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Favina A, Abaatyo J, Kaggwa MM. Dual harm among patients attending a mental health unit in Uganda: a hospital based retrospective study. BMC Psychiatry 2024; 24:154. [PMID: 38388864 PMCID: PMC10885504 DOI: 10.1186/s12888-024-05560-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Dual harm encompasses the complex interplay of the co-occurrence of self-harm and aggression. Individuals with dual harm may display a more hazardous pattern of harmful behaviors like homicide-suicide compared to people with sole harm. This study aimed to examine the presence of dual harm among general psychiatry inpatients in a mental health unit in Uganda. METHODS A retrospective chart review of 3098 inpatients from January 2018 to December 2021. Dual harm reported experience at admission was based on experiences of self-harm with harm to people or property or both. Logistic regression assessed the association between dual harm and sociodemographics and clinical characteristics. RESULTS A total of 29 (1%) patients experienced dual harm, with five having experienced self-harm with both harm to others and property, 23 with harm to people, and one with harm to property. Dual harm was statistically significantly associated with the male gender at bivariate analysis. However, there were no statistically significant factors associated with dual harm at multivariate analysis or sensitivity analysis with the specific types of dual harm. CONCLUSION General psychiatry inpatients in Uganda experience dual harm before admission at lower prevalence than in previous literature. However, no investigated sociodemographic and clinical factors could explain these experiences. Further studies looking at dual harm are warranted to understand these unfortunate experiences with serious consequences among patients in Uganda.
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Affiliation(s)
- Alain Favina
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joan Abaatyo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.
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Rabbany JM, Ellis S, Metts A, Burke A, Brent DA, Melhem N, Marcott S, Mann JJ. Mood Disorders and Aggressive Traits Mediate Effects of Reported Childhood Adversity on Suicide Attempt Risk. Arch Suicide Res 2023; 27:1207-1230. [PMID: 36052407 DOI: 10.1080/13811118.2022.2112118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Childhood adversity (CA) is linked to suicidal behavior as well as to mood disorders and aggressive traits. This raises the possibility that depression and aggressive traits mediate the relationship of childhood adversity to suicide risk. Moreover, it is not known if they operate independently or interactively. AIMS To determine whether, and how, mood disorders and aggressive traits mediate the effects of reported physical and sexual abuse on future suicidal behavior. METHODS Five hundred and forty-eight subjects, offspring of parents with mood disorders, were interviewed at baseline and at yearly follow-ups with questionnaires assessing aggression, mood disorders, and suicidal behavior. The mediation analysis involved a three-step process, testing the relationships between (1) CA and attempt; (2) CA and putative mediators; and (3) putative mediators and suicide attempt, adjusting for CA. RESULTS Aggressive trait severity and mood disorder onset each mediated the relationship between CA and future suicide attempts. Greater aggression severity also raised the hazard of the development of a mood disorder. If aggressive trait severity was clearly elevated, then onset of mood disorder did not increase further the hazard of the suicide attempt. Including family as a random effect had a much bigger effect on attempt outcome for physical abuse compared with sexual abuse. CONCLUSIONS Amelioration of aggressive traits and treatment of mood disorders in CA-exposed offspring of a parent with a mood disorder may prevent future suicide attempts and may reduce the risk of mood disorder. Familial factors influence the impact of childhood physical abuse but not sexual abuse. HIGHLIGHTSChildhood Adversity (CA) predicted future mood disorder and aggression severity.Depression and aggression mediate the relationship between CA and suicide attempts.When one mediator is present, the presence of the other does not increase the hazard.Between family variation contributed much more to suicidal behavior outcomes relative to the effect of physical abuse, but sexual abuse contributed to suicidal outcomes more than family variation.
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3
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Early life stress, depression and epigenetics. VITAMINS AND HORMONES 2023; 122:307-337. [PMID: 36863799 DOI: 10.1016/bs.vh.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Different factors are essential in increasing the vulnerability to psychiatric disorders, such as genetics. Among these factors, early life stress (ELS), including sexual, physical, emotional abuse, and emotional and physical neglect, enhances the odds of having menial conditions throughout life. Exhaustive research has shown that ELS leads to physiological changes, such as alteration in the HPA axis. During the most critical development period (childhood and adolescence), these changes increase the risk of having child-onset psychiatric disorders. Furthermore, research has suggested a relationship between early life stress and depression, particularly more prolonged episodes of depression with treatment-resistant outcomes. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders is polygenic, multifactorial and highly complex, with innumerable low-effect genetic variants interacting with each other. However, whether there are independent effects among subtypes of ELS remains unclear. This article provides an overview of the interplay of epigenetics, the HPA axis, early life stress and the development of depression. Advances in our knowledge of epigenetics in the context of early life stress and depression provide a new understanding of the genetic influence on psychopathology. Furthermore, they could lead to identifying new targets for clinical intervention.
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4
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Alexithymia and depressive symptoms mediated the relationship between childhood trauma and suicidal risk in Chinese male prisoners. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03975-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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5
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Screening for ADHD Symptoms among Criminal Offenders: Exploring the Association with Clinical Features. Healthcare (Basel) 2022; 10:healthcare10020180. [PMID: 35206795 PMCID: PMC8872480 DOI: 10.3390/healthcare10020180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is a disabling disorder. High rates of ADHD have been consistently reported among prisoners. The main objectives were (1) to estimate the prevalence of ADHD symptoms in a sample of male inmates and (2) to investigate the relationship between ADHD symptoms and socio-demographic/clinical features. According to the high prevalence of childhood trauma among inmates, we assessed whether exposition to childhood trauma can be related to the presence of ADHD symptoms. Methods: A total of 159 male prisoners admitted to Monza prison between January 2020 and June 2021 were included. Both Wender Utah ADHD rating scale and adult ADHD self-report scale were administered to assess ADHD symptoms. Moreover, inmates completed the childhood trauma questionnaire. Results: Data were available for 108 inmates. Thirty-five prisoners (32.4%) were found on screening to meet the criteria for symptoms of ADHD. Cocaine use disorder, prescription of mood stabilizers and a history of emotional abuse significantly increased the likelihood of having clinically significant ADHD symptoms. Furthermore, patients who experienced physical neglect resulted in meeting the criteria for ADHD symptoms. Conclusions: ADHD symptoms are widespread among inmates and are associated with specific risk factors. Screening for ADHD should be done to provide appropriate intervention strategies.
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Icick R, Karsinti E, Brousse G, Chrétienneau C, Trabut JB, Belforte B, Coeuru P, Moisan D, Deschenau A, Cottencin O, Gay A, Lack P, Pelissier-Alicot AL, Dupuy G, Fortias M, Etain B, Lépine JP, Laplanche JL, Bellivier F, Vorspan F, Bloch V. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Subst Abus 2021; 43:623-632. [PMID: 34597243 DOI: 10.1080/08897077.2021.1975875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Suicide attempts have been associated with both cocaine use disorder (CocUD) and childhood trauma. We investigated how childhood trauma is an independent risk factor for serious and recurrent suicide attempts in CocUD. Method: 298 outpatients (23% women) with CocUD underwent standardized assessments of substance dependence (Diagnostic and Statistical Manual-mental disorders, fourth edition, text revised), impulsiveness, resilience, and childhood trauma, using validated tools. Suicide attempts history was categorized as single vs. recurrent or non-serious vs. serious depending on the lifetime number of suicide attempts and the potential or actual lethality of the worst attempt reported, respectively. Bivariate and multinomial regression analyses were used to characterize which childhood trauma patterns were associated with the suicide attempts groups. Results: 58% of CocUD patients reported childhood trauma. Recurrent and serious suicide attempts clustered together and were thus combined into "severe SA." Severe suicide attempt risk increased proportionally to the number of childhood traumas (test for trend, p = 9 × 10-7). Non-severe suicide attempt risk increased with impulsiveness and decreased with resilience. In multinomial regression models, a higher number of traumas and emotional abuse were independently and only associated with severe vs. non-severe suicide attempts (effect size = 0.82, AUC = 0.7). The study was limited by its cross-sectional design. Conclusion: These preferential associations between childhood trauma and severe suicide attempts warrant specific monitoring of suicide attempts risk in CocUD, regardless of the severity of addiction profiles.
