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Progestin-Only IUDs Linked to 22% Lower Ischemic Stroke Risk
Women who used levonorgestrel-releasing intrauterine devices (LG-IUDs) were 22% less likely to have a stroke than those who did not use hormonal contraception, new research suggested.
The Danish study, which included 1.7 million women, also showed no increased risk for intracerebral hemorrhage for those using the IUDs.
“The finding raises the question of whether levonorgestrel, in addition to its contraceptive properties, could have the potential to prevent (ischemic stroke),” wrote corresponding author Tom Skyhøj Olsen, MD, PhD, of Bispebjerg University Hospital, Copenhagen, Denmark, and coauthors.
The research was published online on May 16, 2024, in the journal Stroke.
A Big-Picture Look
Commonly used combined hormonal contraceptives that contain both progestins and ethinylestradiol are linked to an increased risk for ischemic stroke. Previous research suggested that progestin-only options, including LG-IUDs, are not associated with elevated risk and may even lower the risk. The IUDs had also been previously associated with lower risk for thromboembolism.
The new study was a large-scale investigation of all reproductive-age women in Denmark that compared stroke risk in those who used the progestin-only IUDs with those who didn’t use hormonal contraception. It also examined the risk for intracerebral hemorrhage, which had not been previously studied.
The historic cohort study drew on several large national databases in Denmark, including the Danish Stroke Registry, to evaluate the interplay between IUD contraception, stroke, and intracerebral hemorrhage. The study looked back at data collected on all nonpregnant Danish women aged 18-49 years who lived in Denmark for some or all of the period between 2004 and 2021.
Mean age of the 1.7 million women in the study was 30 years, and the mean follow-up period was about 7 years. More than 364,700 participants used LG-IUDs.
During the study period, 2916 women had an ischemic stroke, and 367 experienced intracerebral hemorrhage.
Among IUD users, the incidence of stroke was 19.2 per 100,000 person years. For women who didn’t use contraception, the rate was 25.2.
Overall, those who used an IUD had a 22% lower risk for ischemic stroke than those who didn’t (incidence rate ratio [IRR], 0.78; 95% CI, 0.70-0.88).
The incidence of brain bleeds was similar in both groups.
Does Age Matter?
The incidence of stroke did not differ significantly between the three age groups analyzed in the study: Women aged 18-29 years, 30-39 years, and 40-49 years. Incidence rates of intracerebral hemorrhage were similar between age groups 30-39 years and 40-49 years, but the risk was higher for those aged 18-29 years than for those aged 40-49 years (IRR, 4.49; 95% CI, 1.65-12.19).
The researchers urged caution in interpreting the apparent higher risk for brain bleeds in younger women, noting that the overall number of events was low, resulting in wide CIs.
Investigators also found that women who moved to Denmark from non-Western countries had a significantly lower stroke rate than native Danes. Incidence rates of intracerebral hemorrhage were not affected by country of origin.
The research team noted that they had only indirect information about women’s stroke risk factors including diabetes, high blood pressure, and migraine and had no information about smoking, alcohol consumption, and body mass index.
“Regarding a possible potential for stroke prevention, our study cannot stand alone and requires confirmation in further research. Even though the incidence rate for [ischemic stroke] and [intracerebral hemorrhage] did not significantly change after adjustment for various factors, bias…cannot be fully ruled out,” the researchers wrote.
The study was funded by the Aase og Ejnar Danielsens Fond and Familien Hede Nielsens Fond. The authors reported no relevant financial relationships.
A version of this article appeared on Medscape.com.
Women who used levonorgestrel-releasing intrauterine devices (LG-IUDs) were 22% less likely to have a stroke than those who did not use hormonal contraception, new research suggested.
The Danish study, which included 1.7 million women, also showed no increased risk for intracerebral hemorrhage for those using the IUDs.
“The finding raises the question of whether levonorgestrel, in addition to its contraceptive properties, could have the potential to prevent (ischemic stroke),” wrote corresponding author Tom Skyhøj Olsen, MD, PhD, of Bispebjerg University Hospital, Copenhagen, Denmark, and coauthors.
The research was published online on May 16, 2024, in the journal Stroke.
