Skip to main content Accessibility help
×
Home

Childhood adversities as risk factors for onset and persistence of suicidal behaviour

  • Ronny Bruffaerts (a1), Koen Demyttenaere (a1), Guilherme Borges (a2), Josep Maria Haro (a3), Wai Tat Chiu (a4), Irving Hwang (a4), Elie G. Karam (a5), Ronald C. Kessler (a4), Nancy Sampson (a4), Jordi Alonso (a6), Laura Helena Andrade (a7), Matthias Angermeyer (a8), Corina Benjet (a9), Evelyn Bromet (a10), Giovanni de Girolamo (a11), Ron de Graaf (a12), Silvia Florescu (a13), Oye Gureje (a14), Itsuko Horiguchi (a15), Chiyi Hu (a16), Viviane Kovess (a17), Daphna Levinson (a18), Jose Posada-Villa (a19), Rajesh Sagar (a20), Kate Scott (a21), Adley Tsang (a22), Svetlozar M. Vassilev (a23), David R. Williams (a24) and Matthew K. Nock (a25)...

Abstract

Background

Suicide is a leading cause of death worldwide, but the precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour (suicide ideation, plans and attempts) are not well understood.

Aims

To examine the associations between childhood adversities as risk factors for the onset and persistence of suicidal behaviour across 21 countries worldwide.

Method

Respondents from nationally representative samples (η = 55 299) were interviewed regarding childhood adversities that occurred before the age of 18 years and lifetime suicidal behaviour.

Results

Childhood adversities were associated with an increased risk of suicide attempt and ideation in both bivariate and multivariate models (odds ratio range 1.2–5.7). The risk increased with the number of adversities experienced, but at a decreasing rate. Sexual and physical abuse were consistently the strongest risk factors for both the onset and persistence of suicidal behaviour, especially during adolescence. Associations remained similar after additional adjustment for respondents' lifetime mental disorder status.

Conclusions

Childhood adversities (especially intrusive or aggressive adversities) are powerful predictors of the onset and persistence of suicidal behaviours.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Childhood adversities as risk factors for onset and persistence of suicidal behaviour
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Childhood adversities as risk factors for onset and persistence of suicidal behaviour
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Childhood adversities as risk factors for onset and persistence of suicidal behaviour
      Available formats
      ×

Copyright

Corresponding author

Ronny Bruffaerts, Department of Neurosciences, University Psychiatric Center – Katholieke Universiteit Leuven (UPC-KUL), Herestraat 49, B-3000 Leuven, Belgium. Email: ronny.bruffaerts@med.kuleuven.be

Footnotes

Hide All

Declaration of interest

R.C.K. has been a consultant for GlaxoSmithKline, Kaiser Permanente, Pfizer, Sanofi-Aventis, Shire Pharmaceuticals, and Wyeth-Ayerst, has served on advisory boards for Eli Lilly & Company and Wyeth-Ayerst, and has had research support for his epidemiological studies from Bristol-Myers Squibb, Eli Lilly & Company, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Ortho-McNeil Pharmaceuticals, Pfizer and Sanofi-Aventis.

