Adverse Experiences and Suicidal Ideation in Adolescence: Exploring the Link Using the LONGSCAN Samples

Childhood maltreatment, peer victimization, borderline personality feature, suicidal risk in adolescents: Direct and indirect associations among developmental trajectories

INTRODUCTION

Childhood maltreatment, peer victimization, and borderline personality traits have all been shown to be linked to suicidal risk. However, there remains a need to illuminate the possible direct and indirect pathways among them from a developmental perspective that could serve as intervention targets. This study thus aimed to investigate the direct and indirect relationships among developmental trajectories of childhood maltreatment, peer victimization, borderline personality feature, and suicidal risk in adolescents.

METHODS

A total of 1648 Chinese adolescents (48.12% boys; Mage = 13.69; SD = 0.82) in junior middle schools completed self-report measures on three-time points across 1 year. Latent growth curve modeling was used to evaluate the direct and indirect relationships among the developmental trajectories of the aforementioned study variables.

RESULTS

The developmental trajectories of childhood maltreatment, peer victimization, and borderline personality feature were positively and directly related to the developmental trajectory of suicidal risk; and the developmental trajectories of childhood maltreatment, peer victimization were indirectly related to the developmental trajectory of suicidal risk through the mediating effect of the developmental trajectory of borderline personality feature.

CONCLUSIONS

The findings elucidated the direct and indirect longitudinal relationships among childhood maltreatment, peer victimization, borderline personality feature, and suicidal risk, highlighting that interventions should target childhood maltreatment, peer victimization, and borderline personality feature to decrease suicidal risk in adolescents with a developmental perspective.

Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients

BACKGROUND

Exposure to adverse childhood experiences (ACE) have been found to have profound negative consequences on an individuals' health. Non-suicidal self-injury (NSSI) is a clinically complex and serious global health issue and is closely related to suicide attempts. Previous research has found associations between ACE and NSSI and suicide attempts in clinical samples. However, this association has to our knowledge not been studied to this extent in a sample of forensic psychiatric patients. The aim of this study was therefore to describe the prevalence of adverse childhood experiences (ACE) and their associations with non-suicidal self-injury (NSSI) and/or suicide attempts in forensic psychiatric patients.

METHODS

The current study is a cross-sectional study of a consecutive cohort of 98 forensic psychiatric patients (86.7% male) in Sweden. We invited 184 patients with a predicted stay of > 8 weeks who had been cleared for participation by their treating psychiatrist. Of these, 83 declined and 98 eligible patients provided informed consent. Information on ACE, NSSI, and suicide attempts derived from files, self-reports (Childhood Trauma Questionnaire-Short Form; CTQ-SF), and interviews were compared separately among participants with and without NSSI or suicide attempts using t-tests. The dose-response association between ACE and NSSI/suicide attempts was analysed using binary logistic regression.

RESULTS

In file reviews, 57.2% of participants reported physical abuse, 20% sexual abuse, and 43% repeated bullying by peers during childhood. NSSI and suicide attempts were associated significantly with CTQ-SF total scores, with medium effect sizes (d = .60 to .63, p < .01), and strongly with several CTQ-SF subscales. Parental substance abuse was also associated with NSSI (p = .006, OR = 3.23; 95% confidence interval [CI] = 1.36 to 7.66) and suicide attempts (p = .018, OR = 2.75; 95% CI = 1.18 to 6.42). Each additional ACE factor predicted an increased probability of NSSI (p = .016, OR = 1.29; CI = 1.04 to 1.59) but not of suicide attempts. When anxiety and depressive disorders were included in the model, ACE remained a significant predictor of NSSI.

CONCLUSIONS

We report extensive ACE, from both files and self-reports. When comparing groups, correlations were found between ACE and NSSI, and ACE and suicide attempts among forensic psychiatric patients. ACE seem to predict NSSI but not suicide attempts in this group, even when controlling for affective and anxiety disorders. Early ACE among forensic psychiatric patients, especially physical and emotional abuse and parental substance abuse, have important impacts on self-harming behaviours that must be acknowledged both by the institutions that meet them as children and in their later assessment and treatment.

The effect of childhood adversities on the persistence of suicidal ideation and plans among college students: A longitudinal study

BACKGROUND

Exposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence.

