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Wallace ER, O'Neill S, Lagdon S. Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review. J Adolesc 2024. [PMID: 38372179 DOI: 10.1002/jad.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index. METHODS A scoping review guided by Arksey and O'Malley's five-stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies. RESULTS Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti-LGBTQ+ policies/legislation. Key protective factors include self-affirming strategies, adult/peer support, at-school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender-affirming services and LGBTQ+ inclusive policies and legislation. CONCLUSIONS Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio-ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio-ecological model, and these studies should include a focus on protective factors and significant within-group differences.
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Affiliation(s)
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Susan Lagdon
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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2
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Parchem B, Wheeler A, Talaski A, Molock SD. Comparison of anxiety and depression rates among LGBTQ college students before and during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:31-39. [PMID: 34919495 DOI: 10.1080/07448481.2021.2013238] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/16/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare rates of anxiety and depression among LGBTQ college students before and during the COVID-19 pandemic and examine pandemic-related stressors and protective factors. PARTICIPANTS Two cohorts of LGBTQ college students, aged 18-25, sampled before (N = 3,484) and during (N = 1,647) the pandemic. METHODS The Healthy Minds Study (HMS) is an annual mental health survey administered to college students in the United States, which included additional items related to the COVID-19 pandemic. RESULTS Mean anxiety symptoms were significantly lower mid-pandemic compared to pre-pandemic, but no differences in mean depressive symptoms were detected. Results varied by sexual and gender minority status. Financial stress, pandemic-related concerns, and witnessing discrimination were risk factors while academic persistence, positive mental health, and formal support were protective factors. CONCLUSIONS Mental health and instrumental support from institutions will be critical for college students during the pandemic. Affirming and empowering spaces for LGBTQ college students may leverage protective factors.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Adam Wheeler
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Amber Talaski
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sherry Davis Molock
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
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3
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Sorkhou M, Rashid T, Dere J, Uliaszek A. Psychological Distress in Treatment-Seeking University Students: An Intersectional Examination of Asian Identity and Gender Identity. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2022. [DOI: 10.1080/87568225.2022.2145252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Maryam Sorkhou
- Addictions Division, Center for Addictions and Mental Health, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Tayyab Rashid
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Jessica Dere
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Amanda Uliaszek
- Addictions Division, Center for Addictions and Mental Health, Toronto, Canada
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
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4
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Kimball D, Bonds S, Brady JP, Blashill AJ. Suicidality, Sexual Orientation, and Race/Ethnicity: Results from a U.S. Representative Adolescent Sample. Arch Suicide Res 2022; 26:1950-1957. [PMID: 34459367 DOI: 10.1080/13811118.2021.1965928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: We examined sadness/hopelessness and suicide among racial/ethnic and sexual minority youth (SMY).Methods: 2017 Youth Risk Behavior Survey (YRBS) data on sadness/hopelessness and suicide were analyzed among White, Black, and Hispanic/Latino youth.Results: A main effect of sexual minority (SM) identity emerged for sadness/hopelessness, suicidal ideation, suicide plan, suicide attempts, and injurious attempts; SMY reported increased risk compared to their heterosexual peers. An interaction between Black race and SM identity emerged for sadness/hopelessness, suicidal ideation, and suicide plan; White SMY were at greater risk than Black SMY. A main effect of Black race on suicide attempts was found; Black youth reported increased risk of suicide attempts compared to White youth.Conclusions: Black SMY exhibited lower risk of sadness/hopelessness, suicide ideation, and suicide plans than their White SMY peers, whereas Black youth overall were more likely to report suicide attempts than their White peers.HIGHLIGHTSThere was an interaction of sexual minority identity and race (Black or White) for three outcomes.SM and Black identities were associated with higher risk for suicide attempts.Only SM identity was associated with increased risk of injurious suicide attempts.
