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  Links of adversity in childhood with mental and physical health outcomes: A systematic review of longitudinal mediating and moderating mechanisms

  Hales, George K.; Saribaz, Zeliha E.; Debowska, Agata; Rowe, Richard; University of Sheffield (SAGE Publications, 2022-02-28)

  Adverse childhood experiences (ACEs) have been associated with causes of early death, addiction, mental illness, and poor health. However, studies investigating underlying mechanisms often rely on cross-sectional data or inappropriate study designs. To prevent the negative sequelae associated with ACEs, it is imperative to understand the mechanisms underlying the prospective relationship. The aim of this present review was to provide a synthesis and critical evaluation of the literature regarding the mechanisms underlying this relationship. A search in SCOPUS, MedLine via Ovid, PsycINFO via Ovid, and Web of Science was performed. Studies that utilised a prospective design assessing ACEs in childhood or adolescence, outcomes in adulthood, and analysed either a mediating or moderating relationship were included, unless the study relied on informant report or official records to assess childhood maltreatment types of ACEs. Twenty-two studies examining a longitudinal mediation or moderation were included in a systematic review. A review of the studies found links to psychopathology, delinquent and problem behaviours, poor physical health, and poor socioeconomic outcomes. A clear image of underlying mechanisms is not forthcoming due to (a) poor study design in relation to assessing longitudinal mechanisms, and (b) heterogeneity in the adversities, mechanisms, and outcomes assessed. Based on the review, several gaps and limitations are highlighted and discussed.
• Comparison of person-centred and cumulative risk approaches in explaining the relationship between adverse childhood experiences and behavioural and emotional problems

  Hales, George K.; Debowska, Agata; Rowe, Richard; Boduszek, Daniel; Levita, Liat; University of Sheffield; University of Chester

  Adverse childhood experiences (ACEs) commonly co-occur, and researchers often estimate their impact using a cumulative risk approach. The person-centred approach offers another approach to operationalise the co-occurrence of ACEs. This study aims to estimate latent classes of ACEs in a sample of UK children, examine their relationship with emotional and behavioural problems, and compare the explanatory value of the latent classes to cumulative risk scores. Data were collected among a general population sample of British 10-year-old children extracted from the UK Household Longitudinal Study (N = 601). Seven items characterised ACEs, comprising parent-report physical discipline, emotional abuse, supervisory neglect, maternal psychological distress, and child-report parental educational disinterest, bullying victimisation, and adverse neighbourhood. Outcome measures were derived from the self-report Strengths and Difficulties Questionnaire including total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behaviour. Latent class analysis resulted in a 3-class solution: low ACEs, household challenges, community challenges. Compared to the other classes, the community challenges class scored substantially worse on total difficulties, emotional symptoms, and peer subscales. The cumulative risk score was associated with all outcomes except prosocial behaviour. Cumulative risk models accounted for a larger proportion of variance compared with the latent class models, except for peer problems which the person-centred model explained better. This study confirms that ACEs are associated with impairment in child functioning, and that both person-centred and cumulative risk approaches can capture this relationship well. Specifically, the person-centred approach demonstrated how co-occurring risks factors in the community challenges class produced particularly poor internalising outcomes.
• What makes a ‘good man’? A mixed-methods exploration of UK adolescent attitudes towards masculinity

  McNulty, Anne; Birney, Megan E. (Informa UK Limited, 2023-01-24)
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  The Process of Replication Target Selection in Psychology: What to Consider?

  Pittelkow, Merle-Marie; Field, Sarahanne M.; Isager, Peder M; van ’t Veer, Anna E; Anderson, Thomas; Cole, Scott N; Dominik, Tomás; Giner-Sorolla, Roger; Gok, Sebahat; Heyman, Tom; et al. (The Royal Society, 2023-02-01)

