Association between Childhood Trauma and Suicidal Behavior in the General Population

Neural indices of cognitive reappraisal impact the association between childhood trauma and suicide risk in adulthood

BACKGROUND

Childhood trauma exposure is a risk factor for suicide. However, not all trauma exposed individuals experience suicidal urges and core factors moderate this risk pathway. Individual differences in volitional emotion regulation capacity may be one key factor that shapes the association between childhood trauma and suicide; however, few studies have comprehensively investigated these associations using both subjective and objective indicators of emotion regulation. We therefore utilized a multimodal design with 80 adults reporting active suicidal urges.

METHODS

Participants completed self-report forms capturing suicidogenic cognitions and severity of suicidal ideation. Volitional cognitive reappraisal was measured using self-report and prefrontal cortex activation (PFC; i.e., ventrolateral and dorsolateral) during instructed reappraisal with functional magnetic resonance imaging.

RESULTS

Hierarchal linear regression analyses revealed evidence of childhood trauma by PFC activation interactions on suicide risk. At low levels of vlPFC activation, but not high levels, greater childhood trauma was associated with greater suicidal ideation severity and suicide cognitions. Similarly, at low levels of dlPFC activation, but not high levels, greater childhood trauma was associated with suicide cognitions.

CONCLUSION

Hypoactivation of regulatory PFC regions during volitional emotion regulation may contribute to increased suicide risk amongst individuals with a history of childhood trauma.

Further evidence for the association between childhood trauma and suicidal ideation in young individuals: A twin based study

BACKGROUND

Suicide is a major cause of death among youth. Childhood trauma (CT) has emerged as a leading environmental risk factor for suicidal ideation (SI). The present study intends to understand the association between CT and SI in a sample of twins, highlighting the relevance of CT per se, regardless of genetic vulnerability.

METHODS

Data were derived from a general population young twin study, the TwinssCan project (N = 796; mean age = 17.4). Different types of CT (physical, emotional and sexual) were explored with CTQ and SI through SCL-90-R. The discordance within twin-pairs was used to dissect the genetic and CT effects in SI.

RESULTS

Total CT and all subdomains were associated with an increased risk for SI. The within-pair differences analysis in monozygotic and dizygotic twins suggested that part of this association is not attributable to genetic predisposition, which points out the relevance of CT itself upon the increase of SI. This result converged with CT subdomain analyses of physical abuse and neglect.

LIMITATIONS

While within-pair twin analyses control for genetic risk, additional environmental shared and individual characteristics should be controlled for (such as poverty or protective factors). More detailed information on SI would be of great interest to better capture the complexity of this construct.

CONCLUSION

CT appears to be an important environmental risk factor for SI and at least partly independent of Gene-Environment correlation (rGE). This study highlights the importance of including the history of CT in psychiatric evaluations of patients. The burden of the psychosocial environment on SI could be disentangled by further research on environmental risk and protective factors.

Childhood maltreatment and suicide attempts: A prospective cohort study in Chinese middle school students

BACKGROUND

Suicide is a global public health crisis, and little evidence has focused on associations between suicide attempts and childhood maltreatment (CM) in Chinese middle school students.

OBJECTIVE

This study aimed to explore the relationship between childhood maltreatment and suicide attempts and the sex difference in Chinese middle school students.

PARTICIPANTS AND SETTING

In this prospective cohort study, students in grades 7 and 8 filled out the questionnaire at baseline and 6-month follow-up.

METHODS

Demographic data, childhood maltreatment, and suicide attempts were surveyed. Depression, anxiety, and stress were measured at baseline as covariates. Logistic regression was employed to measure the impact of childhood maltreatment and its sex differences on suicide attempts.

RESULTS

Among 782 students, 39.6 % suffered from childhood maltreatment, and the incidence rate of suicide attempts in 6 months was 4.60 % (36/782). After controlling for covariates, childhood maltreatment (adjusted odds ratio, OR = 2.899, 95%CI = 1.349-6.227) and its subtypes, physical abuse (adjusted OR = 4.077, 95%CI = 1.593-10.505) and emotional neglect (adjusted OR = 2.179, 95%CI = 1.059-4.481) were independent risk factors of suicide attempts. The association remained significant in females but not males, while no interactions between sex and childhood maltreatment were found.

CONCLUSIONS

Childhood maltreatment was prevalent in Chinese middle school students and closely associated with the incidence of suicide attempts, which provided valuable evidence for suicide prevention.

The lasting effects of childhood trauma on developing psychiatric symptoms: A population-based, large-scale comparison study

Background

Childhood trauma (CT) increases rates of psychiatric disorders and symptoms, however, the lasting effect of CT into adulthood has little exploration using large-scale samples.

Objectives

This study estimated the prevalence of CT in a large sample of Chinese young adults, examining the risk factors of current psychological symptoms among those with CT experiences.

Methods

117,769 college students were divided into CT and non-CT groups. The propensity score matching method balanced the confounding sociodemographic factors between the two groups, compared to 16 self-reported psychiatric disorders (e.g., depression, anxiety, eating disorder, obsessive-compulsive disorder, autism, social anxiety disorder, post-traumatic stress disorder), and seven current psychiatric symptoms. Hierarchical regression employed the significant risk factors of the seven current psychiatric symptoms.

Results

The prevalence of CT among young adults was 28.76% (95% CI: 28.47-29.04%). Youths with CT experiences reported higher psychiatric disorder rates and current symptom scores (P < 0.001). Sociodemographic factors (females, family disharmony, low socioeconomic status, poor relationship with parents, lower father's education level) and lifestyle factors (smoking status, alcohol consumption, lack of exercise) were significantly associated with current psychiatric symptoms.

Results

Public health departments and colleges should develop strategies to promote mental health among those who have experienced CT.

Development of a Checklist for Predicting Suicidality Based on Risk and Protective Factors: The Gwangju Checklist for Evaluation of Suicidality

OBJECTIVE

The aim of the study was to develop a checklist for mental health clinicians to predict and manage suicidality.

METHODS

A literature review of the risk and protective factors for suicide was conducted to develop a checklist for evaluating suicidality.

RESULTS

The fixed risk factors included sex (male), age (older individuals), history of childhood adversity, and a family history of suicide. Changeable risk factors included marital status (single), economic status (poverty), physical illness, history of psychiatric hospitalization, and history of suicide attempts. Recent discharge from a mental hospital and a recent history of suicide attempts were also included. Manageable risk factors included depression (history and current), alcohol problems (frequent drinking and alcohol abuse), hopelessness, agitation, impulsivity, impaired reality testing, and command hallucinations. Protective factors included responsibility to family, social support, moral objections to suicide, religiosity, motivation to get treatment, ability to cope with stress, and a healthy lifestyle. A final score was assigned based on the sum of the risk and protective factor scores.

CONCLUSION

We believe that the development of this checklist will help mental health clinicians to better assess those at risk for suicidal behavior. Further studies are necessary to validate the checklist.