Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-23T10:55:40.163Z Has data issue: false hasContentIssue false
  • English
  • Français

More than words: The association of childhood emotional abuse and suicidal behavior

Published online by Cambridge University Press:  23 March 2020

R.M.F. de Araújo  and
D.R. Lara
R.M.F. de Araújo*
Affiliation:
Faculty of Biosciences, Medicine, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga 6681, Pd 12APorto Alegre, RS90619-900, Brazil
D.R. Lara
Affiliation:
Faculty of Biosciences, Medicine, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga 6681, Pd 12APorto Alegre, RS90619-900, Brazil
*
* Corresponding author.Faculdade de Biociências, PUCRS, Av. Ipiranga, 6681, Pd12A, Porto Alegre, RS 90619-900, Brazil. Fax: +55 51 9316 5810. E-mail address:rmpsiquiatria@gmail.com (R.M.F. de Araüjo).
Get access

Abstract

Background

All types of abuse and neglect have been associated with suicide attempts. However, the association between the level of each type of childhood trauma and suicidal behavior severity (including the progression from ideation to attempts), adjusting for their co-occurrence, is not yet clear.

Methods

We used a cross-sectional web-based survey collected from the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) to investigate the isolated effects of each type of childhood trauma on suicidal behavior severity. The sample consisted of 71,429 self-selected volunteers assessed with the Childhood Trauma Questionnaire (CTQ) and the following key question: “Have you ever thought about or attempted to kill yourself?” (Suicidal Behavior Questionnaire, SBQ-17).

Results

After adjusting for demographic variables, and childhood trauma subtypes, severe emotional abuse (EA) was associated with suicidal ideation and attempts, mainly for serious suicide attempts (OR, 22.71; 95% CI, 2.32–222.05). We found associations of smaller magnitude for severe emotional neglect (EN) with serious suicide attempts, and for severe physical neglect (PN) and sexual abuse (SA) with attempts without really meaning to die. No meaningful trend for physical abuse (PA) was found. Using as reference group ideators, EA was associated with serious suicide attempts, with a peak at the 95th percentile (OR, 4.39; 95% CI, 2.04–9.41). We found associations of smaller magnitude for PN and SA, and no meaningful trend for EN and PA.

Conclusions

Suicidal behavior was strongly associated with emotional abuse in childhood, even when compared with ideators, suggesting that it is a relevant factor for the progression from ideation to attempts.