  Increased execution of replication studies contributes to the effort to restore credibility of empirical research. However, a second generation of problems arises: the number of potential replication targets is at a serious mismatch with available resources. Given limited resources, replication target selection should be well justified, systematic, and transparently communicated. At present the discussion on what to consider when selecting a replication target is limited to theoretical discussion, self-reported justifications, and a few formalized suggestions. In this Registered Report, we proposed a study involving the scientific community to create a list of considerations for consultation when selecting a replication target in psychology. We employed a modified Delphi approach. First, we constructed a preliminary list of considerations. Second, we surveyed psychologists who previously selected a replication target with regards to their considerations. Third, we incorporated the results into the preliminary list of considerations and sent the updated list to a group of individuals knowledgeable about concerns regarding replication target selection. Over the course of several rounds, we established consensus regarding what to consider when selecting a replication target.
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  Does authentic self‐esteem buffer the negative effects of bullying victimization on social anxiety and classroom concentration? Evidence from a short‐term longitudinal study with early adolescents

  Boulton, Michael J.; Macaulay, Peter J. R.; University of Chester; University of Derby (2022-12-22)

  Background: Bullying victimization is a risk factor for social anxiety and disrupted classroom concentration among young people. Self‐esteem has been implicated as a protective factor, but extant literature is sparse. Aims: Aim of present study was to test if a new measure of authentic self‐esteem can buffer the negative effects of bullying victimization on social anxiety and disrupted classroom concentration concurrently and across time. Sample: A short‐term longitudinal questionnaire design was employed with 836 12‐ and 13‐year‐olds. Methods: Peer nominations of bullying victimization and self‐reports of authentic self‐esteem were collected during winter term, and self‐reports of social anxiety and disrupted classroom concentration were solicited then and also 5 months later. Results: Hierarchical multiple regression models indicated that authentic self‐esteem moderated the association between bullying victimization and (i) social anxiety both concurrently and longitudinally and (ii) disrupted classroom concentration longitudinally. The Johnson‐Neyman technique identified where on its scale authentic self‐esteem had its buffering effects, and these were found to be at relatively low or moderate levels. Conclusions: Even moderate levels of authentic self‐esteem can mitigate the association between being bullied and (i) social anxiety and (ii) disrupted classroom concentration. Efforts to monitor and where necessary enhance the authentic self‐esteem of young people are warranted.
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  The roles of personality traits, AI anxiety, and demographic factors in attitudes towards artificial intelligence

  Kaya, Feridun; Aydin, Fatih; Schepman, Astrid; Rodway, Paul; Yetişensoy, Okan; Demir Kaya, Meva; Ataturk University; Sivas Cumhuriyet University; University of Chester; Bayburt University (Taylor and Francis, 2022-12-07)

  The present study adapted the General Attitudes toward Artificial Intelligence Scale (GAAIS) to Turkish and investigated the impact of personality traits, artificial intelligence anxiety, and demographics on attitudes toward artificial intelligence. The sample consisted of 259 female (74%) and 91 male (26%) individuals aged between 18 and 51 (Mean = 24.23). Measures taken were demographics, the Ten-Item Personality Inventory, the Artificial Intelligence Anxiety Scale, and the General Attitudes toward Artificial Intelligence Scale. The Turkish GAAIS had good validity and reliability. Hierarchical Multiple Linear Regression Analyses showed that positive attitudes toward artificial intelligence were significantly predicted by the level of computer use (β = 0.139, p = 0.013), level of knowledge about artificial intelligence (β = 0.119, p = 0.029), and AI learning anxiety (β = −0.172, p = 0.004). Negative attitudes toward artificial intelligence were significantly predicted by agreeableness (β = 0.120, p = 0.019), AI configuration anxiety (β = −0.379, p < 0.001), and AI learning anxiety (β = −0.211, p < 0.001). Personality traits, AI anxiety, and demographics play important roles in attitudes toward AI. Results are discussed in light of the previous research and theoretical explanations.
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  Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing

  Finucane, Anne M.; Hulbert-Williams, Nicholas J.; Swash, Brooke; Spiller, Juliet A.; Lydon, Brigid; Milton, Libby; Gillanders, David; Edge Hill University; University of Chester; Marie Curie Hospice Edinburgh; University of Edinburgh (Sage Publications, 2022-12-28)

