Proximal Risk of Suicide-Related Behavior in Black Youth With a Parental History of Mood Disorder

Suicide rates have risen disproportionately in Black youth, yet little is known about risk factors specific to this population.

We sought to identify proximal risk factors for suicide-related behavior (SRB) in a sample of Black youth at high risk for mood disorders.

The sample, drawn from a longitudinal study, included 156 Black youth aged 17 years or younger at baseline. Participants underwent baseline diagnostic and clinical assessment, including suicidal ideation and SRB, and yearly assessments for new SRB. Observations were censored at the time point closest to the first episode of SRB or the last observation for those without SRB. Chi-square, Fisher's exact test, t-tests, and Firth logistic regression were used.

Twelve participants experienced SRB during follow-up. The average age of participants at baseline was 12.6 years (SD = 2.7). Participants were 44% female and 10% identified as Hispanic. Self-reported irritability, aggression, suicidal ideation, and a depression diagnosis were significant at the univariate level. Medium to large effect sizes were found for self-reported impulsive aggression, parental substance use disorder, and childhood abuse, all consistent with prior reports to be associated with SRB in youth. Using Firth logistic regression, younger age (β = -.60; p = .001) and depression diagnosis (β = 2.32, p = .006) were proximal risk indicators of SRB.

Risk factors identified in this study are consistent with previous reports in majority White samples. A depression diagnosis was the strongest indicator, highlighting the importance of early identification of depression in Black youth, particularly in younger youth with a family history of mood disorder.