Influence of childhood abuse and neglect subtypes on late-life suicide risk beyond depression

Abstract

The association of childhood maltreatment and suicide has been extensively examined within the population. Depression figures as a main cause for the elevated suicide rate in advanced ages and is often related to childhood maltreatment. The purpose of the present study was to examine the relationship between childhood maltreatment subtypes and suicide risk, testing geriatric depression as a moderator. This is a cross-sectional study looking at a sample of 449 individuals 60 year s old or older from the Multidimensional Study of the Elderly of Porto Alegre Family Health Strategy, Brazil (EMI-SUS/POA). Childhood maltreatment (Childhood Trauma Questionnaire), geriatric depressive symptoms (Geriatric Depression Scale), and suicide risk (Mini International Neuropsychiatric Interview) were assessed. The subtypes of childhood abuse and neglect were significantly associated with suicide risk. In the multivariate analysis, controlling for age, gender, income, marital status, ethnicity, smoking, and geriatric depression symptoms, all trauma subtypes remained associated with suicide risk with the exception of physical neglect (EA = 3.65; PA = 3.16; SA = 5.1; EN = 2.43; PN = 1.76). The present study showed that childhood maltreatment subtypes predicted suicide risk, and geriatric depression does not directly mediate this relation.

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

“…Childhood maltreatment is also associated with earlier age of first suicide attempt [51]. Additionally, an association between childhood maltreatment and suicide risk in 449 individuals 60 years of age or older was recently reported from the Multidimensional Study of the Elderly of Porto Alegre Family Health Strategy [52]. The effect was independent of geriatric depressive symptom severity.…”

“…Several groups have sought to determine the impact of single types of childhood maltreatment on mood disorders. Although all types of childhood maltreatment (physical, emotional, and sexual) increase disease vulnerability and risk for more severe illness course in mood disorders, including increased risk for suicide [52], there may be some distinctions between individual subtypes and associated outcomes [70]. An association between sexual abuse and lifetime risk for anxiety disorders, depression, and suicide attempts independent of other types of maltreatment has been reported [2,71,72].…”

Rates of neglect in a national sample: Child and family characteristics and psychological impact

“…Child neglect, the omission of needed caregiving behaviors, is the most common form of maltreatment reported to authorities (U.S. Department of Health & Human Services, 2018), and is associated with at least as much harm as other forms of child abuse (Gilbert et al, 2009;Stoltenborgh, Bakermans-Kranenburg, & van IJzendoorn, 2013). Adverse impacts include substance abuse (Hussey, Chang, & Kotch, 2006), post-traumatic stress disorder (Widom, 1999), suicide risk (Behr Gomes Jardim et al, 2018), violent behavior (McGuigan, Luchette, & Atterholt, 2018), and developmental delays (Hildyard & Wolfe, 2002). Yet, neglect remains a less studied and understood form of maltreatment (Mennen, Kim, Sang, & Trickett, 2010;Stoltenborgh et al, 2013).…”

Association between Childhood Maltreatment and Suicidal Ideation and Suicide Attempts among Chinese Adolescents: The Moderating Role of Depressive Symptoms

“…However, the role of depressive symptoms in the association between childhood abuse and suicidality was not consistent in different studies. A study of elderly people over 60 years of age showed that the interaction terms of various types of childhood maltreatment and depression symptoms were not significantly related to suicide [22]. In addition, other studies have suggested that depression symptoms may play a mediating role in childhood abuse and suicidal behavior [28,50], but these studies did not rule out the association between the interaction terms of childhood abuse and depression symptoms, and suicidal behavior before the mediation analysis.…”

“…For example, a study analyzed the interaction between childhood abuse and mental disorders, and its impacts on suicidal behavior and found that childhood abuse had a significant impact on suicidal behavior in the general population but not on individuals with mood disorders [20]. However, another study showed that the interaction terms of various types of childhood maltreatment and depression symptoms were not significantly related to suicide [22]. Finally, few studies have explored the potential moderating role of depressive symptoms in the association between childhood abuse and suicidal behavior in Chinese adolescents.…”