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Perry SW, Rainey JC, Allison S, Bastiampillai T, Wong ML, Licinio J, Sharfstein SS, Wilcox HC. Achieving health equity in US suicides: a narrative review and commentary. BMC Public Health 2022; 22:1360. [PMID: 35840968 PMCID: PMC9284959 DOI: 10.1186/s12889-022-13596-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Suicide rates in the United States (US) reached a peak in 2018 and declined in 2019 and 2020, with substantial and often growing disparities by age, sex, race/ethnicity, geography, veteran status, sexual minority status, socioeconomic status, and method employed (means disparity). In this narrative review and commentary, we highlight these many disparities in US suicide deaths, then examine the possible causes and potential solutions, with the overarching goal of reducing suicide death disparities to achieve health equity. The data implicate untreated, undertreated, or unidentified depression or other mental illness, and access to firearms, as two modifiable risk factors for suicide across all groups. The data also reveal firearm suicides increasing sharply and linearly with increasing county rurality, while suicide rates by falls (e.g., from tall structures) decrease linearly by increasing rurality, and suicide rates by other means remain fairly constant regardless of relative county urbanization. In addition, for all geographies, gun suicides are significantly higher in males than females, and highest in ages 51–85 + years old for both sexes. Of all US suicides from 1999–2019, 55% of male suicides and 29% of female suicides were by gun in metropolitan (metro) areas, versus 65% (Male) and 42% (Female) suicides by gun in non-metro areas. Guns accounted for 89% of suicides in non-metro males aged 71–85 + years old. Guns (i.e., employment of more lethal means) are also thought to be a major reason why males have, on average, 2–4 times higher suicide rates than women, despite having only 1/4—1/2 as many suicide attempts as women. Overall the literature and data strongly implicate firearm access as a risk factor for suicide across all populations, and even more so for male, rural, and older populations. To achieve the most significant results in suicide prevention across all groups, we need 1) more emphasis on policies and universal programs to reduce suicidal behaviors, and 2) enhanced population-based strategies for ameliorating the two most prominent modifiable targets for suicide prevention: depression and firearms.
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Affiliation(s)
- Seth W Perry
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. .,Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. .,Department of Neurosurgery, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. .,Department of Public Health and Preventive Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
| | - Jacob C Rainey
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Stephen Allison
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Tarun Bastiampillai
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Mind and Brain Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.,Department of Psychiatry, Monash University, Clayton, Australia
| | - Ma-Li Wong
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.,Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.,Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Julio Licinio
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.,Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.,Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Department of Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.,Department of Pharmacology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
| | - Steven S Sharfstein
- Sheppard Pratt Health System, Baltimore, MD, USA.,Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Suicide Attempts Among Racial and Ethnic Groups in a Nationally Representative Sample. J Racial Ethn Health Disparities 2022; 9:1783-1793. [PMID: 34291440 PMCID: PMC8294284 DOI: 10.1007/s40615-021-01115-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/25/2021] [Accepted: 07/13/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate suicide attempt prevalence and potentially related sociodemographic and psychiatric factors among racial and ethnic groups. METHODS Between 2012 and 2013, the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) conducted semi-structured interviews with 36,309 adults in the USA. We identified lifetime suicide attempt prevalence and significant predictors for each racial/ethnic group using stratified logistic regressions. Analyses were exploratory without a priori hypotheses. RESULTS Asian/Native Hawaiian/other Pacific Islander and Black individuals had the lowest prevalence of suicide attempts while Alaska Native/American Indian and White individuals had the highest prevalence. Identifying as female and meeting criteria for psychiatric diagnoses featuring mood regulation difficulties (depression, borderline personality disorder, bipolar I disorder) were consistently related to a suicide attempt history across racial and ethnic groups, whereas substance abuse disorders and other sociodemographic factors differed between racial and ethnic groups in their associations with suicide attempt history. CONCLUSIONS Although several factors were consistently related to suicide risk across racial and ethnic groups, the prevalence of suicide attempts and overall pattern of related factors were not uniform between racial and ethnic groups. POLICY IMPLICATIONS Study findings highlight the importance of considering suicide risk within the context of race and ethnicity both regarding the overall prevalence of risk and in determining personal factors associated with elevated risk. A failure to appreciate experiences related to race and ethnicity may adversely impact suicide risk assessment and treatment, ultimately contributing to health disparities. Results suggest that additional research is warranted.
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Sousa GSD, Ramos BMD, Tonaco LAB, Reinaldo AMDS, Pereira MO, Botti NCL. Factors associated with suicide ideation of healthcare university students. Rev Bras Enferm 2022; 75. [DOI: https:/doi.org/10.1590/0034-7167-2020-0982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Abstract
ABSTRACT Objectives: to analyze the factors associated with suicidal ideation in students from healthcare graduation courses. Methods: quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire. Results: the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times. Conclusion: the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.
