Exposure to physical and sexual violence and suicidal ideation among schoolchildren

Abstract

Objective: The purpose of this study was to estimate the association between exposure to physical and sexual violence, and suicidal ideation in Brazilian Schoolchildren, accounting for confounding variables of religious practice, and problems with alcohol and other drugs. Methods: This study consists of a cross-sectional analytical approach of a larger school-based study conducted in 2012 in two medium-sized municipalities in south of Brazil. Participants were 3,547 students aging 12 to 17 years old who answered an assembled questionnaire. Descriptive and Logistic Regression analyses were conducted with suicide ideation outcome testing prediction models stratified by sex. Results: Suicide ideation prevalence in the sample was of 21.7%, and regression analysis indicated that girls and boys exposed to physical or sexual violence had 3.42 and 3.14 times more probability of referring suicidal ideation in the past 30 days. Adjusted analyses showed little interference of religious practice, while problems with alcohol and other drugs seemed to also explain suicidal ideation in the sample. Conclusion: We highlight the importance of future longitudinal studies to investigate the mechanisms through which exposure to physical or sexual abuse influence suicidal ideation among boys and girls, as well as mediation studies that could enlighten the role of drug and alcohol use in this relationship. RESUMOObjetivo: O objetivo deste estudo foi estimar a associação entre exposição à violência física e sexual e ideação suicida em escolares brasileiros, controlando para variáveis relacionadas a prática religiosa e problemas com álcool e outras drogas. Métodos: Este estudo consiste de um recorte transversal de um estudo maior realizado em 2012 em dois municípios de médio porte no sul do Brasil. No total, 3.547 alunos de 12 a 17 anos responderam a um questionário desenvolvido para o estudo em questão. Análises descritivas e de regressão logística foram conduzidas testando modelos preditores de ideação suicida estratrificados por sexo. Resultados: A prevalência de ideação suicida na amostra foi de 21,7% e a análise de regressão indicou que meninas e meninos expostos à violência física ou sexual tinham 3,42 e 3,14 vezes mais probabilidade de referir ideação suicida nos últimos 30 dias. As análises ajustadas mostraram pouca interferência da prática religiosa, enquanto problemas com álcool e outras Violence exposure and suicidal ideation drogas também parecem explicar ideação suicida na amostra. Conclusão: Destacamos a importância de futuros estudos longitudinais para investigar os mecanismos por meio dos quais a exposição ao abuso físico ou sexual influencia a ideação suicida em meninos e meninas, bem como estudos de mediação que possam esclarecer o papel do uso de drogas e álcool nessa relação. Palavras-chaveIdeação suicida, comportamento adolescente, abuso infantil.

Association of Childhood Maltreatment With Suicide Behaviors Among Young People

“…However, an additional 328 studies were excluded because they did not meet the inclusion criteria for this review. This process left 79 individual studies eligible for inclusion based on 337 185 unique young individuals (1 study contained a mixed sample with adults older than 24 years; this study was excluded from the overall sample calculation) (Figure and eTable in the Supplement). The mean (SD) age of the participants was 15.67 (2.11) years, with those identifying as female constituting most of the sample (63.19% vs 36.81% male).…”

“…Sexual abuse was associated with 2.5-fold increased odds for suicide ideation (33 studies 35,36,38,41,42,45,46,[48][49][50][51]53,55,61,65,67,69,[76][77][78]83,85,[92][93][94][95]101,103,104,106,107,109,110 Seven individual studies explored the link between sexual abuse and suicide plans in children and young people. The pooled OR indicated that sexual abuse was associated with 4-fold increased odds for suicide plans (7 studies 38,42,44,55,65,76,77 ; OR, 4.12; 95% CI, 2.44-6.95; I 2 = 77.4%), and heterogeneity was high.…”

“…Results of Meta-analyses of the Association Between Forms of Childhood Maltreatment and Suicide Behaviors in YouthSexual abuse was associated with 2.5-fold increased odds for suicide ideation (33 studies35,36,38,41,42,45,46,[48][49][50][51]53,55,61,65,67,69,[76][77][78]83,85,[92][93][94][95]101,103,104,106,107,109,110 ; OR, 2.46; 95% CI, 2.08-2.90; I 2 = 94.6%), and heterogeneity was high. Physical abuse (23 studies35,45,46,48,51,55,64,67,[69][70][71]78,83,85,[91][92][93]95,98,103,104,107,…”

“…; OR, 2.46; 95% CI, 2.08-2.90; I 2 = 94.6%), and heterogeneity was high. Physical abuse (23 studies35,45,46,48,51,55,64,67,[69][70][71]78,83,85,[91][92][93]95,98,103,104,107,109 ; OR, 1.95; 95% CI, 1.67-2.27; I 2 = 81.9%), emotional abuse (7 studies35,45,72,78,79,104,109 ; OR, 1.82; 95% CI, 1.47-2.25; I 2 = 88.0%), and overall child abuse (7 studies39,58,59,65,69,96,99 ; OR, 2.36; 95% CI, 1.98-2.82; I 2 = 0.0%) were associated with approximately 2-fold increased odds for suicide ideation, but heterogeneity was high or the number of studies was low in this analysis (funnel plots are shown in eFigure 13 in the Supplement).…”

Self-esteem, posttraumatic stress disorder and suicidal ideation among victims of sexual violence

“…Alix et al, 39 found that self-blame and shame were both found to be predictors of PTSD, depressive symptoms and suicidal ideation among sexually abused children and adults. Similarly, 40 reported that girls and boys exposed to physical or sexual violence had 3.42 and 3.14 times more probability of referring suicidal ideation in the past 30 days. High rates of suicidal behaviour have been consistently reported among PTSD patients exposed to combat trauma, physical/sexual abuse, intimate partner violence, natural disasters or a mixture of different traumatic events 41 traumatic events such as childhood abuse increase a person's suicide risk.…”