The impact of adverse childhood experiences on suicidal ideation and attempts in African American adolescents: examining the moderation effect of religious activity on the progression of suicide

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Veronica J. Thornton (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Andrew Supple

Abstract: Trauma from Adverse Childhood Experiences (ACEs) which include neglect, abuse, and household dysfunction increase the risk of depressive symptoms 2.5- to 3.6-fold and suicidal attempts 2- to 5-fold. The most recent theoretical model of suicidal progression, Three-Step Theory, postulates psychological distress (such as trauma from ACEs), leads to hopelessness (a depressive symptom), and subsequently to suicidal ideation and suicidal attempts. However, no person-centered model of ACEs and their link to hopelessness and later suicidal behavior has been conducted amongst African American or adolescent populations. Therefore, the first goal of this study was to test the validity of the Three-Step Theory of Suicide by creating the first person-centered model of the ACEs to suicidal behavior association in an African American adolescent sample using a latent class analysis. The second goal was to explore the potential moderating effect of a protective factor (religious participation) on the Three-Step Model for this demographic which was unknown. Religious participation, a common practice within the African American community, was predicted to provide an alternative method for coping with traumatic experiences like ACEs by mitigating the use of the maladaptive coping following hopelessness. African American adolescents (N=705) aged 14 to 18 years were extracted from the 2015 Dane County Youth Assessment. A latent class analysis revealed three typologies, a Low ACES class, a Neglect ACES class, and a High ACES class. Results validated the use of the Three-Step Model for the sample demographic.Trauma from Adverse Childhood Experiences (ACEs) which include neglect, abuse, and household dysfunction increase the risk of depressive symptoms 2.5- to 3.6-fold and suicidal attempts 2- to 5-fold. The most recent theoretical model of suicidal progression, Three-Step Theory, postulates psychological distress (such as trauma from ACEs), leads to hopelessness (a depressive symptom), and subsequently to suicidal ideation and suicidal attempts. However, no person-centered model of ACEs and their link to hopelessness and later suicidal behavior has been conducted amongst African American or adolescent populations. Therefore, the first goal of this study was to test the validity of the Three-Step Theory of Suicide by creating the first person-centered model of the ACEs to suicidal behavior association in an African American adolescent sample using a latent class analysis. The second goal was to explore the potential moderating effect of a protective factor (religious participation) on the Three-Step Model for this demographic which was unknown. Religious participation, a common practice within the African American community, was predicted to provide an alternative method for coping with traumatic experiences like ACEs by mitigating the use of the maladaptive coping following hopelessness. African American adolescents (N=705) aged 14 to 18 years were extracted from the 2015 Dane County Youth Assessment. A latent class analysis revealed three typologies, a Low ACES class, a Neglect ACES class, and a High ACES class. Results validated the use of the Three-Step Model for the sample demographic. Hopelessness fully mediated the Neglect ACES class associations with suicidal ideation and suicide attempts. However, hopelessness partially mediated the High ACES class associations with suicidal ideation and suicide attempts. The second hypothesis was not supported such that the Three-Step Model was not moderated by religious participation. Mediation results suggested Neglect may be a less severe form of ACEs for African American youth such that its relationship to suicidal behavior is fully mediated by hopelessness. However, experiences of multiple ACEs especially physical abuse or family chaos may place African American youth at higher risk for suicidal behavior, above and beyond hopelessness. These findings suggest that the Three-Step model explains the association between moderate- and/or low- intensity ACEs and suicidal behavior. However, hopelessness and other factors contribute to the association between abuse- and family chaos- related ACEs, and suicidal behavior. These results suggest that African American youth may benefit from trauma and suicidal behavior screeners that reflect severity categories for types of ACEs in addition to number of ACEs. Finally, African American youth who are at risk for neglect may need to be routinely screened for hopelessness.

Additional Information

Publication
Thesis
Language: English
Date: 2020
Keywords
Adolescents, Adverse childhood experiences, African American, Hopelessness, Latent-class analysis, Suicidal behavior
Subjects
African American youth $x Suicidal behavior
Suicidal behavior $x Risk factors
Mental health $x Religious aspects
Psychic trauma in children
Despair

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