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8
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Kalibatseva Z, Bathje GJ, Wu IHC, Bluestein BM, Leong FTL, Collins-Eaglin J. Minority status, depression and suicidality among counseling center clients. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:295-304. [PMID: 32343191 DOI: 10.1080/07448481.2020.1745810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 01/02/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
Objective This study examined race/ethnicity, gender, sexual orientation, and financial stress and their association with depression and suicidality among university counseling center clients. Methods: The sample included 3,189 participants who received services at a university counseling center. Results: Asian American college students reported more depressive symptoms than European American and Hispanic students and were more likely to have a depression diagnosis than European American and African American students. Female and lesbian/gay/bisexual/questioning (LGBQ) individuals had higher depressive symptom scores, were more likely to have a depression diagnosis, and history of suicidal ideation and attempts than male and heterosexual individuals, respectively. Students with high financial stress reported higher depression scores and were more likely to have experienced past and current suicidality. More minority statuses were associated with higher risk for depression and suicidality. Conclusions: Counseling center clients who identified with one or more minority groups had higher risk for depression and suicidality.
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Affiliation(s)
| | | | - Ivan H C Wu
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Brooke M Bluestein
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Frederick T L Leong
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Jan Collins-Eaglin
- Associate Dean of Students for Personal Success and Wellness, Pomona College, Claremont, California, USA
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9
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Sousa GSD, Ramos BMD, Tonaco LAB, Reinaldo AMDS, Pereira MO, Botti NCL. Factors associated with suicide ideation of healthcare university students. Rev Bras Enferm 2021; 75Suppl. 3:e20200982. [PMID: 34852151 DOI: 10.1590/0034-7167-2020-0982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 06/15/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the factors associated with suicidal ideation in students from healthcare graduation courses. METHODS quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire. RESULTS the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times. CONCLUSION the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.
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10
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Barbot B, Eff H, Weiss SR, McCarthy JB. The role of psychopathology in the relationship between history of maltreatment and suicide attempts among children and adolescent inpatients. Child Adolesc Ment Health 2021; 26:114-121. [PMID: 32424956 DOI: 10.1111/camh.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/23/2020] [Accepted: 04/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND This retrospective chart review study investigates the relationship between the history of various forms of abuse and the presence of mood disorders and psychotic symptoms in predicting suicide attempts among psychiatrically hospitalized children and adolescents. METHOD A multi-mediation analysis was conducted with an archival dataset of 101 children and adolescents hospitalized predominantly for mood disorders and bipolar disorders with and without history of psychotic symptoms. RESULTS Results showed that history of suicide attempts was directly associated with physical abuse and indirectly associated with sexual abuse (mediated by bipolar disorders). Emotional abuse was also indirectly related to history of suicide attempts, mediated by mood disorders for boys, and by psychotic symptoms for girls. CONCLUSIONS This study is among the first to differentiate the unique effects of different types of early maltreatment on psychopathology, particularly mood disorders and psychotic symptoms, and histories of suicide attempts in psychiatrically hospitalized children and youth. KEY PRACTITIONER MESSAGE Little is known about the relationships between histories of maltreatment, psychopathology, and suicide (considered simultaneously) among hospitalized children and adolescents. Different forms of abuse are associated with distinct psychopathology symptoms, and in turn, risk for suicide attempts. Only physical abuse is directly related to a history of suicide attempts, while sexual and emotional abuse are indirectly related (mediated by mood disorders and psychotic symptoms). These risk pathways are partly distinct for girls and boys. Identifying unique and cumulated risk factors can help prevent suicidality among hospitalized youth.
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Affiliation(s)
- Baptiste Barbot
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium.,Child Study Center, Yale University, New Haven, CT, USA
| | - Henry Eff
- Department of Psychology, Pace University, New York City, NY, USA
| | - Shira R Weiss
- Sagamore Children's Psychiatric Center, Dix Hills, NY, USA
| | - James B McCarthy
- Department of Psychology, Pace University, New York City, NY, USA.,School of Psychology, Adelphi University, Garden City, NY, USA
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11
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Hatchel T, Polanin JR, Espelage DL. Suicidal Thoughts and Behaviors Among LGBTQ Youth: Meta-Analyses and a Systematic Review. Arch Suicide Res 2021; 25:1-37. [PMID: 31597541 DOI: 10.1080/13811118.2019.1663329] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Suicide continues to be the second-leading cause of death for all youths aged 15-24. Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are at a significantly higher risk for suicidal thoughts or behaviors (STB). Establishing and understanding correlates of STB among LGBTQ youth is one important step toward enhancing prevention, intervention, and research efforts. To synthesize current knowledge on suicide among LGBTQ youth, the present meta-analyses offer results from 44 studies over the past 20 years. Two-hundred and thirty-four correlation coefficient effect sizes were calculated and categorized. To be included, the study had to quantitatively examine correlates of STB among LGBTQ youth. A number of social-science databases were used to examine the existing published research. Results illustrated the variability among correlates of STB as well as substantial limitations in the extant literature. There was a heterogeneity of effect sizes, a lack of novel correlates, a focus on risk, a dearth of theoretically driven designs, moderate publication bias, a paucity of developmentally driven analyses, and a dearth of research with transgender youth.