AIMS

The study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year.

METHOD

Data were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year.

RESULTS

At baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses.

LIMITATIONS

Retrospective report of CA exposure, and low baseline response rate.

CONCLUSIONS

Using a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.

Timing of childhood adversities and self-injurious thoughts and behaviors in adolescence

Greater childhood adversity predicts a higher likelihood of later self-injurious thoughts and behaviors (SITB). There is little research focused on whether the timing of childhood adversity predicts SITB. The current research examined whether the timing of childhood adversity predicted parent- and youth-reported SITB at age 12 and 16 years in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) cohort (n = 970). We found that greater adversity at age 11-12 years consistently predicted SITB at age 12 years, while greater adversity at age 13-14 years consistently predicted SITB at age 16 years. These findings suggest there may be sensitive periods during which adversity may be more likely to lead to adolescent SITB, which can inform prevention and treatment.

Co-occurrence patterns of adverse childhood experiences and their associations with non-suicidal self-injury and suicidal behaviors and gender difference among middle school students: A three-city survey in China

BACKGROUND

Previous research has found increasing evidence of adverse childhood experiences (ACEs) leading to non-suicidal self-injury (NSSI) and suicidal behaviors. Most studies have focused on a certain type or timing of ACEs or the patterns of multiple types; however, few of them have examined the patterns of ACEs combined types and timing and the gender differences in the association between ACEs and self-harming behaviors.

METHODS

A cross-sectional survey was conducted in three Chinese cities from November 2020 to May 2021. We asked 16,853 middle school students to anonymously complete a questionnaire to provide the details of their own ACEs and NSSI or suicidal behaviors.

RESULTS

Latent class analysis identified four classes: high ACEs (10 %), high abuse/neglect (20.3 %), moderate ACEs (26.7 %) and low ACEs (43 %). Logistic regression models demonstrated that students in the high ACEs, high abuse/neglect and moderate ACEs subgroups were more likely to engage in NSSI and suicidal behaviors than students with low ACEs. Compared with boys, girls had a higher probability of engaging in NSSI and suicidal behaviors when exposed to the same level of ACEs.

CONCLUSION

Co-occurrence of ACEs is associated with high risk of NSSI and suicidal behaviors. Our findings recognized the most dangerous patterns and latent class membership, which supply the evidence for policy makers to adopt preventive measures to protect high-risk individuals. Strategies to relieve the impact of ACEs, especially on girls, need to be considered comprehensively.

LIMITATIONS

The study was limited by cross-sectional design, as causality could not be confirmed. In addition, because our survey was retrospective, potential recall bias can not be ignored.

Violência emocional intrafamiliar contra crianças e adolescentes e suas repercussões

O objetivo deste estudo foi identificar as repercussões na infância, na adolescência e na vida adulta da violência emocional intrafamiliar vivenciada no período infanto-juvenil em artigos publicados entre 2009 e 2019, por meio de uma revisão sistemática de literatura. Para a organização dos dados, utilizou-se o software Zotero; para a sistematização e análises, o software SPSS (versão 2.3). Na infância e na adolescência, as principais repercussões foram sintomas internalizantes (ex.: ansiedade, depressão, problemas psicossomáticos, insegurança), problemas cognitivo-comportamentais e impactos no rendimento escolar. Na idade adulta, as principais repercussões foram sintomas externalizantes (ex.: agressividade, reprodução da violência) e sintomas internalizantes. Conclui-se que a violência emocional vivenciada na infância e na adolescência é transcultural, transgeracional e um fator de risco para o desenvolvimento, podendo ocasionar prejuízos cognitivo-comportamentais e interferir nos relacionamentos interpessoais ao longo do ciclo de vida. Tornar visível este tipo de violência contribui para enfrentamento e minimização dos efeitos negativos da violência.

