Original articleAdverse Childhood Experiences and Suicidal Behaviors Among Youth: The Buffering Influence of Family Communication and School Connectedness
Section snippets
Objectives
Using samples of 5,341 middle school and 4,980 high school youth drawn from all schools in western state, we aimed to determine (1) whether family communication and school connectedness offer protection against suicidal behaviors in the presence of ACEs (direct protective effect) and (2) whether family communication and school connectedness buffer the association between ACEs and suicidal behaviors (interacting protective effect) on the multiplicative and additive scales.
Participants and procedures
The Youth Risk Behavior Survey (YRBS) is a national, school-based surveillance system established by the Centers for Disease Control and Prevention (CDC) in 1991 to monitor the prevalence of risk behaviors among high school youth. A small number of states also choose to conduct the YRBS in middle schools [20]. Data for the present study were obtained from a 2019 middle school and high school YRBS conducted in a western state. A strata (region)/cluster (classroom) sampling design was used to
Results
Table 1 shows the characteristics of middle school and high school participants. Just more than half of both samples were male, and the most common racial/ethnic group was Hispanic (45% middle school and 43% high school). Most students lived in urban settings, about 42% qualified for free or reduced-price lunch, and 8% of middle school students and 5% of high school students lived in a military household. Approximately 15% of middle school youth and 21% of high school youth self-reported 3+
Discussion
The main objectives of this study were to determine (1) whether family communication and school connectedness offer protection against suicidal behaviors in the presence of ACEs (direct protective effect) and (2) whether family communication and school connectedness buffer the association between ACEs and suicidal behaviors (interacting protective effect). Our findings suggest that both family communication and school connectedness had a direct protective effect on suicidal behaviors, as they
Conclusions
In summary, the findings suggest family communication and school connectedness may buffer the association between ACEs and suicidal behaviors, particularly among middle school youth. Strength-based approaches to suicide prevention that focus on the family and school setting are warranted. For example, a large randomized trial demonstrated that a school-based intervention designed to help youth deal with stress, adverse life events, and suicidal thoughts by improving coping skills and school
References (33)
- et al.
Psychiatric risk factors for adolescent suicide: A case-control study
J Am Acad Child Adolesc Psychiatry
(1993) - et al.
Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study
Am J Prev Med
(1998) - et al.
Sexual identity, adverse childhood experiences, and suicidal behaviors
J Adolesc Health
(2018) - et al.
Child and adolescent suicide attempts, suicidal behavior, and adverse childhood experiences in South Africa: A prospective study
J Adolesc Health
(2015) - et al.
School-based suicide prevention programmes: The SEYLE cluster-randomised, controlled trial
Lancet
(2015) Leading causes of death by age group, United States - 2018
- et al.
Suicide and suicidal behavior
Epidemiol Rev
(2008) - et al.
Youth Risk Behavior Surveillance — United States, 2017
MMWR Surveill Summ
(2018) - et al.
Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication
JAMA Psychiatry
(2013) - et al.
Cross-national prevalence and risk factors for suicidal ideation, plans and attempts
Br J Psychiatry
(2008)
Epidemiology of youth suicide and suicidal behavior
Curr Opin Pediatr
Child and adolescent suicide: Epidemiology, risk factors, and approaches to prevention
Paediatr Drugs
Involvement in bullying and suicide-related behavior at 11 Years: A prospective birth cohort study
J Am Acad Child Adolesc Psychiatry
Adolescent violence perpetration: Associations with multiple types of adverse childhood experiences
Pediatr
Positive youth development : Theory, research and application
Risky families: Family social environments and the mental and physical health of offspring
Psychol Bull
Cited by (24)
Interpersonal violence and suicide risk: Examining buffering effects of school and community connectedness
2024, Children and Youth Services ReviewAdverse childhood experiences and adolescent handgun carrying
2023, Journal of Criminal Justice
Conflicts of interest: The authors have no conflicts of interest to disclose.
Disclaimer: The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.