Suicide Risk in Black Adolescents: The Role of Thwarted Belongingness and Interpersonal Discrimination in Predicting Suicide Ideation

Background: Black youth suicide is a significant public health concern in the United States, particularly among those aged 0-24. Understanding the underlying mechanisms of suicide ideation and behaviors is crucial to developing prevention strategies, yet few suicide frameworks apply theoretically grounded risk factors for suicide germane to black youth. The Interpersonal Theory of Suicide (IPTS) explains the role of perceived burdensomeness and thwarted belongingness in suicide ideation and behaviors. Recent studies highlight using IPTS as a framework to assess the heightened suicide mortality rates among black youth in the US. Using IPTS, this study aims to explore links between thwarted belongingness, discrimination, and suicide risk among black youth.

Method: The study used logistic regression analyses on a sample of 1,070 black youth from the National Survey of American Life-Adolescent (NSAL-A) to evaluate suicide risk among black youth, focusing on the interplay between thwarted belongingness, interpersonal discrimination, and suicide risk. The construct of thwarted belongingness was operationalized based on school involvement, peer, and family emotional support questions, including self-report measures on social emotional support from family and friends. Youth also reported on their experiences with interpersonal discrimination, and engagement in suicide behaviors. Descriptive statistics were utilized to summarize the study sample's characteristics, while logistic regression models were implemented to estimate the association between perceived belongingness, interpersonal discrimination, and suicide risk among black youth. The analysis controlled for confounding factors, including age, gender identity, and mental health history.

Results: Our model explained 18.67% of the variance in suicidal ideation (p < 0.001). Findings revealed that gender identity was a significant predictor of suicidal ideation, with females having 2.23 times the odds of experiencing suicidal ideation than males (p < 0.01). Moreover, black adolescents who reported experiencing frequent discrimination (10+ instances) had 3.90 times the odds of suicidal ideation (p < 0.05) compared to those who did not report discrimination. We also found that black adolescents with a mood disorder had 4.92 times the odds of experiencing suicidal ideation (p < 0.05) compared to those without a mood disorder. Emotional support from family had a protective effect, with individuals who reported receiving emotional support having 46% lower odds of suicidal ideation (p < 0.01). Similarly, sport involvement had a protective effect, with individuals reporting sports involvement having 45% lower odds of suicidal ideation (p < 0.05). However, factors such as race/ethnicity, age, household income, and peer social support did not show significant associations with suicidal ideation in this model.

Conclusion and Implications: Findings align with IPTS and highlight the need to address mental health concerns, enhance social support systems, foster inclusive and equitable environments, and develop gender identity-specific approaches in suicide prevention programming for black adolescents. Targeted interventions aimed at reducing discrimination, promoting emotional support from family, and encouraging sports involvement could potentially serve as effective suicide prevention strategies among black adolescents. Further research is needed to confirm the ongoing relevance and reliability of these findings, as other variables not considered in this research may also be essential and require exploration.