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Duprey EB, Handley ED, Wyman PA, Ross AJ, Cerulli C, Oshri A. Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention. Dev Psychopathol 2023; 35:1732-1755. [PMID: 36097812 PMCID: PMC10008764 DOI: 10.1017/s0954579422000414] [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] [Indexed: 11/06/2022]
Abstract
Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.
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Affiliation(s)
- Erinn B. Duprey
- Children’s Institute, University of Rochester, Rochester, NY, USA
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Elizabeth D. Handley
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Peter A. Wyman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew J. Ross
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Catherine Cerulli
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- The Susan B. Anthony Center, University of Rochester, Rochester, NY, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
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Cohen JR, Stutts M. Interpersonal Well-Being and Suicidal Outcomes in a Nationally Representative Study of Adolescents: A Translational Study. Res Child Adolesc Psychopathol 2023; 51:1327-1341. [PMID: 37222862 DOI: 10.1007/s10802-023-01068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/25/2023]
Abstract
Adolescent suicide continues to rise despite burgeoning research on interpersonal risk for suicide. This may reflect challenges in applying developmental psychopathology research into clinical settings. In response, the present study used a translational analytic plan to examine indices of social well-being most accurate and statistically fair for indexing adolescent suicide. Data from the National Comorbidity Survey Replication Adolescent Supplement were used. Adolescents aged 13-17 (N = 9,900) completed surveys on traumatic events, current relationships, and suicidal thoughts and attempts. Both frequentist (e.g., receiver operating characteristics) and Bayesian (e.g., Diagnostic Likelihood Ratios; DLRs) techniques provided insight into classification, calibration, and statistical fairness. Final algorithms were compared to a machine learning-informed algorithm. Overall, parental care and family cohesion best classified suicidal ideation, while these indices and school engagement best classified attempts. Multi-indicator algorithms suggested adolescents at high risk across these indices were approximately 3-times more likely to engage in ideation (DLR = 3.26) and 5-times more likely to engage in attempts (DLR = 4.53). Although equitable for attempts, models for ideation underperformed in non-White adolescents. Supplemental, machine learning-informed algorithms performed similarly, suggesting non-linear and interactive effects did not improve model performance. Future directions for interpersonal theories for suicide are discussed and clinical implications for suicide screening are demonstrated.
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Affiliation(s)
- Joseph R Cohen
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA.
| | - Morgan Stutts
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA
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Russotti J, Herd T, Handley ED, Toth SL, Noll JG. Patterns of Mother, Father, and Peer Attachment Quality as Moderators of Child Maltreatment Risk for Depression and PTSD Symptoms in Adolescent Females. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6888-6914. [PMID: 36695104 PMCID: PMC10050148 DOI: 10.1177/08862605221138654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Child maltreatment (CM) is a robust risk factor for adolescent depressive and post-traumatic stress disorder (PTSD) symptoms. Quality attachment relationships have been posited as a protective factor but findings are equivocal and studies have not adequately considered the complex network of interpersonal relationships that adolescents rely on. The current study applied a person-centered approach to (a) identify subgroups of adolescent females characterized by distinct patterns of attachment quality with peers, fathers, and mothers and (b) determine if the effect of maltreatment on depressive and PTSD symptoms varied as a function of distinct patterns of attachment quality. Data came from a prospective, longitudinal cohort study of 464 racially diverse and adolescent females designed to examine the developmental sequelae of substantiated CM (260 maltreated and 204 demographically matched, nonmaltreated comparisons). Latent profile analysis (LPA) revealed four profiles of attachment characterized by: (a) above-average attachment quality across all three relationships (N = 207, 44.6%); (b) below-average quality with father and friends and above-average quality with mothers (N = 128, 27.6%); (c) below-average quality across all three relationships (N = 106, 22.9%); and (d) very low-(-1 SD) quality with mothers and above-average quality with fathers and friends (N = 23, 5.0%). Moderation models revealed that cumulative maltreatment exposure resulted in greater adolescent depressive symptoms only for those with a profile of attachment consisting of very low-quality maternal attachment and high-quality father and friend attachments. Profiles did not significantly moderate the effect of maltreatment on PTSD symptoms. Results identify subgroups of maltreatment survivors most vulnerable to the development of depression in adolescence. Such groups should be targets for the provision of finite clinical resources with clinical interventions that seek to promote healthy maternal attachment relationships to mitigate the impact of maltreatment on depression.