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Affiliation(s)
- Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Emily Karsinti
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,ED139, Laboratoire CLIPSYD, Paris Nanterre University, Nanterre, France
| | - Georges Brousse
- INSERM UMR-1107, Neuro-Dol, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Clara Chrétienneau
- INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France
| | | | - Beatriz Belforte
- APHP, Hôpital Européen Georges Pompidou, CSAPA Monte-Cristo, Paris, France
| | | | | | | | - Olivier Cottencin
- Université de Lille, CHU Lille - Psychiaty and Addiction Medicine Department, INSERM U1172 - Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
| | - Aurélia Gay
- Service d'Addictologie, CHU St Etienne, Saint Etienne, France
| | | | | | - Gaël Dupuy
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Maeva Fortias
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Pierre Lépine
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Louis Laplanche
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Vanessa Bloch
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
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Heleniak C, Bolden CR, McCabe CJ, Lambert HK, Rosen ML, King KM, Monahan KC, McLaughlin KA. Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence. Res Child Adolesc Psychopathol 2021; 49:1211-1225. [PMID: 33786696 PMCID: PMC8324573 DOI: 10.1007/s10802-021-00805-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance-the ability to persist in the face of distress-and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16-17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial Addition Task. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling for socio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.
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Affiliation(s)
- Charlotte Heleniak
- Department of Psychology, Columbia University, 1190 Amsterdam Ave, New York, NY, 10027, USA.
| | - China R Bolden
- School of Psychology, Family, and Community, Seattle Pacific University, Seattle, Washington, USA
| | - Connor J McCabe
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Hilary K Lambert
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Maya L Rosen
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Kevin M King
- Department of Psychology, University of Washington, Guthrie Hall (GTH), Seattle, WA, 119A 98195-1525, USA
| | - Kathryn C Monahan
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA
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8
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Capuzzi E, Caldiroli A, Besana F, Tagliabue I, Capellazzi M, Cova F, Rubelli P, Sergio MR, Truisi E, Buoli M, Clerici M. The association between childhood trauma and lifetime suicide attempts among a sample of male prisoners: A pilot observational study. J Forensic Leg Med 2021; 80:102180. [PMID: 33991929 DOI: 10.1016/j.jflm.2021.102180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prisoners have higher rates of suicide attempts compared with general population. A history of childhood trauma (CT) is common among incarcerated subjects and it is a well-known risk factor for lifetime suicide attempts. Therefore, the purpose of the study was to investigate whether lifetime suicide attempts may be related to the exposition to CT among male prisoners. METHOD We conducted a cross sectional study recruiting newly arrived inmates in an Italian jail, between January 2017 and June 2018. Prisoners were interviewed to collect socio-demographic and clinical information. Moreover, inmates completed the Childhood Trauma Questionnaire. We excluded prisoners unable to speak or read Italian, with learning disabilities or current severe psychiatric symptoms. RESULTS A total of 215 consecutive male inmates were included. Fifty-one prisoners (23.7%) had a history of attempted suicide. The most reported CT was physical neglect. Multivariate logistic regression analysis showed that a history of childhood sexual abuse, emotional neglect and psychiatric diagnosis significantly increased the likelihood of lifetime suicide attempt. CONCLUSIONS A previous history of suicide attempt is highly prevalent among inmates. In agreement with previous findings, lifetime suicide attempts seem to be associated with the presence of CT and psychiatric diagnosis. Therefore, CT should be considered as a relevant variable to improve the programs for the prevention of suicide in prison.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy.
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Filippo Besana
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900, Monza (MB), Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900, Monza (MB), Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900, Monza (MB), Italy
| | - Francesca Cova
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Paola Rubelli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Maria Ripalta Sergio
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Emanuele Truisi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy; Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900, Monza (MB), Italy
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9
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Zheng F, Wu W, Wang L, Ngoubene-Atioky AJ, Chen L. Childhood trauma and suicidal ideation among Chinese female prisoners: The mediating roles of negative emotions and social support. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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10
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Chen G. Exposure to Family Violence of Israeli Inmates: Does Sex Make a Difference? Psychiatr Q 2020; 91:389-401. [PMID: 31930454 DOI: 10.1007/s11126-020-09713-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of the current study was to examine differences by sex (a) in history of child abuse and neglect (CAN) and exposure to parental partner violence (PPV); and (b) in the association of CAN and PPV with violent offenses, substance use, suicidal behavior, and psychiatric problems. This cross-sectional study investigated sex differences in CAN and exposure to PPV in a sample of 290 Israeli inmates (65 women and 225 men). Participants completed a self-report measures of the Childhood Trauma Questionnaire, and the revised Conflict Tactics Scale to measure PPV. The findings indicated that the female inmates had experienced significantly more sexual abuse (p < .001), and more exposure to PPV (p = .030), compared with male inmates. Female inmates who had experienced CAN were at higher risk of committing violent offenses than male inmates and female inmates were also more likely than male inmates to have been engaged in suicidal behaviors (39.3% and 18.5%, respectively), and to have had psychiatric problems (40% and 14.2%, respectively). The findings also revealed that psychiatric problems and suicidal behavior can be predicted by CAN and family substance use. The findings highlight the effects of the adverse childhood experience of exposure to CAN and PPV on behavioral problems. Appropriate treatment requires simultaneous intervention that targets all three issues of childhood trauma, substance use disorders, and psychiatric problems for both sexes.
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Affiliation(s)
- Gila Chen
- Department of Criminology, Ashkelon Academic College, 12 Ben Tzvi St., 78109, Ashkelon, Israel.
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11
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Fjeldsted R, Teasdale TW, Bach B. Childhood trauma, stressful life events, and suicidality in Danish psychiatric outpatients. Nord J Psychiatry 2020; 74:280-286. [PMID: 31833427 DOI: 10.1080/08039488.2019.1702096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Increasing evidence points to an association between adverse life experiences and suicide risk, which include childhood trauma and maltreatment as well as recent stressful life events. Accordingly, the assessment of childhood trauma and recent stressful life events might contribute to the detection of suicidal risk in a clinical setting.Aim: To investigate the association of childhood trauma and current stressful life events with suicidal behavior and improve identification of suicidality in psychiatric outpatients.Method: The Childhood Trauma Questionnaire (CTQ), the Stressful Life Events (SLE) questionnaire, and the Suicide Behaviors Questionnaire-Revised (SBQ-R) were administered to 103 psychiatric outpatients (77% women). We employed binary logistic regression analysis to estimate the statistical risk of suicide attempt for patients being exposed to childhood trauma and the influence of recent stresssful life events. A ROC-analysis was used to estimate the ability of CTQ to predict suicidal behavior.Results: A substantial association between suicidal behavior and severe childhood trauma was found (OR = 3.68), whereas no significant association was found for recent stressful life events. The result was tested against possible confounding demographic factors (sex, age, job status, educational level and marital status). Childhood trauma was found to explain around 15% of the total variance in suicidality.Conclusion: The findings partially supported our hypothesis that childhood traumas (but not recent stressful life events) may play a substantial role in suicidality, and therefore assessment of childhood trauma may contribute to the detection of suicidal behavior in a psychiatric outpatient population. However, longitudinal research and replication in other populations are warranted for more conclusive findings.
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Affiliation(s)
- Rita Fjeldsted
- Psychiatric Clinic Slagelse, Psychiatric Services Region Zealand, Slagelse, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Bo Bach
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Copenhagen, Denmark
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12
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Ryan AT, Daruwala SE, Perera KU, Lee-Tauler SY, Tucker J, Grammer G, Weaver J, Ghahramanlou-Holloway M. The Relationship between Trauma Exposure and Psychiatric Hospitalization for Suicide Ideation or Suicide Attempt among Patients Admitted to a Military Treatment Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2729. [PMID: 32326534 PMCID: PMC7215778 DOI: 10.3390/ijerph17082729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/02/2020] [Accepted: 04/09/2020] [Indexed: 11/16/2022]
Abstract
Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual's likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems.
