Associations between suicide attempts and risk behaviors: Violence, bullying, drug use, and alcohol abuse among high school students in Puerto Rico, 2011

Suicide is the third leading cause of death in young Puerto Ricans. Literature review established that several psychosocial and health risk behaviors contribute to the rates of suicide and suicide attempts among young-aged populations. However, few studies have explored the role of youth risk behaviors and its relation to suicide in Puerto Rico. The goal of this study is to explore the association between suicide attempts and risk behaviors: violence, bullying, drug use, and alcohol abuse. We analyzed the Center for Disease Control and Prevention 2011 Youth Risk Behavior Surveillance (YRBS) data. The YRBS surveyed a random sample of 1,517 high school students from 34 Puerto Rican public schools, 94% Hispanic and 54% female. We performed descriptive statistics to determine frequencies. Bivariate analyses were used to examine the association between suicide attempts and carrying a weapon in school, bullying, cyber bullying, dating violence, physical fights, alcohol abuse, marihuana use, ecstasy use, cocaine use, and drugs without prescription use. Chi square test and Cramer’s V coefficient were used to determine the strength of the association. Analysis revealed that the associations between suicide attempts and all behaviors were statistically significant (p<0.05). Being cyber bullied showed a trend to suicide attempts with a Cramer’s V value of 0.193. Puerto Rican adolescents who exhibited the ten risk behaviors have a higher likelihood to attempt suicide in the previous 12 months. Schools and state agencies should establish or re-evaluate interventions programs to reduce suicide attempts associated with risk behaviors among Puerto Rican adolescents.