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Calvo N, Lugo-Marín J, Oriol M, Pérez-Galbarro C, Restoy D, Ramos-Quiroga JA, Ferrer M. Childhood maltreatment and non-suicidal self-injury in adolescent population: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2024; 157:107048. [PMID: 39332140 DOI: 10.1016/j.chiabu.2024.107048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 09/03/2024] [Accepted: 09/11/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is highly prevalent among adolescents. However, knowledge about the possible factors that might precede and influence its development remains scarce. OBJECTIVE Our goal is to examine the impact of adverse childhood events, and more specifically of different types of childhood maltreatment (CM) in adolescent NSSI. This involves performing a systematic review and meta-analysis of the different CM subtypes (physical and emotional neglect, physical and emotional abuse, sexual abuse) in clinical and non-clinical samples of adolescents with NSSI. PARTICIPANTS AND METHODS A digital search of the PsycInfo, PubMed and Web of Science platforms for articles published up to June 2022 was performed. The search terms were "self harm", "non-suicidal self-injury", "childhood maltreatment" and "adolescents". RESULTS Forty-six articles that fit the research objectives were included in the study, which covered a total of 1,505,430 adolescents, of whom 560,337 belonged to the NSSI group, while 945,093 were in the control group. The results describe strong positive associations between all CM subtypes and NSSI, especially with emotional abuse (odds ratio [OR] 2.91, 95 % CI 2.37-3.56) and sexual abuse (OR 2.72, 95 % CI 2.12-3.48), in clinical and non-clinical samples of adolescents. CONCLUSIONS The experience of CM, and especially emotional and/or sexual abuse, seems to be associated with a greater risk of developing NSSI in adolescence. Therefore, early identification and detection of children who have suffered or are suffering these forms of CM are of vital importance for instigating psychotherapeutic treatments that can minimize the risk of developing NSSI in adolescence.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona, Spain
| | - Jorge Lugo-Marín
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Monterrat Oriol
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Citlalli Pérez-Galbarro
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Damià Restoy
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Josep-Antoni Ramos-Quiroga
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona, Spain
| | - Marc Ferrer
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona, Spain
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2
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Hashim M, Iqbal N, Halligan S, Alimoradi Z, Pfaltz M, Farooqi SR, Khan I, Galán CA, Vostanis P. Association of Childhood Sexual Abuse with Adolescent's Psychopathology: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024:15248380241281365. [PMID: 39323210 DOI: 10.1177/15248380241281365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/27/2024]
Abstract
Childhood Sexual Abuse (CSA) poses a significant risk to mental health, especially among adolescents. This systematic review and meta-analysis investigates the association between CSA and adolescent psychopathology. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we conducted an extensive search across multiple databases, including PubMed, Scopus, PsycINFO, Science Direct, Embase, and ProQuest, resulting in 27,207 observational studies. From this pool, 87 studies (n: 189,393) were included in the qualitative synthesis and 78 studies were included in meta-analysis, discussing CSA and adolescent's psychopathology Random effect model with Cohen's d values were used to analyze data. To assess publication bias, funnel plots, Egger's regression test, and the fill and trim method were employed, with no significant bias found. The results indicated a positive correlation between CSA and adolescent psychopathology, for example, depression, anxiety, PTSD, suicidal ideation, nonsuicidal self-injury, anger, substance use, and sexrelated behaviors (Pooled association: 0.13-0.25, 95% CI [0.04, 0.28]). Subgroup analysis showed the strongest association in clinical samples. Furthermore, the moderator analysis suggested minimal influence of study-level variables, as well as men showing higher levels of anger and suicidal ideation. The positive correlation between CSA and psychopathological outcomes highlights the detrimental effects of CSA on adolescents' mental health. To mitigate these effects, increased awareness, prevention efforts, and targeted interventions are essential.
