Trajectories of Suicide Ideation and Attempts from Early Adolescence to Mid-Adulthood: Associations with Race/Ethnicity

  • Jennifer Toller ErausquinEmail author
  • Thomas P. McCoy
  • Robin Bartlett
  • Eunhee Park
Empirical Research


Prior research has demonstrated that behavioral, demographic, and mental health characteristics are associated with suicide, particularly among youth and young adults. Although recent research has begun to explore developmental trajectories of suicide-related outcomes, few studies to date have extended beyond late adolescence. Understanding different trajectories of suicide-related thoughts and behaviors from adolescence through mid-adulthood has the potential to refine developmental perspectives on suicide risk and to inform prevention efforts. Using National Longitudinal Study of Adolescent to Adult Health data (n = 9421 respondents with data at all four waves), this study analyzed suicide-related outcomes across ages 12–31 years. Growth mixture modeling (GMM) was used to estimate trajectory classes for past-year suicide ideation and attempts, followed by multinomial logistic regression to explore the association between race/ethnicity and class membership. In weighted descriptive analyses, the sample was 50.0% female; it was 15.5% African American, 2.1% Asian/Pacific Islander, 12.0% Hispanic, 0.9% other, and 65.9% White. GMM results revealed three trajectory classes for ideation: sustained higher risk, sustained lower risk, and adolescent-limited risk. Two trajectory classes emerged for attempts: declining higher risk and sustained lower risk. For ideation, African Americans were less likely than Whites to be in either the sustained higher risk or the adolescent-limited risk trajectory. For attempts, African Americans had significantly lower odds than Whites and Asians/Pacific Islanders had nearly four times the odds of Whites of being in the sustained higher risk trajectory, though the latter was only marginally significant. The finding of associations between race/ethnicity and distinct patterns of suicide-related behavioral development from early adolescence into mid-adulthood suggests new directions for developmental research and provides evidence to inform future suicide prevention efforts.


Suicide Health Race/ethnicity Longitudinal analysis Add health 



This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from grant P01-HD31921 for this analysis.

Authors’ Contributions

J.T.E conceptualized data analysis, summarized relevant extant empirical and theoretical research, interpreted results, and led the writing and revision of the manuscript; T.P.M. participated in the design, performed statistical analyses, participated in the interpretation of data, drafted the methods section of the manuscript, and participated in revisions; R.B. summarized relevant extant empirical and theoretical research, contributed to interpretation of results, drafted the discussion section, and participated in revisions; E.P. conceptualized data analysis, contributed to the introduction/background on theory, and participated in revisions. All authors read and approved the final manuscript.

Data Sharing and Declaration

The data that support the findings of this study are available from Add Health, a program project at the University of North Carolina at Chapel Hill. Restrictions apply to the availability of these data, which were used under license for the current study. Information on how to obtain the Add Health data files is available on the Add Health website (


The authors received no funding support for this study.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

ll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Public Health EducationUniversity of North Carolina at GreensboroGreensboroUSA
  2. 2.School of NursingUniversity of North Carolina at GreensboroGreensboroUSA
  3. 3.School of NursingUniversity at BuffaloBuffaloUSA

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