Abstract
Informed by diathesis-stress models of suicide risk, this longitudinal study examines the psychopathological mechanisms through which early maltreatment increases the risk for suicidal ideation and self-harm in middle childhood. The sample included 2958 families from the Fragile Families and Child Wellbeing Study, who participated in interviews at child’s ages of 3 and/or 5, and 9. Via the Child Behavior Checklist, primary caregivers reported on the child’s suicidal ideation and self-harm at age 9 and on clinically elevated depressive/anxious symptoms, aggressive behaviors, attention problems, and comorbid aggression and depressive/anxious symptoms at age 5. Past year neglect and physical/psychological abuse were measured via the Parent–Child Conflict Tactics Scale at age 3. Multivariate structural equation models indicated that early neglect had a significant indirect effect on suicidal ideation via clinically elevated depressive/anxious symptoms (OR = 1.57, 95% CI 1.09–2.25) and comorbid symptomatology (OR = 1.28, 95% CI 1.02–1.62), and on self-harm also via clinically elevated depressive/anxious symptoms (OR = 1.39, 95% CI 1.04–1.84) and comorbid symptomatology (OR = 1.20, 95% CI 1.01–1.43). Early physical/psychological abuse had a significant indirect effect on self-harm via clinically elevated attention problems (OR = 1.09, 95% CI 1.01–1.21). Unique developmental pathways for suicidal ideation and self-harm emerged among children exposed to abuse or neglect. For those exposed to early neglect, interventions should target depressive/anxious symptoms, especially when comorbid with aggression, to prevent suicidal ideation and self-harm. For children exposed to early physical/psychological abuse, problems with attention and impulsivity may be targets for reducing the risk for self-harm.
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This study was approved by the Internal Review Board of Cornell University and meets all ethical considerations according to the 1964 Declaration of Helsinki and its later amendments. Informed written consent was obtained by FFCWS researchers from all participants prior to inclusion in the study.
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Paul, E., Ortin, A. Psychopathological mechanisms of early neglect and abuse on suicidal ideation and self-harm in middle childhood. Eur Child Adolesc Psychiatry 28, 1311–1319 (2019). https://doi.org/10.1007/s00787-019-01287-8
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DOI: https://doi.org/10.1007/s00787-019-01287-8