New research suggests children who are repeatedly abused, or are abused by a member of their immediate family, are at higher risk of attempting suicide in later life. This effect is significant and can be life-threatening.
Sexual abuse — and to a lesser extent, physical abuse — in childhood have both been associated with suicidality. However, not all individuals who were abused as children go on to think about or attempt suicide.
This latest study sheds new light on the indicators of risk for suicide attempt.
Between 1986 and 1988, researchers recruited families of children attending French-speaking nursery schools in Quebec, Canada, to take part in the study. A total of 3,388 children participated.
Contact sexual abuse in childhood was reported by 9.9 percent of the children (men 2.7%, women 18.0%), physical abuse by 20.6 percent (men 26.3%, women 14.3%) and both types of abuse by 8.2 percent (men 4.0%, women 12.8%).
The least severe type of contact sexual abuse — touch — was the most frequently reported behavior, at 49 percent. Threats and force were reported in 22 and 30 percent of the remaining sexual abuse cases, respectively. In a third of the sexual abuse cases, the abuser was a family member; in about two-thirds, the abuse occurred on multiple occasions.
Overall, participants with no history of childhood abuse were less likely to demonstrate suicidal behavior than those who had been abused. Analysis shows that the non-abused group had a lower prevalence of lifetime suicide attempts (6.0%) than the physical abuse (11.7%), sexual abuse (14.8%) and both abuse types (32.2%) groups.
The study also indicates that the risk of suicide in later life is related to the frequency of abuse during childhood and the identity of the abuser.
Repeated abuse was generally more strongly associated with suicide attempts than a single occurrence of abuse. Furthermore, sexual abuse by an immediate family member (such as a father, stepfather or brother) carried the greatest risk. Abuse perpetrated by an extended family member (uncle or cousin) carried an intermediate risk, while abuse by an unrelated individual (an acquaintance, romantic partner or stranger) carried a weaker risk.
The researchers propose two possible explanations for this pattern.
First, abuse by a father or stepfather is considered especially traumatic, possible because such abuse is more likely to occur in families with multiple problems and also because these families cannot provide safe and healing conditions following abuse.
Second, abuse by close family members may have long-term consequences on the development of health attachment patterns necessary for mental health.
The study appears to confirm the association between suicide attempts and childhood abuse, and shows that the characteristics of the abuser and abusive acts may be important additional indicators of risk for suicide attempts.
This was a large-scale study with robust methodology and a randomized sample size. While the results need to be replicated in order to show they are generalizeable, the study was well-designed and is likely to shed insight on this growing problem. One limitation of the study is that it was only conducted on one nationality; it’s not clear whether the results generalize to other nationalities.
The study was published in the August 2008 issue of the British Journal of Psychiatry.
Source: Royal College of Psychologists