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Layland EK, Exten C, Mallory AB, Williams ND, Fish JN. Suicide Attempt Rates and Associations with Discrimination Are Greatest in Early Adulthood for Sexual Minority Adults Across Diverse Racial and Ethnic Groups. LGBT Health 2020; 7:439-447. [PMID: 33290152 PMCID: PMC7757577 DOI: 10.1089/lgbt.2020.0142] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The study purpose was to investigate differences in past 5-year suicide attempts among racially/ethnically diverse sexual minority (SM) and heterosexual adults across the life course and examine the association of discrimination with past 5-year suicide attempts among SM adults. Methods: Using nationally representative data collected from 2012 to 2013, we assessed differences in age-varying prevalence of past 5-year suicide attempts among Black, Hispanic, and White SM and heterosexual adults (ages 18-60). We tested whether the association between discrimination and suicide attempts differed by race/ethnicity among SM adults. All secondary data analyses were approved by the Institutional Review Boards of The Pennsylvania State University and University of Maryland. Results: Compared with heterosexual adults of any race/ethnicity, SM adults exhibited elevated suicide attempt rates until the late twenties when prevalence for Black and Hispanic SM adults declined. Disparities persisted into the mid-40s for White SM adults. Among SM adults of all races/ethnicities, the relationship between SM discrimination and suicide attempts was strongest between ages 18 and 25. For SM adults reporting SM discrimination, odds of suicide attempts were 3.6 times higher for White SM adults and 4.5 times higher for Black and Hispanic SM adults, relative to same-race/ethnicity SM adults who did not report SM discrimination. The effect of SM discrimination was robust among Black and Hispanic SM young adults even when accounting for racial/ethnic discrimination. Conclusions: SM adults of all racial/ethnic groups demonstrated disparities when contrasted with heterosexual adults of any race/ethnicity, although ages characterized by heightened prevalence rates of suicide attempts differed by race/ethnicity. Early adulthood is a critical period for intervention seeking to disrupt the association between SM discrimination and suicide attempts.
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Affiliation(s)
- Eric K. Layland
- The Methodology Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Cara Exten
- College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Allen B. Mallory
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Natasha D. Williams
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
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Busby DR, Horwitz AG, Zheng K, Eisenberg D, Harper GW, Albucher RC, Roberts LW, Coryell W, Pistorello J, King CA. Suicide risk among gender and sexual minority college students: The roles of victimization, discrimination, connectedness, and identity affirmation. J Psychiatr Res 2020; 121:182-188. [PMID: 31837538 PMCID: PMC7008002 DOI: 10.1016/j.jpsychires.2019.11.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Little is known about how victimization and discrimination relate to suicide risk among sexual and gender minority (SGM) college students, or what is protective for these students. The current study will: 1.) determine the extent to which interpersonal victimization, discrimination, identity affirmation, and social connectedness are associated with suicide risk characteristics, and if race and/or ethnicity moderates this association; 2.) examine whether identity affirmation and social connectedness are protective against associations between victimization or discrimination and suicide risk characteristics. METHOD Participants were 868 students (63.6% female) from four United States universities who completed an online screening survey and met the following study inclusion criteria: self-identification as gender and/or sexual minority, endorsement of at least one suicide risk characteristic and no current use of mental health services. Participants also completed measures that assessed demographics, non-suicidal self-injury (NSSI), victimization, discrimination, connectedness, and LGBTQ identity affirmation. RESULTS Victimization was positively associated with depression severity, suicidal ideation, alcohol misuse, suicide attempt history, and NSSI. Discrimination was positively associated with depression severity, suicide attempt history, and NSSI. Connectedness was inversely associated with depression severity, suicidal ideation severity, suicide attempt history, and NSSI, and moderated the association between victimization and suicide attempt history. LGBTQ identity affirmation moderated the link between victimization and depression. CONCLUSIONS Results suggest efforts to decrease victimization and discrimination and increase connectedness may decrease depressive morbidity and risks for self-harm among SGM college students. Further, increasing LGBTQ identity affirmation may buffer the impact of victimization on depression.
