Are there sensitive periods when child maltreatment substantially elevates suicide risk? Results from a nationally representative sample of adolescents

Abstract

Background Although child maltreatment is a well documented risk factor for suicidal behavior, little is known about whether the timing of child maltreatment differentially associates with risk of suicidal ideation, suicide plans, or suicide attempts. The goal of this study was to examine whether a first exposure to physical or sexual abuse during specific developmental periods significantly elevated risk for suicidal behavior in adolescents. Methods Data came from the National Comorbidity Survey Adolescent Supplement, a population-based sample of US adolescents aged 13–18 years old (n = 9,272). Using discrete time survival analysis, we assessed the association between timing of first abuse (early childhood: ages 0–5; middle childhood: ages 6–10; adolescence: ages 11–18) and suicidal ideation, plans, and attempts. Results Exposure to either physical or sexual abuse increased the odds of reporting suicidal ideation (odds ratio [OR] = 5.06 and OR = 3.56, respectively), plans (OR = 3.63 and OR = 3.58, respectively), and attempts (OR = 5.80 and OR = 4.21, respectively), even after controlling for sociodemographic covariates and psychiatric disorders. However, the timing of physical and sexual abuse exposure was unassociated with suicidal behavior (all p values >.05). Conclusions Exposure to child maltreatment is strongly associated with risk for adolescent suicidal behaviors, though this association did not vary based on the developmental timing of first exposure. These findings suggest that prevention efforts should be implemented throughout early development and target all children, regardless of when they were first exposed.

Childhood maltreatment, neuropsychological function and suicidal behavior

“…Early age of sexual abuse has been associated with higher suicidal intent (Lopez‐Castroman et al., ). However, a more recent study found that the timing of physical and sexual abuse was not associated with subsequent suicidal behavior (Gomez et al., ). We did not collect information about medication use on the day of testing, which could impact the results.…”

“…Suicide risk is elevated in individuals with psychiatric disorders such as mood disorders, chronic psychotic disorders and alcohol and substance use disorders (Harris & Barraclough, ). Childhood maltreatment has been associated with higher risk for psychiatric disorders and suicidal behavior (Anda et al., ; Gomez et al., ; Liu et al., ; Nemeroff, ; Short & Nemeroff, ).…”

Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment

“…Brown, Cohen, Johnson, & Smailes, 1999;Castellv ı et al, 2017;Fergusson, Boden, & Horwood, 2008;Fergusson, Horwood, & Lynskey, 1996;Nelson et al, 2002). Sexual abuse has been shown to have longerterm effects than physical abuse (Fergusson et al, 2008), another potent risk factor for suicidal ideation and attempt (Dunn, McLaughlin, Slopen, Rosand, & Smoller, 2013;Gomez et al, 2017). Although less frequently studied, emotional abuse also has been shown to increase likelihood of suicidal ideation in older children and adolescents controlling for covariates such as history of suicidal ideation, depressive symptoms, and in some cases controlling for sexual and physical abuse (Gibb et al, 2001;Miller et al, 2016).…”

Самоповреждающее Поведение Подростков: Дефиниции, Эпидемиология, Факторы Риска И Защитные Факторы. Сообщение I

“…Инцест связан с СП детей и подростков [99]. У сексуального насилия более долгосрочные последствия, чем физическое [90], будучи сильнейшим фактором риска СП [100,101] независимо от социальноэкономического статуса семьи, диссоциативных симптомов молодежи, негативных жизненных событий, симптомов психического здоровья, разлуки с близкими, тюремного заключения, уровня образования и изменения в попечителе. Риск попытки самоубийства в 15 раз выше у подростков мужского пола, ставших жертвами сексуального насилия, чем девочек [102].…”

“…Incest is associated with SB of children and adolescents [99]. Sexual violence has more long-term consequences than physical [90], being the strongest risk factor for SB [100,101], regardless of the socioeconomic status of the family, dissociative symptoms of youth, negative life events, symptoms of mental health, separation from relatives , imprisonment, level of education and change in trustee. The risk of suicide attempt is 15 times higher in male adolescents who are victims of sexual violence than girls [102].…”