Objective Evaluate suicide attempt prevalence and potentially related sociodemographic and psychiatric factors among racial and ethnic groups. Methods Between 2012 and 2013, the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) conducted semi-structured interviews with 36,309 adults in the USA. We identified lifetime suicide attempt prevalence and significant predictors for each racial/ethnic group using stratified logistic regressions. Analyses were exploratory without a priori hypotheses. Results Asian/Native Hawaiian/other Pacific Islander and Black individuals had the lowest prevalence of suicide attempts while Alaska Native/American Indian and White individuals had the highest prevalence. Identifying as female and meeting criteria for psychiatric diagnoses featuring mood regulation difficulties (depression, borderline personality disorder, bipolar I disorder) were consistently related to a suicide attempt history across racial and ethnic groups, whereas substance abuse disorders and other sociodemographic factors differed between racial and ethnic groups in their associations with suicide attempt history. Conclusions Although several factors were consistently related to suicide risk across racial and ethnic groups, the prevalence of suicide attempts and overall pattern of related factors were not uniform between racial and ethnic groups. Policy Implications Study findings highlight the importance of considering suicide risk within the context of race and ethnicity both regarding the overall prevalence of risk and in determining personal factors associated with elevated risk. A failure to appreciate experiences related to race and ethnicity may adversely impact suicide risk assessment and treatment, ultimately contributing to health disparities. Results suggest that additional research is warranted.
Despite decades of significant effort in research, policy, and prevention, suicide rates have continued to rise to the current peak of 14.6 per 100,000 deaths. This has resulted in a concerted effort to identify biomarkers associated with suicidal behavior in the brain, to provide predictions that are better than the chance of discerning who will die by suicide. We propose that the lateral habenula (LHb), and its dysfunction during a suicidal crisis, is a critical component of the transition from suicidal ideations to self-harm. Moreover, the LHb—a key functional node in brain reward circuitry—has not been ascribed a contributory role in suicidal behavior. We argue that the LHb anchors a “suicide circuit” and call for suicide researchers to directly examine the role of the LHb, and its long-term modulation, in response to the negative affect in suicidal behavior. Discerning the neural mechanisms of this contribution will require the collaboration of neuroscientists and psychologists. Consequently, we highlight and discuss research on LHb as it relates to suicidal ideation, suicidal behavior, or death by suicide. In so doing we hope to address the bench-to-bedside translational issues currently involved in suicide research and suggest a developmental framework that focuses on specific structures motivated by theoretical anchors as a way to incorporate neurobiological findings within the context of clinical theory.
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