Health Risk and Protective Behaviors of Suicide Attempts in Adolescents with Suicide Ideation.

Abstract

Suicidality among adolescents is a major public health concern. Although prior research has identified numerous risk factors for suicidal thoughts and behaviors, little is known about factors that uniquely predict suicide attempts. Additionally, although lesbian, gay, and bisexual (LGB) youth are at high risk for suicidality, suicidal behaviors in LGB youth are poorly understood. Based on the theories grounded in the ideation-toaction framework, the present study used structural equation modeling to examine health risk and protective behaviors associated with the escalation from suicidal ideation to suicide attempts among adolescents with suicide ideation generally, and LGB adolescents specifically. Data were drawn from the 2013 and 2015 Hawai‘i High School Youth Risk Behavior Surveys. Overall, consistent with the hypothesis, disinhibition predicted the escalation to attempts in adolescents with suicide ideation. Further, higher academic performance was associated with lower suicide attempt risk in adolescents with and without suicidal ideation. Contrary to expectations, the model identified for the full sample was not supported for LGB adolescents. Among LGB youth with suicide ideation, self-harm and victimization potentiated suicide attempt risk. These findings point to the potential importance of suicide prevention efforts that incorporate specific risk and protective factors associated with the escalation from suicide ideation to attempts for adolescents generally and LGB youth specifically.