  Background: Acceptance and Commitment Therapy is a form of Cognitive Behavioural Therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of settings including occupational contexts where emotional labour is high. Acceptance and Commitment Therapy could help palliative care staff to manage work-related stress and promote wellbeing. Aim: To develop, and feasibility test, an online Acceptance and Commitment Therapy intervention to improve wellbeing of palliative care staff. Design: A single-arm feasibility trial of an 8-week Acceptance and Commitment Therapy -based intervention for staff consisting of three online facilitated group workshops and five online individual self-directed learning modules. Data was collected via online questionnaire at four time-points and online focus groups at follow-up. Setting/participants: Participants were recruited from Marie Curie hospice and nursing services in Scotland. Results: 25 staff commenced and 23 completed the intervention (93%). 15 participated in focus groups. Twelve (48%) completed questionnaires at follow-up. Participants found the intervention enjoyable, informative, and beneficial. There was preliminary evidence for improvements in psychological flexibility (Cohen’s d = 0.7) and mental wellbeing (Cohen’s d = 0.49) between baseline and follow-up, but minimal change in perceived stress, burnout or compassion satisfaction. Conclusion: Online Acceptance and Commitment Therapy for wellbeing is acceptable to palliative care staff and feasible to implement using Microsoft Teams in a palliative care setting. Incorporating ways to promote long-term maintenance of behaviour changes, and strategies to optimise data collection at follow-up are key considerations for future intervention refinement and evaluation.
• A systematic review of the qualitative research examining stakeholders’ perceptions of the characteristics of helpful sport and exercise psychology practitioners

  Tod, David; Pullinger, Samuel; Lafferty, Moira E.; University of Chester; Lancaster University; Inspire Institute of Sport (Taylor and Francis, 2022-11-29)

  Research indicates sport psychology practitioners vary in their abilities to help athletes. Understanding the characteristics of helpful practitioners can inform applied sport psychology training. We reviewed qualitative research on stakeholders’ perceptions of the characteristics of practitioners. The electronic and manual search yielded 33 studies, with extracted data being subject to an abductive analysis. We also critically appraised the studies according to criteria listed by the Cochrane Collaboration. Results indicated that stakeholders perceived that helpful practitioners were able to (a) build rapport or interpersonal bonds with athletes, (b) develop real relationships based on openness and realistic perceptions, (c) inspire hope and suitable expectations, (d) promote engagement in the change process, and (e) operate well in the contexts where clients are located. The critical appraisal indicated that the studies provide an informed representation of stakeholders’ perceptions, but also where research may improve, such as considering the researcher-participant relationship. The review points to avenues of future research, such as experiments testing if the characteristics stakeholders believe describe helpful practitioners lead to better client outcomes. The current findings can also inform the training, supervision, and continued professional development of trainees and practitioners.
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  Prior associations affect bumblebees’ generalization performance in a tool-selection task

  Chow, Pizza Ka Yee; Lehtonen, Topi K.; Näreaho, Ville; Loukola, Olli J.; University of Chester; University of Oulu; Natural Resources Institute Finland (Cell Press, 2022-10-31)

  A small brain and short life allegedly limit cognitive abilities. Our view of invertebrate cognition may also be biased by the choice of experimental stimuli. Here, the stimuli (color) pairs in Match-To-Sample (MTS) tasks affected the performance of buff-tailed bumblebees (Bombus terrestris). We trained the bees to roll a tool, ball, to a goal that matched its color. Color-matching performance was slower with yellow-and-orange/red than with blue-and-yellow stimuli. When assessing the bees’ concept learning in a transfer test with a novel color, the bees trained with blue-and-yellow (novel color: orange/red) were highly successful, the bees trained with blue-and-orange/red (novel color: yellow) did not differ from random, and those trained with yellow-and-orange/red (novel color: blue) failed the test. These results highlight that stimulus salience can affect the conclusions on test subjects’ cognitive ability. Therefore, we encourage paying attention to stimulus salience (among other factors) when assessing invertebrate cognition.
• From Physical to Virtual: Reflections on the Move from the Lecture Hall to the Digital Classroom

  Lafferty, Moira E.; Roberts, Emma; University of Chester; Aberystwyth University (Springer, 2022-11-25)

