Direct and indirect effects of maltreatment typologies on suicidality in a representative Northern Irish sample: Psychopathology only partially mediates the relationship
Graphical abstract
Section snippets
Materials and methods
The survey was conducted in accordance with the latest version of the Declaration of Helsinki and the study design was approved by the ethical committee at Ulster University. Informed consent of the survey participants was obtained after the nature of the procedures had been fully outlined.
Associations between exposures to maltreatment, parental maladjustment, civil conflict, psychiatric diagnoses and suicidality
The results of the regression analyses are detailed in Table 1. To begin with, the strong association between suicidality and sexual molestation was mainly consistent with previous reports (McHolm et al., 2003, Molnar et al., 2001, Ogata et al., 1990). The non-significant association between suicidality and exposures to rape and physical abuse are dissonant with the findings of Joiner and colleagues (2007), where rape and physical abuse were reported to be the strongest risk factors for suicide
Role of funding source
The survey was carried out in conjunction with the World Health Organization WMH Survey Initiative, which is supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline,
Conflicts of interest
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Author contributions
Both authors devised the theoretical rationale and conducted the literature review for this study. Dr McKenna conducted the analysis, wrote the first draft of the manuscript and revised the manuscript after the initial peer review process. Dr Gillen edited and revised the manuscript and completed the reference section.
Acknowledgements
I would like to thank (1) the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation and fieldwork; (2) Professor Brendan Bunting (PI on NISHS), Professor Siobhan O′ Neill and Dr Samuel Murphy (co-ordinators of NISHS based at Ulster University) for providing the data for this research project; (3) Dr. Finola Ferry who coded the conflict trauma variable; (4) Dr. Liam Mahedy from Cardiff University who was involved in the initial coding of the
References (64)
- et al.
The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction
Child Abuse Negl.
(2004) - et al.
Childhood physical and sexual abuse and lifetime number of suicide attempts: a persistent and theoretically important relationship
Behav. Res. Ther.
(2007) - et al.
Six year follow-up of a clinical sample of self-harm patients
J. Affect. Disord.
(2010) - et al.
Identification of child maltreatment with the parent-child conflict sample of American parents
Child Abuse Negl.
(1998) Factor analysis and the AIC
Psychometrika
(1987)- et al.
Additive impact of childhood emotional, physical, and sexual abuse on suicide attempts among low-income African American women
Suicide Life-Threat. Behav.
(2002) - et al.
The family history method using diagnostic criteria: reliability and validity
Arch. Gen. Psychiatry
(1977) Diagnostic and Statistical Manual of Mental Disorders
(1994)- et al.
Multigenerational perspectives on coping with the Holocaust experience: an attachment perspective for understanding the developmental sequalae of trauma across generations
Int. J. Behav. Dev.
(1998) Variations in risk and treatment factors among adolescents engaging in different types of deliberate self-harm in an inpatient sample
J. Clin. Child Adolesc. Psychol.
(2010)
Risk factors for suicide in psychiatric outpatients: a 20-year prospective study
J. Consult. Clin. Psychol.
Childhood adversities as risk factors for onset and persistence of suicidal behaviour
Br. J. Psychiatry
Trauma associated with civil conflict and posttraumatic stress disorder: evidence from the Northern Ireland Study of Health and Stress
J. Trauma. Stress
Lifetime prevalence of health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress
Psychol. Med.
Children and Political Violence Children and Political Violence
Suicide attempts versus nonsuicidal self-injury among individuals with anxiety disorders in a nationally representative sample
Depress. Anxiety
Annual research review: resilient functioning in maltreated children – past, present, and future perspectives
J. Child Psychol. Psychiatry
The ISTSS expert consensus treatment guidelines for complex PTSD in adults
Longitudinal pathways between political violence and child adjustment: the role of emotional security about the community in Northern Ireland
J. Abnorm. Child Psychol.
Suicide and deliberate self harm in older Irish adults
Int. Psychogeriatrics
Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span. Findings from the Adverse Childhood Experiences Study
J. Am. Med. Assoc.
Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study
Pediatrics
Childhood adversities and risk for suicidal ideation and attempts: a longitudinal population-based study
Psychol. Med.
Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) I: associations with first onset of DSM-IV disorders
Arch. Gen. Psychiatry
Childhood adversities and suicide attempts: a retrospective study
J. Fam. Violence
Transgenerational transmission of war-related trauma
Repetition of deliberate self-harm: a study of the characteristics and subsequent deaths in patients presenting to a general hospital according to extent of repetition
Suicide & Life-Threatening Behav.
How often does deliberate self-harm occur relative to each suicide? A study of variations by gender and age
Suicide & Life-Threatening Behav.
IBM SPSS Statistics for Windows, Version 22.0
Why People Die by Suicide
Four studies on how past and current suicidality relate even when “everything but the kitchen sink” is covaried
J. Abnorm. Psychol.
Mental disorders and war in Lebanon
Cited by (9)
Childhood maltreatment, psychiatric symptoms, and suicidal thoughts among adolescents receiving substance use treatment services
2021, Journal of AdolescenceCitation Excerpt :Second, internalizing and externalizing paths from childhood maltreatment to suicidal thoughts via adolescent psychopathology (i.e., anxiety, mood and conduct disorder symptoms) are modeled simultaneously to evaluate the specificity of these pathways. In some studies (e.g., Miller et al., 2016) a specific emotional maltreatment-depressive symptom pathway has been described while in other studies the presence of any psychopathology has been identified as a partial mediator of relations between childhood maltreatment and suicidal thoughts (McKenna & Gillen, 2016). Third, the present study assessed differences in the direct and indirect paths between childhood maltreatment and suicidal thoughts across gender groups, in order to document if gender differences noted previously (Rhodes et al., 2014) could be replicated in a sample of adolescents receiving substance use treatment services.
Suicide in Northern Ireland: epidemiology, risk factors, and prevention
2020, The Lancet PsychiatryCitation Excerpt :These coping strategies then have a protective role against the effects of stress.37 Maltreatment was also associated with suicidal behaviour, which was common in Northern Ireland.38 Parental mental illness and sexual abuse accounted for the highest proportions of mental illness and suicidal behaviour.39
Childhood neglect and suicidal behavior: Findings from the National Comorbidity Survey Replication
2020, Child Abuse and NeglectCitation Excerpt :In particular, going unsupervised was associated with all forms of suicidal behavior while lacking medical care was linked to both suicidal ideation and suicide attempts. Although some previous studies have found that childhood neglect or some of its forms are not associated with suicidal behavior (Brown et al., 1999; McKenna & Gillen, 2016; Ramiro, Madrid, & Brown, 2010), that the association may vary across settings (Borges et al., 2010), or that neglect has an indirect effect on suicidal behavior (Bahk, Jang, Choi, & Lee, 2017), our finding that any/greater neglect was associated with all forms of suicidal behavior accords with the results of an earlier systematic review and meta-analysis, which stated that there was robust evidence that childhood neglect was associated with suicidal behavior (attempts) (Norman et al., 2012). It is also in line with the findings from a recent study by Vanderminden et al. (2019) where all forms of lifetime and past year neglect were associated with youth suicidal ideation in a model that was adjusted for demographic covariates.
The relationships between father involvement and parental acceptance on the psychological adjustment of children and adolescents: The moderating effects of clinical status
2017, Psychiatry ResearchCitation Excerpt :The clinical status of a child´s psychological problems more severely affects the individual's behavior on a psychological, social or emotional level. Moreover, the presence of a clinical condition is associated with greater psychological discomfort and a poorer quality of life for the child that suffers from it (Kandemir et al., 2014; McKenna and Gillen, 2016). Accordingly, it is important to explore the effects of any clinical condition when examining such psychopathologies (i.e.: internalizing and externalizing problems) in children and adolescents (Ciciolla et al., 2014; De Bolle et al., 2010).
More than words: The association of childhood emotional abuse and suicidal behavior
2016, European PsychiatryCitation Excerpt :This is important as the correlation between them is robust, mainly between physical abuse, emotional abuse and emotional neglect [22]. The minimal association of physical abuse with lifetime suicidal attempt is consistent with the findings by Jeon et al. [37] and McKenna et al. [38]. Moreover, when adjusting for other types of maltreatment, childhood physical abuse is negatively associated with neuroticism [39], fear, sensitivity and anxiety traits, and positively associated with volition and mature coping, especially in men [24].
Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis
2019, Psychological Medicine