Weight perceptions and pre-suicide behaviors among United States high school students, YRBS 2011 Open Access

Croston, Merriah (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/tt44pn37g?locale=en
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Abstract

Suicide is the 3rd leading cause of death for adolescents and young adults 15-24 years, behind homicides and unintentional injuries (1). Further, when data from the 2009 Youth Risk Behavior Survey (YRBS) were analyzed, 16% of US 9th to 12th grade students in reported suicidal ideation, 13% reported creating a plan, and 8% reported at least one suicide attempt during the previous year.

Research shows that obesity and perceived weight are related to pre-suicide behaviors, such as suicidal ideation, suicide planning, and suicide attempt (2,3). The purpose of this research was to explore the association between perceived weight status and pre-suicide behaviors, and further characterize factors that confound, moderate, or mediate the association between perceived weight status and pre-suicide behaviors among a nationally representative sample of high school students who participated in the YRBS in 2011.

Results of this study show that for all outcomes, high school students who perceived themselves to be overweight were more likely to engage in pre-suicide behaviors. The relationships between perceived weight status and all pre-suicide behaviors were moderated by age, and the relationship between perceived weight status and suicide planning was moderated by sex. The relationship between perceived weight status and suicidal ideation was confounded by age, prolonged sadness, and unhealthy weight control behaviors. The relationship between perceived weight status and suicide planning was confounded by sex, age, prolonged sadness, discord between actual and perceived weight status, and unhealthy weight control behaviors. The relationship between perceived weight status and suicide attempt was confounded by age, race/ethnicity, prolonged sadness, and discord between actual and perceived weight status.

Results of this study suggest that there are particular subpopulations of high school students who perceive themselves to be overweight and are potentially at greater risk of attempting suicide than other subpopulations. In consideration of the Healthy People 2020 goal to reduce the rate of attempted suicide among adolescents by 10%, targeted primary prevention efforts and intervention programs in schools, physicians' offices, and at home could be implemented to address the increased risk of pre-suicide behaviors among youth who perceive themselves to be overweight.

Table of Contents

Table of Contents

Chapter II: Introduction 1

A. Introduction and rationale 1

B. Research question and hypotheses 2

C. Theoretical framework 3

Chapter II: Literature Review 5

A. Suicide as a public health problem 5

B. Continuum of pre-suicide behaviors: thoughts, communications and behaviors 7

C. Pre-suicide behaviors among youth 11

D. Associations between obesity, weight perception, and pre-suicide behaviors among youth 24

Chapter III: Methodology 29

A. Research design 29

B. Target population and sample 30

C. Instrument and measures 31

D. Data collection procedures and management 31

E. Limitations 34

F. Delimitation 35

G. Data selection and variable coding 35

H. Data analysis procedures 39

I. IRB clearance 41

Chapter IV: Results 42

A. Outcomes, perceived weight status, demographic characteristics, and confounding factors 42

B. Weight status and covariates by outcome 43

C. Stratified analysis 48

D. Multiple logistic regression analysis 48

Chapter V: Discussion 56

A. Study strengths and limitations 63

B. Implications for suicide prevention and public health 64

C. Directions for future research 65

D. Conclusion 65

Appendix I: Citations 67

Appendix II: Tables 73

Appendix III: SAS programs103

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