Considering Developmental Phenotypes of Suicidality for Young Black Children

Kate Keenan, Stephanie Stepp, Leslie A. Anderson, Marisha Humphries, Alison E. Hipwell, Kimberley Mbayiwa
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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.

Abstract Image

考虑黑人儿童自杀倾向的发育表型
自杀目前是5-11岁儿童死亡的第五大原因,在过去十年中,自杀率增加了两倍多,黑人儿童的自杀率明显高于白人儿童。明确儿童早期自杀表型对预防自杀行为至关重要。这种表型需要与文化相关,并在黑人青年中进行严格的测试,以产生将为预防科学提供信息的数据。我们使用人际自杀理论来指导理论模型和研究方案的发展,以开展一项关于年轻黑人儿童自杀的研究。该模型以生态适应为基础,考虑了结构性、系统性和人际种族主义的背景,这对于概念化自杀风险和识别降低黑人青年自杀意念和行为可能性的因素至关重要。IPTS组件的发育适应性是基于现有的研究,这些研究支持理论相似的结构与早期儿童抑郁和/或后来的自杀行为之间的关联。模型成分包括孤独和缺乏家庭联系,低自我价值和绝望,以及冲动。这些成分是通过问卷调查和对面部情绪、心率变异性和自我报告情绪等行为探针的反应来测量的。风险和保护因素分别包括暴露于种族主义和歧视以及种族认同和社会化。一项加速的纵向设计,招募5 - 9岁的儿童在45个月内进行6次重复评估,将使我们能够测试从幼儿到青春期早期的稳定性。在与文化相关的风险因素(例如,种族主义)和保护因素(例如,种族社会化和身份)的背景下,对自杀的早期风险和稳定性进行强有力的测试,将有助于努力扭转最近黑人青年自杀的趋势。
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