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Affiliation(s)
| | - Toria Herd
- The Pennsylvania State University, State College, USA
| | | | | | - Jennie G Noll
- The Pennsylvania State University, State College, USA
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Lambert SF, Boyd RC, Ialongo NS. Protective factors for suicidal ideation among Black adolescents indirectly exposed to community violence. Suicide Life Threat Behav 2022; 52:478-489. [PMID: 35150017 DOI: 10.1111/sltb.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/25/2021] [Accepted: 11/12/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Community violence exposure has been identified as a risk factor for Black youth suicide ideation. However, little is known about factors that protect community violence exposed youth against suicide ideation. The current study examined associations between knowledge of family member and peers' community violence exposure and Black youth's subsequent suicidal ideation, and investigated self-worth and social support as protective factors. METHOD Participants were a community sample of Black youth (N = 447, 47.4% female; Mage = 11.77, SD = 0.35) who reported about community violence exposure, self-worth, social support, and suicide ideation in grades 6 and 7. RESULTS Regression analyses revealed that grade 6 knowledge of family member and peers' community violence exposure was associated with increases in suicide ideation assessed in grade 7. Self-worth attenuated the association between knowledge of others' community violence exposure and suicide ideation for male adolescents. For female adolescents, social support attenuated the association between knowledge of others' community violence and suicide ideation. CONCLUSIONS Findings highlight the consequential impact of knowledge about community violence for Black youth's suicidal ideation. Enhancing protective factors for Black youth is an important target for intervening with exposure to violence and reducing suicide ideation.
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Affiliation(s)
- Sharon F Lambert
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Two pathways to suicidal intention in Ecuadorian adolescents: The role of parental and peer attachment, depression and impulsivity. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00757-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yang H, Ran G, Zhang Q, Niu X. The Association between Parental Attachment and Youth Suicidal Ideation: A Three-Level Meta-analysis. Arch Suicide Res 2021; 27:453-478. [PMID: 34964432 DOI: 10.1080/13811118.2021.2020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Youth suicidal ideation is regarded as a serious psychological problem that hinders their mental health development. Parental attachment is considered a critical factor linked with youth suicidal ideation, but existing findings are still inconsistent. The present study was based on the PRISMA method; it employed a three-level meta-analysis to obtain reliable estimates of effect size and examined a range of moderators (sample, publication, outcome). Through the retrieval of articles published before November 2020, a systematic search yielded 31 independent studies (N = 12848) from which 109 effect sizes could be extracted. The present meta-analysis revealed a significant negative correlation between parental attachment and youth suicidal ideation (r = -0.108, p < 0.001), implying that youths show a higher level of suicidal ideation when they experienced lower quality of parental attachment. Moreover, the overall association was influenced by different parental attachment patterns. More specifically, youth suicidal ideation was more strongly associated with parental alienation (r = 0.501, p < 0.001) than with parental communication (r = -0.173, p < 0.001). The moderator analyses also showed that the type of instrument used was a significant moderator of the association between parental attachment and youth suicidal ideation. The strength of the overall association was significantly stronger when measured with the IPPA (Inventory of Parent and Peer Attachment) (r = -0.181, p = 0.003) than with the ECR (Experiences in Close Relationships) (r = 0.085, p = 0.003). These results indicate that assessing parental attachment is important in strengthening interventions that target suicidal ideation among youths.HIGHLIGHTSOur analysis revealed a significant negative association between parental attachment and youth.Specifically, the presence of a secure relationship with parents, as perceived by the youth, brings forth feelings of appreciation, acceptance, safety, and confidence, that predispose the individual to seek help in a more consistent manner and to resist to maladjusted behavior when faced with adversity. However, a low quality of attachment produces cognitions associated with perceived burdensomeness and failed belongingness, which increase a youth's vulnerability to suicidal ideation.The parental attachment pattern showed a significant moderating effect on the association between parental attachment and youth suicidal ideation.Regarding the association between parental attachment and youth suicidal ideation, we observed that the manner in which parental attachment is measured is another moderating effect.
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Liu RT, Lawrence HR, Burke TA, Sanzari CM, Levin RY, Maitlin C, Paszek C, Zhu X. Passive and active suicidal ideation among left-behind children in rural China: An evaluation of intrapersonal and interpersonal vulnerability and resilience. Suicide Life Threat Behav 2021; 51:1213-1223. [PMID: 34514644 PMCID: PMC8678197 DOI: 10.1111/sltb.12802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although theoretical conceptualizations of suicide hold that passive and active suicidal ideation are etiologically distinct, existing research observing this distinction is modest, with most prior studies focusing exclusively on active ideation. Understanding processes associated with passive ideation is clinically important insofar as passive ideation may precede active ideation, and thus serve as an earlier intervention target prior to potential onset of suicidal behavior. We aimed to evaluate intrapersonal and interpersonal vulnerability and resilience factors for passive ideation and differentiating passive from active ideation. METHOD Left-behind adolescents in rural China (n = 371) were assessed for passive and active ideation, depressive symptoms, rumination, grit, peer support, and peer victimization. RESULTS Overall, 15.9% of the sample endorsed passive ideation without active ideation, and 17.8% endorsed active ideation. In multivariate analyses, rumination and grit differentiated left-behind children with passive ideation from those with no ideation. Depressive symptom severity predicted active ideation among adolescents with passive ideation. CONCLUSIONS The current findings suggest that rumination and grit may characterize passive ideation. Although passive and active ideation may differ modestly in vulnerability and resilience factors, depressive symptoms may be important to monitor among those with passive ideation and have not yet experience active ideation.
