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Pontes NMH, Thompson S, Saffold TL, Pontes MCF. Additive interactions between sex and forced sexual intercourse victimization on depressive symptoms and suicidality: Youth risk behavior survey 2001-2017. Nurs Outlook 2022; 70:866-878. [PMID: 36396504 DOI: 10.1016/j.outlook.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/01/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adolescents who have been forced to have sexual intercourse have higher rates of depressive symptoms and suicidality. PURPOSE This research investigated whether the association between adolescent forced sexual intercourse victimization and depressive symptoms or suicidality varies significantly by sex. METHOD This secondary analysis pooled cross-sectional data from the Youth Risk Behavior Survey 2001 through 2017 (N = 132,580) using R to estimate adjusted risk differences and additive interactions. FINDINGS Results show an extremely high prevalence of depressive symptoms and suicidality among adolescents who experience forced sexual victimization. This association is significantly higher among females for depressive symptoms, but significantly higher among males for suicide attempt or suicide attempt requiring treatment. RESULTS also showed that approximately 40% of both males and females who attempted suicide requiring treatment also had a history of forced sexual intercourse victimization. DISCUSSION These findings highlight the importance of screening for sexual victimization, depression and suicidality among adolescents.
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Affiliation(s)
- Nancy M H Pontes
- The State University of New Jersey, School of Nursing, Camden, NJ.
| | - Summer Thompson
- Health Sciences Clinical, Psychiatric and Mental Health Nurse Practitioner Program, University of California San Francisco, School of Nursing
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2
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Scheer JR, Clark KA, Talan A, Cabral C, Pachankis JE, Rendina HJ. Longitudinal associations between childhood sexual abuse-related PTSD symptoms and passive and active suicidal ideation among sexual minority men. CHILD ABUSE & NEGLECT 2021; 122:105353. [PMID: 34638046 PMCID: PMC8612966 DOI: 10.1016/j.chiabu.2021.105353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Sexual minority men report high rates of childhood sexual abuse (CSA) and adulthood suicidality. However, mechanisms (e.g., PTSD symptoms) through which CSA might drive suicidality remain unknown. OBJECTIVE In a prospective cohort of sexual minority men, we examined: (1) associations between CSA and suicidal thoughts and behaviors; (2) prospective associations between CSA-related PTSD symptoms and suicidal ideation; and (3) interpersonal moderators of these associations. PARTICIPANTS AND SETTING Participants included 6305 sexual minority men (Mage = 33.2, SD = 11.5; 82.0% gay; 53.5% White) who completed baseline and one-year follow-up at-home online surveys. METHODS Bivariate analyses were used to assess baseline demographic and suicidality differences between CSA-exposed participants and non-CSA-exposed participants. Among CSA-exposed participants, multivariable logistic regression analyses were used to regress passive and active suicidal ideation at one-year follow-up on CSA-related PTSD symptoms at baseline. Interactions were examined between CSA-related PTSD symptoms and interpersonal difficulties. RESULTS CSA-exposed sexual minority men reported two-and-a-half times the odds of suicide attempt history compared to non-CSA-exposed men (95% CI = 2.15-2.88; p < 0.001). Among CSA-exposed sexual minority men, CSA-related PTSD symptoms were prospectively associated with passive suicidal ideation (adjusted odds ratio [aOR] = 1.38; 95% CI = 1.19; 1.61). Regardless of CSA-related PTSD symptom severity, those with lower social support and greater loneliness were at elevated risk of active suicidal ideation at one-year follow-up. CONCLUSIONS CSA-related PTSD symptom severity represents a psychological mechanism contributing to CSA-exposed sexual minority men's elevated suicide risk, particularly among those who lack social support and report loneliness.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse NY 13244, USA.
| | - Kirsty A Clark
- Department of Medicine, Health & Society, Vanderbilt University, Nashville, TN 37212, USA
| | - Ali Talan
- Whitman-Walker Institute, Inc., Washington, DC 20009, USA
| | - Cynthia Cabral
- Counseling and Wellness Center, St. Joseph's College, Brooklyn, NY 11205, USA
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - H Jonathon Rendina
- Whitman-Walker Institute, Inc., Washington, DC 20009, USA; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
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3
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Tubman JG, Oshri A, Duprey EB, Sutton TE. Childhood maltreatment, psychiatric symptoms, and suicidal thoughts among adolescents receiving substance use treatment services. J Adolesc 2021; 89:18-27. [PMID: 33839366 DOI: 10.1016/j.adolescence.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/18/2021] [Accepted: 03/22/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Childhood maltreatment experiences are associated with future suicidal thoughts and suicide attempts, yet the roles of specific psychiatric symptoms mediating this relation remain to be clarified. To clarify these relations, we tested a model incorporating multiple forms of childhood maltreatment (sexual abuse, physical punishment, emotional neglect), past year psychiatric disorder symptoms during adolescence (anxiety, mood, and conduct disorders) and recent suicidal thoughts. METHODS We administered structured interviews to 394 adolescents receiving outpatient substance use treatment services in the Southeastern United States (280 males; Mage = 16.33; SDage = 1.15). Structural equation models (SEMs) were used to evaluate the degree to which relations between childhood maltreatment and suicidal thoughts were mediated by specific past-year psychiatric symptoms. RESULTS Mood disorder symptoms significantly mediated the relation between neglect/negative home environment and suicidal thoughts. This path of influence did not vary by gender. CONCLUSIONS Childhood maltreatment and subsequent psychopathology influence suicidal thoughts among adolescents receiving substance use treatment services. The findings of the present study have implications for the adaptation and delivery of substance use treatment services to adolescents to enhance treatment engagement and outcomes.
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Desai S, Tanguay-Sela M, Benrimoh D, Fratila R, Brown E, Perlman K, John A, DelPozo-Banos M, Low N, Israel S, Palladini L, Turecki G. Identification of Suicidal Ideation in the Canadian Community Health Survey-Mental Health Component Using Deep Learning. Front Artif Intell 2021; 4:561528. [PMID: 34250463 PMCID: PMC8264793 DOI: 10.3389/frai.2021.561528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Suicidal ideation (SI) is prevalent in the general population, and is a risk factor for suicide. Predicting which patients are likely to have SI remains challenging. Deep Learning (DL) may be a useful tool in this context, as it can be used to find patterns in complex, heterogeneous, and incomplete datasets. An automated screening system for SI could help prompt clinicians to be more attentive to patients at risk for suicide. Methods: Using the Canadian Community Health Survey-Mental Health Component, we trained a DL model based on 23,859 survey responses to classify patients with and without SI. Models were created to classify both lifetime SI and SI over the last 12 months. From 582 possible parameters we produced 96- and 21-feature versions of the models. Models were trained using an undersampling procedure that balanced the training set between SI and non-SI; validation was done on held-out data. Results: For lifetime SI, the 96 feature model had an Area under the receiver operating curve (AUC) of 0.79 and the 21 feature model had an AUC of 0.77. For SI in the last 12 months the 96 feature model had an AUC of 0.71 and the 21 feature model had an AUC of 0.68. In addition, sensitivity analyses demonstrated feature relationships in line with existing literature. Discussion: Although further study is required to ensure clinical relevance and sample generalizability, this study is an initial proof of concept for the use of DL to improve identification of SI. Sensitivity analyses can help improve the interpretability of DL models. This kind of model would help start conversations with patients which could lead to improved care and a reduction in suicidal behavior.
