Sachs-Ericsson Natalie J, Stanley Ian H, Sheffler Julia L, Selby Edward, Joiner Thomas E
Department of Psychology, Florida State University, United States.
Department of Psychology, Florida State University, United States.
J Affect Disord. 2017 Jun;215:15-22. doi: 10.1016/j.jad.2017.03.030. Epub 2017 Mar 9.
Childhood abuse is linked to suicide. Potential pathways include the increased risk for the development of psychiatric disorders and the contribution of abuse to suicide capability. The current study compared the effects of childhood non-violent and violent abuse in the prediction of suicide attempts, and examined the potential mediated effects of psychiatric disorders.
Data from the National Comorbidity Surveys were obtained. At baseline, assessments of childhood non-violent abuse (e.g., parental verbal abuse) and violent abuse (e.g., parental physical abuse, relative rape) were obtained. We also assessed for other adverse childhood experiences, baseline suicidal behaviors, and psychiatric disorders. At the ten-year follow-up, we assessed for psychiatric disorders and suicide attempts that had occurred over time.
Both non-violent and violent abuse predicted attempts, though participants experiencing violent abuse had significantly higher rates. Bootstrapped mediation analyses determined that the influence of non-violent abuse on suicide attempts was indirect, and exerted its influence through the psychiatric disorders that occurred during the ten-year follow-up.
The study relied on retrospective reports of childhood abuse. Further, we could not clearly determine the temporal order of the psychiatric disorders and suicide attempts occurring over follow-up.
Different mechanisms may underlie the pathway between violent and non-violent abuse and suicide attempts. Verbal abuse may lead to negative cognitive styles and psychiatric disorders associated with suicidality; violent abuse may contribute to the capacity for suicide. Interventions may need to be specifically tailored to meet the distinct needs of individuals who have experienced past childhood abuse.
童年期受虐与自杀有关。潜在途径包括精神障碍发生风险增加以及虐待对自杀能力的影响。本研究比较了童年期非暴力虐待和暴力虐待在预测自杀未遂方面的作用，并检验了精神障碍的潜在中介作用。
获取了全国共病调查的数据。在基线时，评估童年期非暴力虐待（如父母言语虐待）和暴力虐待（如父母身体虐待、亲属强奸）情况。我们还评估了其他童年期不良经历、基线自杀行为和精神障碍。在十年随访时，我们评估了随访期间发生的精神障碍和自杀未遂情况。
非暴力虐待和暴力虐待均能预测自杀未遂，不过遭受暴力虐待的参与者发生率显著更高。自抽样中介分析确定，非暴力虐待对自杀未遂的影响是间接的，且通过十年随访期间发生的精神障碍发挥作用。
本研究依赖于对童年期虐待的回顾性报告。此外，我们无法明确确定随访期间精神障碍和自杀未遂的时间顺序。
暴力虐待和非暴力虐待与自杀未遂之间的途径可能存在不同机制。言语虐待可能导致与自杀相关的消极认知方式和精神障碍；暴力虐待可能导致自杀能力增强。干预措施可能需要专门针对有童年期受虐经历个体的不同需求进行定制。