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Affiliation(s)
| | | | - Kai Zheng
- University of California, Irvine, CA, USA
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14
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Higgins Tejera C, Horner-Johnson W, Andresen EM. Application of an intersectional framework to understanding the association of disability and sexual orientation with suicidal ideation among Oregon Teens. Disabil Health J 2019; 12:557-563. [DOI: 10.1016/j.dhjo.2019.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/07/2019] [Accepted: 05/20/2019] [Indexed: 10/26/2022]
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15
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Alarcão AC, Dell' Agnolo CM, Vissoci JR, Carvalho ECA, Staton CA, de Andrade L, Fontes KB, Pelloso SM, Nievola JC, Carvalho MD. Suicide mortality among youth in southern Brazil: a spatiotemporal evaluation of socioeconomic vulnerability. BRAZILIAN JOURNAL OF PSYCHIATRY 2019; 42:46-53. [PMID: 31433002 PMCID: PMC6986484 DOI: 10.1590/1516-4446-2018-0352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/17/2019] [Indexed: 11/22/2022]
Abstract
Objective: To conduct a geospatial analysis of suicide deaths among young people in the state of Paraná, southern Brazil, and evaluate their association with socioeconomic and spatial determinants. Methods: Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics. Data on suicide mortality rates (SMR) were extracted for three age groups (15-19, 20-24, and 25-29 years) from two 5-year periods (1998-2002 and 2008-2012). Geospatial data were analyzed through exploratory spatial data analysis. We applied Bayesian networks algorithms to explore the network structure of the socioeconomic predictors of SMR. Results: We observed spatial dependency in SMR in both periods, revealing geospatial clusters of high SMR. Our results show that socioeconomic deprivation at the municipality level was an important determinant of suicide in the youth population in Paraná, and significantly influenced the formation of high-risk SMR clusters. Conclusion: While youth suicide is multifactorial, there are predictable geospatial and sociodemographic factors associated with high SMR among municipalities in Paraná. Suicide among youth aged 15-29 occurs in geographic clusters which are associated with socioeconomic deprivation. Rural settings with poor infrastructure and development also correlate with increased SMR clusters.
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Affiliation(s)
- Ana C Alarcão
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
| | | | - João R Vissoci
- Departamento de Medicina, UEM, Maringá, PR, Brazil.,Global Neurosurgery and Neuroscience Division, Duke Global Health Institute, Duke University, Durham, North California, USA
| | - Elias C A Carvalho
- Núcleo de Processamento de Dados (NPD), UEM, Maringá, PR, Brazil.,Descoberta de Conhecimento e Aprendizagem de Máquina (DCAM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil.,Programa de Pós-Graduação em Informática (PPGIa), PUCPR, Curitiba, PR, Brazil
| | - Catherine A Staton
- Department of Surgery, Duke Global Health Institute, Duke University, Durham, North California, USA
| | - Luciano de Andrade
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil.,Departamento de Medicina, UEM, Maringá, PR, Brazil
| | - Kátia B Fontes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
| | - Sandra M Pelloso
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
| | - Júlio C Nievola
- Programa de Pós-Graduação em Informática (PPGIa), PUCPR, Curitiba, PR, Brazil
| | - Maria D Carvalho
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
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16
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Rimes KA, Shivakumar S, Ussher G, Baker D, Rahman Q, West E. Psychosocial Factors Associated With Suicide Attempts, Ideation, and Future Risk in Lesbian, Gay, and Bisexual Youth. CRISIS 2018; 40:83-92. [PMID: 29932021 DOI: 10.1027/0227-5910/a000527] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Lesbian, gay, and bisexual (LGB) youth have elevated suicidality rates. AIMS To investigate LGB-related and other factors associated with suicide attempts, suicidal ideation, and future suicide risk in a large UK sample. METHOD Logistic regression was used to investigate factors associated with suicidality in 3,275 LGB young adults from the Youth Chances project. RESULTS Suicide attempts (lifetime) were reported by 13.6% of participants; 45.2 % had suicidal ideation in the past year and 9.5% said future suicide attempts were likely. LGB stigma and discrimination experiences were significantly associated with all three aspects of suicidality. These included school stigma factors (e.g., teachers not speaking out against prejudice, lessons being negative about sexual minorities), negative reactions to coming out from family and friends, and LGB-related harassment or crime experiences. Bisexuality, not feeling accepted where one lives, younger sexual minority identification, and younger coming out were also associated with suicidality. Significant non-LGB factors included female gender, lower social support, anxiety/depression help-seeking, experiences of abuse/violence, and sexual abuse. LIMITATIONS This study is cross-sectional and further research is needed to test out whether any of these factors have a causal relationship with suicidality. CONCLUSION A wide range of LGB stigma and discrimination experiences are associated with increased suicidality in LGB youth. Health, social care, and education professionals supporting young people should address LGB-specific risk factors.
