Exploring the Association between Aggression and Suicidal Thoughts and Behaviors in an Urban Pediatric Primary Care...

Rates of suicide among children and adolescents have increased significantly in the past two decades, especially among minoritized youth. Identification of modifiable factors associated with suicidality in diverse samples is important for informing targeted prevention and intervention efforts. Toward this end, this study utilized a multi-informant approach to examine the association between aggression and suicide risk in a urban pediatric sample. Children and adolescents (N=136; 69% Black or African American) between the ages of 6 and 17 (Mage = 11.4 ± 3.0) were recruited while attending a well-child visit at a Baltimore City pediatric primary care clinic. Pediatric participants and their caregivers completed measures of aggressive behavior and depressive problems. Suicide risk was derived from parent-, youth-, and clinician-report of pediatric participants experiencing suicidal thoughts and behaviors. After controlling for demographic variables, results of stepwise logistic regressions revealed that parent- and youth-reported aggressive behavior were significantly associated with suicide risk (OR= 1.18, p =.005 and OR = 1.23, p = .006, respectively). When depressive problems were added to the model, depressive problems were significantly associated with suicide risk (parent-report OR= 1.34, p =.015 and youth-report OR = 1.28, p = .025), but aggressive behavior was no longer significantly associated. Findings from this study suggest that aggression could be an important indicator of suicide risk but not above and beyond the influence of depressive symptoms. In this sample, aggressive behavior may be at least partially explained by depressive symptoms and a manifestation of internal distress.