Associations Between Family Factors,Social Integration,and Suicidal Ideation Across the Life Course of an Urban African American Cohort

Abstract

Suicide is a problem on the rise but not studied extensively among African Americans. It is critical to identify risk factors for suicidal ideation to reduce risk. This study examines whether family and social factors over the life course predict suicidal ideation among African American adults in midlife. We conducted multiple logistic regression analyses on data from a longitudinal cohort of African Americans first assessed in childhood to identify associations with suicidal ideation in midlife (ages 33–42). Findings suggested living without one’s mother in childhood (vs. living with mother alone; aOR = 3.69, p = .017) and parental rule-setting in adolescence (aOR = 0.79, p = .047) were associated with suicidal ideation. Having a lifetime drug disorder (aOR = 2.19, p = .046) or major depression by young adulthood (aOR = 3.58, p < .001) was also associated with an increased risk of suicidal ideation. Findings highlight the importance of intervention for children in mother-absent homes for improving mental health outcomes. Family interventions that promote parental rule-setting and addressing drug problems and depressive symptoms early in the life course offer an area for intervention to reduce suicide over the long term.

Keywords

suicide family systems mental health child development substance abuse

Get full access to this article

View all access options for this article.

References

Ainsworth

M. S.

Bowlby

(1991). An ethological approach to personality development. American Psychologist, 46(4), 333-341. https://doi.org/10.1037/0003-066X.46.4.333

American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed.). American Psychiatric Association.

Balis

Postolache

T. T.

(2008). Ethnic differences in adolescent suicide in the United States. International Journal of Child Health and Human Development, 1(3), 281-296.

Bebbington

P. E.

Minot

Cooper

Dennis

Meltzer

Jenkins

Brugha

(2010). Suicidal ideation, self-harm and attempted suicide: Results from the British psychiatric morbidity survey 2000. European Psychiatry, 25(7), 427-431. https://doi.org/10.1016/j.eurpsy.2009.12.004

Bowlby

(1988). A secure base: Parent-child attachment and healthy human development. Basic Books.

Bretherton

(1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 28(5), 759-775. https://doi.org/10.1037/0012-1649.28.5.759

Brickman

A. L.

Mintz

D. C.

(2003). Datapoints: US rates of self-inflicted injuries and suicide, 1992-1999. Psychiatric Services, 54(2), 168. https://doi.org/10.1176/appi.ps.54.2.168

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (2020). Underlying cause of death 1999−2018 on CDC WONDER online database. https://wonder.cdc.gov/

Chang

E. C.

Chang

O. D.

Martos

Sallay

Lee

Stam

K. R.

Batterbee

C. N.-H.

(2017). Family support as a moderator of the relationship between loneliness and suicide risk in college students: Having a supportive family matters. The Family Journal, 25(3), 257-263. https://doi.org/10.1177/1066480717711102

10.

Chatters

L. M.

Nguyen

A. W.

Taylor

R. J.

Hope

M. O.

(2017). Church and family support networks and depressive symptoms among African Americans: findings from the national survey of American life. Journal of Community Psychology, 46(4), 403-417. https://doi.org/10.1002/jcop.21947

11.

Chatters

L. M.

Taylor

R. J.

Lincoln

K. D.

Nguyen

Joe

(2011). Church-based social support and suicidality among African Americans and Black Caribbeans. Archives of Suicide Research, 15(4), 337-353. https://doi.org/10.1080/13811118.2011.615703

12.

Chen

Kubzansky

L. D.

VanderWeele

T. J.

(2019). Parental warmth and flourishing in mid-life. Social Science & Medicine, 220, 65-72. https://doi.org/10.1016/j.socscimed.2018.10.026.

13.

Cohen

(2004). Social relationships and health. American Psychologist, 59(8), 676-684. https://doi.org/10.1037/0003-066X.59.8.676

14.

