The Relationship between Trauma Exposure and Psychiatric Hospitalization for Suicide Ideation or Suicide Attempt among Patients Admitted to a Military Treatment Setting

Abstract

Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual's likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems.

Prevalence and risk of sexual violence victimization among mental health service users: a systematic review and meta-analyses

“…A further 8 papers were identified through citation tracking, resulting in a total of 26 papers to be included in the review. Six of these studies did not present gender disaggregated prevalence data [9][10][11][12][13][14] and this information could not be obtained from the authors upon contact. This left a total of 20 studies [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] which were included in the meta-analyses.…”

“…Two studies [12,13] investigated the adult lifetime prevalence of sexual violence in psychiatric service users but did not disaggregate data by gender. The first study extracted data from the medical records of US military service members admitted to a psychiatric inpatient service for suicide ideation or attempt [12]. They found that participants experienced sexual violence in 11.7% of those admitted for suicide ideation and 20.7% of those admitted for suicide attempt.…”

Distinguishing clinical and genetic risk factors for suicidal ideation and behavior in a diverse hospital population

“…Impulsivity may increase risk for acting on suicidal thoughts and risk of exposure to more painful events (e.g., drug use, physical fights) which contribute to an acquired capability for escalation of SI to SB 10 . Exposure to trauma (e.g., abuse, combat, physical and sexual violence) can also contribute to this capability by habituating an individual to painful and life threatening events 38,39 , potentially explaining the stronger association of posttraumatic stress disorder with SB compared to SI-only. Furthermore, psychotic disorder diagnoses were also elevated in individuals with SB compared to SI-only and psychotic experiences may elevate risk for SB amongst individuals with SI 40,41 .…”

Suicide attempt, impulsivity, and exposure to trauma in college students

“… 14 Accordingly, adults with depression and a history of childhood abuse were found to be more likely to have attempted suicide than those who did not report such history. 15 Beyond childhood adversities, lifetime traumatic experiences were found to both increase one’s likelihood to be hospitalized following a SA rather than ideation, 16 and to increase acquired capability. 17 In line with this evidence, a recent systematic review demonstrated a significant association between traumatic life events and suicide risk in college students, with medium-to-large effect sizes.…”