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Affiliation(s)
- Arthur T. Ryan
- Veterans Affairs VISN 5 Mental Illness Research, Education and Clinical Center (MIRECC), Baltimore, MD 21201, USA;
- Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD 21201, USA
| | - Samantha E. Daruwala
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (S.E.D.); (K.U.P.); (S.Y.L.-T.); (J.T.)
| | - Kanchana U. Perera
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (S.E.D.); (K.U.P.); (S.Y.L.-T.); (J.T.)
| | - Su Yeon Lee-Tauler
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (S.E.D.); (K.U.P.); (S.Y.L.-T.); (J.T.)
| | - Jennifer Tucker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (S.E.D.); (K.U.P.); (S.Y.L.-T.); (J.T.)
| | | | - Jennifer Weaver
- Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA;
| | - Marjan Ghahramanlou-Holloway
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (S.E.D.); (K.U.P.); (S.Y.L.-T.); (J.T.)
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Serafini G, Lamis DA, Aguglia A, Amerio A, Nebbia J, Geoffroy PA, Pompili M, Amore M. Hopelessness and its correlates with clinical outcomes in an outpatient setting. J Affect Disord 2020; 263:472-479. [PMID: 31969280 DOI: 10.1016/j.jad.2019.11.144] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/04/2019] [Accepted: 11/29/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This study examined whether patients with hopelessness and those without may significantly differ regarding their main presentations and clinical course in a large Italian population. METHODS The recruited sample included 583 currently euthymic outpatients with major affective disorders. The Beck Hopelessness Scale (BHS) assessed hopelessness using a cutoff score of 9 or higher. Participants were categorized based on the presence/absence of hopelessness. A binary logistic regression analysis -accounting for age and gender and considering history of psychotherapy, emotional/physical abuse, depressive symptoms, Toronto Alexithymia Scale (TAS) total score, difficulties identifying and communicating feelings as potential predictors- was carried out in order to detect the variables associated with hopelessness. RESULTS Individuals with hopelessness, compared to those without, were more likely to be older (p=0.005), females (p=0.01), to have a unipolar depressive disorder (p≤0.05), be prescribed antidepressants and psychotherapy in the past (p=0.001 and p≤0.05). Moreover, individuals with hopelessness scored higher on the Montgomery-Asberg Depression Rating Scale (p≤0.05) and on the emotional (p=<0.001), physical abuse (p≤0.01) and physical neglect (p≤0.05) subscales of the Childhood Trauma Questionnaire - Short form, and reported more difficulties identifying (p≤0.001) and communicating feelings (p≤0.001) than those without hopelessness. The multivariate analysis showed that having difficulties identifying feelings is independently associated with hopelessness. DISCUSSION These findings indicate that individuals with difficulties identifying feelings are at higher risk of hopelessness and of negative outcomes. Further studies need to explore the impact of alexithymia on hopelessness and clinical outcomes in the lifetime illness course.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mood Disorders Program, Tufs Medical center, Boston, MA, USA
| | - Jacopo Nebbia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pierre Alexis Geoffroy
- Departement de psychiatrie et d'addictologie, AP-HP, Hopital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant Andrea Hospital, University of Rome, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Angelakis I, Austin JL, Gooding P. Childhood maltreatment and suicide attempts in prisoners: a systematic meta-analytic review. Psychol Med 2020; 50:1-10. [PMID: 31663847 PMCID: PMC6945324 DOI: 10.1017/s0033291719002848] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 12/14/2022]
Abstract
In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. We searched Medline, PsychINFO, Embase, Web of Science and CINAHL from inception until August 2019. Meta-analyses using random effect models were applied, and heterogeneity was quantified using the I2 statistic. Publication bias and risk of bias across studies were assessed. We identified 24 studies comprising 16 586 prisoners. The rates of different types of childhood maltreatment ranged between 29% and 68% [95% confidence interval (CI) 18-81%]. The rate of suicide attempts in prisoners was 23% (95% CI 18-27%). Main results demonstrated that sexual abuse [odds ratio (OR) 2.68, 95% CI 1.86-3.86], physical abuse (OR 2.16, 95% CI 1.60-2.91), emotional abuse (OR 2.70, 95% CI 1.92-3.79), emotional neglect (OR 2.29, 95% CI 1.69-3.10), physical neglect (OR 1.57, 95% CI 1.27-1.94) and combined abuse (OR 3.09, 95% CI 2.14-4.45) were strongly associated with suicide attempts in prisoners. There was an indication of publication bias. Duval and Tweedie's trim-and-fill method was applied, which increased the odds for suicide attempts. Given the high rates of prison suicide deaths and suicide attempts, our findings suggest an urgent need for targeted suicide prevention priorities for prisoners, with a particular focus on ameliorating the effects of childhood traumatic experiences on suicidal prisoners.
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Affiliation(s)
- Ioannis Angelakis
- University of South Wales, School of Psychology, Pontypridd, Wales, UK
| | | | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, MAHSC, Manchester, UK
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15
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Smith NB, Monteith LL, Rozek DC, Meuret AE. Childhood Abuse, the Interpersonal-Psychological Theory of Suicide, and the Mediating Role of Depression. Suicide Life Threat Behav 2018; 48:559-569. [PMID: 29068069 DOI: 10.1111/sltb.12380] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/09/2017] [Indexed: 11/28/2022]
Abstract
Although childhood abuse is a well-known risk factor for suicide, no studies have investigated the role of interpersonal-psychological (Joiner, 2005), constructs in this association. This study examined whether childhood physical, sexual, and emotional abuse were associated with IPTS constructs, and whether depressive symptoms mediated these associations. Ninety-one participants completed self-report measures. Emotional abuse predicted perceived burdensomeness and thwarted belongingness, and depressive symptoms mediated these associations. Physical abuse predicted the acquired capability for suicide, although depression did not mediate this association. These findings suggest that specific types of abuse differentially predict IPTS components and underscore depression as a potential mechanism.
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Affiliation(s)
- Noelle B Smith
- James A. Haley Veterans Hospital, Tampa, FL, USA.,Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, CO, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - David C Rozek
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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16
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Bach SDL, Molina MAL, Jansen K, da Silva RA, Souza LDDM. Suicide risk and childhood trauma in individuals diagnosed with posttraumatic stress disorder. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:253-257. [DOI: 10.1590/2237-6089-2017-0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/04/2018] [Indexed: 11/22/2022]
Abstract
Abstract Introduction Posttraumatic stress disorder (PTSD) develops after exposure to a potentially traumatic event. Its clinical condition may lead to the development of risk behaviors, and its early detection is a relevant aspect to be considered. The aim of this study was to assess the association between childhood trauma and suicide risk in individuals with PTSD. Method This was a cross-sectional study conducted with individuals aged 18 to 60 years who were evaluated at a mental health research outpatient clinic. PTSD diagnosis and suicide risk identification were performed using specific modules of the Mini International Neuropsychiatric Interview (MINI-Plus). The Childhood Trauma Questionnaire (CTQ) was used to evaluate traumatic events in childhood. Results Of the 917 individuals evaluated, 55 were diagnosed with PTSD. The suicide risk prevalence in individuals with PTSD was 63.6%. Emotional neglect and emotional abuse scores tended to be higher in the suicide risk group (p<0.2). Conclusion Our findings showed a higher prevalence of suicide risk in individuals with PTSD and support the hypothesis that the investigation of childhood traumatic experiences, especially emotional neglect and abuse, may help in the early detection of suicide risk in individuals with PTSD.
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Kavurma C, Varol Tas F, Serim Demirgoren B, Demirci F, Akan P, Eyuboglu D, Guvenir T. Do serum BDNF levels vary in self-harm behavior among adolescents and are they correlated with traumatic experiences? Psychiatry Res 2017; 258:130-135. [PMID: 29017139 DOI: 10.1016/j.psychres.2017.09.069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/05/2017] [Accepted: 09/24/2017] [Indexed: 11/30/2022]
Abstract
The aim of this study was to compare serum brain-derived neurotrophic factor (BDNF) levels between adolescents that harm themselves, those that receive psychiatric treatment but do not harm themselves, healthy adolescents, and childhood traumas and to investigate the relationship between traumatic experiences and serum BDNF levels. The cases were divided into two groups of 40 adolescents exhibiting self-harm behavior (self-harm/diagnosed group) and 30 adolescents receiving psychiatric treatment but not exhibiting self-harm behaviors (non self-harm/diagnosed group). The control group (healthy control group) consisted of 35 healthy adolescents with no psychiatric disorders or self-harm behaviors. The adolescents were asked to fill in the Inventory of Statements About Self Injury (ISAS) and Childhood Trauma Questionnaire (CTQ). For BDNF measurement, blood samples were taken from the cases and controls. The serum BDNF level of self-harming adolescents who used the self-cutting method was significantly lower than that of other groups, and serum BDNF levels decreased with the increase in the emotional neglect and abuse severity of self-harming adolescents during childhood. In our study, serum BDNF levels decreased with the increase in emotional abuse in self-harming adolescents. This finding may indicate that neuroplasticity can be affected by a negative emotional environment during the early period.
