Connected for life: How social connectedness can help prevent suicide in American Indian and Alaska Native communities.
Marija Bogic, Luciana E Hebert, Anna Evanson and 11 others
PMID 39034087WHAT IT FOUND
Among AI/AN adults at high suicide risk, lower belonging and more depression or anxiety about historical loss were associated with suicidal thoughts.
Social support and cultural ceremony were associated with fewer thoughts, but not with having attempted.
Key findings
01Of 709 baseline participants, 522 had complete data for this analysis.
02Thwarted belongingness and historical loss symptoms of depression and anxiety were associated with higher suicidal ideation; social support and engagement in AI/AN ceremonies were associated with lower suicidal ideation in adjusted analyses.
03In adjusted models, no latent construct was associated with the odds of having made a suicide attempt; among 386 participants who had attempted, traumatic life events, historical loss depression and anxiety, thwarted belongingness, social support, and AI/AN cultural practices were associated with the number of lifetime attempts.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot show that social support, ceremony, or belongingness caused lower suicidal thoughts or fewer attempts. Participants were already at high suicide risk and lived mainly on reservations or AI/AN communities, so results may not apply to AI/AN adults in urban settings or other tribes. Only 522 of 709 baseline participants had complete data for this analysis, because many completed only primary measures during lengthy phone interviews. Several scales did not fit the data well, so the analysis used shortened or altered versions of some measures. Social support was measured at the same time as past attempts, so current support may reflect response to earlier attempts rather than support before them.
Declared interests
The article declares no competing interests. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that increasing social support or cultural ceremony prevents suicide attempts. The study is cross-sectional, and adjusted models found no predictor associated with whether someone had attempted; social support was positively associated with number of lifetime attempts among those who had attempted.