The value of a modular, multi-focal, therapeutic approach to addressing child maltreatment: Hope for Children and Families Intervention Resources - a discussion article

This discussion article begins by highlighting two trends apparent in the field of child maltreatment. The first, an awareness that multiple forms of maltreatment - polyvictimization - is the rule in populations of abused and neglected children rather than the exception. The second is that current types of child maltreatment are being extended to include Adverse Childhood Experiences (ACEs). These include intra-familial violence, mental health, substance misuse, and inter-generational abuse. The paper introduces an innovative strategy to help the field better organise and prevent the extensive sequelae of polyvictimization and ACEs. This strategy involves the development of a modular approach, which identifies common treatment elements and common factors across the field of effective interventions and organizes them, providing a co-ordinated framework for practitioners to use to address the diverse needs of children and families when vulnerability or maltreatment are identified. The development of this approach, the Hope for Children and Families (HfCF) Intervention Resources, is described using a case example to illustrate its logic and structure. Findings from the HFCF pilot and subsequent training programs suggest that this new approach could be an important milestone in the protection of children from violence, abuse and neglect on the 30th Anniversary of the United Nation's Convention on the Rights of the Child (1989).

Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents

Recent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents (“youth”). Although child maltreatment constitutes a well-established risk factor for suicidal ideation in youth, few efforts have focused on identifying factors associated with maltreated youths’ increased risk for suicidal ideation, especially across development. The present study examined the relations between maltreated youths' (N = 279, M = 12.06 years, 52% female, 53% Latinx) perceptions of their social status and suicidal ideation and compared those relations between pre-adolescents and adolescents. Findings revealed unique developmental patterns: Perceived social status was associated with suicidal ideation, but only in adolescents, who showed greater risk for suicidal ideation if they viewed themselves as lower ranked in society and lower risk for suicidal ideation if they viewed themselves as higher ranked in society. Findings have implications for scientific and practical efforts aimed at better understanding and preventing suicide in a high-risk developmental population.

A population-based case control study of suicide among youth reported for abuse and neglect

BACKGROUND

Research has indicated an association between child abuse and adolescent suicide. Little population-based information exists, however, about the nature of maltreatment experiences or interactions with the child protection system (CPS).

OBJECTIVE

To examine child maltreatment characteristics and system-level responses associated with risk of adolescent suicide.

PARTICIPANTS AND SETTING

Linked vital death records and CPS records were used to identify the population of adolescents who died by suicide in California between 2010 and 2017 and who had a history of at least one report to CPS prior to death.

METHOD

A case control design was used, with cases defined as a suicide of an adolescent with a history of CPS involvement. Using CPS records, living controls were then matched to cases based on year of birth, sex, race and ethnicity, and age of first child maltreatment allegation. A conditional logistic regression model was used to estimate the adjusted odds of adolescent suicide across various CPS and maltreatment characteristics.

RESULTS

Recent CPS involvement, allegations of physical abuse, and allegations of sexual abuse emerged as significant risk factors for death by suicide. No differences in suicide risk were observed between youth with unsubstantiated or substantiated allegations.

CONCLUSIONS

Suicide risk appears to be more closely tied to specific maltreatment experiences than to substantiation or placement into foster care. As adolescent suicide rates rise, better a understanding of risk factors among already vulnerable populations of youth is critical.

The impact of child maltreatment on the mental and physical health of child victims: a review of the evidence

This article gives a general overview of the current situation in relation to a range of widely recognised and also newly identified types of child maltreatment. The academic and clinical evidence relating to the impact of child maltreatment on the mental and physical health of child victims is substantial and steadily increasing in volume. New types of abuse are being identified, and changing environmental circumstances, which exacerbate the possibility of widely recognised types of child maltreatment occurring, are also being described. These include multi-type maltreatment, female genital mutilation and online child maltreatment. Serious questions may arise regarding neglect of the moral and social development of children and young people who become addicted to online gaming and pornography. Multiple national and local definitions of each of these existing and new forms of maltreatment have been created, some of which are covered here. The impact of these abuses on the physical and mental health and development of child victims in families or settings where abuse or neglect has occurred is discussed.

Association between sexual abuse victimization during the life course and suicidal behaviors in male and female college students in China: Timing, duration, types and patterns

BACKGROUND

A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender.

METHODS

Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors.

RESULTS

For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the "moderate SA" class and "persistent SA" class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the "moderate SA" class.

LIMITATIONS

The cross-sectional survey design did not allow to conclude any causality.

CONCLUSIONS

The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.