  This chapter describes our reflections on the lived experiences during the rapid pivot to Emergency Remote Teaching (ERT) in March 2020. Drawing on the narratives of academics from two disciplines – Law and Psychology, we focus on the Continuing Professional Learning and Development (CPLD) offered in the immediate aftermath of the initial UK lockdown. We further describe the support available to staff as they scaffolded and supported students through the transition to online learning. Such students, although accustomed social digital users, were less skilled in digital learning, having chosen to study in-person within a physical campus-based institution. We conclude by making recommendations for sustainable training and development as we move towards the implementation of a blended learning experience for campus learners.
• Life-long learning: life beyond the training

  Lafferty, Moira E.; Tod, David; University of Chester; Liverpool John Moores (Routledge, 2022-12-30)

  If education can be described as “the kindling of a flame not the filling of a vessel” (Plutarch, nd), attainment of a formal sport psychology practice qualification and Health Care Professions Council (HCPC) registration should represent the point at which the kindling fire is fully ignited and kept alight through lifelong learning. The following chapter discusses the applied Sport Psychologist’s lifelong learning journey describing the inter-related areas of Continued Professional Development and education. Through the framework of Kneebone (2020) the journey to expert practitioner is examined and personal stories from practitioners are used to explore stages in their lifelong learning and create guidelines for sport psychologists.
• The British Psychological Society Qualification in Sport and Exercise Psychology (Stage 2)

  Eubank, Martin; Lafferty, Moira E.; Breslin, Gavin; Liverpool John Moores University; University of Chester; Ulster University (Routledge, 2022-12-30)

  This chapter discusses the British Psychological Society’s Stage 2 Qualification in Sport and Exercise Psychology. The first section of the chapter outlines the purpose, aims and requirements of the qualification. This includes details of the entry requirements for the qualification, a summary of the four key qualification competencies that trainees are expected to develop, and how the qualification provides a professional training route to Chartered Psychologist and Registered Sport and Exercise Psychologists status. The second section of the chapter outlines the qualification enrolment process, and discusses the importance and role of supervision, with tips about how to find the right supervisor and maximise the benefits of supervision. The third section of the chapter discusses the qualification assessment process and the methods used to assess trainee competency. The chapter is supported throughout by reflections from trainees, supervisors and assessors on the qualification, who share their experience of the process and provide top tips for future trainees looking to undertake the qualification to become appropriately qualified to work as a Sport and Exercise Psychologist.
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  “It’s not just a man’s world” – Helping female sport psychologists to thrive not just survive. Lessons for supervisors, trainees, practitioners and mentors.

  Lafferty, Moira E; Coyle, Melissa; Prince, Hannah R.; Szabadics, Adrienn; University of Chester; Plymouth Marjon University; Glasgow Caledonian University; Buckingham New University (The British Psychological Society, 2022-09-01)

  In the following article we present composite narratives of female sport and exercise psychologist’s (SEPs) reflections of working as practitioners in situations where they have faced sexism and a culture of toxic masculinity. We discuss the impact both professionally and personally of these experiences and look at what lessons can be learned from the sharing of these narratives. We conclude by offering our thoughts on how these negative shared experiences can be used in a positive way to inform culture change, educate supervisors of the challenges and be woven into supervision so female practitioners feel empowered and supported.
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  Who goes where in couples and pairs? Effects of sex and handedness on side preferences in human dyads

  Rodway, Paul; Schepman, Astrid; University of Chester (Taylor and Francis, 2022-06-21)

  There is increasing evidence that inter-individual interaction among conspecifics can cause population-level lateralization. Male-female and mother-infant dyads of several non-human species show lateralised position preferences, but such preferences have rarely been examined in humans. We observed 430 male-female human pairs and found a significant bias for males to walk on the right side of the pair. A survey measured side preferences in 93 left-handed and 92 right-handed women, and 96 left-handed and 99 right-handed men. When walking, and when sitting on a bench, males showed a significant side preference determined by their handedness, with left-handed men preferring to be on their partner’s left side and right-handed men preferring to be on their partner’s right side. Women did not show significant side preferences. When men are with their partner they show a preference for the side that facilitates the use of their dominant hand. We discuss possible reasons for the side preference, including males preferring to occupy the optimal ‘fight ready’ side, and the influence of sex and handedness on the strength and direction of emotion lateralization.
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  The effects of sex and handedness on masturbation laterality and other lateralised motor behaviours