Compton

M. T.

Thompson

N. J.

Kaslow

N. J.

(2005). Social environment factors associated with suicide attempt among low-income African Americans: The protective role of family relationships and social support. Social Psychiatry and Psychiatric Epidemiology, 40(3), 175-185. https://doi.org/10.1007/s00127-005-0865-6

15.

Cookston

J. T.

(1999). Parental supervision and family structure: Effects on adolescent problem behaviors. Journal of Divorce & Remarriage, 32(1-2), 107-122. https://doi.org/10.1300/J087v32n01_07

16.

Cottler

Robins

Grant

Blaine

Towle

Wittchen

Sartorius

(1991). The CIDI-core substance abuse and dependence questions: cross-cultural and nosological issues. British Journal of Psychiatry, 159(5), 653-658. https://doi.org/10.1192/bjp.159.5.653

17.

Council for Community Services in Metropolitan Chicago (1975). Community analysis project. Report no. 1: Chicago problem analysis. Council for Community Services in Metropolitan Chicago.

18.

Crosby

A. E.

Molock

S. D.

(2006). Introduction: Suicidal behaviors in the African American community. Journal of Black Psychology, 32(3), 253-261. https://doi.org/10.1177/0095798406290552

19.

Crum

R. M.

Juon

H. S.

Green

K. M.

Robertson

Fothergill

Ensminger

(2006). Educational achievement and early school behavior as predictors of alcohol-use disorders: 35-year follow-up of the Woodlawn study. Journal of Studies on Alcohol and Drugs, 67(1), 75-85. https://doi.org/10.15288/jsa.2006.67.75

20.

Curtin

S. C.

Hedegaard

(2019). Suicide rates for females and males by race and ethnicity: United States, 1999 and 2017. NCHS Health E-Stat.

21.

Doane

D. P.

Seward

L. E.

(2011). Measuring skewness: A forgotten statistic? Journal of Statistics Education, 19(2), 1-18. https://doi.org/10.1080/10691898.2011.11889611

22.

Doherty

E. E.

Green

K. M.

Ensminger

M. E.

(2008). Investigating the long-term influence of adolescent delinquency on drug use initiation. Drug and Alcohol Dependence, 93(1-2), 72-84. https://doi.org/10.1016/j.drugalcdep.2007.08.018

23.

Donovan

J. E.

(2004). Adolescent alcohol initiation: A review of psychosocial risk factors. Journal of Adolescent Health, 35(6), 529. https://doi.org/10.1016/j.jadohealth.2004.02.003

24.

Droege

J. R.

Robinson

W. L.

Jason

L. A.

(2017). Suicidality protective factors for African American adolescents: A systematic review of the research literature. SOJ Nursing & Health Care, 3(2), 1-5. http://doi.org/10.15226/2471-6529/3/2/00130

25.

Durkheim

(1951). Suicide: A study in sociology. Free Press.

26.

Elstad

J. I.

(2005). Childhood adversities and health variations among middle-aged men: A retrospective life course study. European Journal of Public Health, 15(1), 51-58. https://doi.org/10.1093/eurpub/cki114

27.

Ensminger

M. E.

Fothergill

K. E.

Doherty

E. E.

Green

K. M.

Robertson

J. A.

Juon

H. S.

(2016). The crossover effect: The influence of social roles in an African American cohort. In Thomas

Y. F.

Price

L. N.

(Eds.), Drug use trajectories among minority youth (pp. 37-62). Springer.

28.

Ensminger

M. E.

Juon

H. S.

Lee

S. Y.

(2009). Social connections in the inner city: Examination across the life course. Longitudinal and Life Course Studies, 1(1), 11-26. https://doi.org/10.14301/llcs.v1i1.27

29.

Felitti

V. J.

Anda

R. F.

Nordenberg

Williamson

D. F.

Spitz

A. M.

Edwards

Koss

M. P.

Marks

J. S.

(1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/S0749-3797(98)00017-8

30.

