Risk Profiles of Suicide Attempts Among Juvenile Justice-Involved Commercially Sexually Exploited Girls–A Latent Class Analysis

• In Event: Self-Injurious Thoughts and Behaviors in Understudied Samples Across the Lifespan: Implications for Transdiagnostic Interventions

Abstract

Introduction: Suicide attempts disproportionately impacts Latinx and Black youth involved in the child welfare system. In particular, girls that have been commercially sexually exploited (CSE) are 3-4 times more likely to have attempts. Youth with histories of CSE have intensive involvement in both justice and child welfare systems as well as other risk factors that are linked to suicide. Although involvement in systems like child welfare and juvenile justice system has been linked to suicide, it is still unknown which factors contribute to this increased risk among CSE girls.

Hypotheses: Using Bronfenbrenner’s (1979) Ecological Systems Theory, we hypothesized that patterns of youth’s environmental systems-involvement would be linked to suicide attempts. In particular, we hypothesized that a profile characterized by individual and macro-level variables (i.e., mood disorder and child welfare contact), would be linked with higher risk of suicide attempts. We also hypothesized that profiles of micro (i.e., parent incarceration and gang involvement) and/or macro system level variables (i.e., child welfare system referrals and out-of-home placements) would be associated with suicide attempts.

Study population: We partnered with the Succeeding Through Achievement and Resilience (STAR) Court, an innovative diversion court program designed specifically for youth impacted by CSE in Los Angeles County. We conducted an exhaustive court file review of the 360 female (Mage=16) participants in STAR court from 2012–2017. The research team systematically transferred data from court files into a secure, electronic database.

Method: As youth’s environmental systems are multidimensional, we used inclusive Latent Class Analysis to identify their profiles of risk indicators. We then used the maximum-probability assignment method to classify youth into latent classes and examined the number of suicide attempts across these risk groups.

Results: Four risk profiles emerged: (1) Parental Incarceration (PI; 30%), (2) Child Welfare Contact (CWC; 25%), (3) Disruptive Behavior and Sleep Problems (DBS; 25%), and (4) Pervasive Risk (PR; 22%). Among youth in the PI group, 5% had one suicide attempt and 3% had multiple attempts. No youth in the CWC group had a suicide attempt, which is contrary to our hypothesis. The rates are significantly higher among youth in the DBS group as 14% had one suicide attempt while 12% had multiple attempts. As hypothesized, youth in the PR were associated with higher risk of suicide attempts, with 28% reporting attempts to end their lives (16% once and 12% twice or more).

Discussion: High prevalence of suicide attempts among juvenile justice-involved girls impacted by CSE underscores the need for comprehensive, specialized suicide screening/assessment, and treatment referrals. Increasing levels of youth psychopathology and high child welfare involvement were associated with more suicide attempts, whereas system-level involvement alone was associated with lower levels of suicide attempts. Findings suggest an important opportunity for multidisciplinary collaboration among mental health providers, child welfare professionals, and juvenile justice practitioners to improve suicide prevention strategies. Future research should prioritize examination of risk profiles that reveal how certain combination of risk factors may be linked to higher risk of suicide rather than the examination of single risk factors alone.

Authors

• Jocelyn Meza, University of California - Los Angeles
  Presenting Author

• Phuc T Nguyen, University of California - Berkeley
  Non-Presenting Author

• Christine Grella, University of California, Los Angeles
  Non-Presenting Author

• Eraka Bath, University of California, Los Angeles
  Non-Presenting Author