Parental education and youth suicidal behaviours: a systematic review and meta-analysis

Abstract

Aims Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations. Methods We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0–18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity. Results We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04–1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98–1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10–1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54–0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05–1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77–1.08). Conclusions The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.

The effect of multigeneration history of suicidality on offspring’s neurodevelopment outcomes: evidence from the Adolescent Brain and Cognitive Development (ABCD) cohort

“…62 Future research should further consider the potential impact of different geographic, ecological and cultural contexts, especially for the cultural differences between the West and the East. 63 Our findings demonstrate the role of the insula and other cortical regions in the intergenerational transmission of suicidality. Prior studies have elucidated neuroanatomic regions involved in suicidality, while the insula had been identified as a key neurobiology basis of suicide [64][65][66][67][68][69] .…”

“…62 Future research should further consider the potential impact of different geographic, ecological and cultural contexts, especially for the cultural differences between the West and the East. 63…”

Effect of Mother's Educational Level on Depression in Children and Adolescents

“…Mothers also are better able to make safer and healthier lifestyle choices [19] , access quality health care for themselves and their children [20] , and engage in positive parenting practices through their educational experiences and extensive resources [21] . In turn, their children are more likely to grow up in homes, schools, and communities with higher resources, and these keep children on a healthy developmental trajectory [22] .…”

Preventing adolescent suicide: Recommendations for policymakers, practitioners, program developers, and researchers

“…Similarly, controlling for state social capital, increasing state spending on transfer payments, medical benefits, and family assistance is associated with decreased state‐level adult suicide rates (Flavin & Radcliff, 2009). For adolescents, parental education (Chen et al, 2022) and socioeconomic status (Farrell et al, 2019) are inversely associated with suicidal ideation and attempts, but not deaths by suicide (Benny et al, 2023; Braudt et al, 2019). Correlational evidence on the role of income inequality in adolescent suicide deaths is also mixed (Benny et al, 2023; Wadsworth et al, 2014).…”