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Affiliation(s)
- Sneha Desai
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
- Aifred Health Inc., Montreal, QC, Canada
| | - Myriam Tanguay-Sela
- Aifred Health Inc., Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - David Benrimoh
- Aifred Health Inc., Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Faculty of Medicine, McGill University, Montreal, QC, Canada
- *Correspondence: David Benrimoh,
| | | | - Eleanor Brown
- Aifred Health Inc., Montreal, QC, Canada
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
| | - Kelly Perlman
- Aifred Health Inc., Montreal, QC, Canada
- Douglas Mental Health University Institute, Montrea, QC, Canada
| | - Ann John
- Swansea University, Swansea, United Kingdom
| | | | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Lisa Palladini
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montrea, QC, Canada
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5
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Steine IM, Nielsen B, Porter PA, Krystal JH, Winje D, Grønli J, Milde AM, Bjorvatn B, Nordhus IH, Pallesen S. Predictors and correlates of lifetime and persistent non-suicidal self-injury and suicide attempts among adult survivors of childhood sexual abuse. Eur J Psychotraumatol 2020; 11:1815282. [PMID: 33312451 PMCID: PMC7717684 DOI: 10.1080/20008198.2020.1815282] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: Childhood sexual abuse (CSA) is a well-established risk factor for non-suicidal self-injury (NSSI) and suicide attempts (SA); still few studies have examined predictors of individual differences in NSSI/SA amongst CSA survivors. Objective: To examine predictors of NSSI and SA among adult CSA-survivors. Methods: In a sample of 516, primarily female adult CSA-survivors recruited from support centres for sexual abuse survivors in Norway, we examined the role of abuse/perpetrator characteristics, and the degree/severity of exposure to other types of childhood maltreatment (cumulative childhood maltreatment; CCM), as predictors of lifetime NSSI and SA. In a subsample of 138 individuals responding to follow-up waves two- and four years later, these same distal factors, as well as previous NSSI and proximal factors in the form of symptoms of mental health disorders (posttraumatic stress, anxiety, depression, sleep disturbances, and eating disorders), relational problems, and perceived social support, were examined as predictors of persistent NSSI. Finally, those attempting new SA during the follow-up period were compared to those who did not on these variables. Results: Higher CCM scores and having had an unknown perpetrator positively predicted lifetime NSSI scores. Higher CCM scores, violent abuse, and having had an unknown perpetrator predicted lifetime SA. Higher CCM scores, previous NSSI, having had a known perpetrator, as well as higher depression-, anxiety- and eating disorder scores, positively predicted persistent NSSI during the four-year follow-up period. Compared to those with no new SA, those reporting new SA during the follow-up period had higher CCM, lifetime NSSI, mental health symptoms and relational problem scores, lower perceived social support scores, and were more likely to have done a past SA and to have experienced abuse involving physical violence. Conclusions: A broad range of both distal and proximal factors should be assessed as potential predictors of NSSI and SA among adult CSA-survivors.
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Affiliation(s)
- Iris M Steine
- Department of Psychology, UC Berkeley, Berkeley, CA, USA.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | | | - John H Krystal
- Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Dagfinn Winje
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Janne Grønli
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Anne Marita Milde
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORCE AS - Regional Centre for Child and Youth Mental Health and Child Welfare, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Inger Hilde Nordhus
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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6
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Ferreira F, Castro D, Araújo AS, Fonseca AR, Ferreira TB. Exposure to Traumatic Events and Development of Psychotic Symptoms in a Prison Population: A Network Analysis Approach. Psychiatry Res 2020; 286:112894. [PMID: 32151849 DOI: 10.1016/j.psychres.2020.112894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 01/03/2023]
Abstract
Previous studies consistently observed an association between exposure to traumatic events and psychotic symptoms. However, little is known about the differential impact of distinct traumatic events and the role of general symptoms in mediating this relationship. Thus, our study aimed to explore the differential association of several traumatic events to the psychotic symptoms in a sample of prisoners and whether this association is mediated by general symptoms. The total sample from the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (N = 3039; 75.4% male) was used. Participants completed a list of traumatic events experienced before reclusion, the Psychosis Screening Questionnaire, Clinical Review Schedule-Revised. Network analysis was used to estimate the network of interactions between traumatic events and general and psychotic symptoms. Shortest paths analysis was performed to identify the different development trajectories. Results suggested that memory problems, compulsions, and irritability might be key mediating symptoms for most traumatic events. However, sexual abuse showed alternative mediators that might be specific of this traumatic event. Finally, the traumatic events, suffered from violence at work, separation/divorce and been homeless showed direct associations with specific psychotic symptoms.
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Affiliation(s)
- Filipa Ferreira
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto.
| | - Daniel Castro
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto
| | - Ana Sofia Araújo
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal
| | - Ana Rita Fonseca
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal
| | - Tiago Bento Ferreira
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto
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7
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The tide does turn: Predictors of remission from suicidal ideation and attempt among Canadians who previously attempted suicide. Psychiatry Res 2019; 274:313-321. [PMID: 30836277 DOI: 10.1016/j.psychres.2019.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
The objectives of this study were to identify factors that contribute to (1) remission from suicidal ideation, and (2) remission from suicide attempt, among Canadians with a lifetime history of suicide attempt. Data for this study came from Statistics Canada's nationally representative 2012 Canadian Community Health Survey-Mental Health. A sample of 769 adult respondents who had ever attempted suicide was analyzed with remission from past year suicidal ideation and remission from past year suicide attempt as outcome variables. Of the 769 respondents who had ever attempted suicide, more than two-thirds (69%) were free from suicidal ideation within the past year, and approximately 87% were free from suicide attempts within the past year. Compared to men, odds were 2.66 times greater for women to be free of suicide attempt and 2.65 times greater to be free of suicidal ideation in the past year. Older age, being free of sleep problems and major depressive episode, having no history of chronic childhood physical abuse, and having two or fewer previous suicide attempts were associated with higher odds of remission from both suicide attempt and ideation in the past year.
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8
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Gray S, Rarick S. Exploring Gender and Racial/Ethnic Differences in the Effects of Child Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2018; 27:570-587. [PMID: 29924694 DOI: 10.1080/10538712.2018.1484403] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/19/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
Child sexual abuse (CSA) has been linked to a number of adverse effects including hypersexuality (HYP), substance use (SUB), suicidality (SUI), and depression (DEP). Despite a plethora of research on CSA, little is known about how it affects adolescents and the cultural factors that influence their coping styles. This study was founded on social-cultural coping theory and the model of traumagenic dynamics of sexual abuse, suggesting that CSA consequences lead to maladaptive coping mechanisms influenced by sociocultural factors. Using archival data, loglinear analysis was conducted to examine gender differences within racial/ethnic groups in HYP, SUI, DEP, and SUB among adolescent survivors of CSA in a National sample of 13,583 male and female high school students. The purpose of the study was to identify differences in the effects of CSA as manifested by variations of maladaptive coping across racial/ethnic groups and gender. Boys were significantly more likely to use substances, while girls were more likely to experience depressive symptoms and suicidality. Notably, this study did not reveal any significant racial/ethnic differences in adolescent coping. These findings can inform treatment planning and interventions for adolescents who may present with DEP, SUI, SUB, or risky sexual behaviors, but may have underlying trauma from CSA. This study contributes to the knowledge base about the processes that take place within adolescent CSA survivors, shedding light on cultural nuances among adolescent coping and informing culturally competent practice.