Flanagan

Auty

Farrington

(2019). Parental supervision and later offending: A systematic review of longitudinal studies. Aggression and Violent Behavior, 47, 215-229. https://doi.org/10.1016/j.avb.2019.06.003.

31.

Fothergill

Ensminger

M. E.

Doherty

E. E.

Juon

H. S.

Green

K. M.

(2016). Pathways from early childhood adversity to later adult drug use and psychological distress: A prospective study of a cohort of African Americans. Journal of Health and Social Behavior, 57(2), 223-239. https://doi.org/10.1177/0022146516646808

32.

Fothergill

K. E.

Ensminger

M. E.

Robertson

Green

K. M.

Thorpe

R. J.

Juon

H. S.

(2011). Effects of social integration on health: A prospective study of community engagement among African American women. Social Science & Medicine, 72(2), 291-298. https://doi.org/10.1016/j.socscimed.2010.10.024

33.

Geiger

J. M.

Piel

M. H.

Julien-Chinn

F. J.

(2017). Improving relationships in child welfare practice: Perspectives of foster care providers. Child and Adolescent Social Work Journal, 34(1), 23-33. https://doi.org/10.1007/s10560-016-0471-3

34.

Heron

M. P.

(2019). Deaths: Leading causes for 2017. National Vital Statistics Reports, 68(6), 1-77. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_06-508.pdf

35.

Hilts

Greene

(2018). Mental health, substance misuse, and suicide: Shared risk and protective factors. The Center for Health Policy at the IU Richard M. Fairbanks School of Public Health, Indianapolis, IN.

36.

Hollingsworth

D. W.

Wingate

L. R.

Tucker

R. P.

O’Keefe

V. M.

Cole

A. B.

(2016). Hope as a moderator of the relationship between interpersonal predictors of suicide and suicidal thinking in African Americans. Journal of Black Psychology, 42(2), 175-190. https://doi.org/10.1177/0095798414563748

37.

Hosmer

D. W.

Jr. Lemeshow

(1989). Applied logistic regression. John Wiley & Son.

38.

Jang

S. J.

Smith

C. A.

(1997). A test of reciprocal causal relationships among parental supervision, affective ties, and delinquency. Journal of Research in Crime and Delinquency, 34(3), 307-336. https://doi.org/10.1177/0022427897034003002

39.

Jones-Eversley

S. D.

Rice

Adedoyin

A. C.

James-Townes

(2020). Premature deaths of young Black males in the United States. Journal of Black Studies, 51(3), 251-272. https://doi.org/10.1177/0021934719895999

40.

Jones

D. J.

Zalot

A. A.

Foster

S. E.

Sterrett

Chester

(2007). A review of childrearing in African American single mother families: The relevance of a coparenting framework. Journal of Child and Family Studies, 16(5), 671-683. https://doi.org/10.1007/s10826-006-9115-0

41.

Juon

H. S.

Ensminger

M. E.

(1997). Childhood, adolescent, and young adult predictors of suicidal behaviors: A prospective study of African Americans. Journal of Child Psychology and Psychiatry, 38(5), 553-563. https://doi.org/10.1111/j.1469-7610.1997.tb01542.x

42.

Kellam

S. G.

Ensminger

M. E.

Turner

R. J.

(1977). Family structure and the mental health of children: Concurrent and longitudinal community wide studies. Archives of General Psychiatry, 34(9), 1012-1022. https://doi.org/10.1001/archpsyc.1977.01770210026002

43.

Kessler

R. C.

McGonagle

K. A.

Swartz

Blazer

D. G.

Nelson

C. B.

(1993). Sex and depression in the national comorbidity survey I: Lifetime prevalence, chronicity, and recurrence. Journal of Affective Disorders, 29(2-3), 85-96. https://doi.org/10.1016/0165-0327(93)90026-G

44.