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Affiliation(s)
| | | | | | | | | | | | - Irum Khan
- Jamia Millia Islamia, New Delhi, India
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3
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Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J 2024; 60:919-944. [PMID: 38451378 DOI: 10.1007/s10597-024-01245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12-17 years) compared to young adults (aged 18-24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Poon JA, López R, Marie-Shea L, Liu RT. Longitudinal Relations Between Childhood Maltreatment, Emotion Regulation Difficulties, and Suicidal Ideation and Non-Suicidal Self-Injury: An 18-Month Investigation of Psychiatrically Hospitalized Adolescents. Res Child Adolesc Psychopathol 2023; 51:1315-1326. [PMID: 37155027 PMCID: PMC10529815 DOI: 10.1007/s10802-023-01067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
Within the Dimensional Model of Adversity and Psychopathology, extant research shows that exposure to threat-including emotional, physical, and sexual abuse-is linked to psychopathology among adolescents; problems with emotion regulation may, at least in part, explain this association. Both theoretical and empirical work also suggests that emotion regulation difficulties-particularly access to emotion regulation strategies-may mediate the relation between threat and self-injurious thoughts and behavior, though no studies to date have explicitly tested this model. The current study tested relations between threat, limited access to emotion regulation strategies, and self-injurious thoughts and behaviors among high-risk youth across an 18-month follow-up. The sample consisted of 180 adolescents (Mage = 14.89; SD = 1.35; ages 12-17; 71.7% female; 78.9% White; 55.0% heterosexual) recruited from an inpatient psychiatric unit. Threat was assessed at baseline using the abuse subscales from Childhood Trauma Questionnaire. Access to emotion regulation strategies was assessed using the Difficulties in Emotion Regulation Scale at baseline, 6-, and 12-months. Presence (versus absence) of non-suicidal self-injury and suicidal ideation severity were assessed at baseline, 12-, and 18-months using the Self-Injurious Thoughts and Behaviors Interview and the Suicidal Ideation Questionnaire-JR, respectively. After accounting for baseline levels of the mediator, outcome, and depressive symptoms, structural equation models supported the role of 12-month access to emotion regulation strategies as a mediator between baseline threat and 18-month suicidal ideation and non-suicidal self-injury. Treatment aimed at bolstering access to emotion regulation strategies may help reduce suicide risk among youth who have experienced childhood abuse.
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Affiliation(s)
- Jennifer A Poon
- Bradley Hospital/Warren T. Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA.
- Emma Pendleton Bradley Hospital, East Providence, USA.
| | | | | | - Richard T Liu
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
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5
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Goldner L, Lev-Wiesel R, Bussakorn B. "I'm in a Bloody Battle without Being Able to Stop It": The Dissociative Experiences of Child Sexual Abuse Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7941-7963. [PMID: 36799511 DOI: 10.1177/08862605231153865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Dissociation in child sexual abuse (CSA) survivors remains under-recognized and diagnosed, partly because of the difficulties involved in identifying dissociative symptoms. Qualitative research can contribute to a better understanding of the lived experiences of dissociation. This study focused on the experiences of dissociation in the context of CSA. In all, 22 female incest survivors, all diagnosed with different dissociative disorders, provided narratives about their experiences of dissociation. The narratives were analyzed using interpretative phenomenological analysis. The narrative analysis revealed four central themes. The first theme deals with reliving the experience of the abuse. The second theme refers to the experience of disconnection from the body, the self, and the surroundings. The third theme covers the lack of coherence in the narrative, and the fourth theme describes the bridge between voluntary controlled and nonvoluntary uncontrolled use of dissociation. The data are discussed in light of several traumagenic constructs, including a lack of self-sense, being entrapped in a victim-aggressor relationship, and distorted time perception. It is suggested that the extent to which participants can control their dissociation and the coherency of their narratives reflects the severity of their dissociation. Clinicians can consider helping clients use dissociation as an adaptive defense mechanism.
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Affiliation(s)
- Limor Goldner
- Faculty of Welfare and Health Sciences, The Emili Sagol CATs Research Center, University of Haifa, Israel
| | - Rachel Lev-Wiesel
- Faculty of Welfare and Health Sciences, The Emili Sagol CATs Research Center, University of Haifa, Israel
- Tel Hai College, Upper Galilee, and the Emili Sagol CATs Research Center, University of Haifa, Israel
| | - Binson Bussakorn
- Faculty of Fine Arts, FAA-Emili Sagol Creative Arts Research and Innovation for Well-being Center, Chulalongkorn University, Bangkok, Thailand
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Lee JY, Jhon M, Kim JW, Kang HJ, Kim SW, Shin IS, Cho HJ, Chun BJ, Kim JM. Interaction effect between childhood abuse and interleukin-1β levels on suicidality in depressed patients. Eur Arch Psychiatry Clin Neurosci 2022; 272:1535-1546. [PMID: 35467148 DOI: 10.1007/s00406-022-01408-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/05/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The roles of childhood abuse and interleukin (IL)-1β levels, a representative pro-inflammatory cytokine, in suicidal behavior are unclear. This study investigated the main and interactive effects of childhood abuse and IL-1β levels on suicidal behavior in patients with a depressive disorder before and after pharmacological treatment. METHODS At baseline, exposure to self-reported childhood abuse, including emotional, physical, and sexual abuse, before the age of 16 years, and IL-1β levels, were measured in 1,094 outpatients with a depressive disorder, 884 of whom were followed for 1 year. Suicidal behavior was evaluated, including previous suicide attempts (at baseline), suicidal ideation (at baseline and follow-up), and fatal/non-fatal suicide attempts (at follow-up). The main and interaction effects of self-reported childhood abuse and IL-1β level on the four types of suicidal behavior were analyzed using logistic regression after adjusting for covariates. RESULTS Individual associations of self-reported childhood abuse were significant only with previous suicidal attempt but not with other suicidal behaviors. There was no significant association of plasma IL-1β level with any suicidal behavior. There were significant interactive associations of self-reported childhood abuse and a high IL-1β level on previous suicide attempts, baseline suicidal ideation, and fatal/non-fatal suicidal attempts during follow-up. CONCLUSION Suicidal behavior in patients with a depressive disorder could be influenced by considering the interactive effect of childhood abuse and IL-1β levels. Our study suggests that childhood trauma and biochemical factors play roles in the pathology of suicide in depressed patients.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hwa Jin Cho
- Department of Pediatrics, Chonnam National University Children's Hospital and Medical School, Gwangju, Korea
| | - Byeong Jo Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, 12 Dong-gu, Gwangju, 61469, Republic of Korea.
