Pathway from attention-deficit/hyperactivity disorder to suicide/self-harm.

To evaluate the effect of ADHD diagnosis by the age of 10 on the suicide/self-harm risk at age 14 and examine factors that may modify/mediate the association, a longitudinal study based on the nationwide survey consisting of 5,107 children in Australia was used. Self-harm and suicidal risks in children with ADHD at age 14 were the main outcomes; ADHD medication, history of bullied or depression, and other sociodemographic disadvantages, were treated as covariates. The diagnosis of ADHD at age 10 is associated with elevated risks of self-harm, suicidal thoughts, planning, or attempts by age 14, with greater susceptibility in males. The pathway from ADHD symptoms to suicide/self-harm could also be mediated by depression and exposure to bullying assessed at age 12. Note that depression and exposure to bullying might at best contribute to less than 10 % of the total effect of ADHD diagnosis on either the risk of suicide or self-harm. Early gender-tailored intervention and prevention strategies are crucial in clinical practice and health policy.

Psychological and socio-ecological correlates of 12-month suicide behavior among junior high school students in the greater Accra region of Ghana.

AIM: In Ghana, we know little about the epidemiology of suicide ideation, plan and attempts among junior high school (JHS) students in Ghana including the years preceding high school. This study explores the onset, characteristics, and recent patterns of 12-month suicide behavior among Ghanaian junior high school (JHS) students. MATERIALS AND METHODS: Paper-based surveys were administered to a sample (n = 800) of junior high school students in the Greater Accra region of Ghana. Self-reported measures on suicide ideation, plan and attempt as well as several psychological and psychosocial factors related to mental health, substance use, poverty, sexual behavior, interpersonal relationships, and family structure were employed. Bi-variate, multivariate and logistic regression analyses were performed using Statistical Package for the Social Sciences (SPSS version 25). RESULTS: This study found that 1 out of 5 adolescents have experienced suicide ideation in the last 12 months. Girls had significantly higher 12-month (χ2 = 3.5, p < 0.05) suicide ideation rates than boys. More importantly, the study found stress significantly increasing the odds of suicide behaviors in the last 12 months (ß = 1.14; CI = 1.05-1.24, p < 0.05) and parental support significantly reducing the odds of suicide behaviors in the last 12 months (ß = 0.86; CI = 0.81-0.91, p < 0.05). Additionally, we found significant associations between sexual intercourse, dating, hunger, substance use, suicide stigma and suicide behaviors. CONCLUSION: This finding highlights a potential emerging suicide crisis among preteens which warrants attention. Additional studies are needed to observe these increasing trends and identify risk, protective and precipitating factors to help prevent suicide among these children.

Factors Associated with Suicide Risk Behavior Outcomes Among Black High School Adolescents.

There is an urgent need for youth suicide research, particularly among Black adolescents, for whom there have been significant increases over time. This study examines associations between eight covariates and suicide ideation, planning, and attempts among a national sample of Black high school adolescents to inform prevention efforts. Utilizing the 2019 National Youth Risk Behavior Survey data, a sample of N = 6225 Black high school participants was analyzed. A weighted classification tree and network analysis were used to visualize data features, and weighted multinomial ordered logistic regression analyses with multiple imputation pooled using Rubin's rules were performed. Suicide ideation rates of 16% were found in the sample and a higher reported rate of suicide attempts (56%) for those who have reported both ideation and planning. Interpersonal and multilevel factors, including suffering from bullying/cyberbullying, carrying a weapon, or being a sexual minority, were significantly associated with all three suicide behaviors. Findings support an interrelated and multilevel nature of suicide risk factors. Prevention programs for Black adolescents should consider the intersectionality of identities and experiences.

Correlates of Suicide Among Middle and High School Students in Ghana.

