Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey.

PURPOSE: Although some studies have examined the association between prescription opioid misuse and mental health outcomes, few have investigated the effects of prescription opioid misuse on suicidal behaviors among Black adolescents. The objective of this study was to investigate the cross-sectional association between prescription opioid misuse and suicidal ideation, suicide plan, and suicide attempt among Black adolescents. METHODS: Data for this study came from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 4798 Black adolescents aged 14-18 years (51.2% female) was analyzed using binary logistic regression. The outcome variables investigated were suicidal ideation, suicide plan, and suicide attempt, and the main explanatory variable was prescription opioid misuse. RESULTS: Of the 4798 Black adolescents, 15% reported ever misusing prescription opioids; 16.2% experienced suicidal ideation; 14% made a suicide plan; and 11.3% attempted suicide during the past 12 months. In the multivariate logistic regression models, Black adolescents who misused prescription opioids had 1.39 times higher odds of making a suicide plan and 1.65 times higher odds of making a suicide attempt during the past 12 months when compared to their counterparts who did not misuse prescription opioids. Other significant factors associated with suicidal behaviors include female sex, school bullying, cyberbullying, depressive symptoms, and illicit drug use. In addition, physical activity had a protective effect on suicide attempt. CONCLUSION: The findings of the present study demonstrate the effects of prescription opioid misuse and its association with suicidal behaviors among Black adolescents.

Suicidal Behaviors in Early Adolescence: The Interaction Between School Connectedness and Mental Health.

Previous research has identified mental health symptoms such as depression and aggression as contributing factors associated with suicidal ideation and attempts in adolescence. However, much of this work has focused on older adolescents (ages > 14) resulting in a dearth of knowledge about early adolescents under 12 years. Moreover, much less is known about school connectedness as a protective factor in the relationship between mental health symptoms and suicidal behaviors. This study examined the interaction effect between school connectedness and mental health symptoms on suicidal behaviors among early adolescents aged 9-12 years. Data were drawn from the Fragile Families and Child Wellbeing Study and yielded an analytic sample (n = 2826) that was majority male (52%), Black (53%), and with an average age of 9.3 years. Data were analyzed using multivariate logistic regression. Among participants, 2% experienced suicidal ideation, and 2% experienced suicide attempts. Black adolescents were more than five times more likely to experience a suicide attempt compared to their White peers (AOR = 5.37; 95% CI = 1.71-16.95; p = .004). There was a significant interaction effect between withdrawn depressed symptoms and school connectedness (AOR = .95; 95% CI = .91-98; p = .006), and between aggressive behavior and school connectedness (AOR = 1.02; 95% CI = 1.01-1.03; p = .001) on suicide attempts. School connectedness did not moderate the relationship between mental health symptoms and suicidal ideation. The findings have important practical implications, which are discussed.

The moderating effect of COVID-19 stress on school racial climate and parent and child mental well-being.

The deleterious and racially disparate health outcomes of COVID-19 have been on full display since the pandemic began in the United States; however, less exploration has been dedicated to understanding short- and long-term mental health outcomes for U.S. parents and their children as a result of COVID's impact on schooling. This cross-sectional study examined U.S. parents perspectives on COVID-19 stress as a moderating influence on the relationship between perceptions of school racial climate (i.e., intergroup interactions and campus racial socialization) and parent and child mental health outcomes. Participants were recruited from Prolific's online survey platform and included a sample of 397 U.S. parents (52% female, average age 40, 74% White) with a child between the ages of 6 and 17, enrolled in a K-12 public school setting during the 2020-2021 academic year. The results revealed that COVID-19 stress moderated the relationship between parents' perceptions of campus racial socialization and parent mental well-being. Parents who reported either low, moderate, or high levels of COVID-19 stress had improved mental health when racial socialization in their child's school was high. This impact was greater for parents with high levels of COVID-19 stress than with low levels of COVID-19 stress. However, parents' perceptions of COVID-19 stress did not moderate the relationship between school racial climate factors and child behavioral and emotional problems. Findings have important implications which are discussed.

Connectedness to Family, School, and Neighborhood and Adolescents' Internalizing Symptoms.

In the U.S., there is a strong national interest in social connectedness as a key determinant in promoting positive well-being in adolescents through building strong bonds and creating protective relationships that support adolescent mental health. To this end, this study examined whether, and to what extent, specific types of connectedness to family, school, and neighborhood were associated with internalizing symptoms (i.e., depression and anxiety) among a diverse sample of adolescents from disadvantaged backgrounds. The sample (n = 2590) was majority male (51%), with an average age of 15.6 years, and identified as Black (49%) and Hispanic/Latino (26%). The results revealed that adolescents who reported strong connections to their parent (ß = -0.128, p < 0.001), school (ß = -0.222, p < 0.001), and neighborhood (ß = -0.116, p = 0.003) were more likely to report lower levels of depressive symptomology, with school connectedness exerting a greater influence. In addition, parent connectedness (ß = -0.157, p < 0.001) and school connectedness (ß = -0.166, p < 0.001) were significantly related to teen anxiety; however, neighborhood connectedness was not (ß = -0.123, p = 0.087). The findings have important implications, which are discussed.

An Examination of Peer Victimization and Internalizing Problems through a Racial Equity Lens: Does School Connectedness Matter?

Although research has given ample consideration to the association between peer victimization and internalizing problems, little is known about the mediating and moderating influences on this relationship. This study investigated whether peer victimization at age 9 indirectly related to internalizing problems at age 15 via school connectedness and whether the direct and indirect associations between peer victimization and internalizing problems were moderated by race. Data were drawn from the Fragile Families and Child Wellbeing Study, which included 2467 adolescents. The sample was equally divided between male and female and 82% identified as Black and Hispanic. Results indicated that the predictive effect of peer victimization over a 6-year period on teen depression and anxiety was explained by increased school connectedness. Furthermore, there was a moderating effect of race on the direct effect of school connectedness and teen depression and anxiety. For both White and ethnic minority youth, increased school connectedness was associated with less teen depression and anxiety. However, this effect was weaker for ethnic minority students in comparison to White students in both moderated mediation models. The moderated mediation results for teen anxiety showed a greater differential effect among race. The findings have important implications, which are discussed.