Understanding Suicidality Among Sexual and Gender Minority Youth: Applying the Interpersonal Theory of Suicide

• In Event: Sexual and Gender Minority Youth’s Mental Health: Learning Over Time

Abstract

Introduction: Suicidality is the second most prevalent cause of death among youth in the United States (Curtin & Heron, 2019). Sexual and gender minority youth (SGMY) think about and attempt suicide at more than three times the rate of cisgender and heterosexual youth (Raifman et al., 2020). Given that the number of youth who identify as SGM has doubled in the past 10 years (Raifman et al., 2020), now more than ever, understanding the mechanisms that contribute to SGMY suicidality is crucial. The interpersonal theory of suicide (IPT; Joiner, 2005) has advanced our understanding of suicidality among SGMY. However, no SGMY-focused IPT studies have used longitudinal data, and only one has examined acquired capability for suicide among SGMY (Grossman et al., 2016). The goals of the current study were: 1) to test IPT prospectively in a large, diverse sample of SGMY, and: 2) to test the role of acquired capability for suicide in determining whether suicidal ideation leads to subsequent suicidal behavior. We hypothesized that higher perceived burdensomeness and thwarted belongingness are related to higher suicidal ideation, which, in turn, is related to higher subsequent suicidal behavior. Additionally, we expected that acquired capability for suicide moderates the association between suicidal ideation and behavior.

Methods: Data came from a panel study of risk and protective factors for suicide among 1,014 SGMY ages 15-21 at baseline recruited from SGMY community organizations in three large U.S. cities. We measured the following IPT constructs across 4 waves spaced nine months apart: perceived burdensomeness, thwarted belongingness, suicidal ideation, suicidal behavior, acquired capability for suicide, and demographic covariates. Path analysis in a structural equation modeling framework was used to test relations among the study constructs (see Figure 1).

Results: Higher levels of perceived burdensomeness were associated with increased suicidal ideation nine months later (b = .15, p <.01). Thwarted belongingness did not significantly predict later suicidal ideation (b = .02, p = .54). Finally, suicidal ideation predicted increased odds of reporting suicidal behavior in later waves (OR = 2.22, p <.01).
There was a significant indirect effect of suicidal ideation on the association between perceived burdensomeness and suicidal behavior, (b = .12, p = .004), but not on the association between thwarted belongingness and suicidal behavior. (b = .01, p = .54). Acquired capability for suicide did not moderate the association between suicidal ideation and later suicidal behavior (OR = 1.40, p = .15).

Discussion: In the first prospective study of IPT among SGMY, perceived burdensomeness—but not thwarted belongingness—was a primary mechanism driving changes in suicidality over time among SGMY. Findings will be discussed in the context of prior empirical studies. Suicide prevention efforts often focus on promoting social belonging; these results suggest that shifting the focus to reducing perceived burdensomeness could be crucial for stemming SGMY suicidality. Further, shorter periods of time between waves of data collection may be needed to detect the relations between acquired capability for suicide and subsequent suicidality suggested by IPT.

Authors

• Meg Bishop, University of Maryland - College Park
  Presenting Author

• Amanda Pollitt, University of Texas at Austin
  Non-Presenting Author

• Stephen T Russell, University of Texas at Austin
  Non-Presenting Author