Examining a Novel Mechanistic Pathway Linking Racism to Suicide Risk in Black Girls

Though previously thought to be low, rates of self-injurious thoughts and behaviors (STBs) and suicide deaths are increasing at alarming rates among Black youth, with the largest increases seen in Black girls. As such, there is an urgent need to investigate factors that increase risk in this vulnerable, yet understudied, population. Exposure to racism at structural and interpersonal levels has been theorized to be a key driver of STBs in Black youth. However, the underlying mechanisms linking racism to STBs among this population are not well understood.

Advanced pubertal timing (i.e., early puberty) may be a key physiological mechanism linking racism exposure to STBs in Black girls. Previous research in non-Black samples has found that stress exposure predicts advanced pubertal timing and that advanced pubertal timing predicts STB risk. Although Black girls have disproportionately high rates of advanced pubertal timing, no studies have examined links between exposure to structural and interpersonal racism, advanced pubertal timing, and STBs specifically among this group. To address this gap, I plan to leverage data from an ongoing NIMH-funded R01 to examine a novel mechanistic, longitudinal pathway linking racism exposure, advanced pubertal timing, and STB risk among a subsample of Black preteen girls (ages 8-11, N=100).

Aim 1. Test pubertal timing as a predictor of short- (days) and long-term (months) STBs H1. Pubertal timing will significantly predict STBs. Aim 2. Examine structural racism as a predictor of (2a) pubertal timing and (2b) short- and long-term STBs, and test whether (2c) pubertal timing significantly mediates the association between structural racism and STBs. H2. Exposure to structural racism will predict advanced pubertal timing (2a) and increased STBs (2b), and advanced pubertal timing will mediate the relationship between structural racism and STBs (2c). Aim 3. Examine whether interpersonal racism moderates the effects of structural racism on (3a) pubertal timing and (3b) short- and long-term STBs. H3. Interpersonal discrimination will moderate the effects of structural racism on (3a) pubertal timing and (3b) STBs. Exploratory Aim 4: Test whether interpersonal racism moderates the structural racism, pubertal timing, and STB risk pathway.

To test these hypotheses, I will use advanced and rigorous methodology, consistent with my training goals. This includes gold-standard interviews and questionnaires assessing STBs and exposure to interpersonal racism, ecological momentary assessment of STBs (2x daily for 3 weeks), and objective indices of structural racism exposure drawn from population data. Additionally, I will operationalize pubertal timing using multimodal methods including child- and parent-reported perceptions of pubertal development, age at menarche, and hormonal assays.

This study will be the first to examine underlying physiological mechanisms linking multilevel racism to STB risk in Black youth. The project is strongly aligned with AFSP’s priorities of conducting suicide prevention research with historically underrepresented racial groups impacted by health inequities (Priority 1a), supporting researchers from historically underrepresented racial and ethnic backgrounds (Priority 1b), and investigating suicide in understudied populations with elevated suicide rates (Priority 2). Findings from this study will be vital in the development of effective, culturally responsive intervention programs for Black girls.