Merai Ritika, Shi Tesia, Wei August X, Ruch Donna A, Bridge Jeffrey A, Pao Maryland, Horowitz Lisa M
Intramural Research Program at the National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Ohio State University College of Medicine and Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
JAACAP Open. 2025 Jan 31;3(3):448-454. doi: 10.1016/j.jaacop.2024.10.009. eCollection 2025 Sep.
Significant racial disparities exist in youth suicide rates. Research has identified family connectedness as a strong protective factor against suicide. However, the role of family in youth mental health can vary based on cultural factors that may differ across race and/or ethnicity. This study aimed to evaluate how race/ethnicity moderates the association between suicide risk and family connectedness.
This secondary analysis of Emergency Department Screen for Teens at Risk for Suicide (ED-STARS) study 1 included youth ages 12 to 17 years. Data were obtained for race/ethnicity, family connectedness (combined score of 2 items, range 2 [low] to 10 [high]), and the Ask Suicide-Screening Questions (ASQ) tool. Binary logistic regression assessed the association between family connectedness and positive ASQ screen, with race/ethnicity as a moderator.
Data for 5,514 participants (50.9% female, 45.8% non-Hispanic White, mean [SD] age = 15.0 [1.7] years) were analyzed. Of all participants, 23.5% (1,293/5,514) screened positive for suicide risk. Overall, participants reported high family connectedness (mean [SD] = 8.2 [1.74]). Multiracial participants had the lowest average family connectedness (7.93) and the highest screen positive rate (28.34% [70/247]). For a 1-unit increase in family connectedness, the odds of screening positive were significantly lower for Black/African American participants (odds ratio 0.54, 95% CI 0.49-0.59) compared to White participants (odds ratio 0.46, 95% CI 0.43-0.49) (difference: = -3.17, = .001).
The protective effect of family connectedness for suicide risk may vary by race/ethnicity. In this study, family connectedness was less protective against suicide risk for Black/African American youth compared to White youth. Findings highlight the importance of cultural considerations in family-based interventions for suicide prevention.
青少年自杀率存在显著的种族差异。研究已确定家庭联结是预防自杀的一个强有力的保护因素。然而，家庭在青少年心理健康中的作用可能因种族和/或民族的文化因素而异。本研究旨在评估种族/民族如何调节自杀风险与家庭联结之间的关联。
这项对青少年自杀风险急诊科筛查（ED-STARS）研究1的二次分析纳入了12至17岁的青少年。获取了种族/民族、家庭联结（两项指标的综合得分，范围为2[低]至10[高]）以及自杀筛查问题（ASQ）工具的数据。二元逻辑回归评估家庭联结与ASQ筛查阳性之间的关联，以种族/民族作为调节变量。
分析了5514名参与者的数据（50.9%为女性，45.8%为非西班牙裔白人，平均[标准差]年龄 = 15.0[1.7]岁）。在所有参与者中，23.5%（1293/5514）自杀风险筛查呈阳性。总体而言，参与者报告家庭联结程度较高（平均[标准差]=8.2[1.74]）。多种族参与者的平均家庭联结程度最低（7.93），筛查阳性率最高（28.34%[70/247]）。家庭联结程度每增加1个单位，黑人/非裔美国参与者筛查呈阳性的几率（优势比0.54，95%置信区间0.49 - 0.59）显著低于白人参与者（优势比0.46，95%置信区间0.43 - 0.49）（差异：=-3.17，=0.001）。
家庭联结对自杀风险的保护作用可能因种族/民族而异。在本研究中，与白人青少年相比，家庭联结对黑人/非裔美国青少年自杀风险的保护作用较小。研究结果凸显了在基于家庭的自杀预防干预中考虑文化因素的重要性。
