Co-occurring suicide attempts and physical fighting: a comparison between Urban, Suburban, and Rural high school students

Abstract

This study examines the prevalence and correlates of co-occurring suicidal behavior (i.e., attempted suicide) and violent behavior (i.e., involved in a physical fight) in a nationally representative sample of high school students. Analyses were based on cross-sectional data from the 2003 Youth Risk Behavior Survey (YRBS), which includes a nationally representative sample (n = 15,214) of high school students in 9th through 12th grade in the United States. Multinomial logistic regression analyses were conducted to test the associations between demographic characteristics, potential risk factors, and suicidal and violent behavior for students across urban, suburban, and rural settings. Suicidal and violent behaviors were classified into four mutually exclusive groups: (1) both suicidal and violent behaviors, (2) violent behavior only, (3) suicidal behavior only, and (4) no suicidal behavior and no violent behavior. The prevalence of involvement in suicide attempts and physical fighting were similar across urban (4.5%), suburban (5.0%), and rural (3.9%) settings. Sadness, weapon carrying, binge drinking, drug use, and low academic grades were significantly associated with suicide attempts and physical fighting across settings. However, low academic grades were associated only with suicide attempts and physical fighting among urban students. Risk factors for physical fighting only and for suicide attempt only, varied across settings. Prevention programs are needed to reduce co-occurring suicidal and violent behaviors. These programs need to be implemented across urban, suburban, and rural settings and target those risk factors that appear to exacerbate risk for involvement in both physical fighting and suicide attempts.