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Childhood adversity and midlife suicidal ideation

  • S. A. Stansfeld (a1), C. Clark (a1), M. Smuk (a1), C. Power (a2), T. Davidson (a3) and B. Rodgers (a4)...



Childhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties.


At 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood.


Illness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67–6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29–5.75), sexual abuse (OR 4.99, 95% CI 2.90–11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI −7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97–27.88) and sexual abuse (OR 6.59, 95% CI 2.40–38.36) with suicidal ideation at 45 years.


Adversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive interventions.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: S. A. Stansfeld, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK (Email:


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Afifi, TO, Enns, MW, Cox, BJ, Asmundson, GJG, Stein, MB, Sareen, J (2008). Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences. American Journal of Public Health 98, 946952.
Agerbo, E, Nordentoft, M, Mortensen, PB (2002). Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case–control study. British Medical Journal 325, 74.
Atherton, K, Fuller, E, Shepherd, P, Strachan, DP, Power, C (2008). Loss and representativeness in a biomedical survey at age 45 years: 1958 British birth cohort. Journal of Epidemiology and Community Health 62, 216223.
Bifulco, A, Moran, PM, Baines, R, Bunn, A, Stanford, K (2002). Exploring psychological abuse in childhood: II. Association with other abuse and adult clinical depression. Bulletin of the Menninger Clinic 66, 241258.
Bradley, RG, Binder, EB, Epstein, MP, Tang, Y, Nair, HP, Liu, W, Gillespie, CF, Berg, T, Evces, M, Newport, DJ, Stowe, ZN, Heim, CM, Nemeroff, CB, Schwartz, A, Cubells, JF, Ressler, KJ (2008). Influence of child abuse on adult depression: moderation by the corticotropin-releasing hormone receptor gene. Archives of General Psychiatry 65, 190200.
Bruwer, B, Govender, R, Bishop, M, Williams, DR, Stein, DJ, Seedat, S (2014). Association between childhood adversities and long-term suicidality among South Africans from the results of the South African Stress and Health study: a cross-sectional study. BMJ Open 4, e004644.
Clark, C, Rodgers, B, Caldwell, T, Power, C, Stansfeld, S (2007). Childhood and adulthood psychological ill health as predictors of midlife affective and anxiety disorders – The 1958 British Birth Cohort. Archives of General Psychiatry 64, 668678.
Clark, C, Caldwell, T, Power, C, Stansfeld, SA et al. (2010). Does the influence of childhood adversity on psychopathology persist across the lifecourse? A 45-year prospective study. Annals of Epidemiology 20, 385394.
Colman, I, Kingsbury, M, Garad, Y, Zeng, Y, Naicker, K, Patten, S, Jones, PB, Wild, TC, Thompson, AH (2016). Consistency in adult reporting of adverse childhood experiences Psychological Medicine 46, 543549.
Colman, I, Wadsworth, ME, Croudace, TJ, Jones, PB (2007). Forty-year psychiatric outcomes following assessment for internalizing disorder in adolescence. American Journal of Psychiatry 164, 126133.
Corcoran, P, Gallagher, J, Keeley, HS, Arensman, E, Perry, IJ (2006). Adverse childhood experiences and lifetime suicide ideation: a cross-sectional study in a non-psychiatric hospital setting. Irish Medical Journal 99, 4245.
Dennis, M, Baillon, S, Brugha, T, Lindesay, J, Stewart, R, Meltzer, H (2007). The spectrum of suicidal ideation in Great Britain: comparisons across a 16–74 years age range. Psychological Medicine 37, 795805.
Dube, SR, Anda, RF, Felitti, VJ, Chapman, DP, Williamson, DF, Giles, WH (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the lifespan: findings from the Adverse Childhood Experiences Study. Journal of the American Medical Association 286, 31263127.
Elander, J, Rutter, M (1996). Use and development of the Rutter's parents’ and teachers’ scales. International Journal of Psychiatric Research 6, 6378.
Enns, MW, Cox, BJ, Afifi, TO, de Graaf, R, Ten Have, M, Sareen, J (2006). Childhood adversities and risk for suicidal ideation and attempts: a longitudinal population-based study. Psychological Medicine 36, 17691778.
Fairweather, AK, Anstey, KJ, Rodgers, B, Jorm, AF, Christensen, H (2007). Age and gender differences among Australian suicide ideators: prevalence and correlates. Journal of Nervous and Mental Disease 195, 130136.
Fanous, AH, Prescott, CA, Kendler, KS (2004). The prediction of thoughts of death or self-harm in a population-based sample of female twins. Psychological Medicine 34, 301312.
Fergusson, DM, Woodward, LJ, Horwood, LJ (2000). Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychological Medicine 30, 2329.
Ghodsian, M (1983). Measuring behaviour in the school and home. In Growing Up in Britain (ed. Fogelman, K), pp. 329338. The Macmillan Press Ltd: London.
Graham, H, Power, C (2004). Childhood disadvantage and health inequalities: a framework for policy based on lifecourse research. Child: Care, Health and Development 30, 671678.
Gunnell, D, Harbord, R, Singleton, N, Jenkins, R, Lewis, G (2004). Factors influencing the development and amelioration of suicidal thoughts in the general population. Cohort study. British Journal of Psychiatry 185, 385393.