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Affiliation(s)
- Richard T. Liu
- Department of Psychiatry, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
| | | | - Taylor A. Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | - Rachel Y. Levin
- Department of Psychiatry, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
| | - Carly Maitlin
- Department of Psychiatry, Columbia University,New York State Psychiatric Institute
| | - Claudia Paszek
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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Feasibility of Using Child Maltreatment Measurement Instruments in the Primary Care Setting: A Systematic Review. J Pediatr Nurs 2021; 61:e1-e14. [PMID: 33926746 DOI: 10.1016/j.pedn.2021.04.002] [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] [Received: 11/15/2020] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 01/10/2023]
Abstract
PROBLEM Child maltreatment is a devastating epidemic affecting millions of children and adolescents in the United States (U.S.) every year. Primary care providers (PCPs) encounter these victims but need resources to aid in the recognition of maltreatment. The purpose of this review is to evaluate child maltreatment measurement instruments and determine feasibility of use by U.S. PCPs. ELIGIBILITY CRITERIA A systematic search was conducted in the PubMed, CINAHL, and PsycInfo databases from 2014 until 2020. Eligibility criteria included articles conducted in the U.S., with use of a child maltreatment measurement instrument, and subjects less than 18 years old. Eligible articles were reference searched to find the original studies for each instrument and were included if they were published in a peer-reviewed paper, could be located, and addressed the development or validation of the instrument. SAMPLE Of the 3816 articles, 111 used a child maltreatment measurement instrument. Sixteen of the 27 identified instruments were evaluated for feasibility using a quality rating with criteria including psychometrics, construct measurement, administration, availability, and cost. RESULTS Six instruments were recommended for use by PCPs. CONCLUSIONS This is the first review evaluating the use of child maltreatment measurement instruments by PCPs and it highlights the combination of psychometric evaluation and other pertinent feasibility criteria to recommend several instruments for use by PCPs. IMPLICATIONS Use of these instruments by PCPs may serve to identify children and families who are at risk for or suffering from maltreatment.
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Manzo G, Piña-Watson B, Gonzalez IM, Garcia A, Meza JI. Disentangling acculturation and enculturation intergenerational gaps: Examining mother-youth value discrepancies and mental health among Mexican-descent college students. J Clin Psychol 2021; 78:298-320. [PMID: 34414572 DOI: 10.1002/jclp.23229] [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: 12/07/2020] [Revised: 06/14/2021] [Accepted: 06/28/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To test the acculturation gap hypothesis by examining mother-youth value discrepancies (both acculturative and enculturative) and their association with mother-youth acculturative conflict and youth mental health outcomes. METHOD Participants were 273 Mexican descent college students attending a large, public, Hispanic Serving Institution (HSI) in West Texas (72% women). The participants' ages ranged 18-25 years (M = 19.33 years; SD = 1.54 years). RESULTS Three models assessed the relationship between mother-youth value discrepancies and mental health outcomes (suicidal ideation, non-suicidal self-injury, and depressive symptoms) as mediated by mother-youth acculturative conflict. Consistently, Mexican heritage cultural values were related to mental health outcomes while American cultural values were not. CONCLUSIONS The study found that increased mother-youth discrepancies on Mexican cultural values were associated with increased negative mental health outcomes. Our findings suggest that adopting or learning new mainstream American values does not substitute for the Mexican cultural values that protect against negative outcomes.
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Duprey EB, Handley ED, Manly JT, Cicchetti D, Toth SL. Child maltreatment, recent stressful life events, and suicide ideation: A test of the stress sensitivity hypothesis. CHILD ABUSE & NEGLECT 2021; 113:104926. [PMID: 33444849 PMCID: PMC7880899 DOI: 10.1016/j.chiabu.2020.104926] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Exposure to child maltreatment is a well-known risk factor for suicide ideation among adolescents. Recent stressful life events may also contribute to this risk. However, the association between these risk factors is unclear in the etiology of suicide ideation for adolescents from socio-economically disadvantaged backgrounds. OBJECTIVE The present study tested the stress generation and stress sensitivity hypotheses in relation to child maltreatment, recent stressful life events (in the past year), and suicide ideation (in the past two weeks). PARTICIPANTS AND SETTING We utilized a sample of diverse, socioeconomically disadvantaged, depressed adolescent girls (N = 175) who were part of a depression treatment intervention. RESULTS Child maltreatment was significantly associated with adolescent suicide ideation, β = .40, p < .001. Results supported the stress sensitivity hypothesis, in that exposure to interpersonal stressors in the past year exacerbated the association between child maltreatment and adolescents' suicide ideation, β = .18, p < .05. We found evidence for a protective factor, cognitive reappraisal, in the association between stressful life events and suicide ideation, β = -.15, p < .05. CONCLUSIONS These findings have several implications for clinical practice and suicide prevention with adolescent girls, and contribute to the extant literature on the role of chronic and acute stress in the etiology of adolescent suicide ideation.
