The mediating role of tolerance for psychological pain in the relationship of childhood trauma to suicidal ideation in individuals with a substance use disorder

Abstract

Objectives The association between childhood trauma and suicidal ideation has been well documented in several populations, including individuals with a substance use disorder (SUD). However, a gap still exists in the literature regarding the mechanisms by which childhood trauma later impacts suicide risk. This cross‐sectional study tested the effect of childhood trauma on suicidal ideation, as well as the mediating effect of tolerance for psychological pain (managing the pain and enduring the pain) in that relationship, controlling for the effect of depressive symptoms, in individuals with a SUD. Methods A sample of 102 adults with a SUD participated in the study. Path analysis by structural equation modelling tested a mediation model. Results Depressive symptoms and lower levels of managing the pain were found to fully mediate the association between childhood trauma and suicidal ideation. Conclusions Our results suggest that depressive symptoms and a lack of ability to manage psychological pain contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions in individuals with SUDs. Moreover, they have relevant implications for prevention and clinical interventions regarding suicidal ideation in this population. Practitioner points Childhood trauma relates to suicidal ideation in individuals with a substance use disorder. Depressive symptoms contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions. A lack of ability to manage psychological pain also contributes towards explaining this relationship. The obtained results have relevant implications for the prevention of and clinical intervention for suicidal ideation in SUD individuals.

Childhood trauma and suicidal ideation among Chinese adolescents: The mediating effects of character strengths and perceived stress

“…In other words, adolescents exposed to more traumatic events in childhood were more likely to report a higher level of suicidal ideation. Indeed, adverse childhood experiences may cause lasting and invisible harm to individuals, be detrimental to children's attachment security, make them have traumatic thoughts and perform more self‐harm, and adversely affect their cognitive, emotional and behavioural adaptation (Martins et al, 2021; Stagaki et al, 2022).…”

“…character strengths, childhood trauma, perceived stress, suicidal ideation has been widely demonstrated in empirical studies (Cicchetti & Rogosch, 2002;Dunn et al, 2013;Gomez et al, 2017;Li et al, 2014;Martins et al, 2021;Toth & Cicchetti, 2013). In addition, prior evidence has shown that the relationship between childhood trauma and suicidal ideation can be explained by other important variables (Miller et al, 2013; and that intervention of these intermediate factors is beneficial to alleviating suicidal ideation (Bahk et al, 2017).…”

“…Childhood trauma is considered a combination of adverse events that individuals experience during childhood and features emotional, physical and sexual abuse and emotional and physical neglect (Bernstein et al, 1997; Bernstein et al, 2003). The theory of developmental psychopathology highlights the long‐term adverse consequences of negative childhood experiences on adolescents' adaptation, including increased suicidal ideation, which has been widely demonstrated in empirical studies (Cicchetti & Rogosch, 2002; Dunn et al, 2013; Gomez et al, 2017; Li et al, 2014; Martins et al, 2021; Toth & Cicchetti, 2013). In addition, prior evidence has shown that the relationship between childhood trauma and suicidal ideation can be explained by other important variables (Miller et al, 2013; Wang et al, 2022) and that intervention of these intermediate factors is beneficial to alleviating suicidal ideation (Bahk et al, 2017).…”

Mediation effect of anxious attachment on relationship between childhood trauma and suicidal ideation sensitive to psychological pain levels

“…In 2,259 Chinese students, a mediating effect of psychological pain on the relationship between emotional abuse and suicidal ideation was found [ 46 ]. Likewise in a clinical setting, Martins et al [ 47 ] report a direct effect of CT on suicidal ideation in 102 subjects with substance abuse disorder. This effect, however, vanished when the capacity to manage psychological pain was introduced as mediator.…”

The Psychosomatic Effects of Childhood Trauma: Insights from Adult Survivors

“…This relationship highlights the importance of considering childhood trauma in the assessment and treatment of physical health conditions, advocating for an integrated approach to care that addresses both psychological and physical health needs. The mediating role of various psychological factors, such as tolerance for psychological pain, in the relationship between childhood C E-ISSN: 3041-8542 trauma and adverse outcomes such as suicidal ideation, points to the complexity of trauma's effects on mental health (Martins et al, 2021). These findings emphasize the need for interventions that target specific psychological mechanisms, potentially mitigating the impact of childhood trauma on adult mental health.…”