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Affiliation(s)
- Katharine A Rimes
- 1 Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Sandhya Shivakumar
- 1 Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Dan Baker
- 3 Department of Family Care and Mental Health, University of Greenwich, London, UK
| | - Qazi Rahman
- 4 Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Elizabeth West
- 5 Department of Family Care and Mental Health, University of Greenwich, London, UK
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17
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Benatov J, Nakash O, Chen-Gal S, Brunstein Klomek A. The Association Between Gender, Ethnicity, and Suicidality Among Vocational Students in Israel. Suicide Life Threat Behav 2017; 47:647-659. [PMID: 28220963 DOI: 10.1111/sltb.12332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 09/17/2016] [Indexed: 11/27/2022]
Abstract
Gender and ethnicity are significant factors when evaluating suicidal risk, especially among ethnically diverse populations. In the current study we explored the association between gender, ethnicity, and suicide ideation and attempts among Arab and Jewish vocational education and training high school students in Israel. Students (N = 3,554) completed a self-report survey evaluating suicide ideation and attempts, depression, anxiety, somatization, and sense of belonging. Hierarchical generalized linear modeling indicated that female Arab adolescents had elevated levels of suicide ideation, higher rates of suicide attempts, and greater psychological distress than Arab males and Jewish students. Furthermore, female Arab adolescents were found to be more susceptible to suicide ideation when depression levels were high. These results are discussed in the context of the double-jeopardy Arab young women face, as members of a minority ethnic group in Israel and their status as women within the patriarchal Arab culture.
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Affiliation(s)
- Joy Benatov
- Psychology, College of Management Academic Studies, Rishon LeZion, Israel
| | - Ora Nakash
- School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
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18
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Correlates of suicidality in firefighter/EMS personnel. J Affect Disord 2017; 208:177-183. [PMID: 27788381 DOI: 10.1016/j.jad.2016.08.078] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/20/2016] [Accepted: 08/24/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Firefighter and Emergency Medical Services (EMS) personnel experience higher rates of lifetime suicidal ideation and attempts than the general population and other protective service professions. Several correlates of suicidality (alcohol use, depression, posttraumatic stress) have been identified in the literature as applicable to firefighter/EMS populations; however, few studies to date have examined the specific correlates of suicidality (lifetime suicidal ideation and/or attempts) in a firefighter/EMS sample. METHODS Participants (N=3036) from a large, urban fire department completed demographic and self-report measures of alcohol dependence, depression, posttraumatic stress disorder (PTSD) symptom severity, and lifetime suicidal ideation and attempts. Participants in this sample performed both firefighter and EMS duties, were predominately male (97%), White (61.6%), and 25-34 years old (32.1%). RESULTS Through hierarchical linear regressions, depression (β=.22, p<.05) and PTSD symptom severity (β=.21, p<.05) were significantly associated with lifetime suicidal ideation (R2 =17.5). Depression (β=.15, p<.001), and PTSD symptom severity (β=.07, p<.01) were significantly associated with lifetime suicide attempts (R2=5.1). LIMITATIONS Several limitations are addressed in the current study. The survey was a self-report pre-existing dataset and lifetime suicidal ideation and attempts were measured using sum scores. Additionally, the disproportionately large sample of males and large, urban setting, may not generalize to female firefighters and members of rural community fire departments. CONCLUSIONS The current study highlights the importance of targeting depression and PTSD symptom severity in efforts to reduce suicidality in firefighter/EMS personnel.
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Mental Health Status of Double Minority Adolescents: Findings from National Cross-Sectional Health Surveys. J Immigr Minor Health 2016; 19:499-510. [DOI: 10.1007/s10903-016-0530-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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