Hancock, M, Elliott, J, Johnson, J, Bukodi, E (2011 a). National Child Development Study: Activity Histories 1974–2009. Centre for Longitudinal Studies, Institute of Education: London.
Hancock, M, Elliott, J, Johnson, J, Bukodi, E (2011 b). National Child Development Study: Partnership Histories 1974–2008. Centre for Longitudinal Studies, Institute of Education: London.
Harford, TC, Yia, H, Grant, BF (2014). Associations between childhood abuse and interpersonal aggression and suicide attempt among U.S. adults in a national study. Child Abuse and Neglect 38, 13891398.
Heider, D, Bernert, S, Matschinger, H, Haro, JM, Alonso, J, Angermeyer, MC; ESEMeD/MHEDEA 2000 Investigators (2007). Parental bonding and suicidality in adulthood. Australian and New Zealand Journal of Psychiatry 41, 6673.
Heikkinen, M, Aro, H, Lonnqvist, J (1993). Life events and social support in suicide. Suicide and Life-threatening Behavior 23, 343358.
Hicks, R & Tingley, D (2011). Causal mediation analysis. Stata Journal 11, 115.
Hornung, OP, Heim, CM (2014). Gene–environment interactions and intermediate phenotypes: early trauma and depression. Frontiers in Endocrinology 5, 14.
Johnson, JG, Cohen, P, Gould, MS, Kasen, S, Brown, J, Brook, JS (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry 59, 741749.
Kendler, KS, Eaves, LJ (1986). Models for the joint effect of genotype and environment on liability to psychiatric illness. American Journal of Psychiatry 143, 279289.
Kendler, KS, Gardner, CO, Prescott, CA (2002). Toward a comprehensive developmental model for major depression in women. American Journal of Psychiatry 159, 11331145.
Kendler, KS, Gardner, CO, Prescott, CA (2006). Toward a comprehensive developmental model for major depression in men. American Journal of Psychiatry 163, 115124.
Kessler, RC, Borges, G, Walters, EE (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617626.
Leitenberg, H, Gibson, LE, Novy, PL (2004). Individual differences among undergraduate women in methods of coping with stressful events: the impact of cumulative childhood stressors and abuse. Child Abuse and Neglect 28, 181192.
Lewis, G, Pelosi, AJ, Araya, R, Dunn, G (1992). Measuring psychiatric-disorder in the community – a standardized assessment for use by lay interviewers. Psychological Medicine 22, 465486.
May, AM, Klonsky, ED, Klein, DN (2012). Predicting future suicide attempts among depressed suicidal ideators: a 10-year longitudinal study. Journal of Psychiatric Research 46, 946952.
Mayfield, D, McLeod, G, Hall, P (1974). The CAGE questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry 131, 11211123.
McGowan, PO, Sasaki, A, D'Alessio, AC, Dymov, S, Labonté, B, Szyf, M, Turecki, G, Meaney, MJ (2009). Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience 12, 342348.
Office of Population Censuses and Surveys (1980). Classification of Occupations. HMSO: London.
Pickles, A, Aglan, A, Collishaw, S, Messer, J, Rutter, M, Maughan, B (2010). Predictors of suicidality across the life span: the Isle of Wight study. Psychological Medicine 40, 14531466.
Power, C, Elliott, J (2006). Cohort profile: 1958 British birth cohort (National Child Development Study). International Journal of Epidemiology 35, 3441.
Rosenman, S & Rodgers, B (2004). Childhood adversity in an Australian population. Social Psychiatry and Psychiatric Epidemiology 39, 695702.
Rubin, DB (1987). Multiple Imputation for Nonresponse in Surveys. J. Wiley & Sons: New York.
Rutter, M (1967). A children's behaviour questionnaire for completion by teachers – preliminary findings. Journal of Child Psychology and Psychiatry and Allied Disciplines 8, 111.
Séguin, M, Lesage, A, Turecki, G, Bouchard, M, Chawky, N, Tremblay, N, Daigle, F, Guy, A (2007). Life trajectories and burden of adversity: mapping the developmental profiles of suicide mortality. Psychological Medicine 37, 15751583.
Shonkoff, JP, Fisher, PA (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and Psychopathology 25, 16351653.
Stansfeld, SA, Clark, C, Rodgers, B, Caldwell, T, Power, C (2008). Childhood and adulthood socio-economic position and midlife depressive and anxiety disorders. British Journal of Psychiatry 192, 152153.
Tiet, QQ, Bird, HR, Davies, M, Hoven, C, Cohen, P, Jensen, PS, Goodman, S (1998). Adverse life events and resilience. Journal of the American Academy of Child and Adolescent Psychiatry 37, 11911200.
Wanner, B, Vitaro, F, Tremblay, RE, Turecki, G (2012). Childhood trajectories of anxiousness and disruptiveness explain the association between early-life adversity and attempted suicide. Psychological Medicine 42, 23732382.
Windsor, TD, Anstey, KJ, Butterworth, P, Rodgers, B (2008). Behavioral approach and behavioral inhibition as moderators of the association between negative life events and perceived control in midlife. Personality and Individual Differences 44, 10801092.
Ystgaard, M, Hestetun, I, Loeb, M, Mehlum, L (2004). Is there a specific relationship between childhood sexual and physical abuse and repeated suicidal behavior? Child Abuse and Neglect 28, 863875.


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Childhood adversity and midlife suicidal ideation

  • S. A. Stansfeld (a1), C. Clark (a1), M. Smuk (a1), C. Power (a2), T. Davidson (a3) and B. Rodgers (a4)...


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