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Cain SM, Rooney EA, Cacace S, Post A, Russell K, Rasmussen S, Baker JC, Cramer RJ. Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis. BMC Public Health 2024; 24:2052. [PMID: 39080601 PMCID: PMC11290251 DOI: 10.1186/s12889-024-19448-z] [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] [Received: 01/11/2024] [Accepted: 07/11/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat). METHOD Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence. RESULTS Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs. CONCLUSIONS Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed.
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Affiliation(s)
- Shannon M Cain
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Emily A Rooney
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive 1st Floor, Columbus, OH, 43210, USA
| | - Samantha Cacace
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Abigail Post
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Kirsten Russell
- Department of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G11QE, UK
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G11QE, UK
| | - Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive 1st Floor, Columbus, OH, 43210, USA
| | - Robert J Cramer
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA.
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA.
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Kirshenbaum JS, Pagliaccio D, Bitran A, Xu E, Auerbach RP. Why do adolescents attempt suicide? Insights from leading ideation-to-action suicide theories: a systematic review. Transl Psychiatry 2024; 14:266. [PMID: 38937430 PMCID: PMC11211511 DOI: 10.1038/s41398-024-02914-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 06/29/2024] Open
Abstract
Suicide is a leading cause of death among adolescents, and recent suicide theories have sought to clarify the factors that facilitate the transition from suicide ideation to action. Specifically, the Interpersonal Theory of Suicide (IPTS), Integrated Motivational-Volitional Model (IMV), and Three Step Theory (3ST) have highlighted risk factors central to the formation of suicidal ideation and suicidal behaviors, which is necessary for suicide death. However, these models were initially developed and tested among adults, and given core socioemotional and neurodevelopmental differences in adolescents, the applicability of these models remains unclear. Directly addressing this gap in knowledge, this systematic review aimed to (1) describe the evidence of leading ideation-to-action theories (i.e., IPTS, IMV, 3ST) as they relate to suicide risk among adolescents, (2) integrate ideation-to-action theories within prevailing biological frameworks of adolescent suicide, and (3) provide recommendations for future adolescent suicide research. Overall, few studies provided a complete test of models in adolescent samples, and empirical research testing components of these theories provided mixed support. Future research would benefit from integrating neurodevelopmental and developmentally sensitive psychosocial frameworks to increase the applicability of ideation-to-action theories to adolescents. Further, utilizing real-time monitoring approaches may serve to further clarify the temporal association among risk factors and suicide.
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Affiliation(s)
- Jaclyn S Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Alma Bitran
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Elisa Xu
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
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Souza K, Sosu EM, Thomson S, Rasmussen S. A systematic review of the studies testing the integrated motivational-volitional model of suicidal behaviour. Health Psychol Rev 2024:1-25. [PMID: 38626312 DOI: 10.1080/17437199.2024.2336013] [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: 06/12/2023] [Accepted: 03/22/2024] [Indexed: 04/18/2024]
Abstract
Despite the influence of the integrated motivational-volitional (IMV)1 model on research and practice, the supporting literature has not been systematically synthesised. This systematic review aims to synthesise the literature testing the IMV model of suicidal behaviour. Using citation and database searching, PsycINFO, EMBASE, PubMed, Web of Science, and Google Scholar were searched for studies referencing the IMV model (last searched on 28th March 2023). Included studies empirically tested the hypotheses of the model. Quality assessment was conducted using the National Institute of Health tool. Findings from 98 records (100 studies, 138,365 participants) were narratively synthesised. Results from studies directly testing the hypothesised pathways of the model supported the defeat-entrapment-suicidal ideation pathway of the IMV model. Case-control studies comparing differences between control, ideation, and enactment groups were consistent with hypotheses in univariate and cross-sectional analyses. However, support for the model was mixed for case-control multivariate and prospective studies. Due to low overlap in variables studied, the role of specific pre-motivational phase variables and stage-specific moderators was inconclusive. The studies received overall good quality ratings. The IMV model presents a promising framework for understanding and preventing suicide. Defeat, entrapment, and key variables may be useful in informing suicide prevention measures.
