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Updated: Sep 10, 2025

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
Published on: July 10, 2017
Exposure to Suicidal Behavior by Sexual and Gender Minority Status Among Adolescents in the Southeastern United
Kirsty A Clark1, Kelly E O'Connor2, Elisa Park3
1Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee; Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee.
Purpose:
To investigate exposure to others' suicidal behavior in explaining the heightened risk for suicidal thoughts and behaviors (STBs) among sexual and gender minority (SGM) adolescents.
Methods:
From December 2022 to May 2023, this cross-sectional survey study recruited 1,128 students from four public high schools (grades 9-12) in one historically segregated county in the southeastern United States. We estimated exposure to others' suicidal behavior and one's own STBs by SGM status.
Results:
SGM adolescents reported significantly higher levels of STBs and more prevalent exposure to friends' and family members' suicide attempts and deaths (all p < 0.01), with 50.2% of SGM adolescents reporting exposure to friends' suicide attempts. In multivariate mediation models adjusted for confounders, exposure to friends' and family members' suicide attempts accounted for 7%-12% of the disparities in STBs between SGM and cisgender/heterosexual adolescents.
Discussion:
Exposure to others' suicidal behavior is prevalent among SGM adolescents and associated with the group's increased risk of STBs. Suicide prevention policies and programs targeting SGM adolescents should enhance school-based screening, increase access to SGM-affirmative mental health resources, and leverage peer-engaged interventions.
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