The momentum for this study is supported by the need to understand how suicidal trajectories present from early adolescence into adulthood among a community-based, nationally representative sample. While longitudinal research among adolescent clinical samples has contributed to the literature, they often do not follow adolescents into adulthood and/or include particular higher-risk groups that include sexual minorities. Clinical samples also include participants who have already disclosed their suicidal behaviors to professionals. Adolescents utilize mental health professionals and disclose to trusted adults less than adults, which arguably heighten risk for suicidal behaviors. Yet no study has tracked help seeking behaviors for sexual minority adolescents experiencing distress. Furthermore, longitudinally, a representative sample of suicidal behaviors over the crucial developmental period of adolescence to young adulthood. This study contributes to the literature and aids in public health efforts, as these groups have not reported significant decreases in suicidal behavior in the past 25 years. The study will focus on a salient protective mechanism: community messaging. We propose that the heterogeneity of suicidal trajectories will not only help explain suicidal behavior disparities, but will aid in tailoring prevention initiatives based upon the onset of symptomology. This proposed work will create profiles that reflect the variation of suicidal behaviors, based on four independent levels of suicidal risk (1) no suicidal behaviors, (2) suicidal ideation yet no attempts, (3) suicide attempts (4) suicide attempts resulting in medical treatment. This work will examine whether particular profiles not only describe how specific subgroups are at a heightened risk in early adolescence, but also elucidate why some might be chronically suicidal and while others might first present suicidal behaviors later in life. The proposed study will use secondary analysis of the Add Health dataset to 1) describe the longitudinal patterns and progression of suicidal behaviors; 2) examine how social relationships and behavioral health are related to the escalation and de-escalation of suicidal behaviors, and 3) observe the heterogeneity of sexual minority presentations in these suicidal behavior trajectories. Profiles will be identified through latent transition analysis. The proposed study will produce recommendations for how pediatricians and other health care providers, as well as educators and community leaders, particularly in the context of gatekeeping and understanding suicidal risk factors, can support parents and other trusted adults in communicating effectively with their children about suicidal behaviors by (1) identifying which particular sexual minority subgroups are at the most need for upstream prevention messaging; and (2) targeting specific social relationships to capitalize on for help-seeking promotion during times of distress.
Sexual minority disparities are consistently found among adolescents engaging in suicidal thoughts and behaviors. We will examine suicidal trajectories among a nationally representative sample, to investigate how community messaging and social relationships are related to risk.
