title: Risk pathways for suicide among Native American adolescents.
abstract: Native American (Native) adolescents have the highest suicide rates in the United States, yet no conceptual models describing risk factors specific to this population exist. We sought to further hone a Native-specific conceptual model developed from quantitative data with qualitative data collected from a longitudinal series of interviews with (N = 22) Native adolescents who had attempted suicide. Four levels of suicide risk emerged, detailing individual, family, community, and societal factors that affect youths' pathways to suicide, along with a variety of subthemes and constructs. Some themes parallel established models of suicide risk; however, others are unique to the experience of this sample, including the impact of overtaxed households and family composition, significant grief burden, contagion, and stigma surrounding treatment seeking. We suggest adaptations of existing themes and constructs in the model. We discuss practical implications for research and intervention development, along with strengths and limitations of the study.
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA ltingey1@jhu.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Tingey
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Cwik
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Novalene
authors.initials: N
authors.lastname: Goklish
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Francene
authors.initials: F
authors.lastname: Larzelere-Hinton
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Angelita
authors.initials: A
authors.lastname: Lee
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Suttle
authors.affiliation: Weill Cornell Medical College, New York City, New York, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Walkup
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Barlow
mesh_terms: D000293:Adolescent; D055812:Community-Based Participatory Research / Q000379:methods; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D008960:Models, Psychological; D012307:Risk Factors; D013405:Suicide / Q000208:ethnology* / Q000523:psychology; D013406:Suicide, Attempted / Q000208:ethnology / Q000523:psychology; D055815:Young Adult
keywords: Aboriginal people, North America; adolescents / youth; model building; qualitative analysis; risk, behaviors; suicide