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Affiliation(s)
| | - Susan Rarick
- b Department of Psychology , Walden University , Minneapolis , MN , USA
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9
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Obikane E, Shinozaki T, Takagi D, Kawakami N. Impact of childhood abuse on suicide-related behavior: Analysis using marginal structural models. J Affect Disord 2018; 234:224-230. [PMID: 29547815 DOI: 10.1016/j.jad.2018.02.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/22/2018] [Accepted: 02/16/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Childhood abuse is associated with adult suicidal behaviors, partially mediated by mental disorders. However, the direct effect of childhood abuse not mediated by mental disorders is uncertain because the same risk factors serve as mediators and confounders of mental disorders and suicidal behaviors. The aim of the study was to estimate the direct effect of childhood abuse not mediated by mental disorders on suicidal behaviors using marginal structural models. METHODS We used cross-sectional data of Japanese adults in Tokyo and neighboring prefectures (The Japanese Study on Stratification, Health, Income, and Neighborhood). We developed a causal diagram of childhood abuse and suicidal behaviors, and defined exposures (childhood abuse), confounders (age, childhood social characteristics), mediators (mental disorders), risk factors (coping, smoking, alcohol consumption, education, physical health), and outcome (suicidal behaviors). We estimated the direct effect of childhood abuse according to sex using inverse-probability weighting at 2 points and compared to total and direct effects estimated by conventional regression models. RESULTS Of 1776 male and 2016 female participants, childhood abuse showed significant total effects on suicidal behaviors. Physical abuse was associated with suicidal ideation (risk ratio: males 2.11 [95% confidence interval: 1.59-2.82], females 2.15 [1.69-2.72]), suicidal plan (risk ratio: males 2.18 [1.21-3.92], females 2.14 [1.24-3.74]), and suicidal attempt (risk ratio: males 2.11 [1.14-5.10], females 4.79 [2.93-7.83]) through direct effect. LIMITATIONS Childhood abuse was measured according to self-report of the past experiences. CONCLUSIONS Our study suggests that childhood abuse is associated with adult suicidal behaviors through direct effects not mediated by mental disorders.
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Affiliation(s)
- Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Tomohiro Shinozaki
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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10
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Hom MA, Matheny NL, Stanley IH, Rogers ML, Cougle JR, Joiner TE. Examining Physical and Sexual Abuse Histories as Correlates of Suicide Risk Among Firefighters. J Trauma Stress 2017; 30:672-681. [PMID: 29083498 DOI: 10.1002/jts.22230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 06/21/2017] [Accepted: 07/27/2017] [Indexed: 11/09/2022]
Abstract
Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideation, plans, and attempts; and (b) current suicide risk (controlling for theoretically relevant symptoms) in this occupational group. A sample of 929 U.S. firefighters completed self-report surveys that assessed lifetime history of physical and sexual abuse; career suicide ideation, plans, and attempts; current suicide risk; and theoretically relevant symptoms. Logistic regression analyses revealed that individuals who reported a history of physical abuse were significantly more likely to report career suicide ideation, adjusted odds ratio [AOR] = 6.12, plans, AOR = 13.05, and attempts, AOR = 23.81, than those who did not. A similar pattern of findings emerged for individuals who reported a sexual abuse history, AORs = 7.83, 18.35, and 29.58 respectively. Linear regression analyses revealed that physical and sexual abuse histories each significantly predicted current suicide risk, even after controlling for theoretically relevant symptoms and demographics, pr2 = .07 and .06, respectively. Firefighters with a history of physical and/or sexual abuse may be at increased risk for suicidal thoughts and behaviors. A history of physical and sexual abuse were each significantly correlated with current suicide risk in this population, even after accounting for the effects of theoretically relevant symptoms. Thus, when conceptualizing suicide risk among firefighters, factors not necessarily related to one's firefighter career should be considered.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Natalie L Matheny
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Ian H Stanley
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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11
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Itani T, Fischer F, Kraemer A. Gender moderates the association between polyvictimization and suicidal ideation among adolescents in the United Arab Emirates. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2017. [DOI: 10.1080/02673843.2017.1377089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Taha Itani
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany
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12
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Khosravani V, Kamali Z, Jamaati Ardakani R, Samimi Ardestani M. The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts. Psychiatry Res 2017; 255:139-145. [PMID: 28549337 DOI: 10.1016/j.psychres.2017.05.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/19/2017] [Accepted: 05/19/2017] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts.
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Affiliation(s)
- Vahid Khosravani
- Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | | - Mehdi Samimi Ardestani
- Departments of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Abstract
The effect of perceived criticism from others is one potentially important risk factor for suicide that has received scant attention, despite decades of research on the role of criticism in the treatment and course of mental illnesses such as schizophrenia and mood disorders. This study analyzed the effect of perceived criticism's association with suicidal ideation and attempts as well as its connection with the suicide related constructs thwarted belongingness and perceived burdensomeness as described in the Interpersonal Theory of Suicide. Fifty participants (66% female, MAge = 18.7), 18 of whom had previously made one or more suicide attempts, completed a battery of self-report assessments as well as two in-person, structured clinical interviews. Analyses demonstrated that perceived parental criticism is a significant indicator of suicide ideation (β = .297, p = .003) and attempts (β = .373, p < .001) and that perceived criticism from close friends is a significant indicator of suicide attempts (β = .297, p = .006). Perceived criticism has a strong indirect effect on suicide ideation and attempts through its effect on thwarted belongingness, but not perceived burdensomeness, while controlling for mental illnesses. Some limitations of this study include the cross-sectional design and the use of a relatively small, restricted age sample. Treatment designed to mitigate perceived criticism and thwarted belongingness may be an important component in combatting suicidal ideation and attempts, particularly among young adults.
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14
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Letourneau EJ, Schaeffer CM, Bradshaw CP, Feder KA. Preventing the Onset of Child Sexual Abuse by Targeting Young Adolescents With Universal Prevention Programming. CHILD MALTREATMENT 2017; 22:100-111. [PMID: 28413921 PMCID: PMC5523139 DOI: 10.1177/1077559517692439] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Child sexual abuse (CSA) is a serious public health problem that increases risk for physical and mental health problems across the life course. Young adolescents are responsible for a substantial portion of CSA offending, yet to our knowledge, no validated prevention programs that target CSA perpetration by youth exist. Most existing efforts to address CSA rely on reactive criminal justice policies or programs that teach children to protect themselves; neither approach is well validated. Given the high rates of desistance from sexual offending following a youth's first CSA-related adjudication, it seems plausible that many youth could be prevented from engaging in their first offense. The goal of this article is to examine how school-based universal prevention programs might be used to prevent CSA perpetrated by adolescents. We review the literature on risk and protective factors for CSA perpetration and identify several promising factors to target in an intervention. We also summarize the literature on programs that have been effective at preventing adolescent dating violence and other serious problem behaviors. Finally, we describe a new CSA prevention program under development and early evaluation and make recommendations for program design characteristics, including unambiguous messaging, parental involvement, multisession dosage, skills practice, and bystander considerations.
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Affiliation(s)
- Elizabeth J. Letourneau
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cindy M. Schaeffer
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Maryland Baltimore, Baltimore, MD, USA
| | | | - Kenneth A. Feder
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Baytunca MB, Ata E, Ozbaran B, Kaya A, Kose S, Aktas EO, Aydın R, Guney S, Yuncu Z, Erermis S, Bildik T, Aydin C. Childhood sexual abuse and supportive factors. Pediatr Int 2017; 59:10-15. [PMID: 27288641 DOI: 10.1111/ped.13065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/07/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Childhood sexual abuse (CSA) can be a devastating life experience and is associated with a higher incidence of mental disorders and suicide attempts. The aim of this study was therefore to identify predictors of mental disorder and suicide attempt in children and adolescents with a history of CSA. METHODS A total of 181 Turkish children and adolescents with a history of CSA were evaluated for age, gender, suicide attempts, family relationships and educational background. Abuse involving the insertion of an organ or foreign object into the individual's body was designated as "qualified sexual abuse" (QSA); other forms of sexual abuse were designated "basic sexual abuse" (BSA). RESULTS Suicide attempts were significantly higher in adolescent girls in the QSA subgroup; age, gender, family integrity, and school attendance were not associated with risk of mental disorders in this group. Among BSA patients, family integrity was significantly associated with suicide attempts. Suicide attempts were approximately 10-fold higher (OR, 10.154; 95% CI: 2.020-51.051; P = 0.005) in children from broken families. Family integrity and school attendance were also noted as weak protective factors against mental disorders in BSA patients. The incidence of mental disorders was 3.5-fold higher in children who had not been attending school (OR, 3.564; 95% CI: 1.379-9.211; P = 0.009). CONCLUSION Family integrity and school attendance were weakly related with psychopathology (e.g. mental disorders or suicide attempts) in BSA survivors but not in QSA survivors. Female gender and puberty also increased the likelihood of suicide attempt in QSA survivors.
