Suicide is the second leading cause of adolescent deaths in the US (Ahmad and Anderson, 2021). Further, the suicide rate for adolescents who identify as racial and ethnic minorities and sexual and gender minorities (SGM) is increasing rapidly (Ruch et al., 2019; Joseph et al., 2022; Ream, 2022), and it's becoming alarmingly more common for these adolescents to seriously consider, plan, and attempt suicide (Gaylor et al., 2023; Ivey-Stephenson et al., 2020; Stone et al., 2023). For example, in 2021, Black adolescents (15.2%) had a higher prevalence reporting a suicide attempt in the past year compared with Asian (8.4%), Hispanic (11.9%), and White (12.4%) adolescents, and the prevalence of past-year suicide attempts was higher in lesbian or gay (15.2%) and bisexual adolescents (26.5%) than heterosexual adolescents (8.1%) (Gaylor et al., 2023). There is a nationwide effort to reduce the annual rate of suicide in the United States by 20% by 2025 (https://project2025.afsp.org/), but equitably achieving this goal will require proper identification and understanding of the risk factors for suicide within both the general population, as well as vulnerable and underserved populations.

Suicidal thoughts and behavior (STB) is an important risk factor for suicide (Franklin et al., 2017; Favril et al., 2022), and several factors are associated with the development of STBs, including childhood adversity and social isolation (Franklin et al., 2017). These factors were all intensified by the COVID-19 pandemic (Anderson et al., 2022). During the pandemic, adolescents experienced significant adversity and isolation that disrupted their lives. For example, 55% of adolescents reported emotional abuse by a parent or other adult in their home, and 24% reported significant amounts of hunger (Krause et al., 2022). Unfortunately, data collected during the Coronavirus (COVID-19) pandemic suggested that almost 20% of adolescents considered and 10% attempted suicide in the past 12 months (Anderson et al., 2022), and other studies have also shown that suicide among adolescents, including intentional and unintentional drug overdoses (Tanz et al., 2022; Anderson et al., 2023), were substantially higher during the pandemic than before (Friedman et al., 2022; Charpignon et al., 2022).

Current research seldom explores sub-population variation in adolescent STBs because it requires large sample sizes. However, the evidence is clear that adolescents who identified as female, racial/ethnic minority, or SGM experienced more adversity and social disruptions during the pandemic (e.g., emotional and physical abuse) than their peers (Krause et al., 2022). Further, the prevalence of STBs is now higher among these same groups compared with their counterparts (Gaylor et al., 2023; Ivey-Stephenson et al., 2020; Stone et al., 2023). However, no evidence is available to support whether pandemic-related stressors (i.e., adversity and social disruptions reported during the pandemic) impacted STBs differently among racial and ethnic minorities and SGM adolescents compared with Whites and non-SGM adolescents. Identifying and examining group differences in STBs based on the degree of exposure to pandemic-related stressors may improve suicide prevention, diagnosis, and treatment across diverse groups as the US continues to address mental health challenges related to the COVID-19 pandemic.

Thus, this study examines the association of pandemic-related stressors (i.e., adversity and social disruptions reported during the pandemic) with STBs among a nationally representative sample of adolescents (Rico et al., 2022). We assess four self-reported STB outcomes: (1) feelings of sadness/hopelessness, (2) suicidal ideation, (3) planned suicide attempt, and (4) any suicide attempt in the past 12 months. The primary hypothesis is that the odds of all STB outcomes will increase as the number of pandemic-related stressors increases. Descriptively, this study also identifies subgroups, such as racial/ethnic minorities and SGM adolescents, that may be particularly vulnerable to STBs based on the degree of adversity and social disruptions experienced during the pandemic. Analytically, this study examines the possible modifying effect of sex, race/ethnicity, and sexual identity on the association of pandemic-related stressors with STBs. We hypothesize that the association of pandemic-related stressors with STBs will be significantly modified by sex, race/ethnicity, and sexual identity, with pandemic-related stressors more strongly associated with STBs among females (relative to males), racial/ethnic minorities (relative to non-Hispanic Whites), and sexual minorities (relative to heterosexuals).