Footnotes

References

Hide All
1 Nock, MK, Borges, G, Bromet, EJ, Alonso, J, Angermeyer, M, Beautrais, A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry 2008; 192: 98105.
2 Nock, MK, Borges, G, Bromet, EJ, Cha, CB, Kessler, RC, Lee, S. Suicide and suicidal behaviour. Epidemiol Rev 2008; 30: 133–54.
3 Kessler, RC, Borges, G, Walters, EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 1999; 56: 617–27.
4 McHolm, AE, MacMillan, HL, Jamieson, E. The relationship between childhood physical abuse and suicidality among depressed women: results from a community sample. Am J Psychiatry 2003; 160: 933–8.
5 Borges, G, Angst, J, Nock, MK, Ruscio, AM, Kessler, RC. Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. J Affect Disord 2008; 105: 2533.
6 Weissman, MM, Bland, RC, Canino, GJ, Greenwald, S, Hwu, HG, Joyce, PR, et al. Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 1999; 29: 917.
7 Risch, N, Herrell, R, Lehner, T, Liang, KY, Eaves, L, Hoh, J, et al. Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events, and risk of depression: a meta-analysis. JAMA 2009; 301: 2462–71.
8 Lipschitz, DS, Winegar, RK, Nicolaou, AL, Hartnick, E, Wolfson, M, Southwick, SM. Perceived abuse and neglect as risk factors for suicidal behaviour in adolescent inpatients. J Nerv Ment Dis 1999; 187: 32–9.
9 Enns, MW, Cox, BJ, Afifi, TO, De Graaf, R, Ten Have, M, Sareen, J. Childhood adversities and risk for suicidal ideation and attempts: a longitudinal population-based study. Psychol Med 2006; 36: 1769–78.
10 Ystgaard, M, Hestetun, I, Loeb, M, Mehlum, L. Is there a specific relationship between childhood sexual and physical abuse and repeated suicidal behaviour? Child Abuse Negl 2004; 28: 863–75.
11 Molnar, B, Buka, S, Kessler, R. Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. Am J Publ Health 2001; 91: 753–60.
12 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA, 1994.
14 Heeringa, S, Wells, JE, Hubbard, F, Mneimneh, Z, Chiu, WT, Sampson, N, et al. Sample designs and sampling procedures. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (eds Kessler, RC & Üstün, TB): 1432. Cambridge University Press, 2008.
15 Pennell, BE, Mneimneh, Z, Bowers, A, Chardoul, S, Wells, JE, Viana, MC, et al. Implementation of the World Mental Health Surveys. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (eds Kessler, RC & Üstün, TB): 3357. Cambridge University Press, 2008.
16 Harkness, J, Pennell, BE, Villar, A, Gebler, N, Aguilar-Gaxiola, S, Bilgen, I. Translation procedures and translation assessment in the World Mental Health Survey Initiative The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (eds Kessler, RC & Üstün, TB): 91113. Cambridge University Press, 2008.
17 Kessler, RC, Ustun, TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004; 13: 93121.
18 Efron, B. Logistic regression, survival analysis, and the Kaplan Meier curve. JAMA 1988; 83: 414–25.
19 Allison, PD. Survival analysis of backward recurrence times. J Am Stat Assoc 1984; 80: 315–22.
20 Wolter, KM. Introduction to Variance Estimation. Springer-Verlag, 1985.
21 Wilsnack, SC, Wonderlich, SA, Kristjanson, AF, Vogeltanz-Holm, ND, Wilsnack, R. Self-reports of forgetting and remembering childhood sexual abuse in a nationally representative sample of US women. Child Abuse Negl 2002; 26: 139147.
22 Hardt, J, Rutter, M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatr 2004; 45: 260–73.
23 Nezlek, JB, Sorrentino, RM, Yasunaga, S, Otsubo, Y, Allen, M, Kouhara, S, et al. Cross-cultural differences in reactions to daily events as indicators of cross-cultural differences in self-construction and affect. J Cross Cult Psychol 2008; 39: 685702.
24 Kitayama, S, Markus, HR, Kurokama, M. Culture, emotion, and well-being: good feelings in Japan and the United States. Cognition Emotion 2000; 14: 93124.
25 Dube, SR, Anda, RF, Felitti, VJ, Chapman, DP, Williamson, DF, Giles, WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span. Findings from the Adverse Childhood Experiences Study. JAMA 2001; 286: 3089–96.
26 Bebbington, PE, Cooper, CC, Minot, S, Brugha, TS, Jenkins, R, Meltzer, H, et al. Suicide attempts, gender, and sexual abuse: data from the 2000 British Psychiatric Morbidity Survey. Am J Psychiatry 2009; 166: 1135–40.
27 Dinwiddie, S, Heath, AC, Dunne, MP, Bucholz, KK, Madden, PA, Slutske, WS, et al. Early sexual abuse and lifetime psychopathology: a co-twin-control study. Psychol Med 2000; 30: 4152.
28 Kessler, RC, Davis, CG, Kendler, KS. Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med 1997; 27: 1101–19.
29 Wenninger, K, Heiman, JR. Relating body image to psychological and sexual functioning in child sexual abuse survivors. J Trauma Stress 1998; 11: 543–62.
30 Nock, MK. Why do people hurt themselves? New insights into the nature and function of self-injury. Curr Dir Psychol Sci 2009; 18: 7883.
31 Anda, RF, Felitti, VJ, Walker, J, Whitfield, CL, Bremner, JD, Perry, BD, et al. The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosciences 2006; 56: 174–86.
32 Levin, HS, Brown, SA, Song, J, McCauley, S, Boake, C, Contant, C, et al. Depression and posttraumatic stress disorder at three months after mild-to-moderate traumatic brain injury. J Clin Exp Neuropsychol 2001; 23: 754–69.
33 Roy, A. Family history of suicide behaviour and earlier onset of suicidal behaviour. Psychiatr Res 2004; 129: 217–9.
34 Pirkis, JE, Burgess, PM, Meadows, GN, Dunt, DR. Suicidal ideation and suicide attempts as predictors of mental health service use. Med J Aust 2001; 175: 542–5.
35 Von Korff, M, Scott, K, Gureye, O, (eds) Mind and Body: Global Perspectives on Mental-Physical Comorbidity. Cambridge University Press, 2009.
36 MacMillan, HL, Fleming, JE, Trocme, N, Boyle, M, Wong, M, Racine, YA, et al. Prevalence of child physical and sexual abuse in the community. Results from the Ontario Health Supplement. JAMA 1997; 278: 131–5.

Related content

Powered by UNSILO
Type Description Title
PDF
Supplementary materials

Bruffaerts et al. supplementary material
Supplementary Material

 PDF (54 KB)
54 KB

Childhood adversities as risk factors for onset and persistence of suicidal behaviour

  • Ronny Bruffaerts (a1), Koen Demyttenaere (a1), Guilherme Borges (a2), Josep Maria Haro (a3), Wai Tat Chiu (a4), Irving Hwang (a4), Elie G. Karam (a5), Ronald C. Kessler (a4), Nancy Sampson (a4), Jordi Alonso (a6), Laura Helena Andrade (a7), Matthias Angermeyer (a8), Corina Benjet (a9), Evelyn Bromet (a10), Giovanni de Girolamo (a11), Ron de Graaf (a12), Silvia Florescu (a13), Oye Gureje (a14), Itsuko Horiguchi (a15), Chiyi Hu (a16), Viviane Kovess (a17), Daphna Levinson (a18), Jose Posada-Villa (a19), Rajesh Sagar (a20), Kate Scott (a21), Adley Tsang (a22), Svetlozar M. Vassilev (a23), David R. Williams (a24) and Matthew K. Nock (a25)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.