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Affiliation(s)
- Muharrem Burak Baytunca
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Emsal Ata
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Burcu Ozbaran
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ahsen Kaya
- Department of Forensic Medicine, School of Medicine, Ege University, Izmir, Turkey
| | - Sezen Kose
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ekin Ozgur Aktas
- Department of Forensic Medicine, School of Medicine, Ege University, Izmir, Turkey
| | - Rezzan Aydın
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Selcen Guney
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Zeki Yuncu
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Serpil Erermis
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Cahide Aydin
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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16
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Lamis DA, Cavanaugh CE, Anastasiades MH, Garcia-Williams A, Anderson C, Kaslow NJ. Intimate Partner Sexual Coercion Mediates the Childhood Sexual Abuse–Suicidal Ideation Link Among African American Women. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798416644885] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Suicide is a leading cause of morbidity and mortality among women. Childhood sexual abuse (CSA) and intimate partner violence are significant risk factors for suicidal ideation among women. The purpose of this study was to examine the interrelationships among these three constructs and test if intimate partner sexual coercion may explain the CSA–suicidal ideation link. African American women ( N = 141) completed an assessment of childhood trauma, intimate partner sexual coercion, and suicide ideation. A significant positive correlation was found between CSA and sexual coercion, between CSA and suicidal ideation, and between sexual coercion and suicidal ideation. Also, intimate partner sexual coercion was found to mediate the relationship between CSA and suicidal ideation when controlling for covariates such as spiritual well-being, self-esteem, and barriers to services. The association between CSA and suicidal ideation may be explained by sexual revictimization in the context of an intimate relationship among African American women. Clinically, practitioners should engage in regular screening for suicide ideation among African American women who have experienced CSA and intimate partner sexual coercion.
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17
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Sachs-Ericsson NJ, Rushing NC, Stanley IH, Sheffler J. In my end is my beginning: developmental trajectories of adverse childhood experiences to late-life suicide. Aging Ment Health 2016; 20:139-65. [PMID: 26264208 DOI: 10.1080/13607863.2015.1063107] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Converging evidence suggests that the sequelae of adverse childhood experiences (ACEs) including childhood abuse (e.g., sexual, physical, emotional/verbal abuse, neglect) and other ACE (e.g., family dysfunction, parental loss, parental psychopathology, substance abuse, incarceration, and domestic violence) have pronounced effects on suicidal behaviors (suicidal ideation, attempts, and death by suicide) in older age. There are fundamental changes in the developmental trajectory of biological, psychological and behavioral processes that result from ACE and that exert influence throughout the life span. Different moderators and mediators may affect the extent and nature of the relationship. However, the literature on the specific mechanisms whereby ACE affects suicidality in later life has not been well identified. METHOD We review and draw from extant multidisciplinary evidence to develop a heuristic framework through which to understand how ACE may lead to suicide in later life. RESULTS Proposed mechanisms span biological factors (neurological, gene-environment), psychiatric and health functioning, and psychosocial development (cognitive biases, coping resources, interpersonal deficits). Evidence suggests that ACEs affect each of these constructs, and it is likely in the interaction of these constructs with late-life stressors that suicidality in older adulthood emerges. CONCLUSION ACEs have persistent and multifaceted effects on suicidality in late life. This association is due to multi-varied pathways. It is believed that the explanatory framework developed herein--in which biological, psychological and behavioral factors are organized, and the role of late-life stressors is highlighted--will spark further scientific inquiry into this important area.
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Affiliation(s)
| | - Nicole C Rushing
- b Department of Psychology , Coastal Carolina University , SC , USA
| | - Ian H Stanley
- c Department of Psychology , Florida State University , FL , USA
| | - Julia Sheffler
- c Department of Psychology , Florida State University , FL , USA
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18
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Klein H, Elifson KW, Sterk CE. How the Interaction of Childhood Sexual Abuse and Gender Relates to HIV Risk Practices among Urban-Dwelling African Americans. ACTA ACUST UNITED AC 2016; 2. [PMID: 30197963 DOI: 10.15744/2454-499x.2.105] [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: 11/05/2022]
Abstract
Purpose Previous research has demonstrated that HIV risk practices often differ based on gender and on whether or not people experienced sexual abuse during their formative (i.e., childhood and adolescence) years. The interaction of these two factors, which is the focus of this paper, has received limited attention. Methods Based on a model derived from Social Disorganization Theory and Syndemics Theory, interviews were conducted between 2009 and 2012 with 1,864 African American adults residing in Atlanta, Georgia in 80 strategically-chosen consensus block groups. Results Based on multiple regression and structural equation analyses, the interaction of sexual abuse and gender was found to be a significant predictor of involvement in (un)protected sex. The interaction of sexual abuse and gender also was related to condom use self-efficacy, which was one of the strongest factors underlying (un)protected sex. Conclusion The relationship of sexual abuse history and gender is relevant in the understanding of HIV risk practices. The interaction of these factors with one another and with other relevant influences that shape people's HIV risk profiles is complex. The Syndemics Theory approach used to conceptualize the relationships among relevant variables in this study is an effective way of trying to understand and address HIV risk practices.
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Affiliation(s)
- H Klein
- Kensington Research Institute, Kensington MD and Rollins School of Public Health, Emory University, Atlanta GA, United States
| | - K W Elifson
- Rollins School of Public Health, Emory University, Atlanta GA, United States
| | - C E Sterk
- Rollins School of Public Health, Emory University, Atlanta GA, United States
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19
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Reed D, Reno J, Green D. Sexual Violence Among Youth in New Mexico: Risk and Resiliency Factors That Impact Behavioral Health Outcomes. FAMILY & COMMUNITY HEALTH 2016; 39:92-102. [PMID: 26882412 DOI: 10.1097/fch.0000000000000093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Research has consistently demonstrated a relationship between history of forced sex and poor behavioral health outcomes. The objectives of this study were to describe this relationship among high school students and to explore the impact of resiliency factors. Using data from the 2013 New Mexico Youth Risk and Resiliency Survey, we found that history of forced sex was associated with negative behavioral health outcomes for males and females, regardless of sexual orientation and disability status. Furthermore, the presence of a caring adult at home appeared to reduce the risk of substance abuse and suicidality among students with and without a history of forced sex.
