Measuring and Mapping Trajectories of Risk and Resilience for Suicidal Thoughts and Behaviors in Sexual Minority Preteens

Vanderbilt University, Nashville TN

Investigators

Abstract

PROJECT SUMMARY/ABSTRACT Today’s sexual minority (SM) youth are coming out at increasingly younger ages, with the average age of disclosure at 13 years old and 35% coming out as preteens. SM preteens experience up to 6 times higher risk for suicidal thoughts and behaviors (STBs) compared with their heterosexual peers. SM preteens’ social and developmental contexts likely contribute to significant risk and protective factors for STBs. For example, they must simultaneously navigate preteen developmental stressors and supports (like peer relationships and first romantic experiences) while also managing an emerging SM identity and associated exposure to stigmarelated stress and resilience. Yet, several knowledge gaps remain. The field of SM preteen research is in its infancy, without consensus on best practices for sampling and recruiting high-risk SM preteens. The field also lacks psychometrically valid assessments for SM preteens as well as longitudinal studies assessing risk and resilience trajectories during this sensitive developmental period. The overarching goal of this rigorous multimethod project is to address these gaps. Youth and parent advisory boards will be assembled to enrich our research and ensure its cultural responsiveness, ethical soundness, and ultimate benefit to SM preteens and families. Our research will address three aims. First, we will use a five-step Delphi process to develop consensus among a diverse panel of experts (including researchers, clinicians, legal experts, parents, leaders of SM community youth groups) on best practices for safely, ethically, and effectively sampling, recruiting, and retaining SM preteens at risk for suicide into research. Second, we will create and pretest an assessment of stigma-related stress and resilience for SM preteens using a three-phase approach (developing an initial item pool; refining items; establishing content validity with SM preteens). Last, we will enroll a national cohort of preteens at risk for suicide with one parent/caregiver, which we will call the SPARK (SM Preteens Advancing ouR Knowledge) Cohort. SPARK participants will be administered an online assessment battery of SM status, developmental stressors and supports, stigma-related stress and resilience, and STBs every 6 months for 2 years. Analyses will use rigorous weighted generalized estimating equations to estimate trajectories of risk and protective factors for STBs. Subgroup analyses will examine how trajectories of STBs and associated risk and protective factors differ by sexual minority status as well as race and ethnicity and other theoretically informed intersectional factors among preteens. This research is guided by an innovative conceptual model integrating advances in developmental science with the NIMHD Health Disparities Framework and involves community partners at SM youth organizations nationwide to enhance feasibility. Findings from this project will advance best practices for sampling SM preteens, measuring stigma-related stress and resilience, and mapping trajectories of risk and protective factors for STBs, aligning with key NIMH priorities.