A Big-Picture Look
Commonly used combined hormonal contraceptives that contain both progestins and ethinylestradiol are linked to an increased risk for ischemic stroke. Previous research suggested that progestin-only options, including LG-IUDs, are not associated with elevated risk and may even lower the risk. The IUDs had also been previously associated with lower risk for thromboembolism.
The new study was a large-scale investigation of all reproductive-age women in Denmark that compared stroke risk in those who used the progestin-only IUDs with those who didn’t use hormonal contraception. It also examined the risk for intracerebral hemorrhage, which had not been previously studied.
The historic cohort study drew on several large national databases in Denmark, including the Danish Stroke Registry, to evaluate the interplay between IUD contraception, stroke, and intracerebral hemorrhage. The study looked back at data collected on all nonpregnant Danish women aged 18-49 years who lived in Denmark for some or all of the period between 2004 and 2021.
Mean age of the 1.7 million women in the study was 30 years, and the mean follow-up period was about 7 years. More than 364,700 participants used LG-IUDs.
During the study period, 2916 women had an ischemic stroke, and 367 experienced intracerebral hemorrhage.
Among IUD users, the incidence of stroke was 19.2 per 100,000 person years. For women who didn’t use contraception, the rate was 25.2.
Overall, those who used an IUD had a 22% lower risk for ischemic stroke than those who didn’t (incidence rate ratio [IRR], 0.78; 95% CI, 0.70-0.88).
The incidence of brain bleeds was similar in both groups.
Does Age Matter?
The incidence of stroke did not differ significantly between the three age groups analyzed in the study: Women aged 18-29 years, 30-39 years, and 40-49 years. Incidence rates of intracerebral hemorrhage were similar between age groups 30-39 years and 40-49 years, but the risk was higher for those aged 18-29 years than for those aged 40-49 years (IRR, 4.49; 95% CI, 1.65-12.19).
The researchers urged caution in interpreting the apparent higher risk for brain bleeds in younger women, noting that the overall number of events was low, resulting in wide CIs.
Investigators also found that women who moved to Denmark from non-Western countries had a significantly lower stroke rate than native Danes. Incidence rates of intracerebral hemorrhage were not affected by country of origin.
The research team noted that they had only indirect information about women’s stroke risk factors including diabetes, high blood pressure, and migraine and had no information about smoking, alcohol consumption, and body mass index.
“Regarding a possible potential for stroke prevention, our study cannot stand alone and requires confirmation in further research. Even though the incidence rate for [ischemic stroke] and [intracerebral hemorrhage] did not significantly change after adjustment for various factors, bias…cannot be fully ruled out,” the researchers wrote.
The study was funded by the Aase og Ejnar Danielsens Fond and Familien Hede Nielsens Fond. The authors reported no relevant financial relationships.
A version of this article appeared on Medscape.com.
Women who used levonorgestrel-releasing intrauterine devices (LG-IUDs) were 22% less likely to have a stroke than those who did not use hormonal contraception, new research suggested.
The Danish study, which included 1.7 million women, also showed no increased risk for intracerebral hemorrhage for those using the IUDs.
“The finding raises the question of whether levonorgestrel, in addition to its contraceptive properties, could have the potential to prevent (ischemic stroke),” wrote corresponding author Tom Skyhøj Olsen, MD, PhD, of Bispebjerg University Hospital, Copenhagen, Denmark, and coauthors.
The research was published online on May 16, 2024, in the journal Stroke.
A Big-Picture Look
Commonly used combined hormonal contraceptives that contain both progestins and ethinylestradiol are linked to an increased risk for ischemic stroke. Previous research suggested that progestin-only options, including LG-IUDs, are not associated with elevated risk and may even lower the risk. The IUDs had also been previously associated with lower risk for thromboembolism.
The new study was a large-scale investigation of all reproductive-age women in Denmark that compared stroke risk in those who used the progestin-only IUDs with those who didn’t use hormonal contraception. It also examined the risk for intracerebral hemorrhage, which had not been previously studied.
The historic cohort study drew on several large national databases in Denmark, including the Danish Stroke Registry, to evaluate the interplay between IUD contraception, stroke, and intracerebral hemorrhage. The study looked back at data collected on all nonpregnant Danish women aged 18-49 years who lived in Denmark for some or all of the period between 2004 and 2021.
