annual percentage change in suicides among Asian, Black, Latino/a, and White persons in Chicago. We also analyzed patterns in suicide method across race/ethnicity, age, and sex groups. Results. Suicides increased significantly among Black males (incidence rate ratio [IRR] = 1.10; 95% confidence interval [CI] = 1.01, 1.20), Black females (IRR = 1.18; 95% CI = 1.04, 1.33), and Latino males (IRR = 1.23; 95% CI = 1.11, 1.38) between 2015 and 2021. Suicides decreased overall among White Chicagoans during this period. A significantly greater proportion of Black males than Black females died by suicide using a firearm (55.79% vs 24.05%; P < .001). Similar results were detected for Latino males and females (32.99% vs 9.09%; P = .001) and White males and females (30.10% vs 11.73%; P < .001). Conclusions. Black persons in Chicago were the only group to experience significant increases in suicide among both males and females from 2015 to 2021, although specific methods used varied by race/ethnicity and sex group. (Am J Public Health. 2024;114(3):319-328. https://doi.org/10.2105/AJPH.2023.307511).

Reducing suicidal ideation in African American adolescents: A randomized controlled clinical trial

OBJECTIVE

Suicide rates among African American adolescents have increased exponentially in recent years. The socioecological stressors that can increase suicide risk for African American adolescents, in conjunction with unique suicide risk manifestations within this group, require culturally sensitive preventive interventions. This study examines the efficacy of the Adapted-Coping With Stress course (A-CWS), a culturally tailored preventive intervention, to reduce suicidal ideation in African American adolescents, utilizing a randomized controlled design.

METHOD

Participants included 410 ninth-grade students in a large Midwestern city; most students identified as Black/African American. Participants were randomly assigned to either the A-CWS intervention or standard care control condition. All participants were assessed at baseline, immediately postintervention, and 6 and 12 months postintervention.

RESULTS

Treatment effects were examined using latent growth models comparing suicidal ideation trajectories in control and intervention conditions. Analyses were conducted using both intention-to-treat and treatment-as-received samples (i.e., intervention condition participants who attended at least 80% of sessions). In both intention-to-treat and treatment-as-received analyses, there was a significant treatment effect: Individuals in the A-CWS intervention condition with higher baseline ideation evidenced a superior reduction in suicidal ideation over the course of the study, relative to their counterparts in the standard care control condition.

CONCLUSION

Findings indicate that the A-CWS preventive intervention is efficacious in reducing suicidal ideation among African American adolescents with higher levels of baseline suicidal ideation and that effects sustain over time, with the strongest effect evidenced 12 months postintervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Severity and Transition of Suicidal Behaviors in Childhood: Sex, Racial, and Ethnic Differences in the Adolescent Brain Cognitive Development (ABCD) Study

PURPOSE

To examine the prevalence, incidence, and transitions of suicide ideation and attempts and sex and racial/ethnic differences among children enrolled in three yearly assessments of the Adolescent Brain Cognitive Development Study. The forms of suicidal ideation (SI) (no SI, passive, nonspecific active, and active) among those who attempted suicide were also described.

METHODS

A subsample of 9,923 children (9-10 years old at baseline, 48.6% female) completed the KSADS-5 questions about suicide ideation and attempts in three yearly assessment (83.5% of baseline sample).

RESULTS

Almost 18% of the children reported suicidal ideation and 2.2% a suicide attempt at one of the three assessments. Passive (6.9%) and nonspecific active (6.4%) were the most frequent forms of suicidal ideation reported. Of the children with suicidal ideation at baseline, 5.9% first attempted suicide in the two subsequent years. Boys (vs. girls) reported more suicidal ideation at baseline. Black children (vs. White and Hispanic/Latinx) and girls (vs. boys) were more likely to start thinking about suicide over time. Black children (vs. White) reported more suicide attempts at baseline and across assessments. More than half of the children who attempted suicide at any assessment reported nonspecific active suicidal ideation (desire to kill oneself without plan/intent/method) as the most severe form of ideation.

