Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non–Gun Owners in the US

Abstract

IMPORTANCEFirearm ownership is associated with increased risk for suicide. OBJECTIVE To examine patterns of associations among suicidal thoughts and behaviors among gun owners and non-gun owners in the US. DESIGN, SETTING, AND PARTICIPANTS In this survey study, cross-sectional online survey data were collected from March to April 2020 from US adults recruited via Qualtrics Panels. Quota sampling was used to approximate US census demographics. MAIN OUTCOMES AND MEASURESThe primary outcomes were past-year passive suicidal ideation, active suicidal ideation, suicidal planning, suicidal behaviors, and nonsuicidal self-injury as measured by items from the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R).Simple latent class analysis (LCA) was used to assign participants to separate classes based on posterior probabilities, and multigroup LCA was used to assess whether the same construct was measured in specified groups. RESULTSOf 65 079 adults invited to participate, 10 625 (16.3%) completed the survey; 9153 responded "yes" or "no" to the firearm ownership item and were included in the analysis. Of these 9153 respondents (4695 [51.3%] male; mean [SD] age, 46.7 [16.8] years), 2773 (30.3%) reported owning a gun and 6380 (69.7%) reported not owning a gun. Compared with non-gun owners, gun owners were more likely to be male (1779 [64.2%] vs 2916 [45.7%]; χ 2 1 , 263.3; P < .001) and White (2090 [75.4%] vs 3945 [61.8%]; χ 2 5 , 232.9; P < .001) and to have served in the military (772 [27.8%] vs 609 [9.5%]; χ 2 1 , 571.4; P < .001).Five distinct patterns of SITBI-R item endorsement were extracted using simple LCA. Multigroup LCA indicated that the probability of SITBI-R item endorsement differed between gun owners and non-gun owners across subgroups. Among gun owners, the probability of past-month nonfatal suicide attempts was highest in class 4 (ranging from 16.8% for reaching out for help to 27.2% for starting, then changing one's mind). Gun owners in class 4 were characterized by high probabilities of endorsing thoughts about specific ways or methods to attempt suicide (100%) and preparatory behavior (100%). Among non-gun owners, the probability of nonfatal suicide attempts was highest in class 5 (ranging from 14.9% for reaching out for help to 29.7% for starting, then changing one's mind). Non-gun owners in class 5 were characterized by high probabilities of endorsing passive suicidal ideation (84.0%-100%), active suicidal ideation (86.7%-95.0%), and thoughts about specific ways or methods to attempt suicide (97.4%) and a specific place (92.1%) to attempt suicide. CONCLUSIONS AND RELEVANCEIn this study, in subgroups with lower probabilities of suicide attempt, gun owners and non-gun owners showed similar patterns of suicide risk item endorsement, but when the probability of a suicide attempt increased, gun owners were less likely than non-gun (continued) Key Points Question Do survey item response patterns for suicidal ideation and behaviors differ between adult gun owners and non-gun owners in the US? ...

Differences in firearm storage practices among United States military servicemembers who have and have not disclosed suicidal thoughts or attended behavioral health sessions

“…Another consideration in interpreting these findings is that recent research has raised questions regarding the extent to which firearm owners-particularly those at high risk for suicide-feel that typical questions assessing suicidal ideation accurately reflect their lived experience. Specifically, Bryan et al (2022) reported that, in a sample of 10,625 US adults, firearm owners with a higher probability of suicidal behavior were less likely than their peers to endorse suicidal thoughts on the SITBI-R, the same measure utilized in our sample. In the current study, only those endorsing past year or past month suicidal ideation were included and, as such, it is possible that suicidal servicemembers from the larger sample were excluded from the current analyses because the SITBI-R did not accurately capture risk.…”

Disclosure of suicidal ideation and behaviours: A systematic review and meta-analysis of prevalence

“…The results for gender provided some evidence that females may be more likely to disclose suicidal ideation or behaviours to others relative to males. This is an important finding given that males are also more likely to use lethal means when attempting suicide (Bryan et al, 2022). Given that disclosure can be thought of as a coping behaviour and protective factor for death by suicide, this gender effect may help to explain why males more often go on to die by suicide (WHO, 2021).…”

Examining characteristics and experiences of Black firearm owners

“…The fact that elevated suicidal ideation was found among Black firearm owners is an important consideration particularly given that extant literature largely supports that firearm owners are not more likely than nonfirearm owners to experience suicidal ideation (Anestis et al, 2020; Ilgen et al, 2008; Miller et al, 2009). Further, a recent survey of nearly 11,000 U.S. adults revealed that as actual risk of suicide increased (e.g., preparatory behaviors), firearm owners were less likely than nonfirearm owners to endorse suicidal thoughts (Bryan et al, 2022). Recent research has demonstrated that individuals who purchased firearms since March 2020 are more likely to report lifetime, past year, and past month suicidal ideation than are other firearm owners and nonfirearm owners (M. D. Anestis et al, 2021), particularly if the firearm they purchased during this timeframe was their first firearm (Anestis, Bandel et al, 2021).…”

“…Thus, causal inferences cannot be made. Furthermore, prior literature (Bryan et al, 2022) notes concerns regarding the ability for screening tools to accurately detect suicide risk, particularly among firearm owners, highlighting a potential limitation of utilizing self-report measures to assess study variables. Although the time point of data collection can be seen as a strength, it did not allow us to determine firearm ownership habits among Black U.S. residents before the COVID-19 pandemic and the media's increased attention of the social justice movement in 2020.…”