Adverse Childhood Experiences and Suicide Attempts

A new study found that adults who had experienced adverse childhood experiences (ACEs) were more likely to have attempted suicide in their lifetime than those who had not experienced ACEs. These findings remained even after accounting for mental and substance use disorders. Researchers used data from the 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to match people who had attempted suicide with those who had not, based on the presence or absence of nine mental and substance use disorders that are associated with suicide risk. This allowed the researchers to estimate the role that ACEs played in the risk of suicide attempts independent of mental and substance use disorders.

The ACEs included in the study were (1) psychological abuse; (2) physical abuse; (3) sexual abuse; (4) emotional neglect; (5) physical neglect; (6) witnessing violence against a mother or other adult female; (7) substance misuse by a parent or other household member; (8) mental illness, suicide attempt, or suicide death of a parent or other household member; (9) incarceration of a parent or other household member; and (10) parents’ separation or divorce.

Researchers found that:

• Men who had experienced four or more ACEs and women who had experienced two or more ACEs had significantly increased risk of attempting suicide at least once, compared to members of each sex with no ACEs.
• Men and women who reported having a parent or relative with mental illness were more likely to have attempted suicide than those who did not.
• Men who had experienced childhood emotional neglect were more likely to have attempted suicide than those who had not.
• Men and women who had experienced childhood sexual abuse were more likely to have attempted suicide multiple times compared to those who had not. 

The age at which respondents experienced ACEs, and the duration and severity of ACEs, were not measured.  For this reason, the researchers cautioned that these results could not prove that ACEs caused the increase in suicide attempts. However, the findings still highlight the need for early detection of ACEs and targeted interventions to prevent future suicide attempts.

Choi, N. G., Dinitto, D. M., Marti, C. N., & Segal, S. P. (2017). Adverse childhood experiences and suicide attempts among those with mental and substance use disorders. Child Abuse & Neglect, 69, 252–262.