Mean age of the 1.7 million women in the study was 30 years, and the mean follow-up period was about 7 years. More than 364,700 participants used LG-IUDs.
During the study period, 2916 women had an ischemic stroke, and 367 experienced intracerebral hemorrhage.
Among IUD users, the incidence of stroke was 19.2 per 100,000 person years. For women who didn’t use contraception, the rate was 25.2.
Overall, those who used an IUD had a 22% lower risk for ischemic stroke than those who didn’t (incidence rate ratio [IRR], 0.78; 95% CI, 0.70-0.88).
The incidence of brain bleeds was similar in both groups.
Does Age Matter?
The incidence of stroke did not differ significantly between the three age groups analyzed in the study: Women aged 18-29 years, 30-39 years, and 40-49 years. Incidence rates of intracerebral hemorrhage were similar between age groups 30-39 years and 40-49 years, but the risk was higher for those aged 18-29 years than for those aged 40-49 years (IRR, 4.49; 95% CI, 1.65-12.19).
The researchers urged caution in interpreting the apparent higher risk for brain bleeds in younger women, noting that the overall number of events was low, resulting in wide CIs.
Investigators also found that women who moved to Denmark from non-Western countries had a significantly lower stroke rate than native Danes. Incidence rates of intracerebral hemorrhage were not affected by country of origin.
The research team noted that they had only indirect information about women’s stroke risk factors including diabetes, high blood pressure, and migraine and had no information about smoking, alcohol consumption, and body mass index.
“Regarding a possible potential for stroke prevention, our study cannot stand alone and requires confirmation in further research. Even though the incidence rate for [ischemic stroke] and [intracerebral hemorrhage] did not significantly change after adjustment for various factors, bias…cannot be fully ruled out,” the researchers wrote.
The study was funded by the Aase og Ejnar Danielsens Fond and Familien Hede Nielsens Fond. The authors reported no relevant financial relationships.
A version of this article appeared on Medscape.com.
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All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>Women who used levonorgestrel-releasing intrauterine devices (LG-IUDs) were 22% less likely to have a stroke than those who did not use hormonal contraception, </metaDescription> <articlePDF/> <teaserImage/> <teaser>The IUDs had also been previously associated with lower risk for thromboembolism.</teaser> <title>Progestin-Only IUDs Linked to 22% Lower Ischemic Stroke Risk</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>card</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>fp</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>ob</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term>5</term> <term>15</term> <term canonical="true">23</term> </publications> <sections> <term>27970</term> <term canonical="true">39313</term> </sections> <topics> <term canonical="true">200</term> <term>280</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Progestin-Only IUDs Linked to 22% Lower Ischemic Stroke Risk</title> <deck/> </itemMeta> <itemContent> <p>Women who used levonorgestrel-releasing intrauterine devices (LG-IUDs) were 22% less likely to have a stroke than those who did not use hormonal contraception, new research suggested.</p> <p>The Danish study, which included 1.7 million women, also showed no increased risk for intracerebral hemorrhage for those using the IUDs.<br/><br/>“The finding raises the question of whether levonorgestrel, in addition to its contraceptive properties, could have the potential to prevent (ischemic stroke),” wrote corresponding author Tom Skyhøj Olsen, MD, PhD, of Bispebjerg University Hospital, Copenhagen, Denmark, and coauthors.<br/><br/>The research was <a href="https://www.ahajournals.org/doi/abs/10.1161/STROKEAHA.124.047438">published online</a> on May 16, 2024, in the journal <em>Stroke</em>.<br/><br/></p> <h2>A Big-Picture Look</h2> <p>Commonly used combined hormonal contraceptives that contain both progestins and ethinylestradiol are linked to an increased risk for ischemic stroke. Previous research suggested that progestin-only options, including LG-IUDs, are not associated with elevated risk and may even lower the risk. The IUDs had also been previously associated with lower risk for thromboembolism.</p> <p>The new study was a large-scale investigation of all reproductive-age women in Denmark that compared stroke risk in those who used the progestin-only IUDs with those who didn’t use hormonal contraception. It also examined the risk for intracerebral hemorrhage, which had not been previously studied.