(PS2-C64) Comparing Risk and Protective Factors for Suicidal Behavior in College Students with Hidden and Visible Disabilities

Despite research showing that people with any disability attempt suicide at a rate four times that of individuals with no disabilities (Meltzer et al., 2011), there is a lack of research on risk and protective factors for suicide among individuals with different types of disabilities. Those with hidden disabilities may face challenges that could increase their suicide risk that those with visible disabilities do not face, and vice versa, but there is limited research regarding this idea (Pederson, 2020). Current models of suicidal behavior emphasize factors such as perceived burdensomeness, thwarted belongness, and negative attitudes towards oneself as critical to increasing risk for suicidal ideation. For students with disabilities, a sense of connection to their school and satisfaction with disability support services may represent additional, culturally specific, factors impacting risk. However, it is not clear from existing research whether all these risk factors differentially impact risk for suicidal thinking among individuals with hidden versus visible disabilities, which was the focus of the current study.   

Participants (Mage = 22.4, SD = 5.8yrs, 64.7% female, 89.3% white) were recruited via email invitation from five university disability services and asked to complete an anonymous online survey measuring burdensomeness, belongingness, self-esteem, school engagement, resilience, social support, satisfaction with campus disability resources, and suicidal thoughts/behavior. A one-way ANOVA showed significant differences between those with hidden, physical, and both hidden+physical (e.g., combo) groups on suicidal thoughts (F(2,261) = 4.48, p < .02) and lifetime suicide attempts (F(2,261) = 4.72, p < .01). Post hoc analyses showed that the hidden and combo groups significantly differed from each other but not from the physical disability group which fell between them. We then ran three regression analyses to see which variables were associated with lifetime suicidality in each group. All three models were significant and explained 50-55% of variance. Among those with hidden disabilities, burdensomeness (b = 0.316, t = 2.09, p = .040), self-esteem (b = .420, t = 2.47, p = .016), and quality of disability services (b = -.190, t = -1.94, p = .056) were predictive of suicidality. In those with physical disabilities, self-esteem (b = .512, t = 3.06, p = .003) and quality of disability services (b = -.244, t = -2.38, p = .021) were predictors. Within the combo group, burdensomeness (b = .636, t = 4.27, p < .001) and resilience (b = .230, t = 2.41, p = .019) were significant. 

These results highlight the importance of tailoring prevention strategies to the unique needs of each disability group. In addition, perceived quality of disability services had a protective relationship with suicidality within two groups, suggesting that access to quality disability services and accommodations may help reduce suicidality. It is important that schools are equipped to provide accessible services to a diverse array of students to reduce mental health emergencies. Identifying unique factors related to suicide risk for those with disabilities is a first step to inform preventive interventions.