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Affiliation(s)
- Danielle Reed
- New Mexico Department of Health, Epidemiology & Response Division, Santa Fe
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20
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Unlu G, Cakaloz B. Effects of perpetrator identity on suicidality and nonsuicidal self-injury in sexually victimized female adolescents. Neuropsychiatr Dis Treat 2016; 12:1489-97. [PMID: 27382291 PMCID: PMC4922799 DOI: 10.2147/ndt.s109768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Child sexual abuse and sexual dating violence victimization are common problems that are known to have long-term negative consequences. This study aimed to compare the sociodemographic, abuse-related, and clinical features of female adolescents who were sexually abused by different perpetrators, and identify the factors associated with suicidality and nonsuicidal self-injury (NSSI) in these cases. PATIENTS AND METHODS Data of 254 sexually abused female adolescents between the ages of 12-18 years were evaluated. The cases were classified into three groups, namely "sexual dating violence", "incest", and "other child sexual abuse", according to the identity of the perpetrator. The three groups were compared in terms of sociodemographic, abuse-related, and clinical features. RESULTS Major depressive disorder was the most common psychiatric diagnosis, which was present in 44.9% of the cases. Among all victims, 25.6% had attempted suicide, 52.0% had suicidal ideation, and 23.6% had NSSI during the postabuse period. A logistic regression analysis revealed that attempted suicide was predicted by dating violence victimization (adjusted odds ratio [AOR] =3.053; 95% confidence interval [CI] =1.473, 6.330) and depression (AOR =2.238; 95% CI =1.226, 4.086). Dating violence victimization was also the strongest predictor of subsequent suicidal ideation (AOR =3.500; 95% CI =1.817, 6.741). In addition, revictimization was determined to be an important risk factor for both suicidal ideation (AOR =2.897; 95% CI =1.276, 6.574) and NSSI (AOR =3.847; 95% CI =1.899, 7.794). CONCLUSION Perpetrator identity and revictimization are associated with negative mental health outcomes in sexually victimized female adolescents. Increased risk of suicidality and NSSI should be borne in mind while assessing cases with dating violence and revictimization histories, in particular.
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Affiliation(s)
- Gulsen Unlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Burcu Cakaloz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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21
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Lee W, Ti L, Marshall BDL, Dong H, Wood E, Kerr T. Childhood Sexual Abuse and Syringe Sharing Among People Who Inject Drugs. AIDS Behav 2015; 19:1415-22. [PMID: 25428283 DOI: 10.1007/s10461-014-0930-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Childhood sexual abuse is associated with adverse health outcomes. However, the impact of sexual abuse on HIV risk behaviors among people who inject drugs (IDU) has not been thoroughly characterized. We therefore sought to identify whether childhood sexual abuse was associated with syringe sharing among a sample of IDU in Vancouver, Canada. We assessed sexual abuse among two cohorts of IDUs via the Childhood Trauma Questionnaire. Multivariate logistic regression was used to estimate the relationship between childhood sexual abuse and syringe sharing. In total, 1380 IDU were included in the study, and 426 (30.9 %) IDU reported childhood sexual abuse. Syringe sharing (Adjusted Odds Ratio = 1.83, 95 % Confidence Interval 1.28-2.60) remained independently associated with childhood sexual abuse after adjustment for potential confounders. Given that a history of childhood sexual abuse appears to be elevated among IDU who engage in HIV risk behaviors (i.e., syringe sharing), HIV prevention efforts should include efforts to address historical trauma in this population.
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Affiliation(s)
- William Lee
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada,
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22
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Panagioti M, Gooding PA, Triantafyllou K, Tarrier N. Suicidality and posttraumatic stress disorder (PTSD) in adolescents: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2015; 50:525-37. [PMID: 25398198 DOI: 10.1007/s00127-014-0978-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 11/10/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE There is growing evidence in the literature that a diagnosis of Posttraumatic Stress Disorder (PTSD) is an important contributory factor to suicidality in adolescents. However, there is no existing review of the literature examining the relationship between PTSD and suicidality in adolescents. This study aims to provide the first systematic review and meta-analysis of the association between PTSD and suicidality in adolescents. METHODS Five bibliographic databases (Medline, EMBASE, PsycINFO, Web of Science and PILOT) were screened for suitable articles. Twenty-eight studies (which provided 28 independent samples) were included in the review. The overall meta-analyses of the association between PTSD and suicidality were followed by subgroup and meta-regression analyses. RESULTS A highly significant positive association was found between PTSD and suicidality (d = 0.701, 95% CI 0.555-0.848). The subgroup and meta-regression analyses showed that the association between PTSD and suicidality persisted whilst adjusting for various sources of between-study heterogeneity, such as, different levels of severity of suicidality, target groups, and methodological quality of the studies. CONCLUSIONS Suicidality in adolescents with PTSD is a major problem which requires further research effort. The implications of these results are discussed.
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Affiliation(s)
- Maria Panagioti
- Institute of Population Health, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK,
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23
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Park S, Hong JP, Jeon HJ, Seong S, Cho MJ. Childhood exposure to psychological trauma and the risk of suicide attempts: the modulating effect of psychiatric disorders. Psychiatry Investig 2015; 12:171-6. [PMID: 25866516 PMCID: PMC4390586 DOI: 10.4306/pi.2015.12.2.171] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/01/2014] [Accepted: 04/11/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We examined whether childhood exposure to psychological trauma is associated with greater suicidality and whether specific psychiatric disorders modulate this association in a representative sample of Korean adults. METHODS The Korean version of the Composite International Diagnostic Interview 2.1 was administered to 6,027 subjects aged 18-74 years. Subjects who experienced a traumatic event before the age of 18 years, the childhood-trauma-exposure group, were compared with controls without childhood trauma exposure. RESULTS Childhood exposure to psychological trauma was associated with lifetime suicidal ideation (OR=3.19, 95% CI=2.42-4.20), suicide plans (OR=4.15, 95% CI=2.68-6.43), and suicide attempts (OR=4.52, 95% CI=2.97-6.88). These associations weakened after further adjustment for any psychiatric disorders, but they were not eliminated. The risk of suicide attempts related to childhood trauma increased with the presence of a concurrent alcohol use, depressive, or eating disorder. CONCLUSION In terms of clinical implications, patients with these disorders who have a history of childhood trauma should be carefully assessed for their suicide risk and aggressively treated for psychiatric disorders.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sujeong Seong
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Maeng Je Cho
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
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Khan A, McCormack HC, Bolger EA, McGreenery CE, Vitaliano G, Polcari A, Teicher MH. Childhood Maltreatment, Depression, and Suicidal Ideation: Critical Importance of Parental and Peer Emotional Abuse during Developmental Sensitive Periods in Males and Females. Front Psychiatry 2015; 6:42. [PMID: 25870565 PMCID: PMC4378368 DOI: 10.3389/fpsyt.2015.00042] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/09/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The adverse childhood experience (ACE) study found that risk for depression increased as a function of number of types of childhood maltreatment, and interpret this as a result of cumulative stress. An alternative hypothesis is that risk depends on type and timing of maltreatment. This will also present as a linear increase, since exposure to more types of abuse increases likelihood of experiencing a critical type of abuse at a critical age. METHODS 560 (223M/337F) young adults (18-25 years) were recruited from the community without regard to diagnosis and balanced to have equal exposure to 0-4 plus types of maltreatment. The Maltreatment and Abuse Chronology of Exposure Scale assessed severity of exposure to 10 types of maltreatment across each year of childhood. Major depressive disorder (MDD) and current symptoms were evaluated by SCID, interview, and self-report. Predictive analytics assessed importance of exposure at each age and evaluated whether exposure at one or two ages was a more important predictor than number, severity, or duration of maltreatment across childhood. RESULTS The most important predictors of lifetime history of MDD were non-verbal emotional abuse in males and peer emotional abuse (EA) in females at 14 years of age, and these were more important predictors across models than number of types of maltreatment (males: t 9 = 16.39, p < 10(-7); females t 9 = 5.78, p < 10(-4)). Suicidal ideation was predicted, in part, by NVEA and peer EA at age 14, but most importantly by parental verbal abuse at age 5 in males and sexual abuse at age 18 in females. CONCLUSION This study provides evidence for sensitive exposure periods when maltreatment maximally impacts risk for depression, and provides an alternative interpretation of the ACE study results. These findings fit with emerging neuroimaging evidence for regional sensitivity periods. The presence of sensitive exposure periods has important implications for prevention, preemption, and treatment of MDD.