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Cioffi CC, Schweer-Collins ML, Leve LD. Pregnancy and miscarriage predict suicide attempts but not substance use among dual-systems involved female adolescents. CHILDREN AND YOUTH SERVICES REVIEW 2022; 137:106494. [PMID: 37089705 PMCID: PMC10118061 DOI: 10.1016/j.childyouth.2022.106494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Background To examine the associations between adolescent pregnancy and pregnancy outcomes on substance use and suicide attempts in a sample who is at greater risk for substance use and suicide attempts - those who have been involved with the uvenile justice and child welfare systems. Methods Using a prospective, longitudinal design, we examined the role of adolescent pregnancy outcomes on risk for suicide attempts and substance use among a sample of 166 female adolescents with juvenile justice system and child welfare involvement. Results Of participants, 36% (n = 60) reported at least one adolescent pregnancy with a total of 109 pregnancies reported. Adolescent pregnancy was associated with an increase in later suicide attempts (aOR = 1.68, 95% CI 1.06-2.72). Miscarriage was associated with a 2-fold increase in the likelihood of later suicide attempts, (aOR = 2.12, 95% CI 1.10-4.12). No participants who reported induced abortion (n = 13) reported suicide attempts. Adolescent pregnancy, miscarriage, and abortion were not significantly associated with later substance use (Ps > 0.05). Conclusions Healthcare professionals should conduct routine screening for suicidality in the months following a miscarriage, offer education to caregivers about how to support youth who experience pregnancy loss, provide additional social supports and familiarize themselves with local and virtual behavioral health resources to prevent suicide attempts among female adolescents who are at high risk and experience miscarriage.
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Steel CMS, Newman E, O’Rourke S, Quayle E. Suicidal ideation in offenders convicted of child sexual exploitation material offences. BEHAVIORAL SCIENCES & THE LAW 2022; 40:365-378. [PMID: 35043473 PMCID: PMC9541809 DOI: 10.1002/bsl.2560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/07/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
Understanding the prevalence of suicidal ideation in Child Sexual Exploitation Material (CSEM) offenders and their psychological concerns provides the basis for early treatment and intervention. This research solicited responses (n = 78) via an anonymous, web-based survey from adults in the United States previously convicted of CSEM offences. Significant suicidal ideation was present in 73% of respondents (n = 57), and 19% (n = 15) reported attempting suicide after they were made aware of an investigation, with 41% (n = 32) stating they would have been likely to seek counselling if provided a contact. Most of the respondents felt they were not treated with fairness, understanding, and compassion by investigators, and that their primary psychological strains were going to jail and their families finding out. This research highlights the need for more empathetic investigative approaches, as well as the need for more rapid assessment and treatment of proximal suicide risk in this population.
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Affiliation(s)
- Chad M. S. Steel
- University of EdinburghEdinburghUK
- MS 2B5George Mason UniversityFairfaxVirginiaUSA
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9
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Wekerle C, Kim K, Wong N. Child Sexual Abuse Victimization: Focus on Self-Compassion. Front Psychiatry 2022; 13:818774. [PMID: 35308875 PMCID: PMC8924043 DOI: 10.3389/fpsyt.2022.818774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Katherine Kim
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nikki Wong
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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10
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Cha C, Lee MR. Healing from sexual violence among young women in South Korea. Int J Ment Health Nurs 2022; 31:51-61. [PMID: 34490979 DOI: 10.1111/inm.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 11/26/2022]
Abstract
Reports of sexual violence against young women have been increasing. Due to limited support, young women who experience sexual violence have difficulties in healing, resulting in long-term consequences for individuals and society. We used grounded theory combined with a Photovoice approach to explore young women's experience of healing from sexual violence. From interviews and Photovoice activities of 29 participants, we identified a social process of healing that included internalizing anger, cutting off connections, reaching a turning point with support, restoring connections, struggling through individual internal processes, and transforming sexual violence into a stepping stone. The process of healing from sexual violence identified in this study shows commonalities as well as cultural and age-specific aspects from experiences of sexual violence among young women. In addition, this theory presented a new perspective on healing that contrasts with the past belief that disclosure is the key to healing.
