Childhood maltreatment and suicidal behaviors among heterosexual and sexual minority youth in China.

This study explored self-reports of five childhood maltreatment (CM) subtypes and their associations with current suicide risk in a sample of 500 homeless persons. Participants completed the Childhood Trauma Questionnaire and the Mini-International Neuropsychiatric Interview. Individual, unique, and cumulative associations of CM subtypes and subtype combinations with suicide risk (no vs. low vs. moderate/high) were examined. In multivariate analyses, four of the five CM subtypes were associated with suicide risk in individual models, but not in a model that included all CM subtypes. The strongest associations were found for reports of multitype CM involving all five subtypes. Mental disorders and female sex were independently associated with suicide risk. Clinicians working with CM victims should be aware that homeless clients are likely to report multitype maltreatment and should assess a variety of CM experiences. Future studies need to further examine multitype maltreatment and suicidal behaviors in homeless populations with complex conditions.

A Suicide-Specific Diagnosis – The Case Against

Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to predict suicide is no better now than it was 50 years ago. There are many potential explanations for this lack of progress, but the absence, until recently, of comprehensive theoretical models that predict the emergence of suicidal ideation distinct from the transition between suicidal ideation and suicide attempts/suicide is key to this lack of progress. The current article presents the integrated motivational–volitional (IMV) model of suicidal behaviour, one such theoretical model. We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators (VMs), govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, VMs include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. In this article, we describe the theoretical origins of the IMV model, the key premises underpinning the model, empirical tests of the model and future research directions.

AimsAlthough childhood maltreatment has been widely supported to be a robust predictor of suicide behaviours, the effects of different childhood maltreatment subtypes remain controversial and inconclusive. Moreover, whether the effects differ by sex in urban and rural adolescents is still unknown. This study aimed to quantify the associations between five subtypes of childhood maltreatment and different suicide behaviour involvement.MethodsA multistage cluster sampling method was adopted from April to December 2021 for adolescents aged 12 to 18 across five representative provinces of China. The Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment subtypes. Suicide behaviour involvement was classified as none group, suicide ideator, suicide planner and suicide attempter. Confounding variables include demographic characteristics, smoking, drinking alcohol, depression and anxiety.ResultsAmong a total of 18,980 adolescents, 2021 (10.6%) were suicide ideator, 1595 (8.4%) were suicide planner and 1014 (5.3%) were suicide attempter. Rural females had the highest proportion of suicide ideator (13.8%) and suicide planner (11.5%). Multinomial logistic regression analysis indicated that five childhood maltreatment subtypes were independently associated with suicide behaviours, except for associations between sexual abuse and suicide ideator as well as suicide planner (p > 0.05). Moreover, these associations differ by sex and residence. After adjusted for interactions of different subtypes, structural equation model indicated that the direct effects of childhood maltreatment subtypes on suicide behaviours from high to low were emotional abuse (β = 0.363, p < 0.001), physical abuse (β = 0.100, p < 0.001) and sexual abuse (β = 0.033, p = 0.003), while the effects of physical neglect and emotional neglect were not significant (p > 0.05).ConclusionsFive subtypes of childhood maltreatment have specific and non-equivalence associations with suicide behaviours. Emotional abuse may have the strongest effect, and sexual abuse have an acute effect on suicide behaviours. Suicide prevention programs for Chinese adolescents could focus on those who experienced emotional, physical and sexual abuse. Furthermore, strategies should be tailored by sex and residence, and rural females deserve more attention.