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Affiliation(s)
- Alaptagin Khan
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Hannah C. McCormack
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Elizabeth A. Bolger
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | | | - Gordana Vitaliano
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Ann Polcari
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
- School of Nursing, Northeastern University, Belmont, MA, USA
| | - Martin H. Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
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Willis DG, Rhodes AM, Dionne-Odom JN, Lee K, Terreri P. A hermeneutic phenomenological understanding of men's healing from childhood maltreatment. J Holist Nurs 2014; 33:46-57; quiz 58-9. [PMID: 25294593 DOI: 10.1177/0898010114552706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe and interpret men's experience of healing from childhood maltreatment. DESIGN Hermeneutic phenomenological. METHOD In-depth interviews. Community-based purposive, maximum variation sampling approach. Recruitment occurred through posting flyers and advertisements. Verbatim data were analyzed and themes of the meaning of healing were identified. FINDINGS The meaning of healing was interpreted as "moving beyond suffering." Five themes were identified to capture the multidimensional nature of the phenomenon: (a) breaking through the masculine veneer, (b) finding meaning, (c) choosing to live well, (d) caring for the self using holistic healing methods, and (e) engaging in humanizing relationships. CONCLUSIONS Men who survived childhood maltreatment have needs to heal holistically mind, body, and spirit. Meeting their needs requires the provision of highly compassionate humanistic healing environments and healing-promotive nursing care.
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Soylu N, Ayaz M, Yüksel T. Early-married and sexually abused girls differ in their psychiatric outcomes. CHILD ABUSE & NEGLECT 2014; 38:1552-1559. [PMID: 24994572 DOI: 10.1016/j.chiabu.2014.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 05/22/2014] [Accepted: 05/31/2014] [Indexed: 06/03/2023]
Abstract
Early marriage and sexual abuse are the two of the most frequent types of childhood abuse. Although early marriage is also a type of sexual abuse, it is associated with different physical, social, and mental outcomes than sexual abuse alone. The purpose of this study was to compare early-married girls and sexually abused girls who were referred for forensic evaluation in Turkey in terms of their sociodemographic characteristics, mental disorder rates, and mental symptom severity. We included 63 adolescent girls for whom a judicial report had been demanded and who were under 15 years old when they were married but were not yet 18 years old during the evaluation (15.51±0.78) and 72 sexually abused adolescent girls between 14 and 18 years old (15.80±1.10) in this study. Following a psychiatric evaluation, the study participants completed the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) and the Brief Symptom Inventory (BSI). We used the Windows SPSS 16.0 software program to assess the results. At least one psychiatric disorder was determined in 44.4% of the early-married and 77.8% of the sexually abused cases (p<0.001). A diagnosis of PTSD or ASD was observed in 11.1% of the early-married cases and in 54.2% of the sexually abused victims (p<0.001). MDD was determined in 33.3% of the early-married cases and 56.9% of the sexually abused cases (p=0.006). The CPTS-RI scores of the sexually abused victims were higher than those of the early-married cases (p<0.001). All of the subscale scores of the BSI were higher in the sexually abused adolescents than in the early-married cases (p<0.001). Although early marriage has severe physical, social and mental outcomes, it is not as severe as sexual abuse in terms of psychiatric disorder rates and the psychiatric symptom severity it causes.
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Affiliation(s)
- Nusret Soylu
- Inonu University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Malatya, Turkey
| | - Muhammed Ayaz
- Istanbul Arel University, Faculty of Science and Letters, Department of Psychology, İstanbul, Turkey
| | - Tuğba Yüksel
- Dicle University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Diyarbakır, Turkey
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Yildirim F, Küçükgöncü S, Beştepe EE, Yildirim MS. The Relationship of Childhood Abuse and Neglect with Suicide Attempts in an Adult Unipolar Depression Sample. Noro Psikiyatr Ars 2014; 51:133-140. [PMID: 28360613 DOI: 10.4274/npa.y6802] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 10/09/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Unipolar depression is an important psychiatric disorder that leads to an increased risk of suicide. However, not all depression patients attempt suicide. This reflects the presence of other factors that may be related to suicide other than the sole presence of psychopathology. Drawing upon the clinical evidence linking childhood abuse and neglect experiences with suicide; this study aimed at investigating the relationship of childhood abuse and neglect experiences with suicide attempts in patients with unipolar depression. METHOD One hundred six unipolar depressed patients between the ages of 18 and 65 were included in the study. Patients with comorbid psychiatric disorders, neurological disorders, alcohol-substance abuse problems, and a Beck Depression Inventory (BDI) score of <17 were excluded from the study. The BDI, Childhood Trauma Questionnaire (CTQ-28), State-Trait Anger Expression Inventory (STAXI), and the Suicide Behavior Questionnaire (SBQ) were administered to all patients. Suicidal and non-suicidal cases were determined according to clinic interviews and the patients' responses in the SBQ. RESULTS Sixty-four patients have previously attempted suicide. Although there was no significant difference between unipolar depression patients with a history of suicide attempts and patients with no history of suicide attempts in terms of average age, education and marital status, however, female/male ratio in the former group was determined to be significantly higher. BDI, STAXI continuous anger and outward anger average scores, and average CTQ-28 emotional abuse, physical abuse and total scores were significantly higher in the group with a history of suicide attempts. The predictors of suicide attempts were higher BDI and CTQ-28 physical abuse scores and female gender. The predictors for average SBQ scores were determined as higher BDI, CTQ-28 sexual abuse, and STAXI outward anger and continuous anger scores. CONCLUSION Childhood physical and sexual abuse experiences are important factors in evaluating the presence of suicide attempts and risk of suicide in patients with unipolar depression. Careful questioning of traumatic childhood experiences during psychiatric examinations and monitoring of depression patients is crucial in determining treatment protocols and preventing suicide attempts.
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Affiliation(s)
- Feride Yildirim
- Clinic of Psychiatry, Erzurum Education Research Hospital, Erzurum, Turkey
| | - Suat Küçükgöncü
- Department of Psychiatry, Yale University, New Haven CT, USA
| | - Engin Emrem Beştepe
- Clinic of Psychiatry, Erenköy Mental Health and Neurological Diseases Education and Research Hospital, İstanbul, Turkey
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Childhood adversity, recent life stressors and suicidal behavior in Chinese college students. PLoS One 2014; 9:e86672. [PMID: 24681891 PMCID: PMC3969373 DOI: 10.1371/journal.pone.0086672] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 12/11/2013] [Indexed: 12/24/2022] Open
Abstract
Background Although the independent effects of childhood adversities and of recent negative events on suicidality have been well-documented, the combinative role of childhood and recent adversities on risk for suicidality is still underexplored, especially in the context of Chinese culture and in consideration of specific types of negative events. Method 5989 students, randomly sampled from six universities in central China, completed the online survey for this study. Suicidal behavior, life adversity during childhood and stressful events in recent school life were assessed with designed questionnaires. Results Students experiencing recent stressful life events more often reported an experience of life adversity during childhood. While recent stressful life events and childhood life adversity both were associated with an increased risk for suicidal behavior, the two exposures presented conjunctively and acted interactively to increase the risk. There was noticeable variation of effects associated with specific childhood life adversities, and sexual abuse, poor parental relationship, divorce of parents and loss of a parent were among the adversities associated with the highest increased risk. Recent conflicts with classmates, poor school performance and rupture of romantic relationships were the recent school life stressors associated with the highest increased risk. Conclusions Childhood adversity and recent school life stressors had a combinative role in predicting suicidality of young people studying in Chinese colleges. Unhappy family life during childhood and recent interpersonal conflicts in school were the most important predictors of suicidality in this population.