PURPOSE: We know little about the epidemiology of suicide among middle school students in Ghana, including the years preceding high school. This study explores the onset, characteristics, and recent patterns of suicide among Ghanaian middle and high school students. METHODS: This study used the World Health Organization Global School-based Student Health Survey (GSHS, 2012), which has self-reported measures on suicide ideation, plan, and attempt of middle and high school students in Ghana. Correlation and logistic regression analyses were performed using Statistical Package for the Social Sciences (SPSS version 25). RESULTS: The study found prevalence of suicidal behaviors among the population as follows: ideation (19%), plan (22%), and attempt (25%). Suicide ideation significantly increased the risk for suicide plan (odds ratio [OR] = 9.14; 95% confidence interval [CI] = 7.57-11.02) and attempt (OR = 11.89; 95% CI = 9.82-14.38), whereas suicide plan significantly increased the odds of suicide attempt (OR = 12.64; 95% CI = 10.50-15.19). There was a higher prevalence of suicide ideation, plan, and attempts among middle school students than high school students although only suicide attempt differences were significant (28.4% > 22.3%; χ2 = 17.1, p < .001). DISCUSSION: The onset of suicide among Ghanaian students occurs at younger ages than previously thought, and there were increasing trends in suicide behaviors as age increases. This finding highlights a potential suicide crisis among preteens, which warrants attention. Additional studies are needed to observe these increasing trends, identify risk, protective, and precipitating factors to help prevent suicide among these children.

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.

An Examination of Suicidal Behavior among Black College Students with Exposure to Police Violence.

There is limited research about suicidal behaviors among Black emerging adults (peak age of suicide risk) who report exposure to police violence. The current study applies an integrated approach to examine individual, immediate environment, and community-based risk and protective factors of suicide among Black college students who reported previous exposure to police violence. A purposive sample of Black college students (N = 300) was analyzed using bivariate analyses and binary logistic regression. Outcome variables investigated were lifetime suicidal ideation and suicide attempt. Twenty-eight percent of participants reported lifetime suicidal ideation and 14 percent reported lifetime attempts. Female students were significantly more likely to report lifetime suicidal ideation and recent symptoms of anxiety and to engage in emotional social support than male peers. Logistic regression results demonstrated that higher income and greater depression symptoms were associated with lower reporting of lifetime suicidal ideation. Reporting of more grit, the trait of perseverance and passion for long-term goals, was associated with a lower reporting of both lifetime suicidal ideation and suicide attempt. Findings have implications for how social workers in higher education are encouraged to address suicidal behavior among Black students, including the cultivation of grit.

Assessing the Real-time Influence of Racism-Related Stress and Suicidality Among Black Men: Protocol for an Ecological Momentary Assessment Study.

BACKGROUND: Suicide is the third leading cause of death among Black adults aged 18-35 years. Although men represent a majority of suicide deaths among Black adults, less is known regarding the extent to which unique cultural stressors, such as racism-related stress (eg, racial discrimination), are salient in exacerbating suicide risk among Black men. Moreover, few studies examine the daily influence of racism-related stressors on suicide outcomes using real-time smartphone-based approaches. Smartphone-based mobile health approaches using ecological momentary assessments (EMA) provide an opportunity to assess and characterize racism-related stressors as a culturally sensitive suicide risk factor among Black young adult men. OBJECTIVE: The goal of this study is to describe a protocol development process that aims to capture real-time racism-related stressors and suicide outcomes using a smartphone-based EMA platform (MetricWire). METHODS: Guided by the Interpersonal Theory of Suicide (ITS), we developed a brief EMA protocol using a multiphased approach. First, we conducted a literature review to identify brief measures previously used in EMA studies, with special emphasis on studies including Black participants. The identified measures were then shortened to items with the highest construct validity (eg, factor loadings) and revised to reflect momentary or daily frequency. Feasibility and acceptability of the study protocol will be assessed using self-report survey and qualitative responses. To protect participants from harm, a three-tier safety protocol was developed to identify participants with moderate, elevated, and acute risk based on EMA survey response to trigger outreach by the study coordinator. RESULTS: The final EMA protocol, which will be completed over a 7-day period, is comprised of 15 questions administered 4 times per day and a daily questionnaire of 22 items related to sleep-related impairment and disruption, as well as racism-related stress. Study recruitment is currently underway. We anticipate the study will be completed in February 2023. Dissemination will be conducted through peer-reviewed publications and conference presentations. CONCLUSIONS: This protocol will address gaps in our understanding of Black men's suicide outcomes in the social contexts that they regularly navigate and will clarify the temporal role of racism-related stressors that influence suicidal outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/31241.