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Affiliation(s)
- Chiyoung Cha
- College of Nursing, Ewha Research Institute of Nursing Science, Seoul, South Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, South Korea
| | - Mi-Ran Lee
- Department of Nursing, Kwangju Women's University, Gwangju, South Korea
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11
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Kim JM, Kim JW, Kang HJ, Lee JY, Kim SW, Shin IS, Chun BJ, Stewart R. Investigating associations of childhood abuse and serum brain-derived neurotrophic factor levels with suicidal behaviours in patients with depressive disorders. Br J Psychiatry 2021; 219:598-605. [PMID: 35048824 DOI: 10.1192/bjp.2021.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The role of childhood abuse and serum brain-derived neurotrophic factor (BDNF) levels in suicidal behaviour is controversial. AIMS We aimed to investigate the individual and interactive effects of the childhood abuse and serum BDNF on suicidal behaviour before and after pharmacologic treatment in patients with depressive disorders. METHOD At baseline, reported childhood emotional, physical and sexual abuse were ascertained and serum BDNF levels were measured in 1094 patients with depressive disorder, 884 of whom were followed during a 1-year period of stepwise pharmacotherapy. Suicidal behaviours evaluated at baseline were previous suicide attempt and baseline suicide severity, and suicidal behaviours evaluated at follow-up were increased suicide severity and fatal/non-fatal suicide attempt. Individual and interactive associations of any childhood abuse and serum BDNF levels with four types of suicidal behaviours were analysed using logistic regression models, after adjusting relevant covariates. RESULTS Individual associations of childhood abuse were significant only with previous suicide attempt, and no significant individual associations were found for serum BDNF with any suicide outcome. However, the presence of both childhood abuse and lower serum BDNF levels was associated with the highest prevalence/incidence of all four suicidal behaviours, with significant interactions for baseline suicide severity and fatal/non-fatal suicide attempt during follow-up. CONCLUSIONS Synergistic interactive effects of child abuse and serum BDNF levels on suicidal behaviours were found before and after pharmacologic treatment in patients with depressive disorders. Information combining childhood abuse and serum BDNF levels could improve predictions of suicidal behaviour in patients with depressive disorders.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Byung-Jo Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Republic of Korea
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and The National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, UK
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12
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Park C, Park IH, Yoo T, Kim H, Ryu S, Lee JY, Kim JM, Kim SW. Association between Childhood Trauma and Suicidal Behavior in the General Population. Chonnam Med J 2021; 57:126-131. [PMID: 34123740 PMCID: PMC8167439 DOI: 10.4068/cmj.2021.57.2.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 11/24/2022] Open
Abstract
This study aimed to investigate the associations between various types of childhood trauma and suicidal behavior in the general population in South Korea. This mental health survey included a total of 1,490 general citizens living in a metropolitan South Korean city who completed a questionnaire that assessed respondents' histories of childhood trauma before the age of 12 years, including bullying victimization, emotional abuse, sexual abuse, and physical abuse, as well as suicidal behavior, including current suicidal ideation and histories of suicide planning and attempts. The following psychiatric scales were administered: Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (R-SES), Connor-Davidson Resilience Scale (CD-RISC), Perceived Stress Scale (PSS), and visual analogue scale of EuroQol 5D (EQ-5D). Participants who experienced any childhood trauma had significantly higher HADS and PSS scores, and significantly lower EQ-5D scores. Additionally, participants with any type of childhood trauma were significantly more likely to have current suicidal ideation and histories of planned and attempted suicide. Multivariate analyses adjusted for confounding variables indicated that bullying victimization and sexual abuse were associated significantly with all types of suicidal behavior. Physical abuse was associated significantly with histories of suicide planning and attempts. The present findings showed that any type of childhood trauma was associated with higher levels of suicidality, anxiety, depression, and perceived stress, as well as lower health-related quality of life, in the general population. In particular, associations between childhood trauma and suicidality were identified after adjustment for confounding variables.
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Affiliation(s)
- Cheol Park
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - In-Hoo Park
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Taeyoung Yoo
- Department of Psychiatry, Gwangju City Mental Hospital, Gwangju, Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.,Gwangju Mental Health and Welfare Commission, Gwangju, Korea
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Ahlin EM. Risk Factors of Sexual Assault and Victimization Among Youth in Custody. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP2164-2187NP. [PMID: 29451424 DOI: 10.1177/0886260518757226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research suggests that youth are at higher risk of sexual assault and victimization while in custody than adult inmates. However, compared with adult inmates, very little is known about the risk factors associated with such violence among youth in custody. Without sufficient research on risk factors associated with sexual assault and victimization among youth in custody, practitioners and policy makers may be reliant on the adult literature when making decisions about how to address and prevent such violence among juveniles. This article seeks to determine if extrapolating data from the substantial prison literature is appropriate by assessing the parallels between risk factors of sexual assault and victimization among youth in custody and those identified for adult inmates. This study uses data of 8,659 youth from the second administration of the National Survey of Youth in Custody (NSYC-2) to assess correlates of sexual assault and victimization during periods of detention. Study findings show that experiences with assault and victimization prior to the present period of detention were stronger indicators of sexual assault and victimization while in custody than youth characteristics and demographics and other experiences with assault and victimization. Further, there are differences in risk factors associated with sexual assault and victimization among youth in custody compared to adult inmates, which emphasizes the risk of prior sexual assault and victimization in the community and prior custodial settings.
