Victimization, depression, and the suicide cascade in sexual minority youth

Abstract

Background: Suicidality remains disproportionately prevalent among sexual minority youth, necessitating novel methods of understanding suicide risk in this population. Victimization and depression are especially salient suicide risk factors.

Aims: We aimed to test if victimization and depression were associated with suicidality at each step of a suicide cascade: Ideation, planning, and suicide attempts.

Method: In sample of sexual minorities from the 2015 and 2017 Youth Risk Behavior Survey, we tested nine measures of victimization and depression associated with three outcomes in succession: Suicidal ideation among the full sample (n = 3357), suicide planning among those with ideation (n = 1475), and suicide attempts among those who planned suicide (n = 1073).

Results: Depression was associated with suicidal ideation (aPR = 3.93, 95% CI 3.36–4.60), planning (aPR = 1.38, 95% CI 1.12–1.69), and attempts (aPR = 1.78, 95% CI 1.32–2.41) in successive subsamples. Victimization measures had different associations with suicidality at each successive stage, with the strongest associations observed with suicidal ideation in the general sample and suicide attempts among those who planned suicide.

Conclusions: This may have implications for anti-victimization intervention effectiveness at each stage of suicidality. Additional research into this association among transgender and gender non-conforming youth is recommended.

Keywords:

• Victimization
• depression
• suicide
• sexual minority
• adolescent

Acknowledgments

The authors acknowledge the University of Maryland Prevention Research Center, cooperative agreement #U48 DP006382 from the Centers for Disease Control and Prevention (CDC). Any interpretations and opinions expressed herein are solely those of the authors and may not reflect those of the CDC. The Prevention Research Center is committed to service, teaching, and research around issues of mental health and associated health disparities experienced by LGBTQ + persons.

Ethics statement

As this was a secondary data analysis, this was deemed exempt from Institutional Review Board approval. All participants originally provided written informed consent to participate in the Youth Risk Behavior Survey.

Disclosure statement

None of the authors have any financial conflicts of interest to report.

Data availability

The Youth Risk Behavior Survey can be accessed at https://www.cdc.gov/healthyyouth/data/yrbs/index.htm.