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Chen J, Cai Y, Cong E, Liu Y, Gao J, Li Y, Tao M, Zhang K, Wang X, Gao C, Yang L, Li K, Shi J, Wang G, Liu L, Zhang J, Du B, Jiang G, Shen J, Zhang Z, Liang W, Sun J, Hu J, Liu T, Wang X, Miao G, Meng H, Li Y, Hu C, Li Y, Huang G, Li G, Ha B, Deng H, Mei Q, Zhong H, Gao S, Sang H, Zhang Y, Fang X, Yu F, Yang D, Liu T, Chen Y, Hong X, Wu W, Chen G, Cai M, Song Y, Pan J, Dong J, Pan R, Zhang W, Shen Z, Liu Z, Gu D, Wang X, Liu X, Zhang Q, Li Y, Chen Y, Kendler KS, Shi S, Flint J. Childhood sexual abuse and the development of recurrent major depression in Chinese women. PLoS One 2014; 9:e87569. [PMID: 24489940 PMCID: PMC3906190 DOI: 10.1371/journal.pone.0087569] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 12/23/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set? METHOD Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. RESULTS We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19-5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58-3.15), genital (OR 5.24, 95% CI 3.52-8.15) and intercourse (OR 10.65, 95% CI 5.56-23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11-2.27) and phobia (OR 1.41, 95%CI 1.09-1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20-1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02-2.02). Intercourse (OR 3.47, 95%CI 1.66-8.22), use of force and threats (OR 1.95, 95%CI 1.05-3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20-1.64) were significantly associated with recurrent MD. CONCLUSIONS In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD.
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Affiliation(s)
- Jing Chen
- Huashan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yiyun Cai
- Huashan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Enzhao Cong
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Ying Liu
- The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Jingfang Gao
- Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, People's Republic of China
| | - Youhui Li
- No.1 Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Tao
- Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Kerang Zhang
- No.1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Xumei Wang
- ShengJing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Chengge Gao
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, People's Republic of China
| | - Lijun Yang
- Jilin Brain Hospital, Siping, Jilin, People's Republic of China
| | - Kan Li
- Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, People's Republic of China
| | - Jianguo Shi
- Xian Mental Health Center, Xian, Shaanxi, People's Republic of China
| | - Gang Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, People's Republic of China
| | - Lanfen Liu
- Shandong Mental Health Center, Jinan, Shandong, People's Republic of China
| | - Jinbei Zhang
- No. 3 Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Bo Du
- Hebei Mental Health Center, Baoding, Hebei, People's Republic of China
| | - Guoqing Jiang
- Chongqing Mental Health Center, Chongqing, People's Republic of China
| | - Jianhua Shen
- Tianjin Anding Hospital, Tianjin, People's Republic of China
| | - Zhen Zhang
- No.4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China
| | - Wei Liang
- Psychiatric Hospital of Henan Province, Xinxiang, Henan, People's Republic of China
| | - Jing Sun
- Nanjing Brain Hospital, Nanjing, Jiangsu, People's Republic of China
| | - Jian Hu
- Harbin Medical University, Haerbin, Heilongjiang, People's Republic of China
| | - Tiebang Liu
- Shenzhen Kang Ning Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xueyi Wang
- First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Guodong Miao
- Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Guangzhou, Guangdong, People's Republic of China
| | - Huaqing Meng
- No.1 Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yi Li
- Dalian No.7 Hospital, Dalian, Liaoning, People's Republic of China
| | - Chunmei Hu
- No.3 Hospital of Heilongjiang Province, Beian, Heilongjiang, People's Republic of China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan, Hubei, People's Republic of China
| | - Guoping Huang
- Sichuan Mental Health Center, Mianyang, Sichuan, People's Republic of China
| | - Gongying Li
- Mental Health Institute of Jining Medical College, Jining, Shandong, People's Republic of China
| | - Baowei Ha
- Liaocheng No.4 Hospital, Liaocheng, Shandong, People's Republic of China
| | - Hong Deng
- Mental Health Center of West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qiyi Mei
- Suzhou Guangji Hospital, Suzhou, Jiangsu, People's Republic of China
| | - Hui Zhong
- Anhui Mental Health Center, Hefei, Anhui, People's Republic of China
| | - Shugui Gao
- Ningbo Kang Ning Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Hong Sang
- Changchun Mental Hospital, Changchun, Jilin, People's Republic of China
| | - Yutang Zhang
- No.2 Hospital of Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Xiang Fang
- Fuzhou Psychiatric Hospital, Fuzhou, Fujian, People's Republic of China
| | - Fengyu Yu
- Harbin No.1 Special Hospital, Haerbin, Heilongjiang, People's Republic of China
| | - Donglin Yang
- Jining Psychiatric Hospital, Jining, Shandong, People's Republic of China
| | - Tieqiao Liu
- No.2 Xiangya Hospital of Zhongnan University, Changsha, Hunan, People's Republic of China
| | - Yunchun Chen
- Xijing Hospital of No.4 Military Medical University, Xian, Shaanxi, People's Republic of China
| | - Xiaohong Hong
- Mental Health Center of Shantou University, Shantou, Guangdong, People's Republic of China
| | - Wenyuan Wu
- Tongji University Hospital, Shanghai, People's Republic of China
| | - Guibing Chen
- Huaian No.3 Hospital, Huaian, Jiangsu, People's Republic of China
| | - Min Cai
- Huzhou No.3 Hospital, Huzhou, Zhejiang, People's Republic of China
| | - Yan Song
- Mudanjiang Psychiatric Hospital of Heilongjiang Province, Mudanjiang, Heilongjiang, People's Republic of China
| | - Jiyang Pan
- No.1 Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Jicheng Dong
- Qingdao Mental Health Center, Qingdao, Shandong, People's Republic of China
| | - Runde Pan
- Guangxi Longquanshan Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Wei Zhang
- Daqing No.3 Hospital of Heilongjiang Province, Daqing, Heilongjiang, People's Republic of China
| | - Zhenming Shen
- Tangshan No.5 Hospital, Tangshan, Hebei, People's Republic of China
| | - Zhengrong Liu
- Anshan Psychiatric Rehabilitation Hospital, Anshan, Liaoning, People's Republic of China
| | - Danhua Gu
- Weihai Mental Health Center, Weihai, Shandong, People's Republic of China
| | - Xiaoping Wang
- Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Xiaojuan Liu
- Tianjin First Center Hospital, Tianjin, People's Republic of China
| | - Qiwen Zhang
- Hainan Anning Hospital, Haikou, Hainan, People's Republic of China
| | - Yihan Li
- Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
| | - Yiping Chen
- Clinical Trial Service Unit, Oxford, United Kingdom
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Shenxun Shi
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
- Huashan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Jonathan Flint
- Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom
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Falcão V, Jardim P, Dinis-Oliveira RJ, Magalhães T. Forensic evaluation in alleged sibling incest against children. JOURNAL OF CHILD SEXUAL ABUSE 2014; 23:755-767. [PMID: 25085386 DOI: 10.1080/10538712.2014.949394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sibling incest is a serious form of intrafamilial sexual abuse with health, social, and legal relevance. A retrospective study was conducted through the analysis of forensic medical reports of the alleged sibling incest of victims under 18 years old (n = 68) from 2004 to 2011 as well as the respective judicial outcomes. Results demonstrated that sibling's sexual abuse is associated with several circumstances that might exacerbate its severity such as vaginal, anal, and/or oral penetration. Moreover, the victim's young age, the proximity between victim and abuser, and the fact that it is committed at the victim's and/or abuser's home and by using physical violence and verbal threats justify a late detection of these cases.
