ACEs and Suicidal Behavior in African American Women: Assessment and Prevention
Principal Investigators:
Nadine Kaslow, PhD |Emory School of Medicine
Dorian Lamis, PhD, ABPP |Emory School of Medicine
Co-Investigators:
Sarah Dunn, PhD, ABPP |Emory School of Medicine
Sheryl Heron, MD, MPH |Emory School of Medicine
Partner Organizations:
Why is this Project Important?
Currently, it is the only ICRC funded suicide prevention study designed for African Americans, and the study will provide data toward seeking additional funding (NIMH). Identifying the risk and protective factors, and a multilevel suicide prevention intervention for those African Americans who have previously attempted suicide could serve as a model for state and national efforts to reduce suicide.
This investigation systematically examines the link between two major violence-related public health concerns in low-income African Americans. It also offers an innovative preventive-intervention approach that has the potential to reduce risk factors and increase resilience factors associated with the individual, relationship, and community levels of ecological influence in this population.
Key Contribution to Science:
African Americans are experiencing rising suicide rates, and ACEs are associated with suicide risk in this population. Science has lagged behind this increase as little is known about factors that might influence the ACEs suicide relationship, and few interventions seek to prevent future suicide attempts among African Americans who have previously attempted suicide. This project is designed to advance the field of suicide prevention for this vulnerable population by
- (a) identifying risk and protective factors that influence the ACEs/suicide relationship, and by
- (b) rigorously testing a culturally competent, multilevel suicide prevention intervention targeting African American adults who have previously attempted suicide.
There is growing evidence that certain types of adverse childhood experiences (ACEs) are strongly linked to suicidal behavior, especially in low-income populations, including low-income African Americans. However, we know very little about the link between these ACEs and later suicidal behavior in this group. Even less is known about the risk and resilience factors that may be modifiable in individuals exposed to child abuse and neglect and other ACEs, or if targeting these factors in a preventive intervention may result in better mental health outcomes and a reduction in suicidal behavior.
Currently, there are no preventive interventions specifically designed to lower the risk of suicidal behavior in people with significant exposure to ACEs. Therefore, it's crucial to conduct randomized clinical trials (RCTs) to find out which interventions work best for reducing suicidal behavior and increasing coping skills, connection, and community engagement in low-income African Americans. These interventions should be culturally relevant and could include existing tools, like suicide prevention mobile apps.
To improve these preventive interventions, it's important to identify the risk and resilience factors that influence the success of the interventions in reducing suicidal behavior and enhancing coping, connection, and community engagement. These factors can help refine future interventions.
- Compare individual-, relationship-, and community- level risk and resilience factors that differentiate African American women who attempt suicide who are low versus high on ACEs;
- Evaluate the efficacy of treatment-as-usual plus an award-winning suicide prevention app (app) versus treatment-as-usual plus the suicide prevention app plus an innovative and culturally-informed empowerment group intervention (app + empower) that targets modifiable individual-, relationship-, and community- level factors in decreasing suicidal behavior (ideation, attempts; primary outcome) and increasing coping, connection, and community engagement (secondary outcomes) in recent suicide attempters high on ACEs;
- Determine the individual-, relationship-, and community- level risk and resilience factors that mediate (i.e., explain the relation between) the intervention effects (app versus app + empower, both of which include treatment-as-usual) on the primary and secondary outcomes for African American women suicide attempters high on ACEs
If you or someone you know is considering suicide, know you’re not alone and help is out there. Contact the National Suicide Prevention Lifeline or 1-800-273-8255
Additional ACE and Suicide Prevention Resources