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Association between sexual abuse victimization during the life course and suicidal behaviors in male and female college students in China: Timing, duration, types and patterns. J Affect Disord 2021; 280:30-38. [PMID: 33221605 DOI: 10.1016/j.jad.2020.11.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/15/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender. METHODS Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors. RESULTS For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the "moderate SA" class and "persistent SA" class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the "moderate SA" class. LIMITATIONS The cross-sectional survey design did not allow to conclude any causality. CONCLUSIONS The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.
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15
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González-Acosta CA, Rojas-Cerón CA, Buriticá E. Functional Alterations and Cerebral Variations in Humans Exposed to Early Life Stress. Front Public Health 2021; 8:536188. [PMID: 33553081 PMCID: PMC7856302 DOI: 10.3389/fpubh.2020.536188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 12/04/2020] [Indexed: 01/02/2023] Open
Abstract
Early life stress can be caused by acute or chronic exposure to childhood events, such as emotional, physical, sexual abuse, and neglect. Early stress is associated with subsequent alterations in physical and mental health, which can extend into adolescence, adulthood, and even old age. The effects of early stress exposure include alterations in cognitive, neuropsychological, and behavioral functions, and can even lead to the development of psychiatric disorders and changes in brain anatomy. The present manuscript provides a review of the main findings on these effects reported in the scientific literature in recent decades. Early life stress is associated with the presence of psychiatric disorders, mainly mood disorders such as depression and risk of suicide, as well as with the presence of post-traumatic stress disorder. At the neuropsychological level, the involvement of different mental processes such as executive functions, abstract reasoning, certain memory modalities, and poor school-skill performance has been reported. In addition, we identified reports of alterations of different subdomains of each of these processes. Regarding neuroanatomical effects, the involvement of cortical regions, subcortical nuclei, and the subcortical white matter has been documented. Among the telencephalic regions most affected and studied are the prefrontal cortex, the hippocampus, the amygdala, and the anterior cingulate cortex. Understanding the impact of early life stress on postnatal brain development is very important for the orientation of therapeutic intervention programs and could help in the formulation and implementation of preventive measures as well as in the reorientation of research targets.
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Affiliation(s)
| | - Christian A Rojas-Cerón
- Centro de Estudios Cerebrales, Facultad de Salud, Universidad del Valle, Cali, Colombia.,Departamento de Pediatría, Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia.,Servicio de Pediatría, Hospital Universitario del Valle Evaristo García, Cali, Colombia
| | - Efraín Buriticá
- Centro de Estudios Cerebrales, Facultad de Salud, Universidad del Valle, Cali, Colombia
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16
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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: 11] [Impact Index Per Article: 2.8] [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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17
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Chen L, Ngoubene-Atioky AJ, Zanardelli G, Yuanping D, Yu L. Childhood Abuse and Suicidal Behaviors Among Chinese Migrant Workers: The Mediating Role of Alexithymia and Social Support. Arch Suicide Res 2020; 24:633-647. [PMID: 31502515 DOI: 10.1080/13811118.2019.1658142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aims to investigate the lifetime prevalence of suicidal behaviors in a sample of Chinese migrant workers. It also examined the mediating role of alexithymia and social support in the link between childhood abuse and suicidal behaviors. A total of 1,563 migrant workers were surveyed by using cluster sampling. Results showed that the estimated lifetime prevalence of suicide ideation, plan, and attempt among Chinese migrant workers was 12.8%, 8.1%, and 4.6%, respectively. Structural equation modeling analyses revealed a significant positive association between childhood abuse and suicidal behaviors; this association was partially mediated by social support. A significant path from childhood abuse through alexithymia and social support to suicidal behaviors was also established. Findings of this study emphasize the importance of social support and alexithymia in understanding the possible mechanisms underlying the relationship between childhood abuse and suicidal behaviors and suggest possible avenues for suicide interventions.