Sexual minority youth (SMY) are at higher risk for victimization and suicide than are heterosexual youth (HY). Relatively little research has examined which types of victimization are most closely linked to suicide, which is necessary to develop targeted prevention interventions. The present study was conducted to address this deficit. The data come from the 2011 Chicago Youth Risk Behavior Survey (n = 1,907). Structural equation modeling (SEM) in Mplus evaluated the direct, indirect, and total effects of sexual orientation on a latent indicator of suicidal ideation and behaviors via seven types of victimization. Four indicators of victimization were school-specific (e.g., harassment due to sexual orientation or gender identity (SO/GID), bullying, threatened or injured with a weapon, and skipping school due to safety concerns), and three indicators assessed other types of victimization (e.g., electronic bullying, intimate partner violence, and sexual abuse). Thirteen percent of youth were classified as SMY. Significantly more SMY than HY reported suicidal ideation (27.95% vs. 13.64%), a suicide plan (22.78% vs. 12.36%), and at least one suicide attempt (29.92% vs. 12.43%) in the past year (all P < .001). A greater percentage of SMY reported SO/GID-related harassment, skipping school, electronic bullying, and sexual abuse. Sexual orientation was not directly related to suicidal ideation and behaviors in SEM. Rather, SMY's elevated risk of suicidality functioned indirectly through two forms of school-based victimization: being threatened or injured with a weapon (B = .19, SE = .09, P ≤ .05) and experiencing SO/GID-specific harassment (B = .40, SE = .15, P ≤ .01). There also was a trend for SMY to skip school as a strategy to reduce suicide risk. Although SMY experience higher rates of victimization than do HY, school-based victimization that involves weapons or is due to one's SO/GID appear to be the most deleterious. That SMY may skip school to reduce their risk of suicidal ideation and behaviors is problematic, and schools should be encouraged to enact and enforce policies that explicitly protect SMY from victimization.

Distinct and cumulative effects of child maltreatment on suicidality among Chinese college freshmen: A prospective cohort study.

Sexual orientation disparities in suicide behavior are well-documented. Yet, few studies have examined how developmental assets - key values, self-perceptions, skills, relationships, and opportunities that have been identified as the building blocks of positive youth development - are associated with suicide behaviors, particularly among sexual minority youth. This study examined concurrent associations between young people's developmental assets and suicidal behavior by sexual orientation using a large sample of 116,925 in-school U.S. adolescents (ages 11 to 19, M = 14.74, SD = 1.78). Most of the sample identified as only heterosexual (90.2%); 5% identified as mostly heterosexual, 3.5% as bisexual, 0.6% as mostly lesbian/gay, and 0.7% as only lesbian/gay. Most participants identified as White, non-Latina/o (62.6%) and as cisgender female (50.3%) or cisgender male (47.8%). Compared to only heterosexual adolescents, youth with all other sexual orientations reported lower levels of internal and external developmental assets except for non-sports extracurricular activity participation and social justice values. Identifying as a racial/ethnic minority, particularly for only heterosexual adolescents, and specifically as Latina/o for sexual minority adolescents was associated with greater risk for suicidal behavior. Further, identifying as a gender minority exacerbated risk for suicidal behavior. Relatedly, when youth reported feeling unsafe with their family, or in their school or neighborhood, they were at greater risk for suicidal behavior, regardless of sexual orientation. Feeling hopeful was associated with lower risk for suicidal behavior for all youth. Regardless of sexual orientation, planning and decision-making skills were associated with lower risk and social-emotional skills were associated with heightened risk for suicidal behavior. School boundaries and social justice values were associated with lower risk for suicidal behavior among bisexual adolescents; there were no additional protective assets for mostly/only lesbian/gay adolescents. In conclusion, sexual orientation disparities exist in the lives of adolescents for several internal and external developmental assets. Disparities in suicidal behavior by sexual orientation, however, were largely unexplained by differential associations between developmental assets and suicidal behavior.

Background: There is a high prevalence of childhood maltreatment (CM) among adults with cardiometabolic diseases. However, there is limited information available on the specific patterns of association between CM (cumulative CM, subtype, threat- and deprivation-based CM and co-occurrence) with cardiometabolic health indicators in young adults. Aims: To investigate the patterns of association between CM and cardiometabolic health indicators, including the triglyceride glucose (TyG) index and the TyG-body mass index (TyG-BMI), in a sex-specific manner among young adults. Methods: This cross-sectional study included 817 young adults from the University Student Cohort in Anhui Province, conducted in September 2022. Spearman correlations and linear regressions were used to test the association of cumulative CM, five subtypes of CM - physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect - as well as the threat- and deprivation-based CM and co-occurrence (two or more subtypes of CM) with respect to the TyG index and the TyG-BMI index, in a sex-specific analysis. Results: Cumulative CM was associated with TyG index ( β = 0.06, 95% CI = 0.00 - 0.12). In contrast, none of the CM variables was associated with TyG-BMI index. We revealed profound sex-specific differences, with associations between cumulative CM and TyG index ( β = 0.10, 95% CI = 0.01 - 0.18), between emotional neglect and TyG index ( β = 0.10, 95% CI = 0.00 - 0.20), and between deprivation-based CM and TyG index ( β = 0.09, 95% CI = 0.00 - 0.18) in men only. Also, only men showed an association between deprivation-based CM and TyG-BMI index ( β = 3.06, 95% CI = 0.35 - 5.77). Conclusions: This study indicates that cumulative CM, emotional neglect and deprivation-based CM may be associated with poorer cardiometabolic health in young adults, with these associations being much stronger in men than in women.

