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306566
Suicide Ideation and Attempt in a Reservation-Based Adolescent and Young Adult Sample
Wednesday, November 19, 2014
Teresa Brockie, RN, PhD
,
Nursing Research and Translational Science, National Institutes of Health Clinical Center, Bethesda, MD
Holly Wilcox, PhD
,
Department of Mental Health, Johns Hopkins Medicine, Baltimore, MD
Jacquelyn Campbell, PhD, RN, FAAN
,
Department of Community-Public Health, Johns Hopkins School of Nursing, Baltimore, MD
Gwenyth R. Wallen, PhD, RN
,
Clinical Center, National Institutes of Health, Bethesa, MD
Lawrence Wissow, MD, MPH
,
Johns Hopkins University, Baltimore, MD
Background: Suicide has been the second leading cause of death for Native American youth 15-24 years of age for 30 years. Rates vary widely within and between the 12 Indian Health Service Areas. Methods: To determine the risk and protective factors for lifetime suicide ideation and attempt among a sample of high-risk reservation-based youth an all Native American team used an anonymous web-based questionnaire to collect data from 288 youth 15-24 years of age. Multinomial logistic regression analysis was used to compare three mutually exclusive levels of suicide severity; ideation only, attempt, and no ideation/attempt (reference group). Results: The lifetime prevalence of suicide ideation only, suicide attempt, and no suicide ideation or attempt among this sample was 15%, 35%, and 50%, respectively. Physical neglect, emotional abuse, domestic violence exposure, witnessing violence, victim of violence, or learning of violence, bullying, PTSD symptoms, depression symptoms, prescription drug misuse, inhalant use, and poly-drug use were factors common to both suicide ideation and attempt. After adjusting for age, sex, and tribal affiliation, PTSD symptoms (RRR=3.3, 95% CI: 1.2, 9.4) and poly-drug use (RRR=2.5, 95% CI: 1.0, 6.0) were associated with suicide ideation whereas, PTSD symptoms (RRR=4.4, 95% CI: 1.9, 10.5), depression symptoms (RRR=4.0, 95% CI: 1.8, 8.9), and poly-drug use (RRR=2.1, 95% CI: 1.0-4.3) were associated with suicide attempt. Conclusions: These findings demonstrate PTSD symptoms and poly-drug use as predictors of both suicide ideation and attempt. Development of interventions to prevent suicide and its multiple associated risk factors in high-risk reservation communities is imperative.
Learning Areas:
Diversity and culture
Program planning
Social and behavioral sciences
Learning Objectives:
Compare suicide ideation only, suicide attempt and no ideation or attempt in a high-risk reservation community
Demonstrate the relationship between multiple protective and risk factors for ideation only and attempt.
Discuss the importance of culturally relevant risk behavior and mental health intervention for high-risk reservation adolescents and young adults and the importance of research to address these issues in this population.
Keyword(s): Native Americans, Suicide
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I was the principal investigator of this study focused on the risk and protective factors for suicide ideation and attempt among reservation-based adolescents. Among my research interests has been the development of culturally appropriate suicide prevention strategies for high-risk reservation communities.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
