Childhood Sexual Abuse and Suicidal Behavior: A Meta-analysis

Abstract

BACKGROUND AND OBJECTIVE: Self-inflicted injuries are one of the major causes of disease burden and death globally. Understanding the extent to which this is associated with childhood sexual abuse (CSA) exposure can help inform prevention strategies. We aimed to quantify to what extent CSA was associated with incident suicide attempts in men and women. Longitudinal studies and cotwin analyses from twin studies in any population from any year were eligible for inclusion. Of 22 235 abstracts screened as part of a series of reviews, 9 studies met the inclusion criteria for this review. Characteristics, effect estimates, and quality data were extracted. Randomeffects meta-analysis was used to generate pooled odds ratios (ORs).RESULTS: Seven longitudinal and 2 twin studies with 8733 participants met the inclusion criteria. The overall pooled estimate for longitudinal studies was OR = 2.43 (95% confidence interval: 1.94-3.05), I 2 = 87.5%, P , .0001. The pooled OR from cotwin analysis was 2.65 (95% confidence interval: 0.82-4.49, I 2 = 0%, P = .867). Studies adjusted for a range of confounders, but baseline suicidal behavior was not wellcontrolled. Too few studies met the inclusion criteria to quantitatively examine sources of heterogeneity.CONCLUSIONS: CSA exposure is associated with suicide attempts when a range of different confounders are controlled for, but the temporality of the association is not well established, and the association is highly heterogeneous. Pediatrics 2014;133:e1331-e1344

Posttraumatic Stress Disorder and Suicidal Ideation Among Sexually Abused Adolescent Girls: The Mediating Role of Shame

“…Sexually abused adolescent girls are at high risk of suicidal ideation and attempts (Devries et al, 2014;Miller et al, 2013). In our sample, close to half of participants (46%) reported suicidal ideation in the past three months.…”

“…Suicide is the first worldwide cause of death among adolescent girls aged 15-19 years (Patton et al, 2009). A recent meta-analysis also indicates that between 20% and 22% of suicide and suicidal attempts among women can be imputed to CSA (Devries et al, 2014).…”

“…Suicide is the first worldwide cause of death among adolescent girls aged 15-19 years (Patton et al, 2009). A recent meta-analysis also indicates that between 20% and 22% of suicide and suicidal attempts among women can be imputed to CSA (Devries et al, 2014).Depressive mood is a well-known risk factor for suicidal ideation and behaviors, along with PTSD (Beautrais, 2000;Devenish, Berk, & Lewis, 2016;Krysinska & Lester, 2010;Miller & Eckert, 2009). Recent studies also show that among sexually abused adolescents, not only do depressive and PTSD symptoms predict suicidal ideation (Brabant, Hébert, & Chagnon, 2014), but depressed mood also mediates the relationship between sexual abuse and suicidal ideation (Sigfusdottir, Asgeirsdottir, Gudjonsson, & Sigurdsson, 2013).…”

In my end is my beginning: developmental trajectories of adverse childhood experiences to late-life suicide

“…In a meta-analysis, Paolucci, Genuis, and Violato (2001) found the average unweighted and weighted ds for the relationship between sexual abuse (any unwanted sexual contact) and suicidality (suicidal ideation, plan or attempt) were .64 and .44, respectively. In a recent meta-analysis, Devries et al (2014) found childhood sexual abuse to be associated with suicide attempts even when a range of different confounders (including other types of abuse and parental pathology) were controlled. Specifically, the overall pooled estimate for the longitudinal studies was OR D 2.43, and the pooled OR from co-twin analysis was 2.65.…”

Alexithymia as a mediator of the relationship between child sexual abuse and psychological distress in adolescence: A short-term longitudinal study

“…Following a systematic review of 52 studies, Miller et al (2013) found that CSA was associated with adolescent suicidal ideation and suicide attempts in community as well as clinical samples, relying on both cross-sectional and longitudinal designs, even when controlling for demographics and possible confounder variables (youth mental health, family adversities). Devries et al (2014) in a meta-analysis of longitudinal and twin studies concluded that CSA was associated with increased risk of suicide attempts after controlling for genetic risk factors and family adversity. Given the well-known deleterious impact of CSA, it is essential to identify factors underlying the emergence of symptoms and accounting for the diversity of outcomes in survivors.…”