Keywords

SuicideChild abuseViolenceMiscellaneous
Type
Original article
Information
European Psychiatry , Volume 37 , September 2016 , pp. 14 - 21
Copyright
Copyright © European Psychiatric Association 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization, Suicide data 2014 http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/ [accessed November 15, 2014]Google Scholar
Schmidtke, ABille-Brahe, UDeleo, DAttempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand 1996; 93: 327–338CrossRefGoogle ScholarPubMed
Bertolote, JFleischmann, AA global perspective in the epidemiology of suicide. Suicidologia 2002; 7: 6–9Google Scholar
Beghi, MRosenbaum, JRisk factors for fatal and nonfatal repetition of suicide attempt: a critical appraisal. Curr Opin Psychiatry 2010; 23: 349–355CrossRefGoogle Scholar
Araújo, RMDe, Mazzochi, LLara, DROttoni, GLThinking about dying and trying and intending to die: results on suicidal behavior from a large web-based sample. J Clin Psychiatry 76 2015 e359–e365 10.4088/JCP.13m08864CrossRefGoogle ScholarPubMed
O’Connor, RCSmyth, RFerguson, ERyan, CWilliams, JMGPsychological processes and repeat suicidal behavior: a four-year prospective study. J Consult Clin Psychol 2013; 81: 1137–1143CrossRefGoogle ScholarPubMed
Nock, MKBorges, GBromet, EJAlonso, JAngermeyer, MBeautrais, Aet al.Cross-national prevalence and risk factors for suicidal ideation, plans and attempts Br J Psychiatry 2008; 192: 98–105CrossRefGoogle ScholarPubMed
Nock, MKBorges, GBromet, EJCha, CBRonald, CLee, SSuicide and suicidal behavior. Epidemiol Rev 2008; 30: 133–154CrossRefGoogle ScholarPubMed
Klonsky, EDMay, AMDifferentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. Suicide Life Threat Behav 2014; 44: 1–5CrossRefGoogle ScholarPubMed
ten Have, Mde Graaf, Rvan Dorsselaer, SVerdurmen, JLand, Hvan’t Vollebergh, Wet al.Incidence and course of suicidal ideation and suicide attempts in the general population Can J Psychiatry 2009; 54: 824–833CrossRefGoogle ScholarPubMed
Klonsky, EDMay, AMSaffer, BYSuicide, suicide attempts, and suicidal ideation. Annu Rev Clin Psychol 12 2016 14.1–14.24 10.1146/annurev-clinpsy-021815-093204CrossRefGoogle ScholarPubMed
Van Orden, KAWitte, TKCukrowicz, KCBraithwaite, SSelby, EAThe interpersonal theory of suicide. Psychol Rev 2011; 117: 575–600CrossRefGoogle Scholar
O’Connor, RCNock, MKThe psychology of suicidal behaviour. Lancet Psychiatry 2014; 0366: 1–13http://dx.doi.org/10.1016/S2215-0366(14)70222-6Google Scholar
Klonsky, EDMay, AMThe three-step theory (3ST): a new theory of suicide rooted in the “ideation-to-action” framework. Int J Cogn Ther 2015; 8: 114–129CrossRefGoogle Scholar
Goldsmith, SKPellmar, TCKleinman, AMBunney, WEReducing Suicide:, A National Imperative Washington, DC: The National Academies Press; 2002Google Scholar
Gilbert, RWidom, CSBrowne, KFergusson, DWebb, EJanson, SBurden and consequences of child maltreatment in high-income countries. Lancet 2009; 373: 68–81CrossRefGoogle ScholarPubMed
Norman, REByambaa, MDe, RButchart, AScott, JVos, TThe long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis PLoS Med 2012 9http://dx.doi.org/ 10.1371/journal.pmed.1001349.CrossRefGoogle Scholar
Stoltenborgh, MBakermans-Kranenburg, MJvan Ijzendoorn, MHThe neglect of child neglect: a meta-analytic review of the prevalence of neglect. Soc Psychiatry Psychiatr Epidemiol 2013; 48: 345–355CrossRefGoogle ScholarPubMed
Child maltreatment: prevalence, incidence and consequences in the East Asia and Pacific Region: a systematic review of research Bangkok United Nations Children’s Fund 2012Google Scholar
Dube, SRAnda, RFFelitti, VJChapman, DPWilliamson, DFGiles, WHChildhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the adverse childhood experiences study. JAMA 2001; 286: 3089–3096CrossRefGoogle ScholarPubMed
Sarchiapone, MJaussent, IRoy, ACarli, VGuillaume, SJollant, Fet al.Childhood trauma as a correlative factor of suicidal behavior – via aggression traits. Similar results in an Italian and in a French sample Eur Psychiatry 2009; 24: 57–62CrossRefGoogle Scholar
Grassi-Oliveira, RCogo-Moreira, HSalum, GABrietzke, EViola, TWManfro, GGet al.Childhood Trauma Questionnaire (CTQ) in Brazilian samples of different age groups: findings from confirmatory factor analysis. PLoS One 9 2014 e87118 10.1371/journal.pone.0087118CrossRefGoogle ScholarPubMed
Jeon, HJLee, CFava, MMischoulon, DShim, E.-J.Heo, J.-Y.et al.Childhood trauma, parental death, and their co-occurrence in relation to current suicidality risk in adults J Nerv Ment Dis 2014; 202: 870–876CrossRefGoogle ScholarPubMed
Sudbrack, RManfro, PHKuhn, IMde Carvalho, HWLara, DRWhat doesn’t kill you makes you stronger and weaker: how childhood trauma relates to temperament traits J Psychiatr Res 2015 1–7http://dx.doi.org/10.1016/j.jpsychires.2015.01.001CrossRefGoogle Scholar
Lara, DROttoni, GLBrunstein, MGFrozi, Jde Carvalho, HWBisol, LWDevelopment and validity data of the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). J Affect Disord 2012; 141: 390–398CrossRefGoogle Scholar
Turner, CFKu, LRogers, SMLindberg, LDPleck, JHSonenstein, FLAdolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science 1998; 280: 867–873CrossRefGoogle ScholarPubMed
Addis, MLinehan, MMPredicting suicidal behavior: psychometric properties of the Suicidal Behaviors Questionnaire – Suicidal Behavior Questionnaire (SBQ-17)Poster presented at the Annual Meeting of the Association for the Advancement Behavior Therapy Washington, D.C. 1989 Copyright 1996 by MM Linehan. http://depts.washington.edu/brtc/files/SBQ-18%204%20Month.pdf [acessed October 15, 2010]Google Scholar
