Suicide attempt and suicide plan among U.S. adolescents: The role of repeated and co-occurring violence experiences

•Nearly one in eleven adolescents have attempted suicide.•One in five suffer from at least one form of violence.•Repeated violence experiences significantly increase the risk of suicidal behaviors.•Co-occurring violence experiences explain 40% of variance in suicide attempt. This study is to measure the impact of repeated and co-occurring violence experiences on suicidal behaviors among U.S. adolescents. Data from a nationally representative sample (N = 13, 677) were utilized, collected by 2019 Youth Risk Behavior Survey. Association and correlation between suicidal behaviors (suicide attempt and suicide plan) and multiple violence experiences (weapon-involved violence, physical violence, and sexual violence) were examined using a series of logistic regression models and structural equation modeling (SEM). In the past year, nearly one in eleven adolescents had attempted suicide, one in six planned for suicide, and one in five suffered from at least one form of violence. Adolescents experiencing high frequency of victimization were up to 12 times greater odds of attempting suicide and up to 6 times more likely to plan for suicide. Those with multiple forms of violence experiences had much greater likelihood of attempting suicide and planning for suicide. The three violence experiences were highly correlated with each other and collectively explained about 40% of variance in suicide attempt and 24% of variance in suicide plan. Comprehensive intervention programs and mental health services are needed for adolescents with repeated and concurrent violence experiences to prevent their suicidal behaviors.