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Affiliation(s)
- Kenvil Souza
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Edward M Sosu
- Strathclyde Institute of Education, University of Strathclyde, Glasgow, UK
| | - Scott Thomson
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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John A, Lee SC, Puchades A, Del Pozo-Baños M, Morgan K, Page N, Moore G, Murphy S. Self-harm, in-person bullying and cyberbullying in secondary school-aged children: A data linkage study in Wales. J Adolesc 2023; 95:97-114. [PMID: 36210647 DOI: 10.1002/jad.12102] [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] [Received: 01/18/2022] [Revised: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Although the evidence base on bullying victimization and self-harm in young people has been growing, most studies were cross-sectional, relied on self-reported non-validated measures of self-harm, and did not separate effects of in-person and cyberbullying. This study aimed to assess associations of self-harm following in-person bullying at school and cyberbullying victimization controlling for covariates. METHODS School survey data from 11 to 16 years pupils collected in 2017 from 39 Welsh secondary schools were linked to routinely collected data. Inverse probability weighting was performed to circumvent selection bias. Survival analyses for recurrent events were conducted to evaluate relative risks (adjusted hazard ratios [AHR]) of self-harm among bullying groups within 2 years following survey completion. RESULTS A total of 35.0% (weighted N = 6813) of pupils reported being bullied, with 18.1%, 6.4% and 10.5% being victims of in-person bullying at school only, cyberbullying only and both in-person bullying at school and cyberbullying respectively. Adjusting for covariates, effect sizes for self-harm were significant after being in-person bullied at school only (AHR = 2.2 [1.1-4.3]) and being both in-person bullied at school and cyberbullied (AHR = 2.2 [1.0-4.7]) but not being cyberbullied only (AHR = 1.2 [0.4-3.3]). Feeling lonely during recent summer holidays was also a robust predictor (AHR = 2.2 [1.2-4.0]). CONCLUSIONS We reaffirm the role of in-person bullying victimization on self-harm. Pupils were twice as likely to self-harm following in-person bullying as their nonvictimised peers. Interventions for young people that minimize the potential impacts of bullying on self-harm should also include strategies to prevent loneliness.
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Affiliation(s)
- Ann John
- Population Data Science, Swansea University Medical School, Swansea, UK
- Public Health Wales, 2 Capital Quarter, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Sze Chim Lee
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Alice Puchades
- Population Data Science, Swansea University Medical School, Swansea, UK
- Public Health Wales, 2 Capital Quarter, Cardiff, UK
| | - Marcos Del Pozo-Baños
- Population Data Science, Swansea University Medical School, Swansea, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Kelly Morgan
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Nicholas Page
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Graham Moore
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Simon Murphy
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
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Wang K, He Q, Zhu X, Hu Y, Yao Y, Hommel B, Beste C, Liu J, Yang Y, Zhang W. Smaller putamen volumes are associated with greater problems in external emotional regulation in depressed adolescents with nonsuicidal self-injury. J Psychiatr Res 2022; 155:338-346. [PMID: 36179414 DOI: 10.1016/j.jpsychires.2022.09.014] [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: 02/21/2022] [Revised: 08/17/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
The functions of nonsuicidal self-injury (NSSI) consist of social and emotional aspects (Social influence, Sensation seeking, Internal and External emotion regulation). Previous studies have indicated that dysfunction in reward-related brain structures especially the striatum might drive this habitual behavior. However, no studies to date have investigated the associations between striatum and different functions for adolescents engaging in NSSI behaviors. Here, we recruited 35 depressed adolescents with recent NSSI behaviors and 36 healthy controls and acquired structural brain images, depressive symptoms, social, academic and family environments assessments, in addition to NSSI functions in patients only. Subcortical volumes and cortical thickness were estimated with FreeSurfer. Mixed linear regressions were performed to examine associations between striatal structures (caudate, putamen, nucleus accumbens, pallidum) and NSSI functions, with age, sex, total intracranial volume, hemisphere and depression severity included as covariates. Effect of environmental factors and potential associations with cortical thickness and other subcortical volumes were also tested. We found that, among the four functions, external emotional regulation represented the main function for NSSI engagement. Increased external emotion regulation was significantly associated with smaller putamen volume. No environmental factors biased the association with putamen. No associations with other cortical or subcortical regions were observed. Our findings suggested that smaller putamen might be a biomarker of NSSI engagement for depressed adolescents when they regulated frustrated or angry emotions. The results have potentially clinical implications in early identification and brain intervention of NSSI in youth.
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Affiliation(s)
- Kangcheng Wang
- School of Psychology, Shandong Normal University, Jinan, 250358, China
| | - Qiang He
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Xingxing Zhu
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Yufei Hu
- School of Psychology, Shandong Normal University, Jinan, 250358, China
| | - Yuan Yao
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Bernhard Hommel
- School of Psychology, Shandong Normal University, Jinan, 250358, China; Cognitive Psychology Unit, & Leiden Institute for Brain & Cognition, Institute of Psychology, Leiden University, Netherlands; Department of Child and Adolescent Psychiatry, TU Dresden, Germany
| | - Christian Beste
- School of Psychology, Shandong Normal University, Jinan, 250358, China; Department of Child and Adolescent Psychiatry, TU Dresden, Germany; University Neuropsychology Center, TU Dresden, Germany
| | - Jintong Liu
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, 250014, China
| | - Ying Yang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, 250014, China.
| | - Wenxin Zhang
- School of Psychology, Shandong Normal University, Jinan, 250358, China.
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Improving the Field's Understanding of Suicide Protective Factors and Translational Suicide Prevention Initiatives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031027. [PMID: 33503803 PMCID: PMC7908249 DOI: 10.3390/ijerph18031027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
World Health Organization data show that approximately 800,000 persons die by suicide each year [...].
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