Adolescent Adverse Childhood Experiences and Risk of Adult Intimate Partner Violence

INTRODUCTION

Exposure to adverse experiences during adolescence may have significant implications for intimate partner violence during adulthood because it is during this developmental stage that many youth begin to have romantic relationships. Yet, few prospective longitudinal analyses on this topic exist. This study aims to fill a gap in the literature by examining the adverse childhood experiences during adolescence and intimate partner violence 15 years later during adulthood.

METHODS

Multilevel negative-binomial regression was used to examine the relationship between adolescent adverse childhood experiences (age 13-19 years) and adult intimate partner violence (age 28-34 years) in 499 participants over 5 waves of data from a 24-year longitudinal study (Wave 1: 1994) based in Flint, Michigan. Adolescent adverse childhood experiences included being a victim of violence, observed family conflict, parental intoxication, parental divorce, and observed community violence. Data analysis was conducted between 2019 and 2020.

RESULTS

First, investigators modeled the adverse childhood experience variables as a summary score to predict intimate partner violence during adulthood while controlling for known risk factors and individual random effects. Secondly, this study examined individual adverse childhood experiences iteratively to understand which adverse experiences predicted intimate partner violence in adulthood and found that observed community violence remained significant when accounting for all other adverse childhood experiences (β=0.276, p<0.05).

CONCLUSIONS

These findings support the negative effects of community violence in adolescence on later risk of intimate partner violence. Prevention interventions that focus on community health and violence prevention with a focus on healthy adolescent development may be pertinent in lowering intimate partner violence victimization in adulthood.

Understanding the link between child maltreatment and adolescent future expectations in Northern Uganda: A serial mediation analysis

BACKGROUND

Recent research has identified high levels of child maltreatment and harsh parenting in post-war societies which have had detrimental effects on children's development. Future expectations are an important aspect of adolescents' development particularly in the challenging contexts of post-war societies where social instabilities and violence are prevalent. To date, however, the link between child maltreatment and adolescent future expectations remains understudied.

OBJECTIVE

By applying a socio-ecological perspective, this study aimed to investigate risk (internalizing symptoms) and protective factors (community integration) linking experiences of harsh parenting with adolescents' future expectations.

PARTICIPANTS AND SETTING

Data was collected from N = 199 northern Ugandan adolescents (40.2 % females, M_age = 14.56 years) with structured interviews.

METHODS

Serial mediation analyses were calculated with child maltreatment as the predictor, future expectations as the outcome, and internalizing symptoms as well as community integration as mediating variables.

RESULTS

Results of the mediation model (R² = .22, F(5193) = 10.54, p <  .001, total effect (b = -0.28, p < .005) revealed a direct effect of child maltreatment on future expectations (effect size: -.20, 95 % bootstrap CI = -0.40, -.01) as well as an indirect effect of child maltreatment via internalizing symptoms and community integration on future expectations (effect size of -.07 (95 % bootstrap CI = -0.14, -0.01).

CONCLUSION

Child maltreatment was found to be linked to negative future expectations among Northern Ugandan adolescents, and both internalizing symptoms as well as community integration played mediating roles in the associations. Interventions should take psychopathology and community factors into account.

Longitudinal Impact of Life Events on Adolescent Binge Drinking in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA)

Background: Life events experienced during adolescence are associated with risk and resilience to heavy episodic drinking (HED; i.e. binge drinking). The current study builds on prior research using latent class analysis (LCA) to examine heterogeneity in patterns of adolescent life events at baseline to HED over the course of three years (4 timepoints) as part of the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA). Methods: Life event classes were modeled using LCA that characterized NCANDA participants based upon their responses to the Life Events Questionnaire (N = 467, age: M = 14.98, SD = 1.69, 49.7% female). These baseline latent life event classes were then compared to HED at baseline and years 1, 2 and 3 using multinomial logistic regression. Results: At baseline, the LCA characterized four classes of adolescents based on endorsement of life events: negative-relational conflict (n = 65, 13.9%), negative-financial problems (n = 49, 10.5%), low life events (n = 130, 27.8%), and positive life events (n = 223, 47.8%). Life event trajectories differed for the negative life event classes compared to the other two classes, with greater odds of HED in the negative-financial problems class at year 1. Conclusion: The four latent classes derived from the life events of NCANDA youth yielded a characterization of adolescents that could aid in understanding HED over the subsequent three years, suggesting that everyday life events may inform adolescent binge drinking.

