Child abuse and suicidality in the context of the Interpersonal Psychological Theory of Suicide: A network analysis

Abstract

Objectives While there is evidence for an association of child abuse with suicidality in the course of life, the underlying mechanisms remain unclear. The Interpersonal Psychological Theory of Suicide (IPTS) provides a theoretical framework to investigate this relationship. The present study examines how different subtypes of child abuse are related to suicidal ideation and to attempts in the context of the IPTS. Methods 146 psychiatric inpatients (M = 37.9 years, 62% female) with an acute suicidal crisis (n = 71) or a recent suicide attempt (n = 74) were examined at baseline (T0) and six (T1) months later. We measured emotional, physical, and sexual abuse, the constructs of the IPTS (thwarted belongingness, perceived burdensomeness, and capability for suicide) and suicidal ideation as well as suicide attempts. Using the statistics program R, a network analysis of all named constructs was conducted. Centrality measures were computed. Results Emotional abuse was the most central kind of abuse in the network and had a direct relationship with suicide attempts and an indirect relationship with suicidal ideation via perceived burdensomeness. Physical and sexual abuse showed no significant relations with the different constructs of the IPTS. Conclusion The major limitation of this study was the modest sample size which reduced the number of variables able to be included in the network. Regarding child abuse, the results underline that emotional abuse plays a central role in this network and may be important for suicide risk assessment. Future research should address this topic in a larger sample. Practitioner points Emotional abuse was the most central kind of abuse in this network analysis. Sexual abuse was the only kind of abuse with a direct relation to suicidal ideation. Capability for suicide had just a marginal position in the network analysis. Early interventions addressing the effects of child abuse are recommended. Replications in larger samples and with more relevant variables are needed.

Seeing the past in a new light: Change in reports of childhood abuse and neglect before and after inpatient psychotherapy and its relevance for change in depression symptoms (Postprint)

“…The present findings expand previous evidence of stronger overall associations between depression and emotional abuse (Krakau et al, 2021;Negele et al, 2015). They are also in line with previous network investigations underscoring the centrality of emotional abuse experiences within other contexts, such as suicidal crises (Schönfelder et al, 2021).…”

Suicidal behaviour in the social environment: Does exposure moderate the relationship between an individual's own suicidal ideation and behaviour?

“…This study analysed data from a prospective multicentre study, longitudinally investigating predictors of suicidal ideation and behaviour over the course of 12 months. Further results from this study can be found elsewhere (Forkmann et al, 2020, b;furthermore: Brailovskaia et al, 2019;Höller et al, 2020Höller et al, , 2021Lucht et al, 2020;Paashaus et al, 2019Paashaus et al, , 2020Paashaus et al, , 2021Rath, Teismann, Hoeller, et al, 2021;Rath, Teismann, Schmitz, et al, 2021;Schönfelder et al, 2020Schönfelder et al, , 2021Teismann et al, 2021;Wannemueller et al, 2020). In the current examination, only data from the first assessment (T 0 ) were analysed.…”

Direct and Indirect Effects of Child Maltreatment on Suicidal Ideation among Chinese Left-Behind Children: Does Gender Make a Difference?

“…Contrastingly, research in Brazil demonstrated contradictory findings that emotional neglect is directly associated with suicidal ideation; however, physical neglect and sexual abuse are not [ 21 ]. In a German network analysis, sexual abuse is the only sub-type of abuse directly related to suicidal ideation [ 22 ], whereas a recent meta-analysis shows that physical abuse has the strongest effect on suicidal ideation [ 23 ]. Compared with non-left-behind children, the left-behind children reported a high risk of suicidal ideation if they ever suffered any type of maltreatment [ 24 ].…”