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Affiliation(s)
- Erinn B Duprey
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY, United States; Mt. Hope Family Center, University of Rochester, 187 Edinburgh St, Rochester, NY, United States.
| | - Elizabeth D Handley
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St, Rochester, NY, United States.
| | - Jody Todd Manly
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St, Rochester, NY, United States.
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St, Rochester, NY, United States; Institute of Child Development, University of Minnesota, 51 East River Road, Minneapolis, MN, United States.
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St, Rochester, NY, United States.
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Adams TR, Handley ED, Warmingham JM, Manly JT, Cicchetti D, Toth SL. Patterns of dating violence moderate the effect of child maltreatment on suicide risk among disadvantaged minority female adolescents with depressive symptoms. JOURNAL OF FAMILY VIOLENCE 2021; 36:5-16. [PMID: 34219913 PMCID: PMC8248270 DOI: 10.1007/s10896-020-00153-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Childhood maltreatment is associated with increased suicide risk. However, not all maltreated children report self-injurious thoughts and behaviors, highlighting the presence of other risk factors. Notably, adolescent dating violence (ADV) and child maltreatment are highly comorbid, with ADV also linked to suicide risk among adolescents. Current research further suggests that distinct patterns of ADV involvement are differentially related to adolescent mental health. To date, it is unknown whether differences in ADV patterns moderate changes in suicide risk for adolescents with and without a maltreatment history. This study aims to advance the literature by identifying patterns of ADV in a unique sample of adolescents and by determining the differential association between maltreatment and suicidal ideation and non-suicidal self-harming behaviors based on ADV profiles. METHODS Participants were racially and ethnically diverse low-income non-treatment-seeking adolescent females with elevated depressive symptoms, ages 13-16 (N=198). RESULTS Using latent class analysis, we found support for a 3-class model of dating violence: adolescent females without ADV involvement, those in relationships with mutual verbal abuse, and those in romantic relationships with multiple and more severe forms of ADV, such as verbal abuse and physical violence. A series of latent class moderation models indicated that the effect of child maltreatment on suicidal ideation significantly differed based on ADV class membership. CONCLUSION Results highlight the importance of considering different ADV patterns and maltreatment as interactive risk factors for increased self-injurious thoughts and behaviors. Intervention and prevention approaches relevant to maltreated youths are discussed for families and practitioners.
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Affiliation(s)
| | | | | | | | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester
- Institute of Child Development, University of Minnesota
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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: 125] [Impact Index Per Article: 31.3] [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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Liu RT, Bettis AH, Burke TA. Characterizing the phenomenology of passive suicidal ideation: a systematic review and meta-analysis of its prevalence, psychiatric comorbidity, correlates, and comparisons with active suicidal ideation. Psychol Med 2020; 50:367-383. [PMID: 31907085 PMCID: PMC7024002 DOI: 10.1017/s003329171900391x] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Compared to active ideation, passive ideation remains relatively understudied and its clinical importance poorly defined. The weight that should be accorded passive ideation in clinical risk assessment is therefore unclear. METHODS We conducted a systematic review and meta-analysis of the prevalence of passive ideation, its psychiatric comorbidity, associated sociodemographic characteristics, as well as psychological and environmental correlates. For reference, pooled effects were also calculated for direct comparisons of passive and active ideation with respect to potential correlates. Relevant articles published since inception to 9 September 2019 were identified through a systematic search of MEDLINE and PsycINFO. RESULTS A total of 86 studies were included in this review. The prevalence of passive ideation was high across sample types, ranging from 5.8% for 1-year prevalence to 10.6% for lifetime prevalence in the general population. Passive ideation was strongly associated with sexual minority status, psychiatric comorbidity, psychological characteristics implicated in risk, and suicide attempts. Preliminary evidence exists for a large association with suicide deaths. The effect sizes for individual correlates of passive and active ideation were largely equivalent and mostly non-significant in head-to-head comparisons. CONCLUSIONS Passive ideation is a prevalent clinical phenomenon associated with significant psychiatric comorbidity. Current evidence also suggests notable similarities exist between passive and active ideation in terms of psychiatric comorbidity and psychological and other characteristics traditionally associated with risk.
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Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI02915, USA
| | - Alexandra H Bettis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI02915, USA
| | - Taylor A Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI02915, USA
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