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Child Care Health Dev. 2016 Sep;42(5):725-34. doi: 10.1111/cch.12351. Epub 2016 Jun 9.

The association between adverse childhood experiences (ACEs) and suicide attempts in a population-based study.

Author information

1
Department of Family and Community Medicine, Factor-Inwentash Faculty of Social Work, and Institute for Life Course & Aging, University of Toronto, Toronto, Canada.
2
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
3
Student Life, Outreach and Equity Advisor, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
4
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.

Abstract

OBJECTIVES:

To further our understanding of the relationship between Adverse Childhood Experiences (ACEs) and suicidal behaviour, this study investigates the association between three types of ACEs and lifetime suicide attempts, while considering potential gender-specific and mediating effects.

METHODS:

Data were obtained from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH), a cross-sectional, population-based survey comprised of respondents aged 18 or older who provided self-reported data on past experiences of suicide attempts, as well as childhood sexual abuse (CSA), childhood physical abuse (CPA) and parental domestic violence (PDV) (n = 22 559). After testing for ACE by gender interactions, we estimated the odds of lifetime suicide attempts for each ACE and then investigated whether depression, anxiety, substance abuse and chronic pain acted as mediators of the relationship.

RESULTS:

The odds of suicide attempts are significantly higher among those with a history of CPA (OR = 3.29; 99.9% CI 2.33-4.64), CSA (OR = 4.42; 99.9% CI 3.14-6.23) or PDV (OR = 2.52; 99.9% CI 1.69-3.76), when ACEs are mutually adjusted. There is little evidence that gender acts as a moderator; however, depression, anxiety, substance abuse and chronic pain appear to partially mediate the associations. Depression alone accounts for about a quarter of the associations with CSA and CPA.

CONCLUSIONS:

Mental health factors and chronic pain appear only to partially mediate relationships between ACEs and lifetime suicide attempts. Future research should look at other pathways with the goal of developing multi-level interventions.

KEYWORDS:

abuse; child sexual abuse; risk factors; suicide attempts; violence

PMID:
27280449
DOI:
10.1111/cch.12351
[Indexed for MEDLINE]

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