Cotton, CPeters, DKRange, LPsychometric properties of the suicidal behaviors questionnaire. Death Stud 1995; 19: 391–397CrossRefGoogle ScholarPubMed
Grassi-Oliveira, RStein, LMPezzi, JCTradução e validação de conteúdo da versão em português do Childhood Trauma Questionnaire. Rev Saude Publica 2006; 40: 249–255CrossRefGoogle Scholar
Mazar, NAriely, DDishonesty in everyday life and its policy implications. J Public Policy Mark 25 2006 [1–000]Google Scholar
Kornstein, SGYoung, EAHarvey, ATWisniewski, SRBarkin, JLThase, MEet al.The influence of menopausal status and postmenopausal use of hormone therapy on presentation of major depression in women Menopause 2013; 18: 1199–1216Google Scholar
Bernstein, DPFink, LHandelsman, LFoote, JLovejoy, MWenzel, Ket al.Initial reliability and validity of a new retrospective measure of child abuse and neglect Am J Psychiatry 1994; 151: 1132–1136Google ScholarPubMed
Bernstein, DPStein, JNewcomb, AWalker, MDPogge, EAhluvalia, DTet al.Development and validation of a brief screening version of the Childhood Trauma Questionnaire Child Abus Negl 2003; 27: 169–190CrossRefGoogle ScholarPubMed
Bernstein, DFink, LChildhood trauma questionnaire: a retrospective self-report The Psychological Corporation: San Antonio, TX; 1998Google Scholar
Myers, RClassical and modern regression with applications 2nd ed.Boston, MA: Duxbury; 1990Google Scholar
SM Applied logistic regression analysis Sage university paper series on quantitative applications in the social sciences1995 Thousand Oaks CA: SageGoogle Scholar
Jeon, HJRoh, MSKim, KHLee, JRLee, DYoon, SCet al.Early trauma and lifetime suicidal behavior in a nationwide sample of Korean medical students. J Affect Disord 2009; 119: 210–214CrossRefGoogle Scholar
McKenna ÁE, Gillen, AMCDirect and indirect effects of maltreatment typologies on suicidality in a representative Northern Irish sample: psychopathology only partially mediates the relationship. J Psychiatr Res 2016; 72: 82–90CrossRefGoogle Scholar
Li, XWang, ZHou, YWang, YLiu, JWang, CEffects of childhood trauma on personality in a sample of Chinese adolescents. Child Abuse Negl 2014; 38: 788–796CrossRefGoogle Scholar
Crow, TCross, DPowers, ABradley, BEmotion dysregulation as a mediator between childhood emotional abuse and current depression in a low-income. Child Abuse Negl 2014; 38: 1590–1598CrossRefGoogle Scholar
Hovens, J.G.F.M.Giltay, EJSpinhoven, Pvan Hemert, AMPenninx, B.W.J.H.Impact of childhood life events and childhood trauma on the onset and recurrence of depressive and anxiety disorders. J Clin Psychiatry 2015; 76: 1–8http://dx.doi.org/10.4088/JCP.14m09135CrossRefGoogle ScholarPubMed
Springer, KWSheridan, JKuo, DCarnes, MLong-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women. Child Abus Negl 2007; 31: 517–530CrossRefGoogle ScholarPubMed
Devries, KMMak, JYTChild, JCFalder, GBacchus, LJAstbury, Jet al.Childhood sexual abuse and suicidal behavior: a meta-analysis. Pediatrics 133 2014 e1331 10.1542/peds.2013-2166CrossRefGoogle ScholarPubMed
Barbosa, LPQuevedo, Lda Silva, GDGJansen, KPinheiro, RTBranco, Jet al.Childhood trauma and suicide risk in a sample of young individuals aged 14–35 years in southern Brazil. Child Abus Negl 2014; 38: 1191–1196CrossRefGoogle Scholar
Harford, TCYi, HYGrant, BFAssociations between childhood abuse and interpersonal aggression and suicide attempt among US adults in a national study. Child Abus Negl 2014; 38: 1389–1398CrossRefGoogle Scholar
Lee, M.-A.Emotional abuse in childhood and suicidality: the mediating roles of re-victimization and depressive symptoms in adulthood. Child Abuse Negl 2015 http://dx.doi.org/10.1016/j.chiabu.2015.03.016CrossRefGoogle Scholar
Grunebaum, MFSuicidology meets “Big Data”. J Clin Psychiatry 76 2015 e383–e384 10.4088/JCP.14com09421CrossRefGoogle ScholarPubMed
Teicher, MHParigger, AThe “Maltreatment and Abuse Chronology of Exposure” (MACE) Scale for the retrospective assessment of abuse and neglect during development. PLoS One 10 2015 e0117423 10.1371/journal.pone.0117423CrossRefGoogle ScholarPubMed
Lupien, SJMcewen, BSGunnar, MRHeim, CEffects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev 2009; 10: 434–445CrossRefGoogle ScholarPubMed
Botega, NJBerti, MBarros, DAOliveira, HBDe Dalgalarrondo, PSuicidal behavior in the community: prevalence and factors associated with suicidal ideation. Rev Bras Psiquiatr 2005; 27: 45–53CrossRefGoogle ScholarPubMed
Viana, MCAndrade, LHLifetime prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the São Paulo Metropolitan area, Brazil: results from the São Paulo Megacity Mental Health Survey. Rev Bras Psiquiatr 2012; 34: 249–260CrossRefGoogle Scholar
Millner, AJLee, MDNock, MKSingle-item measurement of suicidal behaviors: validity and consequences of misclassification. PLoS One 2015; 10: 1–17http://dx.doi.org/10.1371/journal.pone.0141606CrossRefGoogle ScholarPubMed
Posner, KBrown, GKStanley, BBrent, DAYershova, KVOquendo, MAet al.The Columbia–Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 2011; 168: 1266–1277CrossRefGoogle ScholarPubMed
Nock, MHolmberg, EPhotos, VMichel, BSelf-injurious thoughts and behaviors interview: development, reliability, and validity in an adolescent sample. Psychol Assess 2007; 19: 309–317CrossRefGoogle Scholar
Shapiro, FThe role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. Perm J 2014; 18: 71–77CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.