Objective

Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality).

Method

We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non−US-born individuals, sexual orientation−based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality.

Results

Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2).

Conclusion

Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.

中文翻译：

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青春期前儿童歧视压力与自杀倾向的关系

客观的

近年来，美国青年自杀率一直在上升，尤其是在美国黑人中，其原因尚不清楚。环境逆境是青少年自杀的关键；因此，有必要研究对黑人青年产生不成比例影响的压力源。我们旨在将种族/族裔歧视的独特贡献与与童年自杀意念和企图（自杀）相关的其他逆境区分开来。

方法

我们分析了青少年大脑认知发展 (ABCD) 研究的数据，该研究包括大量多样化的美国儿童样本（N = 11,235，平均年龄 10.9 岁，20.2% 为黑人），评估了包括歧视在内的多种环境逆境。多变量回归模型测试了自我报告的种族/民族歧视与自杀的关联，包括其他歧视类型（针对非美国出生的个体、基于性取向和基于体重）的多重混杂因素的共变。匹配分析比较了种族/民族歧视和种族认同对自杀的影响。

结果

黑人青年比非黑人青年报告更多的歧视和更高的自杀率。高度种族/族裔歧视与自杀倾向显着正相关，针对其他歧视类型进行调整（比值比 = 2.6，95% CI = 2.1-3.2）。在调整了多个自杀风险因素后，调查结果仍然很重要。一旦经历过，种族/族裔歧视同样与白人、黑人和西班牙裔青年的自杀倾向相关。匹配分析显示种族/族裔歧视与自杀有关（相对风险 = 2.7，95% CI = 2-3.5），而黑人则不然（相对风险 = 0.9，95% CI = 0.7-1.2）。

结论

黑人儿童不成比例地经历种族/族裔歧视，并且与青春期前的自杀有关，超过其他逆境。调查结果强调需要解决歧视问题，将其作为自杀预防策略的一部分。横截面设计阻碍了因果推论。