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Childhood adversity, violent offending heightens suicide risk in adulthood
Adults with a history of childhood adversity who also engaged in violent offending during adolescence have a high risk for suicide in early adulthood, according to findings published in JAMA Psychiatry.
“Previous studies have indicated that childhood adversities are particularly detrimental because of their association with suicide,” Emma Björkenstam, PhD, from the division of social medicine in the department of public health science at Karolinska Institutet in Stockholm, and colleagues wrote. “Some studies have placed adolescent violent offending as a possible link between cumulative [childhood adversities] and later suicidal behavior. These studies have focused on the mediating effect of factors related to violent behavior, such as personality traits, and none of them concerned completed suicides or were population-based.”
Although the relationship between childhood adversities — such as parental death, parental substance abuse and psychiatric disorder, parental criminal offending, parental separation, public assistance recipiency, child welfare intervention and residential instability — and an increased risk for suicide in young adulthood is known, the role adolescent violent offending plays remains unclear, according to researchers.
Björkenstam and colleagues examined whether adolescent violent offending, defined as being convicted of a violent crime between the ages of 15 and 19 years, mediates the link between childhood adversity and suicide. In a population-based longitudinal study, they assessed data on 476,103 Swedish adults born between 1984 and 1988, with follow-up from 20 years of age until Dec. 31, 2013.
Among the adults included in the study, those with a conviction for violent offending had been exposed, to a greater extent, to all childhood adversities compared with those with no violent offending. Overall, 30.8% of participants were exposed to at least one childhood adversity. The most prevalent adversities were parental separation (24%) and parental psychiatric disorder (5.1%). Cumulative childhood adversity was associated with risk for suicide in nonconvicted (adjusted IRR = 2.4; 95% CI, 1.5-3.9) and convicted adolescents, who had a higher risk for suicide (adjusted IRR = 8.5; 95% CI, 4.6-15.7). Compared with those with no childhood adversity and no adolescent violent offending, individuals with four or more adversities in childhood had a 21-fold elevated risk for suicide (IRR = 20.6; 95% CI, 11.3-37.5), and a large part of this risk was linked to psychiatric disorder.
“Accumulated evidence shows that suicide among young people has its roots in early adversity and a negative life pathway during adolescence that includes violent delinquency. It should become possible to early identify high-risk groups,” Björkenstam told Healio Psychiatry. “Screening for mental disorders in young delinquents should be meticulous and a health priority for this group.” – by Savannah Demko
Disclosure : The authors report no relevant financial disclosures.