Parental Emotional Abuse, Sexual Identity, and Adolescent Suicide Attempts During the COVID-19 Pandemic

To examine whether parental emotional abuse increases the odds of adolescent suicide attempts and to assess effect modification by sexual identity.

The 2021 Adolescent Behaviors and Experiences Survey, a cross-sectional nationally representative online survey of 7,705 US high-school students conducted by the Center for Disease Control and Prevention, was used to estimate self-reported parental emotional abuse (exposure) and to examine its relationship with suicide attempt in the past 12 months (outcome). We also assessed sexual orientation as an effect modifier. Univariable and multivariable logistic regression models were used to estimate odds of suicide attempt. We assessed multiplicative effect modification by sexual identity using an interaction term and additive effect modification by estimating the relative excess risk due to interaction.

The majority of the high school students surveyed, identified as heterosexual (77.4%), while the remaining 22.6% identified as lesbian, gay, bisexual, questioning or other (LGBQ). Adolescents reporting parental emotional abuse were three times more likely to report attempted suicide in the past 12 months compared to those without abuse (adjusted odds ratio 3.46, 95% confidence interval 2.50-4.79). Adolescents who identified as LGBQ and reported parental emotional abuse had 10 times higher odds of attempted suicide compared to heterosexual peers without exposure to parental abuse (adjusted odds ratio 10.93, 95% confidence interval 7.28-16.42).

Suicide is a leading cause of death for adolescents and parental emotional abuse may be contributing to suicidality among adolescents, particularly LGBQ youth.