Kessler

R. C.

McGonagle

K. A.

Zhao

Nelson

C. B.

Hughes

Eshleman

Wittchen

H. U.

Kendler

K. S.

(1994). Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States: Results from the national comorbidity survey. Archives of General Psychiatry, 51(1), 8-19. https://doi.org/10.1001/archpsyc.1994.03950010008002

45.

Kessler

R. C.

Wittchen

H. U.

Abelson

J. M.

McGonagle

Schwarz

Kendler

K. S.

Zhao

(1998). Methodological studies of the composite international diagnostic interview (CIDI) in the US national comorbidity survey (NCS). International Journal of Methods in Psychiatric Research, 7(1), 33-55. https://doi.org/10.1002/mpr.33

46.

Lincoln

K. D.

Taylor

R. J.

Chatters

L. M.

Joe

(2012). Suicide, negative interaction and emotional support among Black Americans. Social Psychiatry and Psychiatric Epidemiology, 47(12), 1947-1958. https://doi.org/10.1007/s00127-012-0512-y

47.

Lizardi

Klein

D. N.

(2005). Long-term stability of parental representations in depressed outpatients utilizing the parental bonding instrument. Journal of Nervous and Mental Disease, 193(3), 183-188. https://doi.org/10.1097/01.nmd.0000154838.16100.36

48.

Matlin

S. L.

Molock

S. D.

Tebes

J. K.

(2011). Suicidality and depression among African American adolescents: The role of family and peer support and community connectedness. The American Journal of Orthopsychiatry, 81(1), 108-117. https://doi.org/10.1111/j.1939-0025.2010.01078.x

49.

Miller

A. B.

Eisenlohr-Moul

Giletta

Hastings

P. D.

Rudolph

K. D.

Nock

M. K.

Prinstein

M. J.

(2017). A within-person approach to risk for suicidal ideation and suicidal behavior: Examining the roles of depression, stress, and abuse exposure. Journal of Consulting and Clinical Psychology, 85(7), 712-722. https://doi.org/10.1037/ccp0000210

50.

Miller

A. B.

Esposito-Smythers

Leichtweis

R. N.

(2015). Role of social support in adolescent suicidal ideation and suicide attempts. Journal of Adolescent Health, 56(3), 286-292. https://doi.org/10.1016/j.jadohealth.2014.10.265

51.

Morrison

L. L.

Downey

D. L.

(2000). Racial differences in self-disclosure of suicide ideation and reasons for living: Implications for training. Cultural Diversity & Ethnic Minority Psychology, 6(4), 374-386. https://doi.org/10.1037/1099-9809.6.4.374

52.

Nilsson

Ängarne-Lindberg

(2016). Children who lose a parent suddenly: What kind of assistance do they feel provides relief? A content analysis study of children and their parents. Child Care in Practice, 22(2), 197-209. https://doi.org/10.1080/13575279.2015.1118014

53.

Odafe

M. O.

Salami

T. K.

Walker

R. L.

(2017). Race-related stress and hopelessness in community-based African American adults: Moderating role of social support. Cultural Diversity & Ethnic Minority Psychology, 23(4), 561-569. https://doi.org/10.1037/cdp0000167

54.

Odafe

M. O.

Talavera

D. C.

Cheref

Hong

J. H.

Walker

R. L.

(2016). Suicide in racial and ethnic minority adults: A review of the last decade. Current Psychiatry Reviews, 12(2), 181-198. https://doi.org/10.2174/1573400512666160530124538

55.

Opara

Assan

M. A.

Pierre

Gunn

J. F.

III Metzger

Hamilton

Arugu

(2020). Suicide among Black children: An integrated model of the interpersonal-psychological theory of suicide and intersectionality theory for researchers and clinicians. Journal of Black Studies, 51(6), 611-631. https://doi.org/10.1177/0021934720935641

56.

Petersen

A. C.

Kellam

S. G.

(1977). Measurement of the psychological well-being of adolescents: The psychometric properties and assessment procedures of the How I Feel. Journal of Youth and Adolescence, 6(3), 229-247. https://doi.org/10.1007/BF02138937

57.

