Understanding suicidality in Pacific adolescents in New Zealand using network analysis

Introduction: Pacific adolescents in New Zealand (NZ) are two to three times more likely than NZ Europeans to report suicide attempts and have higher rates of suicidal plans. Suicidal thoughts and behaviours, termed suicidality in this study, result from a complex dynamic interplay of factors which emerging methodologies like network analysis aim to capture. Methods: This study used network analysis to model the relationships between suicidality, self-harm, and individual depression symptoms cross-sectionally, whilst controlling for a multi-dimensional set of variables relevant to suicidality. A series of network models were fitted to data from a community sample of New Zealand-born Pacific adolescents (n=550; 51% male; Mean age (SD) = 17 (0.35)). Results: Self-harm and the symptom measuring pessimism were most strongly related to suicidality, followed by symptoms related to having a negative self-image about looks and sadness. Non-symptom risk factors for self-harm and suicidality differed markedly. Conclusions: Depression symptoms varied widely in terms of their contribution to suicidality. These results highlight the valuable information gained from analysing depression at the symptom-item level. The analysis suggests reducing the sources of pessimism and building self-esteem presented as potential targets for alleviating suicidality amongst Pacific adolescents in New Zealand.