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Profiles of Risk for Self-injurious Thoughts and Behaviors Among System-Impacted Girls of Color - 23/08/24

Doi : 10.1016/j.jaac.2023.06.010 
Ana E. Sheehan, MA a, , Nadia Bounoua, MA a, Raquel E. Rose, MPhil b, Naomi Sadeh, PhD a, Shabnam Javdani, PhD b
a University of Delaware, Newark, Delaware 
b New York University, New York 

Correspondence to Ana Sheehan, MA, University of Delaware, 108 Wolf Hall, Newark, DE 19176University of Delaware108 Wolf HallNewarkDE19176

Abstract

Objective

Suicide is a leading cause of death among youth in custodial settings. Prior research investigating risk factors for suicide among system-impacted youth fail to incorporate an intersectional framework to contextualize suicide risk among system-impacted girls of color.

Method

Profiles of risk for self-injurious thoughts and behaviors (SITBs) were investigated in a sample of 240 racially and ethnically diverse system-impacted girls (mean [SD] age = 14.5 [1.7] years, Hispanic/Latinx 49.6%, Black 37.1%). Participants completed self-report measures evaluating traditional risk factors for suicide (mental health symptoms, trauma exposure) as well as assessments of minority stress (eg, daily discrimination) and recent engagement in SITBs at baseline and 3-month follow-up.

Results

Latent profile analysis revealed 3 distinct profiles: low-risk, characterized by relatively low levels of suicide risk indicators (n = 102); high-risk internalizing, characterized by elevations in internalizing symptom indicators (n = 96); and high-risk comorbid, characterized by relatively high levels of suicide risk indicators (n = 42). Girls in the high-risk profiles reported more SITBs at baseline and 3-month follow-up than girls in the low-risk profile.

Conclusion

Results suggest that indicators of suicide risk can be used to classify system-impacted girls into profiles that differ concurrently and prospectively on SITBs. Findings could be used to inform more accurate risk and referral assessments for system-impacted girls of color, whose SITB-related challenges may be overlooked or framed as criminal. These findings highlight the continued need for assessments evaluating multiple indicators of risk for SITBs in the juvenile legal system.

Plain language summary

System-impacted girls of color represent an understudied subset of youth at elevated risk for engagement in self-injurious thoughts and behaviors (SITBs). This study investigated profiles of risk for SITBs in a sample of 240 racially and ethnically diverse system-impacted girls of color (mean age = 14.5 years) utilizing frequently studied factors associated with SITBs, including mental health symptoms and trauma experiences along with understudied risk factors such as minority stress. The authors found that three distinct profiles of risk for SITBs: “Low-Risk,” characterized by relatively low levels of suicide risk indicators (n = 102); “High-Risk Internalizing,” distinguished by elevations in internalizing symptoms (n = 96); and “High-Risk Comorbid,” defined by relatively high levels of internalizing and externalizing symptoms (n = 42). Participants in both high-risk groups had high levels of trauma, minority stress, and were more likely to identify as a member of a sexually minoritized group.

Diversity & Inclusion Statement

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

Le texte complet de cet article est disponible en PDF.

Key words : adolescence, risk factors, suicide, youth system–impacted


Plan


 Data are from the ROSES Randomized Controlled Trial, supported by the National Institute of Justice (grant 2014-IJ-CX-0044) awarded to Shabnam Javdani. Work was supported in part by the National Science Foundation Graduate Research Fellowship awarded to Ana Sheehan. Work was also supported in part by the National Institute of Mental Health (grant 1F31MH120936-01A2). These institutes had no role in the study design; collection, analysis, or interpretation of the data; writing the manuscript; or the decision to submit the paper for publication.
 This article is part of a special series devoted to addressing bias, bigotry, racism, and mental health disparities through research, practice, and policy. The series is edited by Assistant Editor Eraka Bath, MD, Deputy Editor Wanjikũ F.M. Njoroge, Associate Editor Robert R. Althoff, MD, PhD, and Editor-in-Chief Douglas K. Novins, MD.
 The research was performed with permission from the New York University Institutional Review Board.
 Consent has been provided for descriptions of specific patient information.
 Dr. Sadeh served as the statistical expert for this research.
 Author Contributions
Conceptualization: Sheehan, Bounoua, Sadeh
Data curation: Rose, Javdani
Formal analysis: Sheehan, Bounoua, Sadeh
Funding acquisition: Javdani
Investigation: Rose
Methodology: Sheehan, Sadeh, Javdani
Project administration: Sheehan
Resources: Sadeh, Javdani
Software: Sadeh
Supervision: Sadeh, Javdani
Validation: Sadeh
Visualization: Sheehan, Rose
Writing – original draft: Sheehan, Rose
Writing – review and editing: Bounoua, Rose, Sadeh, Javdani
 Disclosure: Drs. Sadeh and Javdani and Mss. Sheehan, Bounoua, and Rose reported no biomedical financial interests or potential conflicts of interest.


© 2023  American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 63 - N° 9

P. 898-907 - septembre 2024 Retour au numéro
Article précédent Article précédent
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