Using objective measures, the authors found a high rate of childhood sexual and physical abuse in a sample of 66 female psychiatric inpatients. Childhood abuse experiences were correlated with severity of adult psychiatric symptoms. The authors explore the usefulness of adult psychological symptoms, diagnoses, and prescribed medications as factors in the identification of patients who have histories of early sexual and physical abuse.

Addiction and Suicide: An Unmet Public Health Crisis

Exploring the impact of child maltreatment on adult suicidal ideation and suicide attempts.

Child maltreatment affects millions of children internationally every year. Development is negatively impacted by maltreatment increasing the likelihood of maladaptive behaviours. Associations between child maltreatment and suicidal behaviour and suicide in young people has been established. However, there is a research gap in understanding effective ways to respond to and intervene with suicidal behaviour in young people who have experienced child maltreatment. A scoping review was conducted in accordance with the Joanna Briggs Institute methodology to investigate interventions that may be effective in preventing and reducing suicidal behaviours in young people who have experienced child maltreatment. Inclusion criteria were studies: (a) of children and young people who engage in suicidal behaviour and have experienced child maltreatment; (b) published in English during the time period 2000–2020; and (c) focused on responses and interventions to prevent or address suicidal behaviour. Across 37 studies, several intervention targets were identified through reflexive thematic analysis including cultivation of self-compassion, gratitude and future orientation, alleviation of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms and psychological distress and addressing cognitive errors and negative views of the self. Screening and clear assessment of suicidal risk by health professionals and child welfare professionals was endorsed across studies. Several evidence-based treatments were proposed to support intervening with this client group, although only Emotional Intelligence Therapy (EIT) was empirically tested with this population. Utilisation of safe systems that the child or young person is in may be beneficial in addressing and reducing suicidal behaviour, such as inclusion of families, peers and the implementation of school-based interventions strategies. Future research is needed to empirically test and assess the effectiveness of interventions.

A Suicide-Specific Diagnosis – The Case For

Background Childhood maltreatment (CM) is frequently linked to interpersonal problems such as difficulties in social relationships, loneliness, and isolation. These difficulties might partly stem from troubles regulating comfortable interpersonal distance (CIPD). Objective We experimentally investigated whether CM manifests in larger CIPD and whether all subtypes of CM (i.e., physical, emotional, or sexual abuse and physical or emotional neglect) affect CIPD. Methods Using the stop-distance method (i.e. a team member approached participants until the latter indicated discomfort), we assessed CIPD in 84 adults with a self-reported history of CM (24 with depressive symptoms) and 57 adult controls without a history of CM (without depressive symptoms). Results Adults with CM showed a larger CIPD (Mdn = 86 cm) than controls (Mdn = 68 cm), and CIPD was largest for those with CM combined with current depressive symptoms (Mdn = 145 cm) (p’s < .047). In the latter group, all subtypes of CM were associated with a larger CIPD compared to controls (p’s < .045). In the CM group without depressive symptoms, only those with emotional abuse (p = .040) showed a larger CIPD than controls. Conclusions These results add to findings of differential socio-emotional long-term consequences of CM, depending upon the subtype of CM. Future research should explore whether a larger CIPD has a negative impact on social functioning in individuals exposed to CM, particularly in those with depressive symptoms. HIGHLIGHTS Adults with child maltreatment (CM) prefer larger physical distances. • This effect is more pronounced in those with CM and depressive symptoms. • Troubled regulation of physical distance might contribute to interpersonal problems.

Same sex-attraction as a predictor of suicide and self-harm behaviours: The role of bullying and social support