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Affiliation(s)
- Canem Kavurma
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatma Varol Tas
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Burcu Serim Demirgoren
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Ferhat Demirci
- MD, Department of Biochemistry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Pınar Akan
- MD, Department of Biochemistry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Damla Eyuboglu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Taner Guvenir
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Liu J, Fang Y, Gong J, Cui X, Meng T, Xiao B, He Y, Shen Y, Luo X. Associations between suicidal behavior and childhood abuse and neglect: A meta-analysis. J Affect Disord 2017. [PMID: 28623759 DOI: 10.1016/j.jad.2017.03.060] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Relationships of some types of childhood maltreatment and suicidal behavior remain controversial and inconclusive. METHODS Medline, Embase, PsycINFO and Cochrane library were searched for eligible studies, and the results were synthesized in meta-analyses. RESULTS childhood maltreatment was associated positively with suicidal behavior in the total population and maltreatment subgroups. Emotional abuse had the strongest effect (OR =2.33, SMD =0.660, P<0.001). Subgroup analyses showed that the effects of childhood abuse (OR =1.55, SMD =0.523) and neglect (OR =1.25, SMD =0.31) were significant. According to the analysis of dichotomous outcomes, childhood maltreatment was associated positively with suicidal behavior in men and women (women: OR =4.84, P<0.001; men: OR =1.03, P<0.001). Among populations, childhood maltreatment had the strongest effect on suicidal behavior in the general population (OR =3.78, P<0.001). However, the analysis of continuous outcomes showed that the effect was strongest in patients with chronic schizophrenia (SMD =0.89, P<0.001). In addition, childhood maltreatment was associated positively with suicide attempt (OR =1.11, SMD =0.48, P<0.001), but not with suicidal ideation. LIMITATIONS Some subgroup samples were not sufficiently large. CONCLUSIONS Childhood maltreatment increases the risk of suicidal behavior. Emotional abuse had the strongest effect among the five types of maltreatment. The risk of suicidal behavior is higher in the general population, women, and individuals with chronic schizophrenia who have histories of childhood maltreatment.
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Affiliation(s)
- Jianbo Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Yumin Fang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Jingbo Gong
- Department of Applied Psychology, Traditional Chinese Medicine University of Hunan, Changsha 410208, People's Republic of China
| | - Xilong Cui
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Tiantian Meng
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Bo Xiao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Yuqiong He
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Yanmei Shen
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China
| | - Xuerong Luo
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China.
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Chen L, Xu L, You W, Zhang X, Ling N. Prevalence and associated factors of alexithymia among adult prisoners in China: a cross-sectional study. BMC Psychiatry 2017; 17:287. [PMID: 28768497 PMCID: PMC5541430 DOI: 10.1186/s12888-017-1443-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/24/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prison is an extremely stressful environment and prisoners have an increasing risk of suffering from alexithymia. Therefore, this study aims to investigate the prevalence and associated factors of alexithymia among prisoners in China. METHODS A cross-sectional study was conducted in five main jails of the district of Zhejiang province in China, and a total of 1705 adult prisoners ultimately took part in the study. Toronto Alexithymia Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale and several short demographic questions were applied. RESULTS Over 30% of prisoners were classified as alexithymics and as high as 96.2% of prisoners suffered from at least one traumatic experience in their childhood, meanwhile, 81.5%, 53.4% and 85.8% were found to be positive for depression, anxiety and hopelessness symptoms respectively. Education, childhood trauma, negative emotional symptoms including depression, anxiety and hopelessness of the respondents, were negatively or positively associated with alexithymia among prisoners. CONCLUSIONS The results indicated that high prevalence of alexithymia among prisoners is linked with their level of education, experience of childhood trauma and symptoms of negative emotions. Accordingly, the findings in our study can be used for prevention and intervention of alexithymia among prisoners.
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Affiliation(s)
- Li Chen
- Department of Applied Psychology, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Linna Xu
- 0000 0001 2151 7947grid.265850.cDepartment of Economics, University at Albany, State University of New York, Albany, NY USA
| | - Weimin You
- Public Security Sub-Bureau of Huangyan, Taizhou Public Security Bureau, Huangyan, China
| | - Xiaoyan Zhang
- 0000 0004 1764 2632grid.417384.dDepartment of Children’s Health Care, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Allbaugh LJ, Florez IA, Turmaud DR, Quyyum N, Dunn SE, Kim J, Kaslow NJ. Child Abuse - Suicide Resilience Link in African American Women: Interpersonal Psychological Mediators. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2017; 26:1055-1071. [PMID: 31105423 PMCID: PMC6519949 DOI: 10.1080/10926771.2017.1350773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The interpersonal-psychological theory of suicidal behavior (IPTS) is an exemplary model for understanding the desire for suicidal behavior. As such, it is important to explore its applicability in ethnoracial minority groups at increasing risk for suicidal behavior, such as low-income African American women. Guided by the IPTS, the current study used five parallel mediation models to examine if there are links between individual types of childhood abuse (physical, sexual, emotional) and suicide resilience and between cumulative abuse (higher levels of abuse inclusive of all three types, more types of severe levels of abuse) and suicide resilience, and whether the three components of the model (thwarted belongingness, perceived burdensomeness, acquired capability for suicide) mediate these associations. In a sample of low-income, African American women (n = 179), higher levels of each of the three types of childhood abuse and cumulative abuse correlated with lower levels of suicide resilience. Parallel mediation analyses using bootstrapping techniques revealed that increased acquired capability for suicide mediated all five associations and perceived burdensomeness mediated three of the links (emotional abuse, cumulative abuse, and cumulative abuse-severe with suicide resilience). Attention is paid to the clinical implications of the findings in terms of attending to the acquired capability for suicide and suicide resilience in the assessment and treatment of low-income, suicidal, African American women.
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Affiliation(s)
- Lucy J. Allbaugh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ivonne Andrea Florez
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nadia Quyyum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah E. Dunn
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jungjin Kim
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Ayhan G, Arnal R, Basurko C, About V, Pastre A, Pinganaud E, Sins D, Jehel L, Falissard B, Nacher M. Suicide risk among prisoners in French Guiana: prevalence and predictive factors. BMC Psychiatry 2017; 17:156. [PMID: 28464856 PMCID: PMC5414209 DOI: 10.1186/s12888-017-1320-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 04/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide rates in prison are high and their risk factors are incompletely understood. The objective of the present study is to measure the risk of suicide and its predictors in the only prison of multicultural French Guiana. METHODS All new prisoners arriving between September 2013 and December 2014 were included. The Mini International Neuropsychiatric Interview (MINI) was used and socio-demographic data was collected. In order to identify the predictors of suicide risk multivariate logistic regression was used. RESULTS Of the 707 prisoners included 13.2% had a suicidal risk, 14.0% of whom had a high risk, 15.1% a moderate risk and 41.9% a low risk. Predictive factors were depression (OR 7.44, 95% CI: 3.50-15.87), dysthymia (OR 4.22, 95% CI: 1.34-13.36), panic disorder (OR 3.47, 95% CI: 1.33-8.99), general anxiety disorder (GAD) (OR 2.19, 95% CI: 1.13-4.22), men having been abused during childhood (OR 21.01, 95%, CI: 3.26-135.48), having been sentenced for sexual assault (OR 7.12, 95% CI: 1.98-25.99) and smoking (OR 2.93, 95%, CI 1.30-6.63). CONCLUSION The suicide risk was lower than in mainland France, possibly reflecting the differences in the social stigma attached to incarceration because of migrant populations and the importance and trivialization of drug trafficking among detainees. However, there were no differences between nationalities. The results reemphasize the importance of promptly identifying and treating psychiatric disorders, which were the main suicide risk factors.
