Abstract
The present study examines the association of adverse childhood experiences (ACEs) to suicidal behavior and mortality in 508 Finnish adolescents (aged 12–17 years) who required acute psychiatric hospitalization between April 2001 and March 2006. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) were used to obtain information about ACEs, adolescents’ suicidal behavior and psychiatric diagnoses. The cases of death were obtained from Statistics Finland. The results of our study indicated that, among girls, exposure to sexual abuse statistically significantly increased the risk of non-suicidal self-injury (NSSI) (OR, 1.8; 95 % CI, 1.0–3.2) and suicide attempts (OR, 2.3; 95 % CI, 1.0–4.5). The cumulative number of ACEs was also associated with an increased risk of NSSI (OR, 1.2; 95 % CI, 1.0- 1.4) and suicide attempts (OR, 1.2; 95 % CI, 1.0–1.4) in girls. Among all deceased adolescents, ACEs were most notable among those who had died due to accidents and injuries. Gender differences in the types of ACEs were noted and discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Schilling EA, Aseltine RH Jr, Gore S (2007) Adverse childhood experiences and mental health in young adults. BMC Public Health 7:30
Dube SR, Anda RF, Felitti VJ (2001) Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the adverse childhood experiences study. JAMA 286(24):3089–3096
Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF (2004) Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Dis 82:217–225
Oladeji BD, Makanjuola VA, Gureje O (2010) Family-related adverse childhood experiences as risk factors for psychiatric disorders in Nigeria. Br J Psychiatry 196:186–191
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards VMP et al (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med 14(4):245–258
Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF et al (1999) Adverse childhood experiences and smoking during adolescence and adulthood. JAMA 282(17):1652–1658
Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP (1996) The long-term impact of the physical, emotional, and sexual abuse of children: a community study. Child Abuse Negl 20(1):7–21
Lipschitz DS, Winegar RK, Nicolaou AL, Hartnick EW, Michele BA, Southwick SM (1999) Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. J Nerv Ment Dis 187(1):32–39
Ystgaard M, Hestetun I, Loeb M, Mehlum L (2004) Is there a specific relationship between childhood sexual and physical abuse and repeated suicidal behavior? Child Abuse Negl 28:863–875
Ambrosini PJ (2000) Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry 39(1):49–58
Kaufman J, Birmaher B, Rao U, Flynn C, Moreci P, Williamson D et al (1997) Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36(7):980–988
Kokkevi A, Hartgers C (1995) European adaptation of a multidimensional assessment instrument for drug and alcohol dependents. Eur Addict Res 1:208–210
Lin D, Li X, Fan X, Fang X (2011) Child sexual abuse and its relationship with health risk behaviors among rural children and adolescents in Hunan. China. Child Abuse Negl 35(9):680–687
Tsai MH, Chen YH, Chen CD, Hsiao CY, Chien CH (2011) Deliberate self-harm by Taiwanese adolescents. Acta Pediatr 100(11):223–226
Plener PL, Singer H, Goldbeck L (2011) Traumatic events and suicidality in a German adolescent community sample. J Trauma Stress 24(1):121–124
Breslau N, Davis GC, Andreski P, Peterson EL, Schultz LR (1997) Sex differences in posttraumatic stress disorder. Arch Gen Psychiatry 54(11):1044–1048
Pagura J, Stein MB, Bolton JM, Cox BJ, Grant B, Sareen J (2010) Comorbidity of borderline personality disorder and posttraumatic stress disorder in the U.S. population. J Psychiatr Res 44(16):1190–1198
Solantaus T, Paavolainen EJ (2009) Impact of parent’s mental health disorders on psychiatric problems of the offspring (article in Finnish). Duodecim 125:1839–1844
Luoma I, Tamminen T, Kaukonen P, Laippala P, Puura K, Salmelin R et al (2001) Longitudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Adolesc Psychiatry 40(12):1367–1374
Finnish school health survey (2010). http://info.stakes.fi/kouluterveyskysely/FI/tulokset/index.htm
Grøholt B, Ekeberg Ø (2003) Suicide in young people under 15 years: problems of classification. Nord J Psychiatry 57:411–417
Kapusta ND, Tran US, Rockett IRH, De Leo D, Naylor CPE, Niederkrotenthaler T et al (2011) Declining autopsy rates and suicide misclassification. Arch Gen Psychiatry 68(10):1050–1057
Lahti RA, Penttilä A (2001) The validity of death certificates: routine validation of death certification and its effects of mortality statistics. Forensic Sci Int 115(1–2):15–32
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Isohookana, R., Riala, K., Hakko, H. et al. Adverse childhood experiences and suicidal behavior of adolescent psychiatric inpatients. Eur Child Adolesc Psychiatry 22, 13–22 (2013). https://doi.org/10.1007/s00787-012-0311-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-012-0311-8