Childhood abuse experiences, depression and dissociation symptoms in relation to suicide attempts and suicidal ideation.

This study aimed to examine associations between suicide attempts (SA), suicidal ideation (SI), depression, dissociative symptoms, emotional abuse, physical abuse and sexual abuse, and to explore predictors of SA and SI, as well as possible mediating factors. We also aimed to examine support for a dissociative depression subgroup. Participating in this study were 342 adults, of these were 138 respondents with a diagnosis of depression (DG), and 204 respondents comprising a community sample (CS). Respondents completed the Center for Epidemiologic Studies Depression Scale - Revised (CESD-R), Childhood Trauma Questionnaire - Short Form (CTQ-SF), and Dissociative Experience Scale (DES). All but two (DES-Absorption and DES - Depersonalization/Derealization) of the study variable mean scores were higher in the DG than in the CS group. Regression analysis showed that SA was predicted by sexual abuse and DES-Amnesia in the CS group. Structural equation modeling revealed that in both groups the types of abuse were reciprocally correlated, emotional abuse was linked to dissociation, which in turn was related to depression, which is turn was predictive of suicide ideation. Depression had a full mediating effect between dissociation and suicide ideation in the CS, and a partial mediating effect in the DG. Sexual abuse had a direct effect upon depression and suicide ideation in the DG. Cluster analysis provided support for a dissociative depression subtype.