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Affiliation(s)
- Gülen Ayhan
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Avenue des Flamboyants, BP 6006, 97 306, Cayenne CEDEX, France.
| | - Romain Arnal
- Centre d’Investigation Clinique Antilles-Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana France
| | - Célia Basurko
- Inserm CIC 1424, Centre d’Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Avenue des Flamboyants, BP 6006, 97 306 Cayenne CEDEX, France
| | - Vincent About
- Unité de Soins et de Consultations Ambulatoires, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana France
| | - Agathe Pastre
- Unité de Soins et de Consultations Ambulatoires, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana France
| | - Eric Pinganaud
- Centre d’Investigation Clinique Antilles-Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana France
| | - Dominique Sins
- Centre d’Investigation Clinique Antilles-Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana France
| | - Louis Jehel
- Équipe IPSOM, INSERM 1178, Paris, France ,Department of Psychiatry, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique France
| | | | - Mathieu Nacher
- Inserm CIC 1424, Centre d’Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Avenue des Flamboyants, BP 6006, 97 306 Cayenne CEDEX, France ,EA3593, Université de Guyane, Cayenne, French Guiana France
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Verdolini N, Murru A, Attademo L, Garinella R, Pacchiarotti I, Bonnin CDM, Samalin L, Pauselli L, Piselli M, Tamantini A, Quartesan R, Carvalho AF, Vieta E, Tortorella A. The aggressor at the mirror: Psychiatric correlates of deliberate self-harm in male prison inmates. Eur Psychiatry 2017. [PMID: 28641217 DOI: 10.1016/j.eurpsy.2017.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Deliberate self-harm (DSH) causes important concern in prison inmates as it worsens morbidity and increases the risk for suicide. The aim of the present study is to investigate the prevalence and correlates of DSH in a large sample of male prisoners. METHODS A cross-sectional study evaluated male prisoners aged 18+ years. Current and lifetime psychiatric diagnoses were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - DSM-IV Axis I and Axis II Disorders and with the Addiction Severity Index-Expanded Version. DSH was assessed with The Deliberate Self-Harm Inventory. Multivariable logistic regression models were used to identify independent correlates of lifetime DSH. RESULTS Ninety-three of 526 inmates (17.7%) reported at least 1 lifetime DSH behavior, and 58/93 (62.4%) of those reported a DSH act while in prison. After multivariable adjustment (sensitivity 41.9%, specificity 96.1%, area under the curve=0.854, 95% confidence interval CI=0.811-0.897, P<0.001), DSH was significantly associated with lifetime psychotic disorders (adjusted Odds Ratio aOR=6.227, 95% CI=2.183-17.762, P=0.001), borderline personality disorder (aOR=6.004, 95% CI=3.305-10.907, P<0.001), affective disorders (aOR=2.856, 95% CI=1.350-6.039, P=0.006) and misuse of multiple substances (aOR=2.024, 95% CI=1.111-3.687, P=0.021). CONCLUSIONS Borderline personality disorder and misuse of multiple substances are established risk factors of DSH, but psychotic and affective disorders were also associated with DSH in male prison inmates. This points to possible DSH-related clinical sub-groups, that bear specific treatment needs.
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Affiliation(s)
- N Verdolini
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy
| | - A Murru
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain
| | - L Attademo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy; Department of Mental Health, Division of Psychiatry 1, "Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII", Piazza OMS 1, 24127 Bergamo, Italy
| | - R Garinella
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy; Centro di Selezione e Reclutamento Nazionale dell'Esercito, Italian Ministry of Defence, Viale Mezzetti, 2, 06034 Foligno, Perugia, Italy
| | - I Pacchiarotti
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain
| | - C Del Mar Bonnin
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain
| | - L Samalin
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain; EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, hôpital Albert-Chenevier, 40, rue de Mesly, 94000 Créteil, France
| | - L Pauselli
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy; New York Psychiatric Institute Columbia University Medical Center, 1051 Riverside Dr, Unit 100, 10032 New York City, NY, USA
| | - M Piselli
- Functional Area of Psychiatry, University of Perugia, AUSL Umbria 2, Servizio Psichiatrico Diagnosi e Cura Ospedale "S. Giovanni Battista", via Massimo Arcamone, 06034 Foligno, Perugia, Italy
| | - A Tamantini
- Functional Area of Psychiatry, University of Perugia, AUSL Umbria 2, Servizio Psichiatrico Diagnosi e Cura Ospedale "S. Giovanni Battista", via Massimo Arcamone, 06034 Foligno, Perugia, Italy
| | - R Quartesan
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy
| | - A F Carvalho
- Department of Clinical Medicine, Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Av. da Universidade, 2853, 60020-180 Benfica, Fortaleza - CE, Brazil
| | - E Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain.
| | - A Tortorella
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy
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Power J, Gobeil R, Beaudette JN, Ritchie MB, Brown SL, Smith HP. Childhood Abuse, Nonsuicidal Self-Injury, and Suicide Attempts: An Exploration of Gender Differences in Incarcerated Adults. Suicide Life Threat Behav 2016; 46:745-751. [PMID: 27291490 DOI: 10.1111/sltb.12263] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/13/2016] [Indexed: 11/29/2022]
Abstract
The relationship between types of childhood abuse, suicide attempts, and nonsuicidal self-injury (NSSI) was examined in a sample of 415 incarcerated adults (268 men, 147 women). Men and women were equally likely to experience childhood abuse, although women were more likely to report sexual abuse and men were more likely to report emotional neglect. Sexual abuse was the only type of abuse found to predict NSSI and suicide attempts in women. For men, physical abuse and physical neglect were significant predictors of NSSI and suicide attempts, respectively. Gender differences exist and should be examined in future research in this area.
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Affiliation(s)
- Jenelle Power
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Renee Gobeil
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | | | - Mary B Ritchie
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Shelley L Brown
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Hayden P Smith
- Department of Criminology and Criminal Justice, University of South Carolina, Columbia, SC, USA
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Goossens I, Nicholls TL, Torchalla I, Brink J, de Ruiter C. The Perceived Impact of Trauma-Focused Research on Forensic Psychiatric Patients With Lifetime Victimization Histories. J Empir Res Hum Res Ethics 2016; 11:334-345. [PMID: 27887006 DOI: 10.1177/1556264616670769] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceived costs, benefits, and motivations for participating in individual trauma-focused interviews among forensic psychiatric patients ( N = 74). The majority of our participants were male, and 100% endorsed adverse childhood experiences (e.g., abuse, neglect) or exposure to potentially traumatic events (e.g., assault). Levels of posttraumatic avoidance (41.9%), reexperiencing (59.5%), and increased arousal (51.3%) were high. In line with previous studies, our findings suggest an overall positive research experience in this sample. In spite of extensive histories of lifetime victimization we did not find an association between victimization, posttraumatic symptomatology, and a negative research experience. Our findings suggest that participation in trauma-focused research is not only possible with, but also potentially beneficial for forensic patients.
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Affiliation(s)
- Ilvy Goossens
- 1 The University of British Columbia, Vancouver, Canada.,2 BC Mental Health and Substance Use Services, Coquitlam, Canada
| | - Tonia L Nicholls
- 1 The University of British Columbia, Vancouver, Canada.,2 BC Mental Health and Substance Use Services, Coquitlam, Canada
| | - Iris Torchalla
- 3 Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
| | - Johann Brink
- 1 The University of British Columbia, Vancouver, Canada.,2 BC Mental Health and Substance Use Services, Coquitlam, Canada
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25
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Nemeroff CB. Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect. Neuron 2016; 89:892-909. [PMID: 26938439 DOI: 10.1016/j.neuron.2016.01.019] [Citation(s) in RCA: 388] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the past two decades, much evidence has accumulated unequivocally demonstrating that child abuse and neglect is associated with a marked increase in risk for major psychiatric disorders (major depression, bipolar disorder, post-traumatic stress disorder [PTSD], substance and alcohol abuse, and others) and medical disorders (cardiovascular disease, diabetes, irritable bowel syndrome, asthma, and others). Moreover, the course of psychiatric disorders in individuals exposed to childhood maltreatment is more severe. Recently, the biological substrates underlying this diathesis to medical and psychiatric morbidity have been studied. This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain areas associated with mood regulation. Finally, I discuss several candidate gene polymorphisms that interact with childhood maltreatment to modulate vulnerability to major depression and PTSD and epigenetic mechanisms thought to transduce environmental stressors into disease vulnerability.
