Child Maltreatment, Recent Stressful Life Events, and Suicidal Ideation

Duprey, E. B., Handley, E. D., Manly, J. T., Cicchetti, D., & Toth, S. L. (2021). Child maltreatment, recent stressful life events, and suicide ideation: A test of the stress sensitivity hypothesis. Child abuse & neglect, 113, 104926.

What we know

Suicidal ideation is the thought or wish of suicide or death, and it is a major risk factor for later suicide completion. Rates of suicide and suicidal ideation are increasing among teenagers, and suicide is one of the leading causes of death in this age group in the US. Having a history of abuse or neglect in childhood is a risk factor for suicidal ideation later as a teenager. Experiencing a recent stressful life event—such as a divorce, death, or break-up—is also a risk factor for experiencing suicidal ideation. One hypothesis on what leads to suicidal thoughts is that experiencing a stressor (like child maltreatment) early in life makes later stressful events (like a recent break-up) more difficult to cope with.

What this study adds

The study tests the hypothesis on a sample of low-income teenage girls with depression who took part in another research study. The authors found among the teenage girls in their sample, those abused as children were more likely to experience suicidal ideation after a recent (in the past year) stressful life event. However, having good emotion regulation skills (the ability to control emotions) can protect teenagers when they go through a stressful event. Those who scored high on questions about emotion regulation were less likely to have thoughts of suicide, even if they had just had a stressful event.

What this means for practice or policy

The results should be seen as a reminder to clinicians that life stressors may have a greater impact on maltreated teenagers compared to their peers. They should assess clients for a history of child abuse and neglect and screen them for suicidal ideation. By helping their clients build emotion regulation skills, clinicians may be able to strengthen their client’s ability to cope with life stressors. There is also a need for policies that help alleviate poverty, which can affect the amount of stress low-income teenagers go through.

How do we know this is a good study

This study used baseline data collected from a randomized control trial of a depression therapy intervention. Participants were recruited through the Department of Human Services, partnerships with social workers, and organizations that serve teenagers with maltreatment histories. The sample was 175 low-income teenage girls who have depression. The girls were ages 13-15, ethnically and racially diverse, and included those with and without a history of child maltreatment. The data used for this study included a series of questionnaires the girls filled out before the intervention. The questionnaires covered topics such as: depression and suicidal ideation, history of childhood abuse and trauma, recent stressful life events, and emotion regulation. The authors used statistical analysis to look at the relationships between the answers in the questionnaires.