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18
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Angelakis I, Austin JL, Gooding P. Association of Childhood Maltreatment With Suicide Behaviors Among Young People: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2012563. [PMID: 32756929 PMCID: PMC7407092 DOI: 10.1001/jamanetworkopen.2020.12563] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/22/2020] [Indexed: 12/17/2022] Open
Abstract
Importance Children and young people's reports of experiences of adverse childhood events have increased in recent years, and this trend has been associated with an elevated risk for suicide behaviors. However, a systematic review and meta-analysis is needed to confirm the significance of this association in young people. Objective To quantify the association between core types of childhood maltreatment, including sexual, physical, and emotional abuse and/or neglect and suicide behaviors in children and young adults. Data Sources Medline, PsychInfo, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health) databases were searched from January 1, 1980, until December 31, 2019. The reference lists of all the included studies were also checked. Study Selection Quantitative studies that focused on the association between core types of childhood abuse and/or neglect and suicide ideation, plans, and attempts. Data Extraction and Synthesis Data were extracted by 2 independent raters. Publication bias and risk of bias across studies were assessed. Meta-analyses using random-effect models were applied, and heterogeneity was quantified using the I2 statistic. Data were analyzed from January to May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Main Outcomes and Measures The association between core types of childhood maltreatment and suicide behaviors. Results Seventy-nine studies with 337 185 young individuals (mean [SD] age, 15.67 [2.11] years; 63.19% female) were included. The findings demonstrated that sexual abuse (odds ratio [OR], 3.41; 95% CI, 2.90-4.00), physical abuse (OR, 2.18; 95% CI, 1.75-2.71), emotional abuse (OR, 2.21; 95% CI, 1.37-3.57), emotional neglect (OR, 1.93; 95% CI, 1.36-2.74), physical neglect (OR, 1.79; 95% CI, 1.27-2.53), and combined abuse (OR, 3.38; 95% CI, 2.09-5.47) were significantly associated with higher rates of suicide attempts. Core types of childhood maltreatment were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4.0-fold increase for suicide plans. Studies based on community samples (β [SE] = -1.68 [0.79]; P = .04) or with lower methodological quality (β [SE] = -2.86 [1.30]; P = .03) were associated more strongly with suicide attempts in those reporting experiences of sexual abuse, whereas young age was associated with both suicide attempts (β [SE] = -0.59 [0.27]; P = .03) and ideation (β [SE] = -0.41 [0.18]; P = .03). Conclusions and Relevance These findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect.
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Affiliation(s)
- Ioannis Angelakis
- School of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Jennifer L. Austin
- School of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
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19
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Munson MR, Katz CC, Okpych NJ, Courtney ME. Mental Health Management Among Older Youth in Foster Care: Service Utilization and Preparedness. J Adolesc Health 2020; 67:225-231. [PMID: 32317206 DOI: 10.1016/j.jadohealth.2020.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/07/2020] [Accepted: 02/07/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of the study was to document mental health service use (counseling and medication) among youth in foster care, examine how prepared they feel to manage their mental health, and investigate predictors of service use and preparedness. METHODS The study includes a representative sample of youth in California foster care at age 17 years who participated in in-person, structured interviews (n = 727). Survey measures captured youth characteristics, their mental health service use, and their level of preparedness to manage their mental health. Data from a child welfare worker survey were used to capture county-level service availability, helpfulness, and coordination. Binary and ordered logistic regression were used to predict mental health service use and preparedness. RESULTS Youth reported high rates of mental health service use and one-fifth of the sample reported feeling less than prepared to manage their mental health. Youth who screened positive for mental disorders were less prepared than their peers to manage their mental health. Physical (odds ratio [OR] = 1.44; p < .05) and sexual abuse (OR = 2.04; p < .001) predicted past year use of counseling. Sexual abuse also predicted medication use (OR = 1.97; p < .01). Youth who identified as 100% heterosexual were less likely than non-100% heterosexual peers to use counseling (OR = .58; p < .05). The results also suggest geographic variation in use. Finally, caseworkers' perception of greater helpfulness of services in the county they worked predicted greater mental health preparedness (OR = 1.23; p < .05). CONCLUSIONS Mental health service use remains high among youth in foster care. Youth with particular characteristics may benefit from interventions aimed at preparing them for managing their mental health in adulthood.
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Affiliation(s)
- Michelle R Munson
- Silver School of Social Work, New York University, New York, New York.
