Childhood adversity and midlife suicidal ideation

Abstract

BackgroundChildhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties.MethodAt 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood.ResultsIllness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67–6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29–5.75), sexual abuse (OR 4.99, 95% CI 2.90–11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI −7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97–27.88) and sexual abuse (OR 6.59, 95% CI 2.40–38.36) with suicidal ideation at 45 years.ConclusionsAdversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive interventions.

The association between different traumatic life events and suicidality

“…For example, a study based on the WHO’s mental health surveys implemented in 21 countries ( n  = 102,245) and investigating a range of traumatic events and suicidal behaviour (Stein et al, 2010) found that the strongest associations were found for violence-related events. In addition, previous studies have shown increased risk of suicidal behaviour subsequent to adverse and traumatic life events during childhood (Afifi et al, 2016; Bruffaerts et al, 2010), for both suicidal ideation (Stansfeld et al, 2017) and suicide attempts (Dube et al, 2001; Enns et al, 2006; Ford & Gomez, 2015). Furthermore, studies have found that non-interpersonal events such as the loss of a loved one can increase the risk of self-injury (Bylund Grenklo et al, 2013), suicide attempts and suicides (Jakobsen & Christiansen, 2011; Niederkrotenthaler, Floderus, Alexanderson, Rasmussen, & Mittendorfer-Rutz, 2012).…”

Systematic review and critical appraisal of child abuse measurement instruments

“…A recent review of a series of metaanalyses reported that prevalence rates of child abuse for self-report studies are 12.7% for sexual abuse, 22.6% for physical abuse, 6.3% for emotional abuse, 16.3% for physical neglect and 18.4% for emotional neglect (Stoltenborgh et al, 2015). Individuals who experience abuse during childhood are more likely to develop depression (Infurna et al, 2016), post-traumatic stress disorder (Breslau et al, 2014;Brewin et al, 2000), schizophrenia (McGrath et al, 2017;Varese et al, 2012), dissociative disorder (Draijer and Langeland, 1999), personality disorder (Johnson et al, 1999), substance use (Evans et al, 2017;Hamburger et al, 2008;Lo and Cheng, 2007), and suicidal behaviour (Dube et al, 2001;Stansfeld et al, 2017;Tunnard et al, 2014). The total lifetime estimated economic cost of child abuse is estimated at USD124 billion in the United States each year (Fang et al, 2012).…”

Un camino a la reparación psicológica de los niños con ideaciones suicidas

“…Dentro de otras situaciones que pueden ser críticas en la vida de un infante y que se relacionan con actos suicidas, están la exposición a eventos traumáticos o estresores crónicos (Campo et al, 2003;Stansfeld et al, 2017), como el maltrato y violencia infantil (Bella, 2012;Campo et al, 2003;Jiménez, Hidalgo, Camargo y Dulce, 2013;Pérez-Olmos, Rodríguez-Sandoval, Dussán-Buitrago y Ayala-Aguilera, 2007;Suárez, Restrepo, Caballero y Palacio, 2018;Zelaya de Migliorisi, et al, 2012), el abuso sexual (Bella, 2012;Campo et al, 2003;Fernández-Montalvo et al, 2019;Jiménez et al, 2013), los problemas o fracasos escolares (Pérez, 2005;Pérez-Olmos et al, 2007;Victoria et al, 2019), la muerte de algún familiar (Bella, 2012;Jiménez et al, 2013), los problemas o conflictos familiares (Guerrero-Martínez, 2016; Pérez-Olmos et al, 2007;Toro, Paniagua, González y Montoya, 2010),los problemas sentimentales y de pareja en sus figuras parentales (Fernández-Montalvo et al, 2019;Guerrero-Martínez, 2016;Jiménez et al, 2013), presencia de trastornos psiquiátricos (R. Miranda et al, 2008), situación de desplazamiento forzado (Jiménez et al, 2013) Adicionalmente, se tuvieron en cuenta las bases de datos presentadas en español o inglés, de países correspondientes a América Latina, América del Norte y Europa, que tuvieran información disponible sobre eventos de suicidio, en los grupos poblacionales de 5 a 9 años o de 10 a 14 años de edad.…”