Academic journal article Journal of Mental Health Counseling

Changes in Perceived Levels of Environmental Stress before and after a Suicide Attempt in Black American Adolescents: A 14-Year Longitudinal Study

Academic journal article Journal of Mental Health Counseling

Changes in Perceived Levels of Environmental Stress before and after a Suicide Attempt in Black American Adolescents: A 14-Year Longitudinal Study

Article excerpt

A growing interest in factors that may explain suicidality rates in the United States is fueled in part hy the increased rates of suicide behaviors in Black American adolescents, primarily male adolescents. The present longitudinal study investigates the extent to which environmental adversity or stress may relate to the course of suicide attempts in Black American adolescents living in extreme poverty (N = 457). We also consider how age and gender affect the longitudinal relations among the study variables (i.e., environmental stress and suicidality). Results indicate that suicide attempts increase over time, and environmental stress decreases over time. Furthermore, when examined in conjunction with environmental stress and gender, suicide attempts increase to a greater extent among adolescents with higher levels of environmental stress, and this effect is greater for older adolescents than for younger adolescents. Also, when baseline levels of environmental stress, suicide attempts, and gender are considered, different trajectories are found between adolescents with low baseline environmental stress levels and adolescents with high baseline environmental stress levels. Gender was significantly related to outcomes for those participants who self-reported high levels of environmental stress at baseline, but not for those who reported low levels of environmental stress at baseline. We discuss implications for future research and for culturally tailored, systems-focused suicide prevention and intervention efforts.

The far-reaching effects and costs of suicide among all populations cannot be overstated. A 2015 report from the Centers for Disease Control and Prevention (CDC) stated that the annual financial cost of suicide in the United States is approximately $44 billion. Suicide is the 10th leading cause of death in the United States when factoring in the total population (CDC, 2015). Suicide is the third leading cause of death for the U.S. adolescent population (Anderson & Smith, 2005; Substance Abuse and Mental Health Services Administration [SAMHSA], 2013) and is the second leading cause of death among 15- to 24-year-olds (American Association of Suicidology, 2011). An estimated 4,600 adolescent lives are lost annually due to suicide (CDC, 2015), with individuals between the ages of 10 and 19 making more suicide attempts than any other age group (Valuck, Libby, Benton, & Evans, 2007). This latter finding, described by Valuck et al. (2007), suggests that adolescents have an elevated risk of dying by suicide compared to other age groups. Thus, adolescents comprise a vulnerable age group on which clinical research and empirical investigations ought to focus (Musci et al., 2016). In addition to age, race and ethnicity may be uniquely implicated in suicide behaviors (e.g., prevalence, ideations, attempts, and completions).

With regard to race and ethnicity, the research has suggested that suicide is historically less prevalent among Black American adolescents than among other racial and ethnic groups (Joe, Baser, Neighbors, Caldwell, & Jackson, 2009). However, recent studies have found that the rate of suicide may be rising among this demographic-indeed, that suicide is the third leading cause of death for Black American males between the ages of 15 and 24 (Joe et al., 2009; SAMHSA, 2013). Given the lethality and burden of suicide, coupled with the sociodemographic (e.g., race, age, and gender) and environmental factors that may be implicated, researchers must consider a multipronged, culturally focused, systemic approach to understanding suicide among Black American adolescents (Musci et al., 2016; Shain, 2016; Walker, Francis, Brody, Simons, Cutrona, & Gibbons, 2017). Researchers have underscored the need to explore how environmental factors relate to suicide attempts (Bennett & Joe, 2015). Bronfenbrenner's (1994) ecological systems theory is one framework that can undergird a study focused on both individual and environmental factors. …

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