Adverse Childhood Experiences and Suicide Risk: Toward Comprehensive Prevention

Ports, Katie A.; Merrick, Melissa T.; Stone, Deborah M.; Wilkins, Natalie; Reed, Jerry; Ebin, Julie; Ford, Derek C.

doi:10.1016/j.amepre.2017.03.015

Cited by 46 publications

(27 citation statements)

References 16 publications

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“…While suicide rates vary by country, the age-adjusted suicide rate in the United States has increased 33% from 1999 to 2017 with more than 120 Americans dying by suicide every day 2 . With an estimated 2.1 million discharges for self-inflicted injuries from emergency departments and acute care hospitals reported in the US in 2013 alone 3 and $50.8 billion in medical expenditures and lost productivity 4 , suicidal behavior is a major public health and economic burden 5,6 . Given the incalculable emotional and psychological costs, the true public health burden of suicidality is difficult to estimate 6 ; however, these statistics highlight the importance of identifying causal risk factors for developing effective suicide reduction and prevention strategies 7 .…”

Section: Introductionmentioning

confidence: 99%

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

et al. 2020

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Rates of suicidal behavior are increasing in the United States and identifying causal risk factors continues to be a public health priority. Observational literature has shown that educational attainment (EA) and cognitive performance (CP) influence suicide attempt risk; however, the causal nature of these relationships is unknown. Using summary statistics from genome-wide association studies (GWAS) of EA, CP, and suicide attempt risk with > 815,000 combined white participants of European ancestry, we performed multivariable Mendelian randomization (MR) to disentangle the effects of EA and CP on attempted suicide. In single-variable MR (SVMR), EA and CP appeared to reduce suicide attempt risk (EA odds ratio (OR) per standard deviation (SD) increase in EA (4.2 years), 0.524, 95% CI, 0.412–0.666, P = 1.07 × 10−7; CP OR per SD increase in standardized score, 0.714, 95% CI, 0.577–0.885, P = 0.002). Conversely, bidirectional analyses found no effect of a suicide attempt on EA or CP. Using various multivariable MR (MVMR) models, EA seems to be the predominant risk factor for suicide attempt risk with the independent effect (OR, 0.342, 95% CI, 0.206–0.568, P = 1.61 × 10−4), while CP had no effect (OR, 1.182, 95% CI, 0.842–1.659, P = 0.333). In additional MVMR analyses accounting simultaneously for potential behavioral and psychiatric mediators (tobacco smoking; alcohol consumption; and self-reported nerves, tension, anxiety, or depression), the effect of EA was little changed (OR, 0.541, 95% CI, 0.421–0.696, P = 3.33 × 10−6). Consistency of results across complementary MR methods accommodating different assumptions about genetic pleiotropy strengthened causal inference. Our results show that even after accounting for psychiatric disorders and behavioral mediators, EA, but not CP, may causally influence suicide attempt risk among white individuals of European ancestry, which could have important implications for health policy and programs aimed at reducing the increasing rates of suicide. Future work is necessary to examine the EA–suicide relationship populations of different ethnicities.

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Section: Introductionmentioning

confidence: 99%

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

et al. 2020

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“…While this measure is less specific than the classic list of ACEs, it extends the ACEs' focus on household dysfunction. Importantly, the result shows that the primary caregiver's perception of their child's exposure to stressful events is predictive of suicidal ideation in their child at age 15 in the same manner as ACEs (Ports et al, 2017). Of course, it is hard to know the exact mechanism by which stressors influence later life suicidal ideation (if at all) through this question.…”

Section: Discussionmentioning

confidence: 96%

Life-History Factors Influence Teenagers’ Suicidal Ideation: A Model Selection Analysis of the Canadian National Longitudinal Survey of Children and Youth

Ziker

Snopkowski

2020

Evol Psychol

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Suicidality is an important contributor to disease burden worldwide. We examine the developmental and environmental correlates of reported suicidal ideation at age 15 and develop a new evolutionary model of suicidality based on life history trade-offs and hypothesized accompanying modulations of cognition. Data were derived from the National Longitudinal Survey of Children and Youth (Statistics Canada) which collected information on children’s social, emotional, and behavioral development in eight cycles between 1994 and 2009. We take a model selection approach to understand thoughts of suicide at age 15 ( N ≈ 1,700). The most highly ranked models include social support, early life psychosocial stressors, prenatal stress, and mortality cues. Those reporting consistent early life stress had 2.66 greater odds of reporting thoughts of suicide at age 15 than those who reported no childhood stress. Social support of the primary caregiver, neighborhood cohesion, nonkin social support of the adolescent, and the number of social support sources are all associated with suicidal thoughts, where greater neighborhood cohesion and social support sources are associated with a reduction in experiencing suicidal thoughts. Mother’s prenatal smoking throughout pregnancy is associated with a 1.5 greater odds of suicidal thoughts for adolescents compared to children whose mother’s reported not smoking during pregnancy. We discuss these findings in light of evolutionary models of suicidality. This study identifies both positive and negative associations on suicidal thoughts at age 15 and considers these in light of adaptive response models of human development. Findings are relevant for mental health policy.

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“…While this approach is consistent with others researching this topic (Finkelhor et al, 2014), it may mask the differential influence of particular types of violence on the individual (e.g., SV vs bullying). Additionally, the YRBS focuses on individual experiences and does not measure every form of victimization, particularly those happening in family systems or neighborhood environments (Ports et al, 2017). ACEs not measured in by YRBS may warrant consideration in future work on the link between polyvictimization and suicide risk among SMA.…”

Section: Discussionmentioning

confidence: 99%

“…Undoubtably, violence prevention is an important part of suicide prevention for SMA; however, our results suggest that violence prevention alone is likely inadequate for ensuring the mental health of SMA. Alongside efforts to reduce violence directed at SMA and increase the inclusivity of the environments SMA occupy, comprehensive evidence‐based suicide prevention delivered directly to SMA is needed (Ports et al, 2017; Stone et al, 2017). Importantly, such efforts need tailoring to speak to the lived experiences of SMA.…”

Section: Discussionmentioning

confidence: 99%

Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status

Johns

Lowry

Hipp³

et al. 2020

J of Research on Adolesc

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Sexual minority adolescents (SMA) report more suicide risk behaviors than heterosexual adolescents. Polyvictimization (co‐occurrence of multiple types of victimization) may be an important, underresearched correlate of this disparity. With the 2017 national Youth Risk Behavior Survey (N = 13,179), national estimates of polyvictimization and suicide risk were assessed among high school students by sexual minority status (SM vs. heterosexual), and multivariate relationships between sexual minority status, polyvictimization, and suicide risk were tested. Additionally, risk profiles of those who experienced polyvictimization (2 + types of victimization; n = 1,932) were compared across sexual minority status. Results confirm that SMA are more likely to experience polyvictimization than heterosexual adolescents (31.8% v. 12.9%, respectively); however, also indicate that polyvictimization does not fully explain elevated suicide risk among SMA.

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Adverse Childhood Experiences and Suicide Risk: Toward Comprehensive Prevention

Cited by 46 publications

References 16 publications

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

Life-History Factors Influence Teenagers’ Suicidal Ideation: A Model Selection Analysis of the Canadian National Longitudinal Survey of Children and Youth

Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status

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