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. 2022 May 2;5(5):e2211510.
doi: 10.1001/jamanetworkopen.2022.11510.

Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non-Gun Owners in the US

Craig J Bryan  1 , AnnaBelle O Bryan  1 , Heather M Wastler  1 , Lauren R Khazem  1 , Ennio Ammendola  1 , Justin C Baker  1 , Edwin Szeto  1 , Jeffrey Tabares  1 , Christina R Bauder  1
Affiliations

Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non-Gun Owners in the US

Craig J Bryan et al. JAMA Netw Open. .

Abstract

Importance: Firearm ownership is associated with increased risk for suicide.

Objective: To examine patterns of associations among suicidal thoughts and behaviors among gun owners and non-gun owners in the US.

Design, setting, and participants: In this survey study, cross-sectional online survey data were collected from March to April 2020 from US adults recruited via Qualtrics Panels. Quota sampling was used to approximate US census demographics.

Main outcomes and measures: The primary outcomes were past-year passive suicidal ideation, active suicidal ideation, suicidal planning, suicidal behaviors, and nonsuicidal self-injury as measured by items from the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R). Simple latent class analysis (LCA) was used to assign participants to separate classes based on posterior probabilities, and multigroup LCA was used to assess whether the same construct was measured in specified groups.

Results: Of 65 079 adults invited to participate, 10 625 (16.3%) completed the survey; 9153 responded "yes" or "no" to the firearm ownership item and were included in the analysis. Of these 9153 respondents (4695 [51.3%] male; mean [SD] age, 46.7 [16.8] years), 2773 (30.3%) reported owning a gun and 6380 (69.7%) reported not owning a gun. Compared with non-gun owners, gun owners were more likely to be male (1779 [64.2%] vs 2916 [45.7%]; χ21, 263.3; P < .001) and White (2090 [75.4%] vs 3945 [61.8%]; χ25, 232.9; P < .001) and to have served in the military (772 [27.8%] vs 609 [9.5%]; χ21, 571.4; P < .001). Five distinct patterns of SITBI-R item endorsement were extracted using simple LCA. Multigroup LCA indicated that the probability of SITBI-R item endorsement differed between gun owners and non-gun owners across subgroups. Among gun owners, the probability of past-month nonfatal suicide attempts was highest in class 4 (ranging from 16.8% for reaching out for help to 27.2% for starting, then changing one's mind). Gun owners in class 4 were characterized by high probabilities of endorsing thoughts about specific ways or methods to attempt suicide (100%) and preparatory behavior (100%). Among non-gun owners, the probability of nonfatal suicide attempts was highest in class 5 (ranging from 14.9% for reaching out for help to 29.7% for starting, then changing one's mind). Non-gun owners in class 5 were characterized by high probabilities of endorsing passive suicidal ideation (84.0%-100%), active suicidal ideation (86.7%-95.0%), and thoughts about specific ways or methods to attempt suicide (97.4%) and a specific place (92.1%) to attempt suicide.

Conclusions and relevance: In this study, in subgroups with lower probabilities of suicide attempt, gun owners and non-gun owners showed similar patterns of suicide risk item endorsement, but when the probability of a suicide attempt increased, gun owners were less likely than non-gun owners to endorse passive and active suicidal ideation. These findings suggest that assessing a broader range of suicide risk indicators may improve risk detection.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr C.J. Bryan reported receiving grants from the National Institute of Mental Health (NIMH), National Institutes of Health (NIH), the Department of Defense, the New Jersey Gun Violence Research Center, and the American Foundation for Suicide Prevention during the conduct of the study and receiving personal fees from Oui Therapeutics, LLC, and Anduril, LLC, outside the submitted work. Ms A.O. Bryan reported receiving personal fees from Anduril, LLC, and Oui Therapeutics, LLC, outside the submitted work. Dr Wastler reported receiving grants from the American Foundation for Suicide Prevention during the conduct of the study and outside the submitted work. Dr Khazem reported receiving grants from the American Foundation for Suicide Prevention, the University of Minnesota Press, and the Greater Plains Consortium during the conduct of the study. Dr Baker reported receiving grants from the Greater Plains Consortium during the conduct of the study and personal fees from Anduril, LLC, during the conduct of the study and outside the submitted work. Dr Tabares reported receiving grants from the Greater Plains Consortium during the conduct of the study. No other disclosures were reported.

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