Adolescent suicide attempts: Risks and protectors

Objective. In 1997, suicide was the third leading cause of death among 10- to 19-year-olds in the United States, with the greatest increases in suicid e rates in the previous decade experienced by black and other minority yout h. The purpose of this study was to identify risk and protective factors fo r suicide attempts among black, Hispanic, and white male and female adolesc ents. Methods. We used data from the National Longitudinal Study of Adolescent He alth, conducted in 1995 and 1996. A nationally representative sample of 13 110 students in grades 7 through 12 completed 2 in-home interviews, an aver age of 11 months apart. We examined Time 1 factors at the individual, famil y, and community level that predicted or protected against Time 2 suicide a ttempts. Results. Perceived parent and family connectedness was protective against s uicide attempts for black, Hispanic, and white girls and boys, with odds ra tios ranging from 0.06 to 0.32. For girls, emotional well-being was also pr otective for all of the racial/ethnic groups studied, while a high grade po int average was an additional protective factor for all of the boys. Cross- cutting risk factors included previous suicide attempt, violence victimizat ion, violence perpetration, alcohol use, marijuana use, and school problems . Additionally, somatic symptoms, friend suicide attempt or completion, oth er illicit drug use, and a history of mental health treatment predicted sui cide attempts among black, Hispanic, and white females. Weapon-carrying at school and same-sex romantic attraction were predictive for all groups of b oys. Calculating the estimated probabilities of attempting suicide for adol escents with increasing numbers of risk and protective factors revealed tha t the presence of 3 protective factors reduced the risk of a suicide attemp t by 70% to 85% for each of the gender and racial/ethnic groups, including those with and without identified risk factors. Conclusions. In these national samples of black, Hispanic, and white youth, unique and cross-cutting factors derived from a resiliency framework predi cted or protected against attempting suicide. In addition to risk reduction , promotion of protective factors may offer an effective approach to primar y as well as secondary prevention of adolescent suicidal behavior.