Risk Factors for Suicide Ideation and Planning among Rural Appalachian Middle School Adolescents

Background: Studies examining the risk factors for suicide ideation and planning among middle school adolescents are limited.

Methods: Using an abridged Youth Risk Behavior Survey (YRBS)--a confidential, voluntary, and self-administered instrument-- we conducted a cross-sectional study of middle school adolescents (6th-8th grades) (n=490) from an Appalachian county in 2009. It included 50 questions on demographics and several categories of health-risk behaviors.

Results: Overall, 236 (48.2%) were female and 396 (86.4%) were white. 22.3% reported ever seriously thinking about killing themselves and 13.6% reported ever making a plan to kill themselves. In multivariable logistic regression analyses, factors significantly associated with “ever seriously thinking about killing oneself” included: being a “female” (odds ratio=2.7, 95% confidence interval: 1.6-4.5 ); “having ever been bullied on school property” (1.9, 1.2-3.1); “having ever had sex” (2.0, 1.1-3.8); “being slightly or very overweight” (2.1, 1.2-3.5) and “having ever sniffed glue, or breathed the contents of spray cans, or inhaled paints or sprays to get high” (3.0, 2.1-11.9). Factors significantly associated with “ever making a plan to kill oneself” included: being a “female” (2.7, 1.2-4.4); “having ever been bullied on school property” (2.7, 1.4-5.1); “having ever had sex” (2.2, 1.1-4.5); “having ever sniffed glue, or breathed the contents of spray cans, or inhaled paints or sprays to get high” (3.2, 1.5-6.8); and “having ever used any form of cocaine” (3.9, 1.1-14.0).

Conclusion: These risk factors for adolescent suicide ideation and planning have implications for identifying at-risk individuals as early as middle school for targeted suicide prevention programs.