Exploring the Association Between Depression and Suicide Attempt by Race/Ethnicity Open Access

Stoller, Bethany (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/2801ph58q?locale=en


Adolescent depression and suicidality present significant public health problems in the United States. Both the prevalence of depression and the suicide rate among adolescents has increased significantly in the past two decades. While it is known that that risk of depression and suicidal behaviors varies by race/ethnicity, the effects of race/ethnicity on the relationship between suicide attempt and its predictors among adolescents has not previously been studied. The purpose of this thesis is to examine racial/ethnic differences in the relationship between depression, suicidal thoughts, suicide plan, and suicide attempts among American adolescents.

Cross-sectional data from the 2015 and 2017 Youth Risk Behaviors Surveys were used, and SAS survey procedures were used in all analyses to account for the complex survey design and weighting. Three sets of logistic models were conducted, with one for each of the exposures. Each set of models included crude and adjusted models for the total cohort, as well as stratified models for each race/ethnic group. Likelihood ratio tests were used to assess interaction between the exposure and race/ethnicity.

Depression, suicidal thoughts, and suicide plan were all significantly predictive of suicide attempts in every model. Race/ethnicity were found to be significant effect modifiers in the combined models and in a few groups in the stratified models. For each exposure, white students had the strongest relationship between the exposure and suicide attempts while black students had the weakest relationship. Single-race Hispanic students also had a significantly stronger relationship between suicidal thoughts and suicide attempts than the total cohort, while Asian students had a significantly weaker relationship between suicide plan and suicide attempts than the total cohort.

As the first study to examine these relationships among adolescents, these results suggest that the the experience of depression and suicidality among adolescents varies across racial/ethnic groups. Based on these results, further research is needed to better understand racial/ethnic differences in youth depression and suicidality. 

Table of Contents

Table of Contents

I. Literature Review. 1

A. Adolescent Depression. 1

B. Adolescent Suicide. 3

C. Racial Disparities. 4

II. Methods. 8

A. Study Design. 8

B. Data Source. 8

C. Exposure. 9

D. Outcome. 9

E. Effect Modifiers. 10

F. Statistical Analyses. 11

III. Results. 12

IV. Discussion. 15

A. Strengths and Limitations. 16

B. Implications for Future Research. 17

C. Conclusions. 18

V. References. 28

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