Independent and Cumulative Effects of Recent Maltreatment on Suicidal Ideation and Thoughts of Self-harm in a National Sample of Youth.

PURPOSE: This study examines the impact of several forms of past-year maltreatment on thoughts of self-harm and suicidal ideation and considers how these effects may vary by gender.

METHODS

Analyses are based on telephone interviews with a nationally representative sample of 6,364 youth aged 10-17 years, from three waves (2008, 2011, and 2014) of the National Survey of Children's Exposure to Violence. Suicidal and self-harm ideation were measured with items from the Trauma Symptoms Checklist for Children. Emotional maltreatment, physical maltreatment, neglect, and witnessing family violence were measured using items from the Juvenile Victimization Questionnaire.

RESULTS

Over 8% of the sample reported suicidal and/or self-harm ideation in the past month, with females more likely to report these outcomes than males. Youth who experienced recent emotional maltreatment, neglect, or witnessing family violence were more likely to report suicidal or self-harm ideation, independent of the other maltreatment types, presence of an internalizing disorder, and demographics. A dose-response relationship between the number of types of maltreatments and these outcomes was also evident. Finally, females were more negatively affected by emotional abuse and by experiencing two forms of past-year maltreatment than their male counterparts.

CONCLUSIONS

Emotional abuse was the type of maltreatment most strongly related to thoughts of self-harm and/or suicidal ideation and was particularly detrimental to females in this sample. Given the especially damaging effects of exposure to multiple forms of maltreatment, our research highlights the importance of including comprehensive maltreatment assessment in youth suicide and self-harm prevention efforts.