Cumulative Social Network Risks and Youth Suicidal Behaviors: The Role of Youth Resilience

Background/Purpose

Suicide is the second leading cause of death among adolescents. Youth are at risk for suicide if their developmental trajectories are is accompanied by accumulative risks spanning multiple spheres of social networks. This evidence reinforced the importance of integrating social network risks from various domains. Alongside cumulative risks, a burgeoning literature addresses the need to consider youth resilience to understand the protective factors that mitigate the cumulative risks. Yet, few studies examined the cumulative risks and reliance on suicidal behaviors concurrently.

This study aims to integrate ecological theory with resilience perspective to examine the relations among cumulative social network risks, youth resilience, and youth suicidal behaviors. Specifically, it hypothesizes that (a) network risks from different domains account for unique variation in suicidal behaviors; (b) cumulative risk is associated linearly with suicidal behaviors; and (c) youth resilience factors partially counteract cross-domain risks on suicidal behaviors.

This study contributes to the literature through (a) the use of large-scale nationally-representative data and ecologically-based perspective; (b) more holistic examination of risk factors from a broader array of domains; and (c) investigating the impact of cumulative network risks and protective factors simultaneously. Such information could contribute to health promotion and suicide prevention among adolescents experiencing cumulative risks.

Methods

Data and sample: This study uses data from the National Longitudinal Study of Adolescent Health (Wave I-II), including a nationally-representative sample of 4,834 youth in grades 7^th-12^th.

Measures: Cumulative risk index was constructed by a composite score of 15 dichotomized social network risk indicators across domains: family background (parents’ marital status, household size); family networks (closeness with mother/father, satisfied relationships with mother/father, family detachment, parental involvement), peer networks (peer support, peer rejection), school networks (school detachment, perceived prejudice), and neighborhood networks (neighborhood relationship). Resilience was assessed using academic performance, problem-solving ability, and self-esteem. Demographic variables included gender, race/ethnicity, and developmental stage. Psychological characteristics were measured by depressed mood.

Analysis: Multivariate hierarchical logistic regression was used to evaluate the variance contributed by the cumulative risk factors and resilience, controlling for demographic and psychological characteristics and adjusting for complex survey design.

Results

Cumulative risk was significantly associated with suicidal ideation (OR= 1.18, 95% CI = 1.12-1.24) in Time 1 (T1) but not suicidal behaviors in Time (T2) after entering the resilience factors. A protective-reactive effect of self-esteem was found for T1 suicidal ideation (OR= 0.69), T1 suicide attempt (OR=0.43), and T2 suicidal ideation (OR=0.65). Specifically, family detachment was a persistent risk factor for suicidal ideation in both waves. Peer rejection was associated with higher suicide attempt in T1, while school support was related to increased risk of suicide attempt one year after.

Conclusions

Cumulative network risks were related to suicidal ideation, while youth resilience could buffer the negative impacts. Family detachment, peer rejection, and school support are notable network risks that need to be addressed. Self-esteem was the most salient protective factor of suicidal behaviors. Social workers, public health professionals, healthcare practitioners, and community members shall collaborate to promote resilience among adolescents experiencing risks across social network domains.