  Rodway, Paul; Thoma, Volker; Schepman, Astrid; University of Chester; University of East London (Taylor and Francis, 2021-11-26)

  Masturbation is a common human behaviour. Compared to other unimanual behaviours it has unique properties, including increased sexual and emotional arousal, and privacy. Self-reported hand preference for masturbation was examined in 104 left-handed and 103 right-handed women, and 100 left-handed and 99 right-handed men. Handedness (modified Edinburgh Handedness Inventory, EHI), footedness, eyedness, and cheek kissing preferences were also measured. Seventy nine percent used their dominant hand (always/usually) for masturbation, but left-handers (71.5%) were less consistently lateralised to use their dominant hand than right-handers (86.5%). Hand preference for masturbation correlated more strongly with handedness (EHI), than with footedness, eyedness, or cheek preference. There was no difference in masturbation frequency between left and right-handers, but men masturbated more frequently than women, and more women (75%) than men (33%) masturbated with sex aids. For kissing the preferred cheek of an emotionally close person from the viewer’s perspective, left-handers showed a left-cheek preference, and right-handers a weaker right-cheek preference. The results suggest that hemispheric asymmetries in emotion do not influence hand preference for masturbation but may promote a leftward shift in cheek kissing. In all, masturbation is lateralised in a similar way to other manual motor behaviours in left-handed and right-handed men and women.
• The General Attitudes towards Artificial Intelligence Scale (GAAIS): Confirmatory Validation and Associations with Personality, Corporate Distrust, and General Trust

  Schepman, Astrid; Rodway, Paul; University of Chester (Taylor and Francis, 2022-06-14)

  Acceptance of Artificial Intelligence may be predicted by individual psychological correlates, examined here. Study 1 reports confirmatory validation of the General Attitudes towards Artificial Intelligence Scale (GAAIS) following initial validation elsewhere. Confirmatory Factor Analysis confirmed the two-factor structure (Positive, Negative) and showed good convergent and divergent validity with a related scale. Study 2 tested whether psychological factors (Big Five personality traits, corporate distrust, and general trust) predicted attitudes towards AI. Introverts had more positive attitudes towards AI overall, likely because of algorithm appreciation. Conscientiousness and agreeableness were associated with forgiving attitudes towards negative aspects of AI. Higher corporate distrust led to negative attitudes towards AI overall, while higher general trust led to positive views of the benefits of AI. The dissociation between general trust and corporate distrust may reflect the public’s attributions of the benefits and drawbacks of AI. Results are discussed in relation to theory and prior findings.
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  Educators' experiences and perspectives of child weight discussions with parents in primary school settings.

  Coupe, Nia; Peters, Sarah; Ayres, Matilda; Clabon, Katie; Reilly, Alexandra; Chisholm, Anna; University of Chester; Lancaster University; University of Manchester; University of Liverpool (2022-04-22)

  Background: The role of schools in addressing rising childhood obesity levels has been acknowledged, and numerous diet- and physical activity-related interventions exist. Aside from formal interventions, opportunistic parent-educator conversations about child weight can arise, particularly in primary school settings, yet little is known about how useful these are. This study aimed to understand the utility of child weight related conversations with parents through exploring educators' experiences and perspectives. Methods: This qualitative study consisted of semi-structured interviews conducted with primary school teaching staff in the United Kingdom (N = 23), recruited through purposive and subsequent snowball sampling. Interviews were audio-recorded, transcribed, and analysed using thematic analysis. Results: Participants identified opportunities and need for child weight discussions in schools. However, conversations were prevented by the indirect and sensitive nature of conversations, and educators' professional identity beliefs. Using pre-existing face-to-face opportunities, good parent-teacher relationships and holistic approaches to child health and wellbeing were reported as important in optimising these conversations. Conclusions: Whilst educator-parent child weight discussions are necessary, discussions are highly challenging, with contradictory views on responsibility sometimes resulting in avoidance. Educators' roles should be clarified, and communication training tailored to increase teacher confidence and skills. Current social distancing will likely reduce opportunistic encounters, highlighting a need to further improve communication routes.
• “The Fruit of Consultation” – Co-production as a solution to the challenges of safeguarding children and young people in International Christian work, findings from an online survey.

