The Impact of Relational Adverse Childhood Experiences on Suicide Outcomes During Early and Young Adulthood

Abstract

This study aimed at investigating the degree to which relational adverse childhood experiences (ACEs) would affect suicide outcomes during early and young adulthood of Iranian female and male students. In all, 487 undergraduate students (59.2% females) with a mean age of 20.66 ± 1.42 were recruited using a multistage clustering sampling method from eight schools from the fields of humanities, engineering, and basic sciences. Suicide Behavior Questionnaire–Revised form (SBQ-R) was employed for assessing past year suicidal ideation (PYSI, once or more), the meaningful likelihood of future suicide (mLoFS, a score of 2 or more), and suicide risk (SR ≥7). Relational ACEs were assessed in the form of a yes/no question, including caregivers’ maltreatment, household relational dysfunction, family loss events, school events, and sexual abuse. Analyses were conducted using Fisher’s exact test, chi-square test, and univariate binary logistic regression. The rates of PYSI, LoFS, and SR were, respectively, 37.2%, 44.6%, and 30.8%. The most experienced event was witnessing verbal violence (68.8%) and the least was divorce/separation (6.2%). All the events and domains (except family loss events), the interaction of domains, and cumulative events significantly increased the odds of suicide outcomes, in which females were more affected by all types of relational ACEs. Students whose ethnicity was Azari & Turk and who were studying in humanities or basic sciences showed a higher suicide risk than their counterparts. The study showed that the rates of relational ACEs and suicide outcomes were remarkable, in Iran. Because of the detrimental effects of relational ACEs on suicidality, mostly for females, it is necessary to improve the initiatives promoting child protection and legal support for health professionals to address child abuse. There is also an urgent need for providing young students with supports and effective interventions.

Tipping the Scales: Factors Influencing the Decision to Report Child Maltreatment in Primary Care

“…Additionally, the odds of adult survivors experiencing serious depression are more than twice the general population. Adult survivors of CM are also 12 times more likely to commit suicide (Felitti et al, 1998; Pournaghash-Tehrani, Zamanian, & Amini-Tehrani, 2019; Salokangas et al, 2019). Those who experienced CM were also significantly more likely to perpetrate CM, criminal violence, and intimate partner violence (Milaniak & Widom, 2015; Oliver, 1993).…”

Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences

“…Currently, there is a lack of research on gender differences in the association between ACEs and HRB patterns. However, some scholars have attempted to identify gender differences between ACEs and a single risky behavior [ 24 , 25 ]. The overall results have not been uniform; for example, a national urban birth cohort study assessed that girls were more likely to develop externalizing behavioral problems after exposure to adversity, compared to boys [ 49 ].…”

“…Socialization of gender differentiation may enable boys to gain more autonomy and freedom to spend time outside, thus giving boys more opportunities to engage in risky behavior than girls. In addition, studies suggest that the gender differences between ACEs and risk behaviors are uncertain in adolescents [ 24 , 25 ]. Therefore, different socio-cultural contexts may lead to gender differences in the association between ACEs and HRBs patterns.…”

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“…Extensive research has confirmed a dose-response association between ACE scores and an array of health problems across the lifespan (e.g., Anda et al, 2006;Dong et al, 2003). Recent investigations of the ACE questionnaire have provided empirical support for expanding the content, including additional adverse events such as unsafe neighborhoods and perceived discrimination (Cronholm et al, 2015), peer victimization (Finkelhor et al, 2015;Pournaghash-Tehrani et al, 2019), and maltreatment by school authorities (Pournaghash-Tehrani et al, 2019). In addition, global organizations, such as the World Health Organization (WHO), are working through validation trials on a revised version of the ACE International Questionnaire (ACE-IQ;World Health Organization, 2018).…”