Research Aims and Hypotheses: This study is the first epidemiological survey jointly assessing suicide risk, cumulative violence exposure, and protective factors in a large, demographically diverse, general U.S. population sample of adults. First, this study will enhance knowledge on the complex interplay between violence exposure and suicide risk by determining the extent to which suicidal ideation and suicide attempts are associated with cumulative violence (i.e., experiences across multiple forms of violence), as well as particular sub-types of violence, which will help identify individuals at highest risk and in greatest need of suicide screening and preventive interventions. We hypothesize that greater levels of violence exposure across multiple types will be most strongly associated with increased odds for suicidal ideation and attempts. Additionally, this study will address potential disparities by examining demographic differences in suicidal ideation and attempts based on race/ethnicity, sexual orientation, and gender identity. We hypothesize that increased exposure to multiple forms of violence may explain elevated risk of ideation and attempts among groups, particularly racial/ethnic and sexual and gender minority individuals. Finally, this study will determine whether potential protective factors influence the relationship between experiences of cumulative violence and suicidal ideation and attempts, which may serve as targets for suicide prevention interventions among individuals exposed to violence.
Study Sample and Design: An online cross-sectional survey will be administered to a U.S. general population sample of English-speaking adults ages 18 to 44. Qualtrics Panels© will be used to recruit a pre-determined sample size of 5,000 men and women, including oversampling of American Indian/Alaska Native, African American, Latino, and sexual and gender minority individuals. Qualtrics Panels© is an online sampling and survey administration service that recruits samples matched within ± 10% of 2010 U.S. census distributions for age, sex, and race/ethnicity. Suicide risk measures include the Self-Report Columbia-Suicide Severity Rating Scale, with ideation and attempts assessed as independent outcomes. Measures of violence include childhood abuse, childhood bullying, intimate partner violence, sexual assault, community violence, and police violence. Protective factors will be measured at individual (e.g., coping), family/peer (e.g., social support), and community levels (e.g., connectedness).
Potential Impact: Findings are expected to advance knowledge on the complex relationship between cumulative violence exposure and suicide risk, particularly among diverse and understudied populations at highest risk. This knowledge will lead to an improved understanding of the full burden of victimization on suicide risk and identify individuals most in need for targeted screening and suicide prevention efforts. Findings will also identify salient protective factors that may reduce suicide risk, which can be used to develop tailored suicide prevention approaches strategies for diverse communities.
Next Steps: Findings will serve as preliminary data for future studies using longitudinal designs to investigate pathways between cumulative violence and suicide risk within demographically diverse populations. Findings are also expected to inform pre-clinical trial research on intervention targets (e.g., individual, family/peer, community) for the prevention of suicide among individuals exposed or at-risk for victimization, including racial/ethnic and sexual and gender minority populations.