DISCUSSION

Findings suggest a high prevalence of suicidal ideation among children in the US. When conducting risk assessments, clinicians should consider both active and nonspecific active suicidal ideation. Early intervention with children who are thinking about suicide may reduce their risk for attempting suicide.

Investigating the Role of Suicidality and Ethnic Identity among Black Adolescents: A Latent Profile Analysis

OBJECTIVE

Suicide among Black adolescent youth has steadily increased in recent years, yet few studies describe how facets of social identity shape suicidal thoughts and behaviors (STBs) during this critical stage of development. Ethnic identity represents an underexplored, yet important element of social identity among Black youth that may contribute to differential associations with STBs. This study examined the association between ethnic identity and self-reported suicidal ideation, planning, and attempts.

METHODS

Data were drawn from 1,170 African American (n = 810) and Caribbean Black (n = 368) adolescents aged 13-17 (Mean age = 15) that participated in the National Survey of American Life Adolescent supplement study.

RESULTS

Using latent profile analyses, three patterns of ethnic identity were identified: Undifferentiated, Low Ethnic Identification, and Alienated. Caribbean Black adolescents were more likely to be in the Low Ethnic Identification class relative to the Undifferentiated class. Adolescents in the Undifferentiated group reported higher proportions of suicidal ideation, planning, and attempts compared to the remaining latent profile groups.

CONCLUSION

Findings demonstrate that ethnic identity is an important aspect of social identity that can influence STBs among Black adolescents. Considering increased suicide attempts and death rates among Black youth, findings underscore the importance of examining culturally relevant developmental processes that may shape suicidal beliefs and behaviors.

Suicide in young people: screening, risk assessment, and intervention

Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. This review outlines the epidemiology of suicide and suicidal behavior in young people. It discusses intersectionality as an emerging framework to guide research on prevention of suicide in young people and highlights several clinical and community settings that are prime targets for implementation of effective treatment programs and interventions aimed at rapidly reducing the suicide rate in young people. It provides an overview of current approaches to screening and assessment of suicide risk in young people and the commonly used screening tools and assessment measures. It discusses universal, selective, and indicated evidence based suicide focused interventions and highlights components of psychosocial interventions with the strongest evidence for reducing risk. Finally, the review discusses suicide prevention strategies in community settings and considers future research directions and questions challenging the field.

Resilience and Depressive Symptoms Mediated Pathways from Social Support to Suicidal Ideation Among Undergraduates During the COVID-19 Campus Lockdown in China

Purpose

The COVID-19 pandemic has greatly affected people's mental health. The direct and indirect pathways between social support and suicidal ideation in the period are still unclear. This study explores the pathways from social support to suicidal ideation through resilience and depressive symptoms among undergraduates during the COVID-19 campus lockdown.

Methods

During two weeks of the COVID-19 campus lockdown, a total of 12,945 undergraduates at a university in eastern China completed the questionnaire including sociodemographic characteristics, suicidal ideation, social support, resilience, and depressive symptoms. A structural equation modeling (SEM) approach was used to analyze the direct and indirect pathways from social support to suicidal ideation via the mediators of resilience and depressive symptoms.

Results

Of the 12,917 undergraduates included in this study, 7.4% (n = 955) reported they sometimes had suicidal ideation, 0.8% (n = 109) reported they often had suicidal ideation, 0.9% (n = 122) reported they always had suicidal ideation, and 13.2% (n = 1704) reported they had depressive symptoms. Social support exerted significant direct (β = -0.058), indirect (β = -0.225), and total (β = -0.283) effects on suicidal ideation; 20.5% of the total effect was direct, and 79.5% was indirect. Social support predicted suicidal ideation through resilience (β = -0.038), and depressive symptoms (β = -0.087), explaining 13.4%, and 30.7% of the total effect, respectively. Social support predicted suicidal ideation through the sequential mediation of resilience and depressive symptoms (β = -0.099), explaining 35.0% of the total effect.

Conclusion

This is the first study to provide the evidence of pathways from social support to suicidal ideation through resilience and depressive symptoms during the COVID-19 campus lockdown among undergraduates in China. Both direct and indirect pathways from social support to suicidal ideation were identified as intervention targets to reduce suicidal ideation.