<br/><br/>The historic cohort study drew on several large national databases in Denmark, including the Danish Stroke Registry, to evaluate the interplay between IUD contraception, stroke, and intracerebral hemorrhage. The study looked back at data collected on all nonpregnant Danish women aged 18-49 years who lived in Denmark for some or all of the period between 2004 and 2021.<br/><br/>Mean age of the 1.7 million women in the study was 30 years, and the mean follow-up period was about 7 years. More than 364,700 participants used LG-IUDs.<br/><br/>During the study period, 2916 women had an ischemic stroke, and 367 experienced intracerebral hemorrhage.<br/><br/>Among IUD users, the incidence of stroke was 19.2 per 100,000 person years. For women who didn’t use contraception, the rate was 25.2.<br/><br/>Overall, those who used an IUD had a 22% lower risk for ischemic stroke than those who didn’t (incidence rate ratio [IRR], 0.78; 95% CI, 0.70-0.88).<br/><br/>The incidence of brain bleeds was similar in both groups.</p> <h2>Does Age Matter?</h2> <p>The incidence of stroke did not differ significantly between the three age groups analyzed in the study: Women aged 18-29 years, 30-39 years, and 40-49 years. Incidence rates of intracerebral hemorrhage were similar between age groups 30-39 years and 40-49 years, but the risk was higher for those aged 18-29 years than for those aged 40-49 years (IRR, 4.49; 95% CI, 1.65-12.19).</p> <p>The researchers urged caution in interpreting the apparent higher risk for brain bleeds in younger women, noting that the overall number of events was low, resulting in wide CIs.<br/><br/>Investigators also found that women who moved to Denmark from non-Western countries had a significantly lower stroke rate than native Danes. Incidence rates of intracerebral hemorrhage were not affected by country of origin.<br/><br/>The research team noted that they had only indirect information about women’s stroke risk factors including diabetes, high blood pressure, and migraine and had no information about smoking, alcohol consumption, and body mass index.<br/><br/>“Regarding a possible potential for stroke prevention, our study cannot stand alone and requires confirmation in further research. Even though the incidence rate for [ischemic stroke] and [intracerebral hemorrhage] did not significantly change after adjustment for various factors, bias…cannot be fully ruled out,” the researchers wrote.<br/><br/>The study was funded by the Aase og Ejnar Danielsens Fond and Familien Hede Nielsens Fond. The authors reported no relevant financial relationships.</p> <p> <em>A version of this article appeared on <span class="Hyperlink"><a href="https://www.medscape.com/viewarticle/progestin-only-iuds-linked-22-lower-ischemic-stroke-risk-2024a1000agq">Medscape.com</a></span>.</em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>
Trauma, Racism Linked to Increased Suicide Risk in Black Men
One in three Black men in rural America experienced suicidal or death ideation (SDI) in the past week, new research showed.
A developmental model used in the study showed a direct association between experiences pertaining to threat, deprivation, and racial discrimination during childhood and suicide risk in adulthood, suggesting that a broad range of adverse experiences in early life may affect SDI risk among Black men.
“During the past 20-30 years, young Black men have evinced increasing levels of suicidal behavior and related cognitions,” lead author Steven Kogan, PhD, professor of family and consumer sciences at the University of Georgia, Athens, Georgia, and colleagues wrote.
“By controlling for depressive symptoms in assessing increases in SDI over time, our study’s design directly informed the extent to which social adversities affect SDI independent of other depressive problems,” they added.
The findings were published online in Cultural Diversity and Ethnic Minority Psychology.
Second Leading Cause of Death
Suicide is the second leading cause of death for Black Americans ages 15-24, according to the Centers for Disease Control and Prevention. The outlook is worse for Black men, whose death rate from suicide is about four times greater than for Black women.
Previous research suggests Black men are disproportionately exposed to social adversity, including poverty and discrimination, which may increase the risk for SDI. In addition, racial discrimination has been shown to increase the risks for depression, anxiety, and psychological distress among Black youth and adults.
But little research exists to better understand how these negative experiences affect vulnerability to SDI. The new study tested a model linking adversity during childhood and emerging exposure to racial discrimination to increases in suicidal thoughts.
Researchers analyzed data from 504 participants in the African American Men’s Project, which included a series of surveys completed by young men in rural Georgia at three different time points over a period of about 3 years.
