Childhood adversities increase suicidality risk among youths from disadvantaged contexts

Childhood adversities played a role in understanding the risk for suicide attempt among youths of certain ethnic groups who were from disadvantaged contexts, according to results of a longitudinal cohort study published in JAMA Psychiatry.

“In the U.S., racial/ethnic minority school-age youths more frequently report suicide ideation and attempts than white youths,” Lillian Polanco-Roman, PhD, of the department of psychology at the New School in New York, and colleagues wrote. “Adverse childhood experiences, which include child maltreatment, parental loss and parental maladjustment, are linked to [suicide ideation] and [suicide attempt] in adulthood and disproportionately burden Latinx youths, especially those of Puerto Rican background. The unique sociopolitical relationship between the mainland U.S. and Puerto Rico may influence how exposure to ACEs influences [suicide ideation] and [suicide attempt] in Puerto Rican youths on the island and mainland U.S.”

The researchers sought to evaluate lifetime and past-year suicide ideation and suicide attempt prevalence estimates, as well as to assess the effects of sex differences on adverse childhood experiences as a prospective risk factor for 2,004 Puerto Rican young adults from two sociocultural contexts, which were San Juan and Caguas, Puerto Rico, and the South Bronx, New York. They obtained participants’ data from four waves of the population-based cohort study, the Boricua Youth Study, with waves one through three conducted among individuals aged 5 to 17 years between 2000 and 2004 and wave four conducted among individuals aged 15 to 29 years between 2013 and 2017. Participants’ provided data in waves one through three via interviews in childhood and early adolescence regarding adverse childhood experiences, which included physical, sexual and emotional abuse and neglect, as well as exposure to violence, parental loss and parental maladjustment. The researchers used the WHO Composite International Diagnostic Interview to evaluate lifetime and past-year suicide ideation and attempt in young adulthood.

Results showed young women had a prevalence of 9.5% of lifetime suicide attempt and 16.4% of lifetime suicide ideation compared with 3.6% and 11.5%, respectively, for young men; however, the researchers noted the difference in past-year suicide ideation did not statistically significantly differ, with 4.4% for young women and 2.4% for young men. According to logistic regression models that were adjusted for demographics and lifetime psychiatric disorders, young women but not young men with more adverse childhood experiences were at increased risk for suicide ideation, with a lifetime OR of 2.44 (95% CI, 1.54-3.87) and a past-year OR of 2.56 (95% CI, 1.18-5.55). The researchers noted a prospective association between more adverse childhood experiences and lifetime suicide attempt (OR = 1.16; 95% CI, 1.04-1.29) that was not impacted by sex.

“This information may improve identification of children at greatest risk for [suicide ideation] and [suicide attempt] to inform early preventive strategies,” Polanco-Roman and colleagues wrote. “If these findings are replicated, practitioners working with ethnic minority youths from disadvantaged backgrounds who present with [four] or more [adverse childhood experiences] should screen for [suicide ideation] and [suicide attempt] risk. The prevention of cumulative [adverse childhood experiences] in childhood and early adolescence could reduce risk later in life for [suicide attempt] and [suicide ideation], particularly among young women of ethnic minority groups living in underserved contexts.”