Theoretical frameworks informing the relationship between parental death and suicidal behaviour: A scoping review

Background

Exposure to parental death in childhood has been strongly associated with offspring suicide although few studies have applied theoretical models to conceptualise this relationship.

Methods

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Scoping Reviews guidelines, we conducted a scoping review of primary studies that identified a theory/framework explaining the aetiology of suicidal behaviour in adulthood, following childhood exposure to external-cause parental death, including suicide.

Results

The search yielded 1598 articles. Following full-text screening, 23 studies were identified as meeting inclusion criteria. Data extraction was then completed and found that the studies collectively referenced nine theories. The specific theories identified covered a range of biopsychosocial frameworks and included attachment theory, familial transmission of suicide, conservation of resources framework, diathesis-stress model, social integration theory, socio-ecological model, social learning theory, critical period hypothesis or life course approach and the developmental model of antisocial behaviour.

Limitations

It was beyond the scope of this review to conduct rigorous testing and evaluation of the theories identified. Future research could extend on this study by developing criteria to assess the range of theories and frameworks on suicide exposure, as well as the studies providing evidence for these theories, in order to guide more advanced theory development as well as policies, programs and interventions.

Conclusions

Based on these theories, the authors proposed that using an integrated biopsychosocial model will provide a more comprehensive understanding of the diverse risk and protective factors for suicidal behaviour following parental death.

Sexting and Young Adolescents: Associations with Sexual Abuse and Intimate Partner Violence

STUDY OBJECTIVE

To explore whether sexting by young adolescent girls and boys is associated with adverse life experiences including exploitative or violent sexual relationships.

DESIGN AND SETTING

Cross-sectional, anonymous survey of a convenience sample of minor adolescents younger than age 18 years recruited while waiting for care in clinics affiliated with a children's hospital in a low-resource, high-poverty, urban community.

PARTICIPANTS

Five hundred fifty-five adolescents aged 14-17 years, 63% girls and 37% boys.

MAIN OUTCOME MEASURES

We measured sexting by asking, "Have you ever sent a sexually suggestive or naked picture of yourself to another person through text or e-mail?" The survey also measured risk behaviors, sexual abuse, intimate partner violence (IPV), and arrest and included a validated depression scale.

RESULTS

Mean age was 15.6 ± 1.1 years; 59% were Hispanic, 28% were black; 44% of girls and 46% of boys ever had sex; 24% of girls and 20% of boys ever sent a sext. More girls than boys reported sexual abuse (16% vs 3%; P < .01), IPV victimization (15% vs 7%; P < .01), and depression (33% vs 17%; P < .01). More boys than girls reported arrest (15% vs 7%; P < .01). Independent associations with sexting for girls were: ever had sex (odds ratio [OR], 4.59; 95% confidence interval [CI], 2.29-9.19; P < .001); sexual abuse (OR, 3.81; 95% CI, 1.80-8.05; P < .001); IPV victim (OR, 2.72; 95% CI, 1.11-6.62; P < .05), and for boys: ever had sex (OR, 4.26; 95% CI, 1.47-12.32; P < .01); sexual abuse (OR, 38.48; 95% CI, 1.48-999.46; P < .05); IPV perpetration (OR, 16.73; 95% CI, 1.64-170.75; 95% CI, P < .05), as well as cannabis use, older age, other race, and arrest.

CONCLUSION

For young adolescents, sexting is independently associated with exploitative and abusive sexual relationships including sexual abuse and IPV with similarities and differences in predictors of sexting for girls and boys.

A systematic review on the relationship between childhood exposure to external cause parental death, including suicide, on subsequent suicidal behaviour

BACKGROUND

Exposure to parental death in childhood has been associated with offspring suicide risk, although the strength of this association is unclear. The primary aim of this systematic review was to synthesise primary studies on the relationship between childhood exposure to external cause parental death, including suicide, and subsequent suicidal behaviour in adulthood. The secondary objective was to compare suicide-related outcomes of exposure to parental suicide with the outcomes of exposure to other external cause parental deaths.

METHODS

A systematic review was conducted using guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ovid MEDLINE, Cochrane Library, Ovid PsycINFO, Web of Science, CINAHL and EMBASE were searched from January 2008 until November 2018. Two researchers independently screened the articles, performed data extraction and assessed quality of evidence using the Newcastle-Ottawa Scale.