Composite scores for childhood threat and deprivation were developed using the Adverse Childhood Experiences Scale and Childhood Trauma Questionnaire. Everyday discrimination was measured on the Schedule of Racist Events response scale.
To assess their experience with childhood threats, the men in the study, who were about 21 years old on average when they enrolled, were asked if they experienced a series of adverse childhood experiences and deprivation through age 16. Questions explored issues such as directly experiencing physical violence or witnessing abuse in the home and whether the men felt loved and “important or special” as children.
The investigators also asked the men about their experiences of racial discrimination, the quality of their relationships, their belief that aggression is a means of gaining respect, and their cynicism regarding romantic relationships.
Targeted Prevention
Overall, 33.6% of participants reported SDI in the previous week. A history of childhood threats and deprivation was associated with an increased likelihood of SDI (P < .001).
Researchers also found that a history of racial discrimination was significantly associated with the development of negative relational schemas, which are characterized by beliefs that other people are untrustworthy, uncaring, and/or hostile. Negative schemas were in turn associated with an increased risk for suicidal thoughts (P = .03).
“Clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce,” the investigators noted.
“Policy efforts designed to dismantle systemic racism are critically needed. Interventions that address SDI, including programming designed to support Black men through their experiences with racial discrimination and processing of childhood experiences of adversity, may help young Black men resist the psychological impacts of racism, expand their positive support networks, and decrease their risk of SDI,” they added.
The study authors reported no funding sources or relevant financial relationships.
A version of this article appeared on Medscape.com.
One in three Black men in rural America experienced suicidal or death ideation (SDI) in the past week, new research showed.
A developmental model used in the study showed a direct association between experiences pertaining to threat, deprivation, and racial discrimination during childhood and suicide risk in adulthood, suggesting that a broad range of adverse experiences in early life may affect SDI risk among Black men.
“During the past 20-30 years, young Black men have evinced increasing levels of suicidal behavior and related cognitions,” lead author Steven Kogan, PhD, professor of family and consumer sciences at the University of Georgia, Athens, Georgia, and colleagues wrote.
“By controlling for depressive symptoms in assessing increases in SDI over time, our study’s design directly informed the extent to which social adversities affect SDI independent of other depressive problems,” they added.
The findings were published online in Cultural Diversity and Ethnic Minority Psychology.
Second Leading Cause of Death
Suicide is the second leading cause of death for Black Americans ages 15-24, according to the Centers for Disease Control and Prevention. The outlook is worse for Black men, whose death rate from suicide is about four times greater than for Black women.
Previous research suggests Black men are disproportionately exposed to social adversity, including poverty and discrimination, which may increase the risk for SDI. In addition, racial discrimination has been shown to increase the risks for depression, anxiety, and psychological distress among Black youth and adults.
But little research exists to better understand how these negative experiences affect vulnerability to SDI. The new study tested a model linking adversity during childhood and emerging exposure to racial discrimination to increases in suicidal thoughts.
Researchers analyzed data from 504 participants in the African American Men’s Project, which included a series of surveys completed by young men in rural Georgia at three different time points over a period of about 3 years.
Composite scores for childhood threat and deprivation were developed using the Adverse Childhood Experiences Scale and Childhood Trauma Questionnaire. Everyday discrimination was measured on the Schedule of Racist Events response scale.
To assess their experience with childhood threats, the men in the study, who were about 21 years old on average when they enrolled, were asked if they experienced a series of adverse childhood experiences and deprivation through age 16. Questions explored issues such as directly experiencing physical violence or witnessing abuse in the home and whether the men felt loved and “important or special” as children.
The investigators also asked the men about their experiences of racial discrimination, the quality of their relationships, their belief that aggression is a means of gaining respect, and their cynicism regarding romantic relationships.
Targeted Prevention
Overall, 33.6% of participants reported SDI in the previous week. A history of childhood threats and deprivation was associated with an increased likelihood of SDI (P < .001).
Researchers also found that a history of racial discrimination was significantly associated with the development of negative relational schemas, which are characterized by beliefs that other people are untrustworthy, uncaring, and/or hostile. Negative schemas were in turn associated with an increased risk for suicidal thoughts (P = .03).
“Clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce,” the investigators noted.
