Deconstructing the role of the exposome in youth suicidal ideation: Trauma, neighborhood environment, developmental and gender effects

Environment (E) is pivotal in explaining variability in brain and behavior development, including suicidal ideation (SI) and behavior. It is therefore critical to systematically study relationships among environmental exposures (i.e., exposome) and suicidal phenotypes. Here, we evaluated the role of individual-level adversity and neighborhood environment and their interaction (E x E) in association with youth SI. Sample included youth (N = 7,054, ages 11–21) from the Philadelphia Neurodevelopmental Cohort, which investigated clinical phenotypes in a diverse US community population. We examined cross-sectional associations of environmental exposures with lifetime history of SI (n = 671), focusing on interactions between individual-level exposures to assaultive trauma (n = 917) and neighborhood-level socioeconomic status (SES) quantified using geocoded Census data. Models included potential confounds and overall psychopathology. Results showed that assaultive trauma was strongly associated with SI (OR = 3.3, 95%CI 2.7–4, p
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Highlights • Environment (E) is key in shaping development of suicidal ideation (SI). • We integrated individual-level trauma exposure and neighborhood-level data on socioeconomic status (SES) in N=7,054 youths. • Trauma was robustly associated with youth SI in our cohort, while SES had no association with SI. • Only in youth with history of assaultive trauma, low SES was associated with lower SI rates (trauma by SES interaction). • Results suggest a stress inoculation effect that was shown in animal models, but has not been shown in human suicide research.