Children and youngsters who are abused or neglected have three times higher risk of suicide attempts: Analysis
Suicide is recognized as a major public health problem and children and young people who experience physical, sexual, and emotional abuse or neglect are at least two to three times more likely to attempt suicide, according to a research team.
The authors found that suicide attempts were at least three times more likely for children who experienced sexual abuse, two times more likely for children experiencing physical or emotional abuse, and close to two times likely for those who faced emotional or physical neglect. Children and young adults who had been exposed to any type of abuse and neglect were found to have more than 3-fold increased odds for suicide attempts.
These “core types of childhood maltreatment” were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4-fold increase for suicide plans, says the UK-based research team from University of South Wales, University of Manchester, and Manchester Academic Health Science Centre (MAHSC).
“Overall, these results provide compelling evidence of the association between core types of childhood maltreatment and suicide experiences in children and young people. The findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect,” write authors in the report published in JAMA Network Open.
According to the team, childhood maltreatment constitutes experiences of any sexual, physical, and emotional abuse and/or neglect that result in substantiated or possible harm that affects the individual’s physical and mental health. Increasing evidence suggests that childhood maltreatment is strongly associated with self-harm, suicide behavior, lower resilience to mental health problems, and greater impulsivity, they explain.
The severe negative psychological consequences of experiencing childhood abuse and/or neglect often continue into adulthood in the form of substantial mental health problems, including depression, anxiety, and post-traumatic stress disorder, the researchers emphasize. The report states that the rate of maltreatment experienced by 18 years of age was estimated to be 12.5% in a representative US sample. In the UK, the rate of maltreatment of children and adolescents aged 11 to 17 years was 18.6%. It further says that the rates of deaths due to suicide exceed 800,000 people each year globally, implying that almost one person takes his or her own life every 40 seconds.
“Suicide is the second leading cause of death among young people aged 15 to 24 years, and the rates of young people losing their lives to suicide has grown in recent years. Recent evidence suggests that the number of hospitalizations of those attempting to take their own lives has doubled within the past decade, with suicide attempts considerably higher in children and adolescents aged 12 to 17 years,” write authors. They add, “Given that recent evidence suggests both an increase in the recorded adverse events in childhood and an increase in suicide attempts in children and young people, we undertook a comprehensive systematic review and meta-analysis to bridge this research gap regarding the association between childhood maltreatment and the various suicide behaviors in youth.”
The team included 79 studies with 337,185 young individuals in the analysis. Most of the studies were conducted in North America (43 or 54.4%), followed by China or other Asian countries (16 or 20.3%), Europe (11 or 13.9%), Australasia (7 or [8.9%), and South America (1 or 1.3%). All the studies that were included had participants aged 5 to 24 years who had experienced any form of abuse and/or neglect before 18 years of age. The mean age of the participants was 15.67 years, 63.19% were female and 36.81% were male. Data were analyzed from January to May 2020.
Sexual abuse was associated with 3.4-fold increased odds for suicide attempts, and physical abuse was associated with a 2.18-fold increase in the odds for suicide attempts. “The findings demonstrated that sexual abuse (odds ratio 3.41), physical abuse (odds ratio 2.18), emotional abuse (odds ratio 2.21), emotional neglect (odds ratio 1.93), physical neglect (odds ratio 1.79), and combined abuse (odds ratio 3.38) were significantly associated with higher rates of suicide attempts,” reveals analysis.
According to the research team, the study has important clinical implications in that it highlights an urgent need for incorporating suicide prevention strategies into treatment planning for those young children who have experienced abuse. “Overall, these are important findings because suicide plans, especially when they occur during peak suicide ideation, can lead to suicide attempts and deaths by suicide. More research examining the links between suicide ideation, plans, and core types of childhood maltreatment needs to be undertaken,” they recommend.
In a related commentary, experts from McGill University Health Centre and McGill University (both based in Canada) say that a critical challenge is to translate these findings into effective suicide risk-reduction interventions for children who experience maltreatment. “The work should serve as a springboard for future investigations, including an examination of when adverse childhood experiences weaken children’s and young adults’ emotional immunities to subsequent life stresses and interact synergistically with biologically based psychiatric disorders and ultimately suicide,” write experts.