| | - Colleen C Katz
- Silberman School of Social Work at Hunter College, City University of New York, New York, New York
| | | | - Mark E Courtney
- School of Social Service Administration, University of Chicago, Chicago, Illinois
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20
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Zinchuk MS, Avedisova AS, Guekht AB. Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:108-119. [DOI: 10.17116/jnevro2019119031108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Childhood sexual abuse and current suicidal ideation among adolescents: Problem-focused and emotion-focused coping skills. J Adolesc 2018; 67:120-128. [DOI: 10.1016/j.adolescence.2018.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/17/2018] [Accepted: 06/18/2018] [Indexed: 12/26/2022]
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22
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Ng QX, Yong BZJ, Ho CYX, Lim DY, Yeo WS. Early life sexual abuse is associated with increased suicide attempts: An update meta-analysis. J Psychiatr Res 2018; 99:129-141. [PMID: 29454220 DOI: 10.1016/j.jpsychires.2018.02.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/05/2018] [Accepted: 02/05/2018] [Indexed: 12/12/2022]
Abstract
Suicide is an emerging, yet preventable global health issue associated with significant mortality. Identification of underlying risk factors and antecedents may inform preventive strategies and interventions. This study serves to provide an updated meta-analysis examining the extent of association of early life sexual abuse with suicide attempts. Using the keywords [early abuse OR childhood abuse OR sexual OR rape OR molest* OR violence OR trauma OR PTSD] AND [suicid* OR premature OR unnatural OR deceased OR died OR mortality], a preliminary search on the PubMed, Ovid, PsychINFO, Web of Science and Google Scholar databases yielded 12,874 papers published in English between 1-Jan-1988 and 1-June-2017. Of these, only 47 studies were included in the final meta-analysis. The 47 studies (25 cross-sectional, 14 cohort, 6 case-control and 2 twin studies) contained a total of 151,476 subjects. Random-effects meta-analysis found early life sexual abuse to be a significant risk factor for suicide attempts, compared to baseline population (pooled OR 1.89, 95% CI: 1.66 to 2.12, p < 0.001). Subgroup analyses of cross-sectional and longitudinal studies showed similar findings of increased risk as they yielded ORs of 1.98 (95% CI: 1.70 to 2.25, p < 0.001) and 1.65 (95% CI: 1.37 to 1.93, p < 0.001), respectively. In both cross-sectional and longitudinal studies, childhood sexual abuse was consistently associated with increased risk of suicide attempts. The findings of the present study provide strong grounds for funding public policy planning and interventions to prevent sexual abuse and support its victims. Areas for future research should include preventive and treatment strategies and factors promoting resilience following childhood sexual abuse. Future research on the subject should have more robust controls and explore the differential effects of gender and intra-versus extra-familial sexual abuse.
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Affiliation(s)
- Qin Xiang Ng
- KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore; MOH Holdings Pte Ltd, 1 Maritime Square, Singapore, 099253, Singapore.
| | | | | | - Donovan Yutong Lim
- Department of Child and Adolescent Psychiatry, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Wee-Song Yeo
- National University Hospital, National University Health System, Singapore, 119074, Singapore
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23
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Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 2018; 5:51-64. [PMID: 29196062 PMCID: PMC5743605 DOI: 10.1016/s2215-0366(17)30469-8] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Non-suicidal self-injury is being increasingly recognised as a prominent public health concern. Identification of early and modifiable risk factors is necessary to advance the screening and intervention efforts, particularly early detection of at-risk individuals. We aimed to examine childhood maltreatment, including its specific subtypes, in relation to non-suicidal self-injury. METHODS We did a comprehensive meta-analysis of childhood maltreatment (overall, sexual abuse, physical abuse and neglect, and emotional abuse and neglect) in association with non-suicidal self-injury. We also provided a qualitative review of mediators and moderators of this association. We identified relevant articles published from inception to Sept 25, 2017, through a systematic search of Embase, MEDLINE, and PsycINFO. We extracted continuous and categorical data and assessed for potential moderators using ten study characteristics. We generated random-effects models for analysis and evaluated for publication bias. FINDINGS We identified 71 publications that met eligibility criteria. Overall childhood maltreatment was associated with non-suicidal self-injury (odds ratio 3·42, 95% CI 2·74-4·26), and effect sizes for maltreatment subtypes ranged from 1·84 (1·45-2·34) for childhood emotional neglect to 3·03 (2·56-3·54) for childhood emotional abuse. Publication bias was not evident, except in the case of childhood emotional neglect. Across multiple maltreatment subtypes, we found stronger associations with non-suicidal self-injury in non-clinical samples. INTERPRETATION With the exception of childhood emotional neglect, childhood maltreatment and its subtypes are associated with non-suicidal self-injury. Screening of childhood maltreatment history in non-suicidal self-injury risk assessments might hold particular value in community settings, and increased attention to childhood emotional abuse is warranted. FUNDING National Institute of Mental Health.
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24
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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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25
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Power J, Gobeil R, Beaudette JN, Ritchie MB, Brown SL, Smith HP. Childhood Abuse, Nonsuicidal Self-Injury, and Suicide Attempts: An Exploration of Gender Differences in Incarcerated Adults. Suicide Life Threat Behav 2016; 46:745-751. [PMID: 27291490 DOI: 10.1111/sltb.12263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/13/2016] [Indexed: 11/29/2022]
Abstract
The relationship between types of childhood abuse, suicide attempts, and nonsuicidal self-injury (NSSI) was examined in a sample of 415 incarcerated adults (268 men, 147 women). Men and women were equally likely to experience childhood abuse, although women were more likely to report sexual abuse and men were more likely to report emotional neglect. Sexual abuse was the only type of abuse found to predict NSSI and suicide attempts in women. For men, physical abuse and physical neglect were significant predictors of NSSI and suicide attempts, respectively. Gender differences exist and should be examined in future research in this area.
