Co-occurring risk behaviors among White, Black, and Hispanic US high school adolescents with suicide attempts requiring medical attention, 1999–2007: Implications for future prevention initiatives

Abstract

Purpose

To identify subtypes of adolescent suicide attempters by examining risk profiles related to substance use, violent behavior, and depressive symptoms. To examine the relationship between these subtypes and having had two or more suicide attempts during the past year. To explore race and gender differences across subtypes of suicide attempters.

Methods

Data were combined from five nationally representative cohorts of the US Youth Risk Behavior Surveillance System (YRBSS) and focused on a subpopulation of youth who reported a suicide attempt requiring medical attention. Latent class analysis was used to identify subtypes of suicide attempters.

Results

Analysis yielded three classes of youth who attempted suicide, distinguishable by their levels of substance use and violent behaviors: low substance use and violent behaviors, high substance use and violent behaviors, and extreme substance use and violent behaviors. All three classes had a high propensity for endorsing depressive symptoms. The proportion of youth with two or more suicide attempts during the past year increased across subgroup of attempters with higher levels of substance use and violent behaviors. Racial and gender differences were found across subtypes of suicide attempters.

Conclusions

Preventing and treating the co-occurrence of substance use and violent behaviors may serve as essential strategies for reducing suicide attempts, especially among male youth. The use of public health strategies for suicide prevention should take into account the different needs of youth at risk for suicide.

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Acknowledgments

This publication was made possible in part from funding from the Brown Center for Violence and Injury Prevention Grant Number 1R49CE001510 from the Centers for Disease Control (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of CDC. This work was also supported, in part, by grant P20MH071897 (E.D. Caine, PI) to the Center for Public Health and Population Interventions for Preventing Suicide, University of Rochester Medical Center and grant R01MH070689 (L.H. Zayas, PI). We thank the Brown Center for Violence and Injury Prevention, the Center for Latino Family Research, the Center for Mental Health Services Research at Washington University in St. Louis, and the Prevention Science Methodology Group for their ongoing support. We also thank research assistants Christina Lindstrom, MSW, Natalie Morgan, and Jill Kuhlberg, MSW at the George Warren Brown School of Social Work at Washington University in St. Louis for their assistance with formatting and uploading the manuscript (contribution was compensated). The NIMH or CDC had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.

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Correspondence to Juan B. Pena.

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The content is solely the responsibility of the authors and does not necessarily represent the official views of the CDC, NIMH, or the National Institutes of Health.

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Pena, J.B., Matthieu, M.M., Zayas, L.H. et al. Co-occurring risk behaviors among White, Black, and Hispanic US high school adolescents with suicide attempts requiring medical attention, 1999–2007: Implications for future prevention initiatives. Soc Psychiatry Psychiatr Epidemiol 47, 29–42 (2012). https://doi.org/10.1007/s00127-010-0322-z

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Keywords

  • Suicide attempted
  • Adolescent
  • Prevention
  • Health status disparities
  • Risk-taking