Childhood adversity and suicidal ideation: The roles of personality functioning, psychological distress and anhedonia in a serial-parallel mediation model.

BACKGROUND: Understanding the factors that predict suicidality is critical for identifying risks and guiding interventions. Various factors that predict suicide risk have been identified to date, and recent research has begun to focus on the dynamic mechanisms among these factors.

OBJECTIVE: In the present study, we tested a biopsychosocial model in which personality functioning, psychological distress and anhedonia were examined as potential mediators of the association between childhood adversity and current suicidal ideation in a university sample from the eastern region of Türkiye.

METHOD: A total of 477 university students (47% male) were enrolled in the study and invited to complete a series of questionnaires, including the Adverse Childhood Experiences (ACEs) Questionnaire, the Level of Personality Functioning Scale (LPFS-BF 2.0), the General Health Questionnaire-12 (GHQ-12), the Snaith-Hamilton Pleasure Scale (SHAPS) and a set of suicidality questions.

RESULTS: Childhood adversity, psychological distress and anhedonia were directly associated with current suicidal ideation. Additionally, childhood adversity was indirectly associated with suicidality through impaired personality functioning, followed by psychological distress and anhedonia. Anhedonia remained a significant risk factor independent of psychological distress.

CONCLUSION: Despite the inclusion of proximal risk factors, early-life adversity remains strongly associated with suicidal ideation, underscoring the importance of systemic preventive efforts during childhood. Contemporary psychological treatments targeting positive affect and anhedonia may be promising candidates for future clinical research and prevention efforts.