RESULTS

Of the 618 studies identified, 26 were included for review. Only one study found no significant association between childhood exposure to suicide and increased suicide risk in adulthood. Four studies suggested the risk of suicidality in adulthood was greater for those exposed to parental suicide compared to other external cause deaths.

LIMITATIONS

The use of national registers in many studies did not allow for all variables of interest to be examined. Selective samples also limited the generalizability of findings.

CONCLUSIONS

A strong association between parental suicide and suicidal behaviour in adult offspring exists. Interventions for bereaved youth should consider the long-term effects of parental suicide and target individual and environmental-level risk factors for subsequent suicidality.

Exposure to Community Violence and Self-harm in California: A Multilevel, Population-based, Case-Control Study

BACKGROUND

Self-harm is a leading cause of morbidity and mortality. Exposure to community violence is an important and potentially modifiable feature of the social environment that may affect self-harm, but studies to date are limited in the samples and outcomes examined.

METHODS

We conducted a population-based, nested case-control study. Cases were all deaths and hospital visits due to self-harm in California, 2006-2013. We frequency-matched California resident population-based controls from the American Community Survey to cases on age, gender, race/ethnicity, and year of survey/injury. We assessed past-year community violence using deaths and hospital visits due to interpersonal violence in the community of residence. We estimated risk difference parameters that were defined to avoid extrapolation and to capture associations between changes in the distribution of community violence and the population-level risk of self-harm.

RESULTS

After adjustment for confounders, setting past-year community violence to the lowest monthly levels observed within each community over the study period was associated with a 30.1 (95% confidence interval = 29.6, 30.5) per 100,000 persons per year lower risk of nonfatal self-harm but no difference in the risk of fatal self-harm. Associations for a parameter corresponding to a hypothetical violence prevention intervention targeting high-violence communities indicated a 5% decrease in nonfatal self-harm at the population level. In sensitivity analyses, results were robust.

CONCLUSIONS

This study strengthens evidence on the relationship between community violence and self-harm. Future research should investigate reasons for differential associations by age and gender and whether community violence prevention programs have meaningful impacts on self-harm.

Psychometric Properties of the CYBVICS Cyber-Victimization Scale and Its Relationship with Psychosocial Variables

The main goal of the present study was to analyze the psychometric properties of the revised version of the Adolescent Cyber-Victimization Scale (CYBVICS). This scale is composed of 18 items that assess direct and indirect cyber-victimization. Two subsamples participated in the present study. Sample 1 included 1318 adolescents (47.4% boys) from 12 to 16 years old (M = 13.89, SD = 1.32). Sample 2 was composed of 1188 adolescents (51.5% girls) from 12 to 16 years old (M = 14.19, SD = 1.80). First, an exploratory factor analysis was conducted on sample 1. Results yielded a bifactor structure: direct cyber-victimization and indirect cyber-victimization. To confirm the structure of the CYBVICS, we selected sample 2 to perform confirmatory factor analysis and test its convergent validity with theoretically related measures. The results supported the reliability and validity of the two-factor model. In addition, measurement invariance was established. Related to convergent validity, positive correlations between cyber-victimization and peer victimization, depressive symptoms, and offensive communication with the mother and the father were found. Moreover, negative correlations were found between cyber-victimization and open communication with the mother and the father and family self-esteem.

The moderating impact of childhood adversity profiles and conflict on psychological health and suicidal behaviour in the Northern Ireland population

Childhood adversities are key etiological factors in the onset and persistence of psychopathology. In Northern Ireland the Troubles also impacted on the population's psychological health. This study used data from the Northern Ireland Study of Health and Stress a collaborative epidemiological study which used the WMH-CIDI to assess mental health disorders in a nationally representative sample (Part 2, n = 1986). The aims of the study were to assess co-occurrences of childhood adversities and investigate the impact of adversity profiles and conflict experience on psychopathology and suicidal behaviour. Latent Class Analysis uncovered 3 discrete childhood adversity profiles, a low, medium, and high risk class. Individuals from higher risk adversity profiles displayed significantly increased odds of having psychological problems, with conflict exposure also impacting on psychopathology. However, the study revealed that the impact of conflict exposure on suicidal behaviour was moderated by latent class membership and that some adversity may actually be protective. The findings highlight the need to consider that, while adversity can have a negative impact on psychopathology, a lack of adversity early in life may hinder some people from developing adequate coping strategies. Further research is required to identify adversity patterns and other interacting factors that are protective.