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Affiliation(s)
- Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA.
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26
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Dudeck M, Sosic-Vasic Z, Otte S, Rasche K, Leichauer K, Tippelt S, Shenar R, Klingner S, Vasic N, Streb J. The association of adverse childhood experiences and appetitive aggression with suicide attempts and violent crimes in male forensic psychiatry inpatients. Psychiatry Res 2016; 240:352-357. [PMID: 27138831 DOI: 10.1016/j.psychres.2016.04.073] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 02/23/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
Although previous studies in inmates, forensic and psychiatric samples suggest the relation between childhood trauma and suicide behavior as well as between childhood trauma and violent delinquency, the understanding of possible underlying mechanisms is still fragmentary. In a naturalistic study design, we tested if suicidal attempts and violent crimes are differently associated with adverse childhood experiences and levels of appetitive aggression in male forensic psychiatry inpatients. Adverse childhood experiences and appetitive aggression styles were collected by means of self-report measures, suicide attempts were taken from the medical history and violent crimes were appraised by official court records. The data were analyzed by the means of generalized linear models. Results revealed that appetitive aggression and adverse childhood experiences were significant predictors of suicide attempts, whereas violent crimes were associated solely with appetitive aggression. Suicide attempts and violent delinquency in forensic patients seem to be both positively associated with high levels of appetitive aggression, whereas their etiological pathways might differ with regard to adverse childhood experiences. Considering these interrelations to a greater extent might improve both diagnostics and treatment of forensic patients.
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Affiliation(s)
- Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Psychiatry and Psychotherapy III, University of Ulm, Germany
| | - Stefanie Otte
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Katharina Rasche
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Katharina Leichauer
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Susanne Tippelt
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Riad Shenar
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Solveig Klingner
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Nenad Vasic
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany
| | - Judith Streb
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Germany.
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Bernegger A, Kienesberger K, Carlberg L, Swoboda P, Ludwig B, Koller R, Kapusta ND, Aigner M, Haslacher H, Schmöger M, Kasper S, Schosser A. Influence of Sex on Suicidal Phenotypes in Affective Disorder Patients with Traumatic Childhood Experiences. PLoS One 2015; 10:e0137763. [PMID: 26366559 PMCID: PMC4569479 DOI: 10.1371/journal.pone.0137763] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/21/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives In the current study, we aimed to investigate the impact of childhood trauma on suicidal behaviour phenotypes in a group of patients with diagnosed affective disorder (unipolar or bipolar affective disorder). Patients and Methods Patients with and without a history of childhood abuse, measured by Childhood Trauma Questionnaire (CTQ), were assessed to explore risks for suicidal behaviour (including suicide attempt, self-harm and non-suicidal self-injury). The tested sample consisted of 258 patients (111 males and 147 females, in-patients and out-patients at the Department of Psychiatry and Psychotherapy, Medical University of Vienna and University Hospital Tulln, Lower Austria). Psychiatric diagnoses were derived from the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) interview. In addition, patients were administered the Lifetime Parasuicidal Count (LPC), Suicidal Behaviour Questionnaire (SBQ-R), and Viennese Suicide Risk Assessment Scale (VISURIAS) questionnaires. Results In contrast to male suicide attempters, female suicide attempters showed both significantly higher total CTQ scores (p<0.001), and higher CTQ subscores (emotional, physical and sexual abuse, as well as emotional and physical neglect) in comparison to the non-suicidal control group. Besides, females with a history of self-harming behaviour (including suicidal intention) and Non-Suicidal-Self Injury (NSSI) had significantly higher CTQ total scores (p<0.001) than the control group. Conclusion These findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma.
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Affiliation(s)
- Alexandra Bernegger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Klemens Kienesberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Laura Carlberg
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Patrick Swoboda
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Birgit Ludwig
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Romina Koller
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nestor D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Martin Aigner
- University Hospital Tulln, Department of Psychiatry, Tulln, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Michaela Schmöger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Zentrum für Seelische Gesundheit LEOpoldau, BBRZ-Med, Vienna, Austria
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Abstract
Suicide is a prevalent problem among young people in Southern Africa, but prevention programs are largely absent. This survey aimed to identify the behavioral and psychosocial correlates of suicidal ideation among adolescents in Limpopo. A two-stage cluster sample design was used to establish a representative sample of 591 adolescents. Bivariate correlations and multiple linear regression analyses were conducted. Findings show that suicidal ideation is prevalent among adolescents. The psychosocial factors perceived social support and negative feelings about the family and the behavioral factors forced sexual intercourse and physical violence by the partner were found to increase the risk of suicidal ideation. Depression mediated the relationship between these psychosocial and behavioral risk factors and suicidal ideation. This study increased our understanding of the psychosocial and behavioral predictors of adolescent suicidal ideation. The findings provide target points for future intervention programs and call for supportive structures to assist adolescents with suicidal ideation.
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O'Donnell O, House A, Waterman M. The co-occurrence of aggression and self-harm: systematic literature review. J Affect Disord 2015; 175:325-50. [PMID: 25665494 DOI: 10.1016/j.jad.2014.12.051] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 12/19/2014] [Accepted: 12/20/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Epidemiological research supports an association between aggression and self-harm through data on the frequency with which individuals exhibit both behaviours. Unbiased evidence, however, is needed to draw conclusions about the nature and extent of co-occurrence. METHOD Systematic review of published studies was undertaken to evaluate whether or not the frequency with which aggression and self-harm co-occur is beyond that which would be expected by chance. Outcome measures included: (a) between-group differences on a standardised aggression/self-harm measure - the groups defined by scores on a measure of the other behaviour; (b) correlations between the two behaviours; (c) co-occurrence rates in populations defined by the presence of either behaviour; (d) co-occurrence rates in populations not defined by either behaviour. Odds ratios were calculated for studies presenting complete frequency data. RESULTS 123 studies, some yielding more than one type of result, met the inclusion criteria. Most case-control studies found elevated levels of aggression in self-harming populations (or self-harm in aggressive populations) compared to controls. The majority of correlational, co-occurrence rate, and odds ratio data found aggression and self-harm to be associated. LIMITATIONS Results were subject to descriptive synthesis only and thus, unable to report an overall effect size. CONCLUSIONS Evidence suggests that aggression and self-harm frequently co-occur. Such evidence necessitates more theoretical discussion and associated research on the source and nature of co-occurrence. Nonetheless, individuals who present with one behaviour may be considered an 'at-risk' group in terms of exhibiting the other. Such evidence holds implications for practice (e.g. risk assessment).
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Affiliation(s)
| | | | - Mitch Waterman
- Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, UK
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30
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Abstract
Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.
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Affiliation(s)
- Maria Ramberg
- a National Centre for Suicide Research and Prevention, Institute of Clinical Medicine , University of Oslo , Norway
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31
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Sergentanis TN, Sakelliadis EI, Vlachodimitropoulos D, Goutas N, Sergentanis IN, Spiliopoulou CA, Papadodima S. Does history of childhood maltreatment make a difference in prison? A hierarchical approach on early family events and personality traits. Psychiatry Res 2014; 220:1064-70. [PMID: 25468626 DOI: 10.1016/j.psychres.2014.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 10/19/2014] [Accepted: 10/22/2014] [Indexed: 11/29/2022]
Abstract
This study attempts to assess childhood maltreatment in prison through a hierarchical approach. The hierarchical approach principally aims to disentangle the independent effects of childhood maltreatment upon psychiatric morbidity/personality traits, if any, from the burden that the adverse family conditions have already imposed to the mental health of the maltreated individual-prisoner. To this direction, a conceptual framework with five hierarchical levels was constructed, namely: immutable demographic factors; family conditions; childhood maltreatment (physical abuse, neglect and sexual abuse); personality traits, habits and psychiatric morbidity; prison-related variables. A self-administered, anonymous set (battery) of questionnaires was administered to 173 male prisoners in the Chalkida prison, Greece; 26% of prisoners disclosed childhood maltreatment. Psychiatric condition in the family, parental alcoholism and parental divorce correlated with childhood maltreatment. After adjustment for immutable demographic factors and family conditions, childhood maltreatment was associated with aggression (both in terms of Lifetime History of Aggression and Buss–Perry Aggression Questionnaire scores), illicit substance use, personal history of psychiatric condition, current smoking, impulsivity and alcohol abuse. In conclusion, childhood maltreatment represents a pivotal, determining factor in the life course of male prisoners. Delinquents seem to suffer from long-term consequences of childhood maltreatment in terms of numerous mental health aspects.
