Abstract
Background: Differences in risk and protective factors (e.g., victimization, abuse, social support) have been used to explain elevated rates of suicidal ideation and suicide attempts in sexual minority youth (SMY) relative to heterosexual peers. However, little is known regarding how risk and protective factors may explain suicide risk differences among subgroups of SMY. The aims of this study were to 1) examine differences in prevalence and severity for suicide risk and protective factors among SMY, and 2) explore whether risk and protective factors are differentially associated with suicidal ideation and suicide attempts for SMY subgroups. Methods: Participants were 6,423 adolescents (ages 12–17) recruited from 14 Emergency Departments across the United States who completed an assessment of suicide risk and protective factors. SMY were 20% of the sample (n = 1,275) and categorized as bisexual (8%), gay/lesbian (2%), mostly straight (5%), or other sexual minority (5%). Results: Bisexual youth had elevated rates of suicidal ideation and attempts, more risk factors (e.g., bullying victimization, depression), and fewer protective factors (e.g., parent-family connectedness, positive affect) relative to mostly straight and other sexual minority youth. Bisexual and gay/lesbian youth only differed in parent-family connectedness (lower among bisexual youth). Depression and parent-family connectedness had weaker associations with suicidal ideation for bisexual youth. Limitations: Emergency departments were not nationally representative. Study design was cross-sectional, preventing causal inferences. Conclusions: Interventions seeking to mitigate risk factors and promote protective factors are greatly needed for SMY and may benefit from tailoring to address unique stressors for sexual minority subgroups.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 274-281 |
| Number of pages | 8 |
| Journal | Journal of Affective Disorders |
| Volume | 279 |
| DOIs | |
| State | Published - Jan 15 2021 |
Funding
This research was supported by a grant from the National Institute of Mental Health (NIMH), “Emergency Department Screen for Teens at Risk for Suicide” (ED-STARS, U01 MH104311). It was also supported in part by the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), Emergency Medical Services for Children (EMSC) Network Development Demonstration Program under cooperative agreements U03MC00008, U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, U03MC28845, H3MC26201 and U03MC22685. Adam Horwitz receives funding from the National Center for Advancing Translational Sciences (KL2TR002241). Funders had no role in the design, data analysis, interpretation, or preparation of this manuscript. The information or content and conclusions in this manuscript are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NIMH, HRSA, HHS, NCATS, or the U.S. Government. We thank the PECARN Data Coordinating Center staff at the University of Utah, including Marie Kay, BA, and Michelle Robinson, BS, for project management, and Casey Evans, BS, for contributions to data programming and management. We also thank Rebecca Lindsay, MPH, Kristin Aho, MS, and Taylor McGuire, BS, of the University of Michigan for project assistance, as well as the youth and families who participated in the ED-STARS study.
Keywords
- Connectedness
- Risk factors
- Sexual minority youth
- Suicidal ideation
- Suicide attempts
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health