“Policy efforts designed to dismantle systemic racism are critically needed. Interventions that address SDI, including programming designed to support Black men through their experiences with racial discrimination and processing of childhood experiences of adversity, may help young Black men resist the psychological impacts of racism, expand their positive support networks, and decrease their risk of SDI,” they added.
The study authors reported no funding sources or relevant financial relationships.
A version of this article appeared on Medscape.com.
One in three Black men in rural America experienced suicidal or death ideation (SDI) in the past week, new research showed.
A developmental model used in the study showed a direct association between experiences pertaining to threat, deprivation, and racial discrimination during childhood and suicide risk in adulthood, suggesting that a broad range of adverse experiences in early life may affect SDI risk among Black men.
“During the past 20-30 years, young Black men have evinced increasing levels of suicidal behavior and related cognitions,” lead author Steven Kogan, PhD, professor of family and consumer sciences at the University of Georgia, Athens, Georgia, and colleagues wrote.
“By controlling for depressive symptoms in assessing increases in SDI over time, our study’s design directly informed the extent to which social adversities affect SDI independent of other depressive problems,” they added.
The findings were published online in Cultural Diversity and Ethnic Minority Psychology.
Second Leading Cause of Death
Suicide is the second leading cause of death for Black Americans ages 15-24, according to the Centers for Disease Control and Prevention. The outlook is worse for Black men, whose death rate from suicide is about four times greater than for Black women.
Previous research suggests Black men are disproportionately exposed to social adversity, including poverty and discrimination, which may increase the risk for SDI. In addition, racial discrimination has been shown to increase the risks for depression, anxiety, and psychological distress among Black youth and adults.
But little research exists to better understand how these negative experiences affect vulnerability to SDI. The new study tested a model linking adversity during childhood and emerging exposure to racial discrimination to increases in suicidal thoughts.
Researchers analyzed data from 504 participants in the African American Men’s Project, which included a series of surveys completed by young men in rural Georgia at three different time points over a period of about 3 years.
Composite scores for childhood threat and deprivation were developed using the Adverse Childhood Experiences Scale and Childhood Trauma Questionnaire. Everyday discrimination was measured on the Schedule of Racist Events response scale.
To assess their experience with childhood threats, the men in the study, who were about 21 years old on average when they enrolled, were asked if they experienced a series of adverse childhood experiences and deprivation through age 16. Questions explored issues such as directly experiencing physical violence or witnessing abuse in the home and whether the men felt loved and “important or special” as children.
The investigators also asked the men about their experiences of racial discrimination, the quality of their relationships, their belief that aggression is a means of gaining respect, and their cynicism regarding romantic relationships.
Targeted Prevention
Overall, 33.6% of participants reported SDI in the previous week. A history of childhood threats and deprivation was associated with an increased likelihood of SDI (P < .001).
Researchers also found that a history of racial discrimination was significantly associated with the development of negative relational schemas, which are characterized by beliefs that other people are untrustworthy, uncaring, and/or hostile. Negative schemas were in turn associated with an increased risk for suicidal thoughts (P = .03).
“Clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce,” the investigators noted.
“Policy efforts designed to dismantle systemic racism are critically needed. Interventions that address SDI, including programming designed to support Black men through their experiences with racial discrimination and processing of childhood experiences of adversity, may help young Black men resist the psychological impacts of racism, expand their positive support networks, and decrease their risk of SDI,” they added.
The study authors reported no funding sources or relevant financial relationships.
A version of this article appeared on Medscape.com.