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Cuadra LE, Jaffe AE, Thomas R, DiLillo D. Child maltreatment and adult criminal behavior: does criminal thinking explain the association? CHILD ABUSE & NEGLECT 2014; 38:1399-1408. [PMID: 24636359 DOI: 10.1016/j.chiabu.2014.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 02/03/2014] [Accepted: 02/14/2014] [Indexed: 06/03/2023]
Abstract
Criminal thinking styles were examined as mediational links between different forms of child maltreatment (i.e., sexual abuse, physical abuse, and physical neglect) and adult criminal behaviors in 338 recently adjudicated men. Analyses revealed positive associations between child sexual abuse and sexual offenses as an adult, and between child physical abuse/neglect and endorsing proactive and reactive criminal thinking styles. Mediation analyses showed that associations between overall maltreatment history and adult criminal behaviors were accounted for by general criminal thinking styles and both proactive and reactive criminal thinking. These findings suggest a potential psychological pathway to criminal behavior associated with child maltreatment. Limitations of the study as well as research and clinical implications of the results are discussed.
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Affiliation(s)
| | - Anna E Jaffe
- University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Renu Thomas
- University of Nebraska-Lincoln, Lincoln, NE, USA
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Tripodi SJ, Onifade E, Pettus-Davis C. Nonfatal suicidal behavior among women prisoners: the predictive roles of childhood victimization, childhood neglect, and childhood positive support. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2014; 58:394-411. [PMID: 23315427 DOI: 10.1177/0306624x12472879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Women entering prison report high rates of childhood victimization. Women in prison also report higher rates of nonfatal suicidal behavior (self-reported suicide attempts) than women in the general population and similar rates to their male counterparts despite having significantly lower suicide rates than males in the general population. Yet, there is a dearth of research that addresses the relationship between childhood victimization and suicidality for women prisoners in the United States. The purpose of this study is (a) to assess the relationship between childhood victimization and nonfatal suicidal behavior for a random sample of women prisoners; (b) to investigate predictive differences between childhood physical victimization, childhood sexual victimization, childhood neglect, and childhood support; and (c) to determine whether women prisoners with higher frequencies of childhood victimization and neglect are more likely to have attempted suicide than women prisoners with lower frequencies. Results indicate that childhood victimization, neglect, and lack of support are all significantly associated with nonfatal suicidal behavior among women prisoners. Frequency of childhood neglect had a larger effect size than frequency of childhood physical victimization, childhood sexual victimization, and lack of support. The results of this study add to the growing body of literature on childhood victimization and suicidality in general, and nonfatal suicidal behavior for prisoner populations in particular. The article ends with a discussion on clinical implications; particularly the finding that frequency of childhood victimization, childhood neglect, and lack of childhood support matters when determining the risk of suicidality.
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Abstract
The aim of this study is to identify the characteristic features of suicide reattempters. The recognition of the suicide reattempters population as a distinct clinical population may encourage future preventive and clinical work with this high-risk subgroup and thus reduce deaths. A systematic literature review was carried out in order to identify the key demographic, psychological, and clinical variables associated with the repetition of suicide attempts. In addition, we wished to analyze the operational definitions of the repetition of suicide attempts proposed in the scientific literature. Studies published from 2000 to 2012 were identified in PubMed, PsycINFO, and Web of Science databases and were selected according to predetermined criteria. We examined a total of 1480 articles and selected 86 that matched our search criteria. The literature is heterogeneous, with no consensus regarding the operational definitions of suicide reattempters. Comparison groups in the literature have also been inconsistent and include subjects making a single lifetime attempt and subjects who did not reattempt during a defined study period. Suicide reattempters were associated with higher rates of the following characteristics: unemployment, unmarried status, diagnosis of mental disorders, suicidal ideation, stressful life events, and family history of suicidal behavior. Additional research is needed to establish adequate differentiation and effective treatment plans for this population.
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Kim SW, Kang HJ, Kim SY, Kim JM, Yoon JS, Jung SW, Lee MS, Yim HW, Jun TY. Impact of childhood adversity on the course and suicidality of depressive disorders: the CRESCEND study. Depress Anxiety 2013; 30:965-74. [PMID: 23495050 DOI: 10.1002/da.22088] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 01/11/2013] [Accepted: 02/09/2013] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The impact of childhood adversity persists across the life course. This study aimed to investigate the associations of childhood adversity with the course, suicidality, and treatment outcomes of depressive disorders. METHOD A total of 919 people with depressive disorders were recruited. Childhood adversities (≤12 years old) were ascertained using a checklist, in sexual abuse, physical abuse by parents, and separation of parents. Various assessment scales were administered at baseline and over 12 weeks of antidepressants treatment. RESULTS All three forms of childhood adversity were associated with an increased likelihood of experiencing more current stressful events. Scores on the Beck Depression Inventory and Hamilton Anxiety Rating Scale were significantly higher in participants with a history of sexual abuse. Scores on the Beck Depression Inventory, Hamilton Depression Rating Scale, and Perceived Stress Scale were significantly higher, and scores on the WHO Quality of life instrument were significantly lower in participants with a history of physical abuse by parents. They were more likely to receive augmentation and combination treatment after the initial antidepressant treatment, whereas overall response rates to treatment did not differ. Scores on the Beck Scale for suicide ideation were significantly higher after treatment and/or at baseline in patients with sexual or physical abuse. Physical illness was more prevalent in individuals with physical abuse by parents or separation of parents. CONCLUSIONS Depressive patients with a history of childhood adversities had more severe and chronic forms of depression with high suicidality. More intensive treatment with particular clinical attention is indicated for this special population.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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Bresin K, Sima Finy M, Verona E. Childhood emotional environment and self-injurious behaviors: the moderating role of the BDNF Val66Met polymorphism. J Affect Disord 2013; 150:594-600. [PMID: 23541842 DOI: 10.1016/j.jad.2013.01.050] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/30/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous theory has suggested that invalidating environments in the form of emotional maltreatment should be a specific risk factor for the development of self-injurious behaviors (Linehan, 1993, Cognitive-Behavioral Treatment of Borderline Personality Disorder, New York, Guilford Press). However, results from previous studies have been mixed, possibly indicating that this effect may not be the same for all individuals. In fact, some individuals may be more susceptible to environmental influences (i.e., phenotypic plasticity), and this susceptibility may be in part a function of genes that are involved in neuroplasticity (e.g., the brain-derived neurotrophic factor [BDNF] Val66Met polymorphism). METHOD We explored the interaction between retrospective reports of childhood emotional environment and the BDNF Val66Met polymorphism in relation to a history of two main types of self-injurious behaviors, suicide attempt and nonsuicidal self-injury (NSSI), in a sample of individuals with a history of involvement in the criminal justice system. RESULTS For individuals with two Val alleles, there was a significant direct relationship between emotional maltreatment and self-injurious behaviors. However, the relationship was not significant for Met carriers. LIMITATIONS The data are cross-sectional, which means causal inferences cannot be drawn. CONCLUSIONS The results indicate the possibility of a common etiological pathway for NSSI and suicide attempts.
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Affiliation(s)
- Konrad Bresin
- Department of Psychology, University of Illinois Urbana-Champaign, 603 East Daniel Street, Champaign, IL 61820, United States.
