The role of childhood abuse for suicidality in the context of the interpersonal theory of suicide: An investigation in German psychiatric inpatients with depression

Background: Several studies provide evidence for a relationship between childhood abuse and suicidality across the lifespan. To examine this association in the context of the Interpersonal Psychological Theory of Suicide (IPTS), we investigated whether its constructs thwarted belongingness, perceived burdensomeness and capability for suicide are potential mediators.

Methods: Eighty-four German psychiatric inpatients with unipolar depression (M = 37.6 years, 69% female) and current or lifetime suicidal ideation were included. For the assessment we used the Childhood Trauma Screener (CTS), the Rasch-based Screening for Depression (DESC-I), the Interpersonal Needs Questionnaire (INQ), the German Capability for Suicide Questionnaire (GCSQ), the Beck Scale for Suicide Ideation (BSS) and the Suicide Behaviors Questionnaire-Revised (SBQ-R). Simple and multiple mediator analyses were applied.

Results: Most patients (70%) had experienced childhood abuse. Emotional abuse showed an indirect association with suicidal ideation via thwarted belongingness and perceived burdensomeness, whereas physical and sexual abuse were indirectly related to suicide risk via capability for suicide.

Limitations: The small sample size and the cross-sectional design are limiting factors of the present study.

Conclusions: Childhood abuse is a common experience of inpatients with unipolar depression. This study showed its indirect effects on suicidal ideation and risk for suicide, mediated by the constructs of the IPTS. Further research should investigate this issue in other populations and clinicians should be aware of the devastating effects of childhood abuse.