Association Between Discrimination Stress and Suicidality in Preadolescent Children
Abstract
Objective:
Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality).
Method:
We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non–US-born individuals, sexual orientation–based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality.
Results:
Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1–3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2–3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7–1.2).
Conclusion:
Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.
Reprinted from J Am Acad Child Adolesc Psychiatry, Argabright et al., Association Between Discrimination Stress and Suicidality in Preadolescent Children, S0890–8567(21)01355-1, copyright 2021, with permission from Elsevier
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History
Accepted: 12 August 2021
Published in print: Spring 2022
Published online: 22 April 2022
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This article was reviewed under and accepted by ad hoc editor Matthew G. Biel, MD, MSc.
Funding Information
Disclosure: Dr. Njoroge has received grant or research support from the Health Resources and Services Administration (HRSA) / Behavioral Health Workforce Education Training (BHWET) M01HP31292-01-00. She has served as section editor for the AACAP News Editorial Board. She has received royalties from Springer for the Clinical Guide to Psychiatric Assessment of Infants and Young Children (2019). Dr. Barzilay serves on the scientific board and has reported stock ownership in ‘Taliaz Health’, with no conflict of interest relevant to this work. Drs. Moore, Taylor, Guloksuz, R. C. Gur, R. E. Gur, Benton, Mr. Argabright, Mrs. Visoki, and Mss. Ryan and DiDomenico have reported no biomedical financial interests or potential conflicts of interest.This study was supported by the National Institute of Mental Health (NIMH) grants K23MH120437 (R.B.), R21MH123916 (R.B.), RO1MH117014 (T.M.M. and R.C.G.) and the Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania. Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9-10 and follow them over 10 years into early adulthood. The ABCD Study® is supported by the National Institutes of Health (NIH) and additional federal partners under award numbers U01DA041048, U01DA050989, U01DA051016, U01DA041022, U01DA051018, U01DA051037, U01DA050987, U01DA041174, U01DA041106, U01DA041117, U01DA041028, U01DA041134, U01DA050988, U01DA051039, U01DA041156, U01DA041025, U01DA041120, U01DA051038, U01DA041148, U01DA041093, U01DA041089, U24DA041123, and U24DA041147. A full list of supporters is available at https://abcdstudy.org/federal-partners/. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/wp-content/uploads/2019/04/Consortium_Members.pdf. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. This manuscript reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators.
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