Sex Differences in Risk Factors for Suicide Ideation and Attempts Among Maine High School Students

BACKGROUND:   Based on recent data from the CDC, young adolescent girls had the greatest percent increase in suicide deaths between 1999 and 2014 and the gap in male and female suicide rates decreased over this period as more girls have died by suicide. The purpose of this analysis was to examine sex differences among risk factors associated with suicide ideation and suicide attempts among Maine youth to inform prevention and intervention efforts.

METHODS: Using the Maine Integrated Youth Health Survey (MIYHS), a representative survey of Maine high school students, we examined demographic characteristics (sex, grade, race, ethnicity and sexual orientation) as well as risk factors – including aggression, victimization, substance use, emotional/physical disabilities, and sexual behaviors – for suicide ideation and suicide attempts by sex. Cross tabulation and logistic regression analyses were conducted using SAS survey procedures to account for the complex sampling design.

RESULTS: In 2015, 37,989 Maine high school students participated in the MIYHS. Fifteen percent of students considered suicide (19% of females, 10% of males, p < 0.05), 13% made a plan to die by suicide (females 16%, males 9%, p < 0.05), and 10% attempted suicide (females 11%, males 9%, p < 0.05). Both female and male students who reported aggressive behaviors, victimization, risky sexual behaviors, emotional/physical disability or substance use were significantly more likely than students who did not report these risks to have considered, made a plan to or attempted suicide (p < 0.05). Among females, forced sex, dating violence, being threatened at school, smoking, and illegal drug use were especially salient risk factors with over 50% of females with these risks reporting suicide ideation. Similarly, among males, victimization experiences and depression were highly associated with suicide ideation and attempts. There were no significant sex differences by risk factors for suicide attempts, except females who reported engaging in aggressive behaviors (e.g., getting in fights) were significantly more likely than males to have attempted suicide in the past year (p < 0.05).

CONCLUSIONS:   Both female and male Maine high school students who experience aggression, victimization, emotional/physical disability, risky sexual behaviors, and substance use are more likely to consider suicide, make a plan to or attempt suicide. However, Maine female high school students appear to be at an increased risk for all suicide outcomes therefore, identifying at-risk female students should be a priority among prevention efforts.