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All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>One in three Black men in rural America experienced suicidal or death ideation (SDI) in the past week, new research showed.</metaDescription> <articlePDF/> <teaserImage/> <title>Trauma, Racism Linked to Increased Suicide Risk in Black Men</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>cpn</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>fp</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>im</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>pn</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term canonical="true">9</term> <term>15</term> <term>21</term> <term>25</term> </publications> <sections> <term>27970</term> <term canonical="true">39313</term> </sections> <topics> <term>184</term> <term canonical="true">202</term> <term>66772</term> <term>246</term> <term>248</term> <term>176</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Trauma, Racism Linked to Increased Suicide Risk in Black Men</title> <deck/> </itemMeta> <itemContent> <p>One in three Black men in rural America experienced suicidal or death ideation (SDI) in the past week, new research showed.</p> <p>A developmental model used in the study showed a direct association between experiences pertaining to threat, deprivation, and racial discrimination during childhood and <span class="Hyperlink"><a href="https://emedicine.medscape.com/article/806779-overview">suicide</a></span> risk in adulthood, suggesting that a broad range of adverse experiences in early life may affect SDI risk among Black men.<br/><br/>“During the past 20-30 years, young Black men have evinced increasing levels of suicidal behavior and related cognitions,” lead author Steven Kogan, PhD, professor of family and consumer sciences at the University of Georgia, Athens, Georgia, and colleagues wrote.<br/><br/>“By controlling for depressive symptoms in assessing increases in SDI over time, our study’s design directly informed the extent to which social adversities affect SDI independent of other depressive problems,” they added.<br/><br/>The findings were <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fcdp0000641">published online</a> in <em>Cultural Diversity and Ethnic Minority Psychology</em>.<br/><br/></p> <h2>Second Leading Cause of Death</h2> <p>Suicide is the second leading cause of death for Black Americans ages 15-24, according to the Centers for Disease Control and Prevention. The outlook is worse for Black men, whose death rate from suicide is about four times greater than for Black women.</p> <p>Previous research suggests Black men are disproportionately exposed to social adversity, including poverty and discrimination, which may increase the risk for SDI. In addition, racial discrimination has been shown to increase the risks for <a href="https://emedicine.medscape.com/article/286759-overview">depression</a>, anxiety, and psychological distress among Black youth and adults.<br/><br/>But little research exists to better understand how these negative experiences affect vulnerability to SDI. The new study tested a model linking adversity during childhood and emerging exposure to racial discrimination to increases in suicidal thoughts.<br/><br/>Researchers analyzed data from 504 participants in the African American Men’s Project, which included a series of surveys completed by young men in rural Georgia at three different time points over a period of about 3 years.<br/><br/>Composite scores for childhood threat and deprivation were developed using the Adverse Childhood Experiences Scale and Childhood Trauma Questionnaire. Everyday discrimination was measured on the Schedule of Racist Events response scale.<br/><br/>To assess their experience with childhood threats, the men in the study, who were about 21 years old on average when they enrolled, were asked if they experienced a series of adverse childhood experiences and deprivation through age 16. Questions explored issues such as directly experiencing physical violence or witnessing abuse in the home and whether the men felt loved and “important or special” as children.<br/><br/>The investigators also asked the men about their experiences of racial discrimination, the quality of their relationships, their belief that <a href="https://emedicine.medscape.com/article/288689-overview">aggression</a> is a means of gaining respect, and their cynicism regarding romantic relationships.<br/><br/></p> <h2>Targeted Prevention</h2> <p>Overall, 33.6% of participants reported SDI in the previous week. A history of childhood threats and deprivation was associated with an increased likelihood of SDI (<em>P</em> < .001).</p> <p>Researchers also found that a history of racial discrimination was significantly associated with the development of negative relational schemas, which are characterized by beliefs that other people are untrustworthy, uncaring, and/or hostile. Negative schemas were in turn associated with an increased risk for suicidal thoughts (<em>P</em> = .03).<br/><br/>“Clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce,” the investigators noted.<br/><br/>“Policy efforts designed to dismantle systemic racism are critically needed. Interventions that address SDI, including programming designed to support Black men through their experiences with racial discrimination and processing of childhood experiences of adversity, may help young Black men resist the psychological impacts of racism, expand their positive support networks, and decrease their risk of SDI,” they added.<br/><br/>The study authors reported no funding sources or relevant financial relationships.<span class="end"/></p> <p> <em>A version of this article appeared on <span class="Hyperlink"><a href="https://www.medscape.com/viewarticle/trauma-racism-linked-increased-suicide-risk-black-men-2024a10006f1?src=">Medscape.com</a></span>.</em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> <p>The study showed a direct association between experiences pertaining to threat, deprivation, and racial discrimination during childhood and <span class="Hyperlink">suicide</span> risk in adulthood.</p> </itemContent> </newsItem> </itemSet></root>
FROM CULTURAL DIVERSITY AND ETHNIC MINORITY PSYCHOLOGY