Youth suicide risk soars after manifold abuse

Exposure to multiple forms of abuse dramatically drives up the risk of suicidal thoughts in young people, the study found.

Young people exposed to multiple types of abuse are up to six times more likely to have suicidal thoughts than those who were not, a US study has found, suggesting the need for a more holistic approach to treatment.

The study, titled “Recent Victimization Exposure and Suicidal Ideation in Adolescents” and published in Archives of Pediatrics and Adolescent Medicine on Tuesday, examined two waves of longitudinal data from the US National Survey of Children’s Exposure to Violence. In phone interviews, 1186 people aged 10 to 17 years were asked about whether or not they had thought of killing themselves (“suicidal ideation”) following abuse such as bullying, sexual assault, witnessing family violence, exposure to community violence, and maltreatment by a parent or caregiver.

“The risk of suicidal ideation was 2.4 times greater among youth who experienced peer victimisation in the past year, 3.4 times greater among those who were sexually assaulted, and 4.4 times greater among those exposed to maltreatment, relative to children who were not exposed to these types of victimisation,” the study said.

“Findings also showed substantial effects of polyvictimisation (exposure to seven or more individual types of victimisation in the past year), with polyvictims almost six times more likely to report suicidal ideation.”

The results show the need for a more holistic approach to caring for youth at risk, rather than focusing on problems as separate issues, said the study’s lead author, Heather A. Turner, Professor of Sociology and Research Associate at the Crimes against Children Research Centre at the University of New Hampshire.

“Most studies have focused on only one form of victimisation, such as sexual abuse or bullying. But we know that many adolescents are exposed to several different types of victimisation in a relatively short time period. If researchers don’t ask about all those experiences, they are not going to be able to determine which types are most impactful or, importantly, how different forms of victimisation may accumulate to affect suicide ideation. We are able to do this in our study,” said Prof Turner.

Prof Turner said her study used a large, representative sample and interviewed the same adolescents at two points in time.

“This allowed us to determine the effects of recent victimisation on the "new” suicide ideation – thoughts of suicide that were not present prior to the victimisation,“ she said. "As a result we can be more confident that victimisation exposure is a causal risk factor for suicide ideation.”

The findings emphasise the need to include comprehensive victimisation assessment, one that takes into account a wide array of different types of victimisations, in all adolescent suicide prevention and intervention efforts, she said.

“I think, in general, our findings show the importance of a more holistic, youth-centred approach in promoting health and well-being and reducing suicide risk in adolescence – one that recognises potential risks to safety across all contexts of adolescent’s lives – at home, in school, and in their communities.”

Professor Anthony Jorm from the University of Melbourne’s Population Mental Health Group said the study was very well designed and presented strong evidence.

“It shows a number of things clearly. Firstly, bullying by peers and mistreatment within the family lead young people to think about suicide, with young people who receive multiple types of mistreatment being at greatest risk,” he said.

“Secondly, it is well-known that mistreatment within the family and bullying from peers increase risk for depression, and depression in turn increases risk of feeling suicidal. However, this study shows a direct impact on suicidal feelings, as well as an indirect one via depression. The study gives added weight to efforts to reduce bullying and child abuse by showing that action in these areas might reduce the youth suicide rate.”