Childhood adversity, suicidal thoughts and behaviors, and mechanisms of protection in Minnesota Native American youth

• In Event: Diverse Mechanisms in the Development of Internalized Distress and Self-Harm

Abstract

Native American adolescents die by suicide at a higher rate than their non-Native age-mates (CDC, 2017). Adversity in childhood is known to incur risk for suicide in adolescence (Miller et al., 2013) and the association between adverse childhood experiences (ACEs) and suicide attempts has been studied in small samples of Native adolescents (Brockie et al., 2015). However, larger samples are necessary to illuminate the relationship between distinct operationalizations of ACEs and suicide risk. Additionally, factors that might protect against this relationship have yet to be explored. The current project had two aims: I) to examine the relation between adverse childhood experiences and suicide ideation and suicide attempt in Native American adolescents through both the ACEs framework, which examines the cumulative effect of adversity experienced in childhood, and individual adverse experiences. II) Examine factors that protect against the relation between indicators of childhood adversity and suicidal thoughts and behaviors, such as perceived adult caring. Native American adolescents (N= 1176) ages 12-18 (mean= 14.76) completed self-report questionnaires of their demographics, past two weeks depression symptoms, past year suicide ideation, past year suicide attempt, and perceptions of adult caring as part of the Minnesota Student Survey. Additionally, eight adverse childhood experiences were assessed. Reported ACEs were considered individually and also stratified into three additional summary variables: “total” number of ACEs, “any” ACE endorsed, and “high” ACEs. Descriptive statistics can be found in Table 1. Separate multiple logistic regressions were used to examine the relation between each of the ACE variables and suicide ideation and suicide attempt. Each adult caring variable was then tested as a moderator of these associations. Each model controlled for the effects of age, sex, and depressive symptoms. Suicide attempt models also controlled for suicide ideation. The Benjamini-Hochberg correction was applied to all analyses to control for multiple tests. Corrected p-values are reported. All eight ACEs were significantly associated with suicide ideation and three were significantly associated with suicide attempts (all corrected p < .05). ACEs associated with the largest odds of suicide ideation and attempt were physical abuse (OR= 3.25, OR= 2.38), sexual abuse by a non-family member (OR= 3.21, OR= 2.61), and sexual abuse by a family member (OR= 3.61, OR= 3.17). High ACEs was associated with the highest odds of suicide ideation (OR= 3.83). No interaction models were significantly associated with suicide ideation. Results revealed that perceptions of adult relative and teacher caring each significantly moderated the association between sexual abuse by a non-family member and suicide attempt (e.g. Figure 1). Further, perceived teacher and adult community member caring each significantly moderated the association between any ACE and suicide attempt. In these cases, perceived caring was associated with decreased odds of suicide attempt for Native American youth with ACEs. This study reveals that while ACEs incur risk for suicide ideation and attempts, Native American adolescents’ perceptions of adult caring may buffer their likelihood of making attempts. Further, this project exemplifies the importance of examining ACEs individually and in combination to understand suicide risk.

Authors

• Andrea Wiglesworth, University of Minnesota - Twin Cities
  Presenting Author

• Rachael Dumas, University of Minnesota
  Non-Presenting Author

• Bonnie Klimes-Dougan, University of Minnesota - Twin Cities
  Non-Presenting Author