Suicide is the 3rd leading cause of death among adolescents and young adults aged 10-24 years (CDC, 2008). Despite a long period of declining rates of suicide among youth, suicide rates are twice as high as those in the 1950s and a recent study identified the first increase among adolescents in more than a decade (CDC, 2007). Previous studies have identified theoretically grounded and empirically validated risk and protective factors for suicide among adolescents and young adults (Borowsky et al., 2001, Bridge, Goldstein &Brent 2006, van Heeringen 2001). However, relatively few studies have attempted to explicitly compare the influence of specific risk and protective factors across samples of youth in different contexts and with different risk exposures. By considering the relationship between risk characteristics and socioenvironmental context, the results of the current project have direct implications for the development of targeted prevention and intervention efforts designed to reduce adolescent and young adult suicide. The long-term goal of the proposed study is to reduce rates of suicide by directly informing suicide prevention and intervention efforts by identifying differences in theoretically informed risk and protective factors across diverse samples of adolescents and young adults. The current project will use data from four prospective longitudinal studies (National Longitudinal Study of Adolescent Health, NICHD Study of Early Child Care and Youth Development, National Study of Child and Adolescent Well-Being, Behavioral Health/Juvenile Justice Project) to achieve the specific aims. These four data sources include information from more than 25,000 individuals on risk and protective factors for suicide from childhood through young adulthood. The overall objective of this study is in accordance with several national-level objectives related to decreasing suicide prevalence, including: the Surgeon General's Call to Action to Prevent Suicide (Enhance research to understand risk and protective factors, their interaction, and their effects on suicide and suicidal behaviors) """"""""Healthy People 2010"""""""" (reduce the suicide rate among 10-14 year old and 15-19 old youth), and the National Center for Injury Prevention and Control's research priorities in preventing suicidal behavior (priority E: Clarify the influence of contextual forces on suicidal behavior and priority F: Clarify the impact of individual level factors on suicidal behavior). The study will achieve its aims through a comprehensive examination of existing data to better understand the risks for suicidal behavior across socio-environmental contexts. This inter-disciplinary and collaborative project involves three research institutions and is led by a uniquely and highly qualified research team guided by an oversight committee comprised of distinguished and renowned suicide scholars. The project is uniquely positioned to provide cost-effective and useful new findings that will directly inform efforts to reduce injuries and deaths from suicides. Because the proposal relies on existing data, analyses can be conducted quickly and findings can be disseminated rapidly to inform the prevention community and have an impact on suicide prevention within the next 3-5 years. The long-term goal of this study will be achieved by addressing three specific research aims:
Aim I. Investigate whether risk and protective factors for suicidal behavior are unique in predicting suicidal behavior versus predicting co-occurring behavior problems. Recent empirical evidence indicates that protective and risk factors associated with suicide overlap with those predicting youth violence (Lubell &Vetter, 2006). Because these factors may overlap in predicting risk behaviors co-occurring with suicide, it is important to investigate the unique role of contextual factors and individual characteristics in the development of suicidal behavior versus other high risk behaviors such as violence perpetration. It is hypothesized that the identified risk and protective factors will have similar associations with suicidal behaviors and other high risk behaviors such as interpersonal violence, substance use, and delinquency.
Aim II. Identify differences in trajectories for suicidal behaviors associated with the presence of co-occurring risk exposures. Incidence and prevalence rates for suicidal perpetration (CDC, 2008) vary greatly by age among adolescents and young adults. In addition, risk and protective factors of behaviors co-occurring with suicide -such as violence-differ across developmental stages (Dodge &Pettit, 2003). Thus, conducting age-specific analyses of protective and risk factors will allow us to investigate the potential optimal timing for suicide interventions and which factors should receive priority for interventions at specific ages. It is hypothesized that individual level factors will interact with socioenvironmental characteristics and risk exposures to create significant differences in trajectories for suicidal behaviors among comparable populations.
Aim III. Investigate whether risk and protective factors for suicidal behavior are different for various demographic characteristics, including gender. In 2004, suicide rates increased for adolescent females and some younger males (Centers for Disease Control, 2007). In light of this increase, and the need for targeted interventions, it is important to investigate whether risk and protective factors for suicidal behavior differ for females versus males. We hypothesize that peer, family, and neighborhood connectedness is a stronger predictor of suicidal behavior for females when compared to males. In addition to considering how the risk and protective factors for suicidal behavior vary by gender, we also will consider whether they differ across levels of various other demographic characteristics including race, ethnicity (Goldston et al., 2008) and SES.
The current study investigates risk and protective factors underlying suicidal behavior during adolescence and young adulthood, whether they differ from the predictors of other risky behavior (e.g. violence perpetration) and how they may differ across age as well as females and males. Advancing our understanding of individual and contextual factors underlying suicidal behaviors will help develop more effective intervention and prevention programs.
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