Are there sensitive periods when child maltreatment substantially elevates suicide risk? Results from a nationally representative sample of adolescents

BACKGROUND

Although child maltreatment is a well documented risk factor for suicidal behavior, little is known about whether the timing of child maltreatment differentially associates with risk of suicidal ideation, suicide plans, or suicide attempts. The goal of this study was to examine whether a first exposure to physical or sexual abuse during specific developmental periods significantly elevated risk for suicidal behavior in adolescents.

METHODS

Data came from the National Comorbidity Survey Adolescent Supplement, a population-based sample of US adolescents aged 13-18 years old (n = 9,272). Using discrete time survival analysis, we assessed the association between timing of first abuse (early childhood: ages 0-5; middle childhood: ages 6-10; adolescence: ages 11-18) and suicidal ideation, plans, and attempts.

RESULTS

Exposure to either physical or sexual abuse increased the odds of reporting suicidal ideation (odds ratio [OR] = 5.06 and OR = 3.56, respectively), plans (OR = 3.63 and OR = 3.58, respectively), and attempts (OR = 5.80 and OR = 4.21, respectively), even after controlling for sociodemographic covariates and psychiatric disorders. However, the timing of physical and sexual abuse exposure was unassociated with suicidal behavior (all p values >.05).

CONCLUSIONS

Exposure to child maltreatment is strongly associated with risk for adolescent suicidal behaviors, though this association did not vary based on the developmental timing of first exposure. These findings suggest that prevention efforts should be implemented throughout early development and target all children, regardless of when they were first exposed.

The impact of child maltreatment on the risk of deliberate self-harm among adolescents: A population-wide cohort study using linked administrative records

Adolescents exposed to maltreatment have an elevated risk of deliberate self-harm (DSH). The aim of this study was to investigate longitudinally the effects of the number, timing, and type of maltreatment allegations on adolescent risk of having a DSH-related hospital admission, using linked data in Western Australia. A total of 351,372 children born between 1986 and 2000 were followed from birth up to the year 2010. Cox regression models were utilized, while controlling for a range of psychosocial covariates. Compared to children without allegations of maltreatment, children with unsubstantiated allegations only (aHR=1.04, 95%CI: 1.00-1.08, p<.01) and children with a substantiated allegation (aHR=1.10, 95%CI: 1.06-1.15, p<.001) all had significantly increased risk of DSH in adolescence. Among children with a substantiated allegation of maltreatment, the greater the number of allegations, the longer the exposure to maltreatment, and the more types of maltreatment experienced by a child, the higher the child's risk of DSH. However, this dose-response pattern was not found among children with unsubstantiated allegations only. This study calls for the early identification of children who are vulnerable to maltreatment, the better identification of the duration and severity of maltreatment experiences, and the provision of continued care and support, to reduce the child's DSH risk in adolescence.

Characteristics of Child Maltreatment and Adolescent Marijuana Use: A Prospective Study

There has been increasing acceptance of marijuana use in the United States in recent years, and rates among adolescents have risen. At the same time, marijuana use during adolescence has been linked to an array of health and social problems. Maltreated children are at risk for marijuana use, but the relationships among characteristics of maltreatment and marijuana use are unclear. In this article, we examine how the type and the extent of maltreatment are related to the level of adolescent marijuana use. Data analyses were conducted on a subsample of maltreated adolescents (n = 702) from the Longitudinal Studies of Child Abuse and Neglect project. Approximately half the sample had used marijuana, and maltreatment was associated with its use. Multivariate regression models showed that being male, extensive maltreatment, and peer marijuana use were associated with heavy use of marijuana. These findings suggest the importance of comprehensively assessing children's maltreatment experiences and their peers' drug use to help prevent or address possible marijuana use in these high-risk adolescents.