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Blasco-Fontecilla H, Jaussent I, Olié E, Garcia EB, Beziat S, Malafosse A, Guillaume S, Courtet P. Additive effects between prematurity and postnatal risk factors of suicidal behavior. J Psychiatr Res 2013; 47:937-43. [PMID: 23535031 DOI: 10.1016/j.jpsychires.2013.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/20/2013] [Accepted: 02/26/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Pre- and perinatal insults increase suicide risk. The main objective of the present study is to investigate if prematurity interacts in an additive fashion with postnatal risk factors of suicidal behavior. METHOD Sample and procedure: 857 adult suicide attempters consecutively hospitalized for a suicide attempt were included. Studied characteristics of suicide attempts included use of a violent mean, age at first suicide attempt, and number of suicide attempts. Risk factors of suicidal behavior included indexes of pre- and perinatal adversity, childhood maltreatment as measured with the Childhood Trauma Questionnaire, personality traits as measured with the Tridimensional Personality Questionnaire, and family history of suicidal behavior. STATISTICAL ANALYSES Comparisons between the different patterns of suicide attempts characteristics were made using logistic regression with crude and adjusted odds ratios and 95% confidence intervals. RESULTS The risk of violent suicide attempts increased significantly in patients born prematurely (OR [95%] = 2.38[1.12-5.08]). There were additive effects for very preterm birth and 1) emotional abuse (OR [95% CI] = 4.52 [1.75-11.60]), 2) novelty seeking (OR [95% CI] = 8.92[3.09-25.7]), and 3) harm avoidance (OR [95% CI] = 5.81 [2.43-13.90]) on the age at first suicide attempt, after adjustment for potential confounders. CONCLUSIONS Very preterm birth appears to be the first step in a cascade of stressors across lifetime, which affects the risk and the severity of suicidal behavior. Furthermore, very preterm birth, childhood maltreatment and personality traits have additive effects that influence the age at onset of suicide attempt. Our findings may have potential consequences for preventive policies.
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Rajalin M, Hirvikoski T, Jokinen J. Family history of suicide and exposure to interpersonal violence in childhood predict suicide in male suicide attempters. J Affect Disord 2013; 148:92-7. [PMID: 23273935 DOI: 10.1016/j.jad.2012.11.055] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 11/21/2012] [Accepted: 11/21/2012] [Indexed: 01/16/2023]
Abstract
BACKGROUND Family studies, including twin and adoption designs, have shown familial transmission of suicidal behaviors. Early environmental risk factors have an important role in the etiology of suicidal behavior. The aim of the present study was to assess the impact of family history of suicide and childhood trauma on suicide risk and on severity of suicide attempt in suicide attempters. METHODS A total of 181 suicide attempters were included. Family history of suicide was assessed with the Karolinska Suicide History Interview or through patient records. Childhood trauma was assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behavior in childhood (between 6 and 14 years of age) and during adult life (15 years or older). Suicide intent was measured with the Freeman scale. RESULTS Male suicide attempters with a positive family history of suicide made more serious and well planned suicide attempts and had a significantly higher suicide risk. In logistic regression, family history of suicide and exposure to interpersonal violence as a child were independent predictors of suicide in male suicide attempters. LIMITATIONS The information about family history of suicide and exposure to interpersonal violence as a child derives from the patients only. In the first part of the inclusion period the information was collected from patient records. CONCLUSIONS The results of this study imply that suicides among those at biological risk might be prevented with the early recognition of environmental risks.
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Affiliation(s)
- Mia Rajalin
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
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Smith PN, Wolford C, Mandracchia JT, Jahn DR. An exploratory factor analysis of the Acquired Capability for Suicide Scale in male prison inmates. Psychol Serv 2013; 10:97-105. [PMID: 23230965 PMCID: PMC4153467 DOI: 10.1037/a0030817] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prison inmates are exposed to a number of adverse conditions prior to and during incarceration that place them at risk for suicide. The interpersonal theory of suicide may prove useful in better understanding suicide in prisons, allowing for more effective prevention and treatment programs. However, no studies of the interpersonal theory have been conducted in prison populations. Further, there have been no studies examining the factor structure of the assessment of one of the theory's main constructs: the acquired capability for suicide. The current study examined the factor structure of the Acquired Capability for Suicide Scale in a sample of male prison inmates. We found that a 4-factor model provided the best statistical and conceptual fit, though only 3 of these factors were meaningful with an additional method-factor. The 3 resulting factors were each associated with previous exposure to painful and provocative events, but none differentiated suicide attempter status. Results suggest that the interpersonal theory has promise in application to suicide in prison populations, but more work is needed to develop a self-report measure of acquired capability, particularly as it relates to prisoners.
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Teixeira-Filho FS, Rondini CA, Silva JM, Araújo MV. Tipos e consequências da violência sexual sofrida por estudantes do interior paulista na infância e/ou adolescência. PSICOLOGIA & SOCIEDADE 2013. [DOI: 10.1590/s0102-71822013000100011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Discutem-se os tipos de Violência Sexual (VS) sofridos na infância e/ou adolescência e suas vicissitudes, nas trajetórias sexuais de 236 adolescentes, de ambos os sexos, cursando o Ensino Médio no interior do Oeste Paulista que declararam ter sofrido um ou mais tipos de violência sexual. Dentre esses tipos, destacamos a Violência Doméstica Sexual (VDS), aqui definida como intrafamiliar. Nesse caso, observamos que, dentre os 236 adolescentes com histórico de VDS, 94 (39.8%) declararam ter pensado em suicídio e 39 (16.5%) disseram ter tentado, sendo que 35 (89.7%) deles se declararam heterossexuais (27 [77.1%] do sexo feminino) e 4 não-heterossexuais (3 bissexuais e 1 "outro", sendo todos do sexo feminino). A maioria das vítimas finda por relatar o ocorrido aos amigos e responsáveis, mas pouco ou nada é feito, em termos de medidas protetivas a elas.
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Youssef NA, Green KT, Dedert EA, Hertzberg JS, Calhoun PS, Dennis MF, Beckham JC. Exploration of the influence of childhood trauma, combat exposure, and the resilience construct on depression and suicidal ideation among U.S. Iraq/Afghanistan era military personnel and veterans. Arch Suicide Res 2013; 17:106-22. [PMID: 23614484 PMCID: PMC3640796 DOI: 10.1080/13811118.2013.776445] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study evaluated the effect of childhood trauma exposure and the role of resilience on both depressive symptoms and suicidal ideation. The study evaluated 1,488 military personnel and veterans, who served after September 2001, for depressive, suicidal, and PTSD symptoms, combat exposure, childhood trauma exposure, and resiliency. Participants were enrolled as part of an ongoing multicenter study. Outcome measures were depressive symptoms and suicidal ideation. After controlling for the effects of combat exposure and PTSD, results revealed that childhood trauma exposures were significantly associated with depressive symptoms and suicidal ideation. In addition, resilience was negatively associated with depressive symptoms and suicidal ideation, suggesting a potential protective effect. These findings suggest that evaluation of childhood trauma is important in the clinical assessment and treatment of depressive symptoms and suicidal ideation among military personnel and veterans.
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Affiliation(s)
- Nagy A Youssef
- a Durham VA Medical Center; Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham VA Medical Center, USA
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Gunter TD, Chibnall JT, Antoniak SK, McCormick B, Black DW. Relative contributions of gender and traumatic life experience to the prediction of mental disorders in a sample of incarcerated offenders. BEHAVIORAL SCIENCES & THE LAW 2012; 30:615-30. [PMID: 22991312 DOI: 10.1002/bsl.2037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The objective of this study was to quantify the relative contributions of gender and traumatic life experience to psychiatric disorders in a sample of 320 offenders entering a state prison. Women were more likely than men to report traumatic events and personal and family mental health treatment histories; and were more likely to meet criteria for posttraumatic stress, borderline personality, and eating disorders. People reporting traumatic life experiences were more likely than those not so reporting to have family mental histories and to meet criteria for mood, anxiety, psychotic, antisocial personality, and borderline personality disorders, as well as elevated suicide risk. With both gender and trauma included in the logistic regression models, only trauma was a significant predictor of mood, anxiety, psychotic, attention deficit hyperactivity, and antisocial personality disorders, as well as suicide risk. Trauma-informed programming, regardless of gender, is important for incarcerated offenders. To the extent that trauma is also criminogenic, these data suggest that women and men share the risk.
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Affiliation(s)
- Tracy D Gunter
- Indiana University School of Medicine, Department of Psychiatry, Division of Forensic Psychiatry, Indianapolis, Indiana, 46202-7176, USA.
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