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31
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Marshall BDL, Galea S, Wood E, Kerr T. Longitudinal associations between types of childhood trauma and suicidal behavior among substance users: a cohort study. Am J Public Health 2013; 103:e69-75. [PMID: 23865651 PMCID: PMC3966683 DOI: 10.2105/ajph.2013.301257] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVES We examined the longitudinal associations between different types and severities of childhood trauma and suicide attempts among illicit drug users. METHODS Data came from 2 prospective cohort studies of illicit drug users in Vancouver, Canada, in 2005 to 2010. We used recurrent event proportional means models to estimate adjusted and weighted associations between types and severities of childhood maltreatment and suicide attempts. RESULTS Of 1634 participants, 411 (25.2%) reported a history of suicidal behavior at baseline. Over 5 years, 80 (4.9%) participants reported 97 suicide attempts, a rate of 2.6 per 100 person-years. Severe to extreme levels of sexual abuse (adjusted hazard ratio [AHR] = 2.5; 95% confidence interval [CI] = 1.4, 4.4), physical abuse (AHR = 2.0; 95% CI = 1.1, 3.8), and emotional abuse (AHR = 3.5; 95% CI = 1.4, 8.7) predicted suicide attempts. Severe forms of physical and emotional neglect were not significantly associated with an increased risk of suicidal behavior. CONCLUSIONS Severe sexual, physical, and emotional childhood abuse confer substantial risk of repeated suicidal behavior in adulthood. Illicit drug users require intensive secondary suicide prevention efforts, particularly among those with a history of childhood trauma.
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Affiliation(s)
- Brandon D L Marshall
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Easton SD, Renner LM, O'Leary P. Suicide attempts among men with histories of child sexual abuse: examining abuse severity, mental health, and masculine norms. CHILD ABUSE & NEGLECT 2013; 37:380-387. [PMID: 23313078 DOI: 10.1016/j.chiabu.2012.11.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 07/30/2012] [Accepted: 11/19/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Men who were sexually abused during childhood are at risk for a variety of long-term mental health problems, including suicidality. However, little is known about which factors are related to recent suicide attempts for this vulnerable, under-researched population. The purpose of this study was to examine the relationship between abuse severity, mental health, masculine norms and recent suicide attempts among men with histories of child sexual abuse (CSA). METHODS We analyzed survey data gathered from a purposive sample of 487 men who were sexually abused during childhood. The age of the sample ranged from 19 to 84 years (μ = 50.4 years). Recent suicide attempts served as the dependent variable in the study. Self-reported measures of sexual abuse severity, child physical abuse, mental health, masculine norms, and demographic information (age, race) represented the independent variables. RESULTS The results from logistic regression modeling found that five variables - duration of the sexual abuse, use of force during the sexual abuse, high conformity to masculine norms, level of depressive symptoms, and suicidal ideation - increased the odds of a suicide attempt in the past 12 months. CONCLUSION To improve mental health services for men with histories of CSA, mental health practitioners should incorporate sexual abuse severity, current mental health, and adherence to masculine norms into assessment and treatment planning.
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Affiliation(s)
- Scott D Easton
- Graduate School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
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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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34
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Bi B, Xiao X, Zhang H, Gao J, Tao M, Niu H, Wang Y, Wang Q, Chen C, Sun N, Li K, Fu J, Gan Z, Sang W, Zhang G, Yang L, Tian T, Li Q, Yang Q, Sun L, Li Y, Rong H, Guan C, Zhao X, Ye D, Zhang Y, Ma Z, Li H, He K, Chen J, Cai Y, Zhou C, Luo Y, Wang S, Gao S, Liu J, Guo L, Guan J, Kang Z, Di D, Li Y, Shi S, Li Y, Chen Y, Flint J, Kendler K, Liu Y. A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology. Psychol Med 2012; 42:2591-2598. [PMID: 22716960 PMCID: PMC3488812 DOI: 10.1017/s003329171200058x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 03/02/2012] [Accepted: 03/06/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms. METHOD We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD. RESULTS Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9-6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt. CONCLUSIONS This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.
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Affiliation(s)
- B. Bi
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
| | - X. Xiao
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
| | - H. Zhang
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
| | - J. Gao
- ZheJiang Traditional Chinese Medical Hospital, Hangzhou, PRC
| | - M. Tao
- Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, PRC
| | - H. Niu
- No. 1 Hospital of Zhengzhou University, Zhengzhou, PRC
| | - Y. Wang
- Shandong Mental Health Center, Shan Dong, PRC
| | - Q. Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, PRC
| | - C. Chen
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaan Xi, PRC
| | - N. Sun
- No. 1 Hospital of Shanxi Medical University, Shanxi, PRC
| | - K. Li
- Mental Hospital of Jiangxi Province, Jiangxi, PRC
| | - J. Fu
- ShengJing Hospital of China Medical University, Liaoning, PRC
| | - Z. Gan
- No. 3 Affiliated Hospital of Zhongshan University, Guangdong, PRC
| | - W. Sang
- Hebei Mental Health Center, Hebei, PRC
| | - G. Zhang
- No. 4 Affiliated Hospital of Jiangsu University, Jiang Su, PRC
| | - L. Yang
- Jilin Brain Hospital, Jilin, PRC
| | - T. Tian
- Tianjin Anding Hospital, Tianjin, PRC
| | - Q. Li
- No. 1 Mental Health Center Affiliated Harbin Medical University, Heilongjiang, PRC
| | - Q. Yang
- Chongqing Mental Health Center, Chongqing, PRC
| | - L. Sun
- Psychiatric Hospital of Henan Province, Henan, PRC
| | - Ying Li
- Dalian No. 7 People's Hospital and Dalian Mental Health Center, Dalian, PRC
| | - H. Rong
- Shenzhen Kangning Hospital, Shenzhen, PRC
| | - C. Guan
- Nanjing Brain Hospital, Jiang Su, PRC
| | - X. Zhao
- The First Hospital of Hebei Medical University, Shijiazhuang, PRC
| | - D. Ye
- Sichuan Mental Health Center, Sichuan, PRC
| | - Y. Zhang
- Lanzhou University Second Hospital, Second Clinical Medical College of Lanzhou University, Gansu Province, PRC
| | - Z. Ma
- No. 1 Hospital of Chongqing Medical University, Chongqing, PRC
| | - H. Li
- Mental Health Center of West China Hospital of Sichuan University, Si Chuan, PRC
| | - K. He
- Shanghai Tongji University Affiliated Tongji Hospital, Shanghai, PRC
| | - J. Chen
- Shanghai Jiao Tong University School of Medicine Affiliated Shanghai Mental Health Center, Shanghai, PRC
| | - Y. Cai
- Fudan University Affiliated Huashan Hospital, Shanghai, PRC
| | - C. Zhou
- Wuhan Mental Health Center, Hubei, PRC
| | - Y. Luo
- No. 3 Hospital of Heilongjiang Province, Heilongjiang, PRC
| | - S. Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, PRC
| | - S. Gao
- Ningbo Kangning Hospital, Zhejiang, PRC
| | - J. Liu
- Suzhou Guangji Hospital, Jiangsu, PRC
| | - L. Guo
- The Fourth Military Medical University Affiliated Xijing Hospital, Shaanxi, PRC
| | - J. Guan
- Guangzhou Brain Hospital/Guangzhou Psychiatric Hospital, Guangzhou, PRC
| | - Z. Kang
- No. 4 People's Hospital of Liaocheng, Shandong, PRC
| | - D. Di
- Mental Health Institute of Jining Medical College, Shandong, PRC
| | - Yajuan Li
- Xian Mental Health Center, Xian, Shanxi, PRC
| | - S. Shi
- Fudan University Affiliated Huashan Hospital, Shanghai, PRC
| | - Yihan Li
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - Y. Chen
- Clinical Trial Service Unit, Richard Doll Building, Oxford, UK
| | - J. Flint
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - K. Kendler
- Virginia Commonwealth University (VCU), Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Y. Liu
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
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