Self-Harm and Suicidality in US College Students: Associations with Emotional Exhaustion versus Multiple Psychiatric Symptoms

Abstract Purpose This study aimed at describing self-harm and suicidality (SHS) in relation to unobserved heterogeneous groups of college students based on their psychiatric symptoms. SHS of each latent class were examined by race/ethnicity to inform risk factors relevant to subgroups of U.S. college population. Methods The participants (N = 42,779) were drawn from the Spring 2017 American College Health Association-National College Health Assessment II (ACHA-NCHA II) Reference Group. Latent class analysis (LCA) was conducted based on participants’ reports of past-year psychiatric symptoms. The reported SHS were examined by the latent class of students and their race/ethnicity. Results LCA identified two latent classes: The Emotional Exhaustion (EE) class and the Multiple Psychiatric Symptoms (MPS) class. Within the EE class, Black students were at the greatest risk for exhibiting suicide intent and attempted suicide. Within the MPS class, Multiracial students showed the highest odds of self-harm and suicidal intent, and Black students showed the highest odds of attempted suicide, followed by Asians/Pacific Islanders. Limitations The findings were based on a cross-sectional dataset that did not inform the temporal relations of psychiatric symptoms and SHS. Conclusions Utilizing a person-centered latent class analysis, this study revealed that Black students were of the greatest concern for SHS among those who reported only common symptoms of emotional exhaustion. The findings highlight the importance of developing preventive and remedial models that address unique risk factors and mental health needs for various subgroups of U.S. college population.