Arch Suicide Res. 2023 Oct-Dec;27(4):1207-1230. doi: 10.1080/13811118.2022.2112118. Epub 2022 Sep 1.
Childhood adversity (CA) is linked to suicidal behavior as well as to mood disorders and aggressive traits. This raises the possibility that depression and aggressive traits mediate the relationship of childhood adversity to suicide risk. Moreover, it is not known if they operate independently or interactively.
To determine whether, and how, mood disorders and aggressive traits mediate the effects of reported physical and sexual abuse on future suicidal behavior.
Five hundred and forty-eight subjects, offspring of parents with mood disorders, were interviewed at baseline and at yearly follow-ups with questionnaires assessing aggression, mood disorders, and suicidal behavior. The mediation analysis involved a three-step process, testing the relationships between (1) CA and attempt; (2) CA and putative mediators; and (3) putative mediators and suicide attempt, adjusting for CA.
Aggressive trait severity and mood disorder onset each mediated the relationship between CA and future suicide attempts. Greater aggression severity also raised the hazard of the development of a mood disorder. If aggressive trait severity was clearly elevated, then onset of mood disorder did not increase further the hazard of the suicide attempt. Including family as a random effect had a much bigger effect on attempt outcome for physical abuse compared with sexual abuse.
Amelioration of aggressive traits and treatment of mood disorders in CA-exposed offspring of a parent with a mood disorder may prevent future suicide attempts and may reduce the risk of mood disorder. Familial factors influence the impact of childhood physical abuse but not sexual abuse. HIGHLIGHTSChildhood Adversity (CA) predicted future mood disorder and aggression severity.Depression and aggression mediate the relationship between CA and suicide attempts.When one mediator is present, the presence of the other does not increase the hazard.Between family variation contributed much more to suicidal behavior outcomes relative to the effect of physical abuse, but sexual abuse contributed to suicidal outcomes more than family variation.
童年逆境（CA）与自杀行为以及情绪障碍和攻击特质有关。这就提出了这样一种可能性，即抑郁和攻击特质会调节童年逆境与自杀风险的关系。此外，目前还不清楚它们是独立作用还是相互作用。
确定情绪障碍和攻击特质是否以及如何调节报告的身体和性虐待对未来自杀行为的影响。
对 548 名父母患有情绪障碍的子女进行了访谈，在基线和每年的随访中使用问卷评估了攻击性、情绪障碍和自杀行为。中介分析涉及一个三步过程，检验了（1）CA 与尝试之间的关系；（2）CA 与假定的中介因素之间的关系；以及（3）假定的中介因素与自杀尝试之间的关系，同时调整了 CA 的影响。
攻击特质严重程度和情绪障碍发病均介导了 CA 与未来自杀企图之间的关系。攻击性严重程度的增加也增加了情绪障碍发病的风险。如果攻击性特质严重程度明显升高，那么情绪障碍的发病不会进一步增加自杀企图的风险。与性虐待相比，将家庭作为随机效应纳入对身体虐待的尝试结果的影响要大得多。
在父母患有情绪障碍的 CA 暴露子女中，改善攻击特质和治疗情绪障碍可能会预防未来的自杀企图，并降低情绪障碍的风险。家庭因素影响童年期身体虐待的影响，但不影响性虐待。
童年逆境（CA）预测未来的情绪障碍和攻击严重程度。抑郁和攻击中介了 CA 与自杀企图之间的关系。当存在一个中介因素时，另一个因素的存在不会增加危险。与身体虐待相比，家庭变异对自杀行为结果的贡献要大得多，但性虐待对自杀结果的贡献大于家庭变异。