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Affiliation(s)
- Jenelle Power
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Renee Gobeil
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | | | - Mary B Ritchie
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Shelley L Brown
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Hayden P Smith
- Department of Criminology and Criminal Justice, University of South Carolina, Columbia, SC, USA
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26
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Daray FM, Rojas SM, Bridges AJ, Badour CL, Grendas L, Rodante D, Puppo S, Rebok F. The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients. CHILD ABUSE & NEGLECT 2016; 58:91-98. [PMID: 27352091 DOI: 10.1016/j.chiabu.2016.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 04/21/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
Child sexual abuse (CSA) is a causal agent in many negative adulthood outcomes, including the risk for life-threatening behaviors such as suicide ideation and suicide attempts. Traumatic events such as CSA may pose risk in the healthy development of cognitive and emotional functioning during childhood. In fact, high impulsivity, a risk factor for suicidal behavior, is characteristic of CSA victims. The current study aims to understand the relations among CSA, impulsivity, and frequency of lifetime suicide attempts among a female patient sample admitted for suicidal behavior. Participants included 177 female patients between the ages of 18 and 63 years admitted at two hospitals in Buenos Aires, Argentina. Number of previous suicide attempts and CSA were assessed via structured interviews, while impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). A model of structural equations was employed to evaluate the role of impulsivity in the relation between CSA and suicide attempts. CSA (β=.18, p<.05) and impulsivity (β=.24, p<.05) were associated with the number of previous suicide attempts. However, impulsivity was not significantly associated with CSA (β=.09, p>.05). CSA and impulsivity are independently associated with lifetime suicide attempts among female patients with recent suicidal behavior.
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Affiliation(s)
- Federico M Daray
- "Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina; Institute of Pharmacology, School of Medicine, University of Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.
| | - Sasha M Rojas
- Department of Psychological Science, University of Arkansas, United States
| | - Ana J Bridges
- Department of Psychological Science, University of Arkansas, United States
| | | | - Leandro Grendas
- "Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina; Institute of Pharmacology, School of Medicine, University of Buenos Aires, Argentina
| | - Demián Rodante
- "Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina; Institute of Pharmacology, School of Medicine, University of Buenos Aires, Argentina
| | - Soledad Puppo
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Argentina; Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Federico Rebok
- "Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina; Institute of Pharmacology, School of Medicine, University of Buenos Aires, Argentina
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27
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Armiento J, Hamza CA, Stewart SL, Leschied A. Direct and indirect forms of childhood maltreatment and nonsuicidal self-injury among clinically-referred children and youth. J Affect Disord 2016; 200:212-7. [PMID: 27136420 DOI: 10.1016/j.jad.2016.04.041] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/07/2016] [Accepted: 04/16/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although exposure to direct forms of childhood maltreatment is among the most widely studied risk factors for nonsuicidal self-injury (NSSI), research on NSSI has largely overlooked the role of exposure to indirect forms of child maltreatment (i.e., witnessing domestic violence). To address this gap in the literature, the present study examined associations among both direct and indirect forms of child maltreatment and NSSI among clinically-referred children and youth. METHODS Data was collected using the interRAI Child and Youth Mental Health Assessment (ChYMH) at ten mental health agencies. The ChYMH is a comprehensive standardized clinical assessment tool completed by trained assessors using multiple sources. The study included a convenience sample of 747 children and youth (68% male) between ages 8-18 with complex mental health histories referred for inpatient or outpatient care in Ontario, Canada. RESULTS Univariate chi-square analyses indicated positive associations with NSSI and both direct (i.e., physical, sexual) and indirect child maltreatment (i.e., witnessing domestic violence). In a binary multivariate logistic regression analysis controlling for participant age and sex, only exposure to indirect child maltreatment emerged as multivariate predictor of NSSI. LIMITATIONS The sample was limited to only 10 mental health agencies and only consenting parents/guardians referred to mental health services suggesting the study may not be generalizable to all clinical samples. CONCLUSION The present study provides evidence that witnessing domestic violence in childhood is an important risk factor for NSSI. Clinical relevance includes implications for clinicians to develop targeted intervention and prevention strategies for NSSI for children who have witnessed domestic violence.
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Affiliation(s)
- Jenna Armiento
- Faculty of Education, Western University, 1137 Western Road, Canada, N6G 1G7.
| | - Chloe A Hamza
- Faculty of Education, Western University, 1137 Western Road, Canada, N6G 1G7
| | - Shannon L Stewart
- Faculty of Education, Western University, 1137 Western Road, Canada, N6G 1G7
| | - Alan Leschied
- Faculty of Education, Western University, 1137 Western Road, Canada, N6G 1G7
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