Association between discrimination stress and suicidality in preadolescent children

Argabright, S. T.; Visoki, E.; Moore, T. M.; Ryan, D. T.; DiDomenico, G. E.; Njoroge, W. F.; Taylor, J. H.; Guloksuz, S.; Gur, R. C.; Gur, R. E.; Benton, T. D.; Barzilay, R.

Objective: US youth suicide rates are increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality, hence there is a need to study stressors that disproportionately impact Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality) across races. Method: We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study that included a large, diverse sample of US children (N=11,235, mean age 10.9 years, 20.2% Black) phenotyped for environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (towards non-US born individuals; sexual orientation-based; weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. Results: Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively associated with suicidality, adjusting for other discrimination types (odds ratio [OR]=2.6, 95%CI=2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk [RR]=2.7, 95%CI=2-3.5), while Black race was not (RR=0.9, 95%CI=0.7-1.2). Conclusion: Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.