Considering Developmental Phenotypes of Suicidality for Young Black Children

Abstract

Suicide is currently the 5th leading cause of death among children aged 5–11, a rate that has more than tripled in the last decade, and one that has increased significantly more among Black compared to White children. Specifying early childhood phenotypes of suicidality is critical for prevention of suicidal behavior. Such phenotypes need to be culturally relevant and rigorously tested in Black youth to yield data that will inform prevention science. We used the Interpersonal Theory of Suicide, to guide both the development of a theoretical model and a research protocol to conduct a study on suicidality in young Black children. The model was informed by an ecological adaptation which considers the context of structural, systemic, and interpersonal racism as critical for conceptualizing suicidal risk and identifying factors that reduce the likelihood of suicidal ideation and behaviors among Black youth. Developmental adaptations of IPTS components were based on existing research supporting associations between theoretically similar constructs and early childhood depression and/or later suicidality. Model components include loneliness and lack of family connectedness, low self-worth and hopelessness, and impulsivity. The components are measured via questionnaires and reactivity to behavioral probes as measured by facial emotion, heart rate variability, and self-reported mood. Risk and protective factors include exposure to racism and discrimination and racial identity and socialization, respectively. An accelerated, longitudinal design, enrolling 5–9-year-old children for 6 repeated assessments over 45 months will allow us to test stability from early childhood to early adolescence. Conducting robust tests of early risk and stability of suicidality in the context of culturally relevant risk factors (e.g., racism) and protective factors (e.g., racial socialization and identity) will contribute to efforts to reverse recent trends in Black youth suicide.