Price

J. H.

Khubchandani

(2019). The changing characteristics of African-American adolescent suicides, 2001–2017. Journal of Community Health, 44(4), 756-763. https://doi.org/10.1007/s10900-019-00678-x

58.

Raudino

Fergusson

D. M.

Horwood

L. J.

(2013). The quality of parent/child relationships in adolescence is associated with poor adult psychosocial adjustment. Journal of Adolescence, 36(2), 331-340. https://doi.org/10.1016/j.adolescence.2012.12.002

59.

Robinson

W. L.

Case

M. H.

Whipple

C. R.

Gooden

A. S.

Lopez-Tamayo

Lambert

S. F.

Jason

L. A.

(2016). Culturally grounded stress reduction and suicide prevention for African American adolescents. Practice Innovations, 1(2), 117-128. https://doi.org/10.1037/pri0000020

60.

Royal

K. J.

Eaton

S. C.

Smith

Cliette

Livingston

J. N.

(2017). The impact of parental stress and social support on behavioral outcomes of children in African American single-mother households. Journal of Black Sexuality and Relationships, 3(4), 17-33. https://doi.org/10.1353/bsr.2017.0011

61.

Shervington

W. W.

(2000). We can no longer ignore the rising rate of African-American suicide. Journal of the National Medical Association, 92(2), 53-54. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640541/

62.

Singh

G. K.

Siahpush

(2014). Widening rural–urban disparities in life expectancy, US, 1969–2009. American Journal of Preventive Medicine, 46(2), 19-29. https://doi.org/10.1016/j.amepre.2013.10.017

63.

Spitzer

Williams

JBW

Gibbon

First

(1992). The structured clinical interview for DSM-III-R. History, rationale and description. Arch Gen Psychiatry, 49, 624-629. https://doi.org/10.1001/archpsyc.1992.01820080032005

64.

StataCorp (2017) Stata statistical software: release (4.0). Stata Corporation.

65.

Tejedor

M. C.

Diaz

Castillon

J. J.

Pericay

J. M.

(1999). Attempted suicide: Repetition and survival findings of a follow‐up study. Acta Psychiatrica Scandinavica, 100(3), 205-211. https://doi.org/10.1111/j.1600-0447.1999.tb10847.x

66.

Walker

R. L.

Flowers

K. C.

(2011). Effects of race and precipitating event on suicide versus nonsuicide death classification in a college sample. Suicide & Life-Threatening Behavior, 41(1), 12-20. https://doi.org/10.1111/j.1943-278X.2010.00008.x

67.

Walker

R. L.

Lester

Joe

(2006). Lay theories of suicide: An examination of culturally relevant suicide beliefs and attributions among African Americans and European Americans. Journal of Black Psychology, 32(3), 320-334. http://doi.org/10.1177/0095798406290467

68.

Wang

Bao

Gao

Xiang

(2016). Age-period-cohort analysis of suicide mortality by gender among White and Black Americans, 1983–2012. International Journal for Equity in Health, 15(107), 1-9. https://doi.org/10.1186/s12939-016-0400-2

69.

Wittchen

H. U.

Kessler

R. C.

(1994). Modifications of the CIDI in the National comorbidity Survey: The development of the UM-CIDI. https://www.hcp.med.harvard.edu/ncs/ftpdir/um-cidi.pdf

70.

Woolf

S. H.

Chapman

D. A.

Buchanich

J. M.

Bobby

K. J.

Zimmerman

E. B.

Blackburn

S. M.

(2018). Changes in midlife death rates across racial and ethnic groups in the United States: Systematic analysis of vital statistics. BMJ Clinical Research, 362(8164), k3096. https://doi.org/10.1136/bmj.k3096

71.

Murphy

S. L.

Kochanek

K. D.

Bastian

Arias

(2018). Deaths: Final data for 2016. National Vital Statistics Reports, 67(5), 1-76.