  Oakley, Lisa; Lafferty, Moira; McFarlane, Leigh; Thirtyone:eight; University of Chester (Wiley, 2022-06-15)

  Incidents of child abuse such as the Oxfam case in 2010 of sexual abuse of children by volunteers’ and cases of abuse in orphanages by high risk overseas volunteers have highlighted the need for the development of effective safeguarding in the international context. This is of equal importance for faith-based organisations (FBOs) who, like non-governmental organisations (NGOs) are obligated to create safe spaces for their beneficiaries. This paper reports the findings from an online survey conducted in 2019, which was completed by 72 participants, 39 were representatives from organisations based in the UK which support individuals to engage in International Christian Work (ICW), 33 were individuals who are or have been engaged in ICW in the last three years. The online survey collected qualitative data, which was analysed using reflexive thematic analysis whilst descriptive analytical techniques were employed on the quantitative data. The findings illustrate commitment to safeguarding children and young people in ICW but also the complexities, challenges, and tensions around this. The necessity to work collaboratively with local contexts and co-production was identified as key to developing effective safeguarding practice. These findings have implications beyond faith-based organisations to others working in the international context.
• Web-based psychological interventions for people living with and beyond cancer: A meta-review of what works and what doesn’t for maximising recruitment, engagement, and efficacy

  Leslie, Monica; Beatty, Lisa; Hulbert-Williams, Lee; Pendrous, Rosina; Cartwright, Tim; Jackson, Richard; The Finding My Way UK Trial Steering Group; Hulbert-Williams, Nicholas J; Edge Hill University; University of Chester; Flinders University; University of Liverpool (JMIR, 2022-07-08)

  Background: Despite high levels of psychological distress experienced by many patients with cancer, previous research has identified several barriers to accessing traditional face-to-face psychological support. In response, web-based psychosocial interventions have emerged as a promising alternative. Objective: This meta-review aimed to synthesise evidence on: (1) recruitment challenges and enablers; (2) factors that promote engagement and adherence to web-based intervention content; and (3) factors that promote the efficacy of web-based psychosocial interventions for cancer patients and survivors. Methods: We conducted a systematic search for previous reviews which have investigated the recruitment, engagement, and efficacy of online and app-based psychosocial interventions in adult cancer populations. We searched PubMed, CINAHL, PsycINFO, and the Cochrane Library database for relevant literature. Search terms focussed on a combination of topics pertaining to neoplasms and telemedicine. Two independent authors conducted abstract screening, full-text screening, and data extraction for each identified article. Results: Twenty articles met eligibility criteria. There was inconsistency in the reporting of uptake and engagement data; however, anxiety around technology and perceived time burden were identified as two key barriers. Online psychosocial oncology interventions demonstrated efficacy in reducing depression and stress but reported weak to mixed findings for distress, anxiety, quality of life, and wellbeing. While no factors consistently moderated intervention efficacy, preliminary evidence indicated that multi-component interventions and greater communication with a healthcare professional were preferred by participants and associated with superior effects. Conclusions: Several consistently cited barriers to intervention uptake and recruitment emerged, which we recommend future intervention studies address. Preliminary evidence also supports the superior efficacy of multi-component interventions and interventions which facilitate communication with a healthcare professional. However, a greater number of appropriately powered clinical trials, including randomised trials with head-to-head comparisons, are needed to enable more confident conclusions around which online psychosocial oncology interventions work best and for whom.
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  Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis

  Troya, M. Isabela; Spittal, Matthew, J; Pendrous, Rosina; Crowley, Grace; Gorton, Hayley, C; Russell, Kirsten; Byrne, Sadhbh; Musgrove, Rebecca; Hannah-Swain, Stephanie; Kapur, Navneet; et al. (Elsevier, 2022-04-28)

  Background Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. Methods Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. Findings A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4–17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2–139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9–1·7) with again a broad range amongst studies (RR 0·2–18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9–4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7–36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates. Interpretation The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations.

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