Ethnicity Modifies the Effects of Anxiety and Drug Use on Suicidal Ideation among Black Adults in the United States

Abstract

Background: This study aimed to investigate the moderating effect of ethnicity on the effects of multiple psychiatric disorders on serious suicidal thoughts among a nationally representative sample of Black adults in the United States.

Methods: For this study, we used data of 5,181 Black adults (3,570 African Americans and 1,621 Caribbean Blacks) who participated in the National Survey of American Life, 2001-2003. Five lifetime psychiatric disorders (i.e., major depression disorder, general anxiety disorder, alcohol abuse disorder, drug abuse disorder and posttraumatic stress disorder) were considered as independent variables. Lifetime serious suicidal ideation was considered as the dependent variable. Logistic regressions were used to determine if ethnicity modifi es the effects of each psychiatric disorder on serious suicide ideation. Ethnicity was conceptualized as the possible moderator and socio-demographics (i.e., age, gender, education level, employment, marital status and country region) were control variables.

Results: Among African Americans, major depression disorder, general anxiety disorder, posttraumatic stress disorder and alcohol abuse disorder were associated with higher odds of suicidal thoughts. Among Caribbean Blacks, major depression disorder and drug abuse disorder were associated with higher odds of suicidal thoughts. In the pooled sample, the interaction between ethnicity and anxiety disorder was statistically significant, while the interaction between ethnicity and drug abuse disorder was marginally significant.

Conclusions: Based on our study, ethnicity shapes vulnerability of United States Black adults’ suicidality due to psychiatric disorders. General anxiety disorder seems to be a more important risk factor for suicidal ideation among African Americans while drug abuse disorder might contribute more to the risk of suicidal thoughts among Caribbean Blacks.

Keywords: Anxiety, drug use, ethnicity, race, suicide