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In the United States, adolescent suicide ranks as the second leading cause of death. As a developmental phase, adolescence is marked by increased impulsivity and emotional instability, which can precipitate suicidal tendencies. Suicidality, which includes Suicide Ideation (SI), Suicide Plans (SP), and Suicide Attempts (SA), is closely linked to mortality risks among adolescents. Longitudinal data from the National Youth Risk Behavior Survey (YRBS), provides an in-depth, 30-year, nationwide presents a detailed account of behaviors and overall health of American high school students, has served as the foundation for myriad scientific investigations. Utilizing these extensive studies and findings, we conducted a meta-analysis to delve into the intricacies of youth suicidality. Our primary purpose was to glean new insights and knowledge from this analysis.
Methods
The meta-analysis was performed on English-language, peer-reviewed articles from YRBS for 1991-2021, sourced from databases including PubMed, PsycINFO, Scopus, and Web of Science, focusing on youth suicidality. Our study utilized data from the CDC's YRBS, a 30-year national survey monitoring U.S. high school students' health, particularly analyzing the last 17 years of data from 1,729,728 students in grades 9-12 to explore health risk behaviors impacting SI, SP, and SA. Out of 2,894 articles, 28 met the criteria for an in-depth analysis. These articles assessed SI, SP and SA among YRBS participants.
Results
To facilitate analysis, the factors found by previous influence to influence SI, SP, and SA in adolescents were categorized into six groups: substance abuse, victimization, sexual identity, physical health, mental health, and external & complex factors. Complex ties between suicidal behaviors and risk factors were identified through odds ratios (ORs), adjusted odds ratios (AORs), and adjusted prevalence ratios (APRs). Notably, the meta-analysis showed that current marijuana and opioid use significantly raises the risk of SA (RRR = 3.23). Sexual victimization and simultaneous online and offline bullying increase SA risk (OR = 6.23 and AOR > 5.4, respectively). Sexual orientation mismatch elevates SA risk (APR = 1.7), while a sexual minority identity might lower it (AOR = 0.91). American Indian/Alaskan Native males with dual gender identities are at a considerably higher risk for suicidal ideation (SI) (AOR = 19.25). Regular physical activity acts as a protective factor against SI, whereas concussions, particularly in males, amplify SI and SA risks (OR = 1.98). Previous mental health service use correlates with increased SI (RRR = 1.82) and SA risks (RRR = 2.89), with sadness linked more strongly to suicidal behaviors than depression (AOR = 9.2 for SA).
Conclusions
The YRBS provides valuable insight into American youth, detailing factors linked to suicide risk. Our meta-analysis highlights the complex impact of various factors on youth suicide rates, emphasizing the importance of tackling individual, social, and systemic aspects in prevention and intervention strategies. It underscores the need to mitigate risk factors and offer support that is tailored to the needs of at-risk youth. Aiming to 'Strengthen Social Impact through Collaborative Research,' this project combines data science with social work goals to enhance youth well-being and identify predictors of youth suicide.