Residential Transience, Major Depressive Episodes, and the Risk of Suicidal Thoughts, Plans, and Attempts

The association between past-year residential transience (frequent moving) and suicidal ideation among a nationally representative sample of over 190,000 U.S. adults was evaluated. Suicidal thoughts, plans, and attempts were more prevalent among transient adults. Among adults without major depressive episodes (MDE), transience was associated with 70% to 90% greater odds of suicidal ideation compared to nontransient adults. Among adults with MDE, transience was associated with a 60% to 80% increased odds of suicidal ideation compared to nontransient adults. Residential transience may be an indicator for increased suicide risk even in the absence of depression.

Life adversities and suicidal behavior in young individuals: a systematic review

Suicidal behavior in young people is a significant public health problem. However, it is not yet clear whether adversities (adverse life events) may be related to suicidality in adolescence and early adulthood. This paper aimed to investigate systematically the association between the type/number of adverse life events and experiences and suicidal behavior in young people. We developed a detailed strategy to search relevant articles in Pubmed, Scopus, PsycInfo, and Science Direct (January 1980-January 2015) about adverse life events and suicidal behavior. Adverse life events and experiences included maltreatment and violence, loss events, intra-familial problems, school and interpersonal problems. Studies were restricted to suicidal behavior in young people aged 10-25 years. The search yielded 245 articles, of which 28 met our inclusion criteria. Most studies reported a strong association between adversities and suicidality (both suicidal ideation and attempts). Based on the main results, the number of adversities or negative life events experienced seemed to have a positive dose-response relationship with youth suicidal behavior. However, the type of event experienced also appeared to matter: one of the most consistent findings was the association between suicidal behavior and experience of sexual abuse. More prospective studies are needed to elucidate the relative importance of risk accumulation and risk specificity for youth suicide.

Trajectories of Adverse Childhood Experiences and Self-Reported Health at Age 18

OBJECTIVE

Despite growing evidence of links between adverse childhood experiences (ACEs) and long-term health outcomes, there has been limited longitudinal investigation of such links in youth. The purpose of these analyses was to describe the patterns of exposure to ACEs over time and their links to youth health.

METHODS

The current analyses used data from LONGSCAN, a prospective study of children at risk for or exposed to child maltreatment, who were followed from age 4 to age 18. The analyses focused on 802 youth with complete data. Cumulative exposure to ACEs between 4 and 16 was used to place participants in 3 trajectory-defined groups: chronic ACEs, early ACEs only, and limited ACEs. Links to self-reported health at age 18 were examined using linear mixed models after controlling for earlier health status and demographics.

RESULTS

The chronic ACEs group had increased self-reported health concerns and use of medical care at 18 but not poorer self-rated health status. The early ACEs only group did not significantly differ from limited ACEs on outcomes.

CONCLUSIONS

In addition to other negative outcomes, chronic ACEs appear to affect physical health in emerging adulthood. Interventions aimed at reducing exposure to ACEs and early mitigation of their effects may have lasting and widespread health benefits.

Childhood adversity and cell-mediated immunity in young adulthood: does type and timing matter?

Childhood adversity can have powerful effects on health over the life course. Persistent changes in cell-mediated immune function may be one pathway linking adverse childhood experiences with later disease risk. However, limited research has examined childhood adversity in relation to cell-mediated immune function, and in particular, immune response to latent viruses in adulthood. The present study investigated the association of two types of childhood adversity, socioeconomic disadvantage during adolescence and abuse prior to age 18, with Epstein-Barr Virus (EBV) antibody titers in a large nationally representative sample of young adults aged 24-32years. Data were drawn from the National Longitudinal Study on Adolescent Health, Wave 4 (n=13,162). We examined the associations of three indicators of adolescent SES (parental education, household income, and occupational status) and frequency and timing of physical and sexual abuse with EBV antibodies, controlling for age, sex, race/ethnicity, and presence of a smoker in the household during adolescence. Lower parental occupational status and some categories of lower education were associated with elevated EBV antibodies (p<.05), and individuals who reported sexual abuse that occurred more than 10times had elevated EBV antibodies relative to individuals who were not sexually abused (p=0.03). Among individuals exposed to physical abuse, those who were first abused at age 3-5years had heightened EBV antibodies relative to those first abused during adolescence (p=0.004). This study extends prior research linking early adversity and immune function, and provides initial evidence that childhood adversity has a persistent influence on immune responses to latent infection in adulthood.