Adverse Childhood Experiences and Suicide Attempts: The Mediating Influence of Personality Development and Problem Behaviors
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Adverse childhood experiences, comprised of forms of maltreatment and certain dysfunctional household environments, can affect the development of a child in a variety of different ways. This multitude of developmental changes may subsequently produce compounding harmful effects on the child’s life and increase acutely maladaptive outcomes, including adolescent suicidal behavior. This study uses data collected from 2007 to 2012 for 64,329 Florida Department of Juvenile Justice youth (21.67 % female, 42.88 % African American, and 15.37 % Hispanic) to examine the direct and indirect effects of adverse childhood experiences on suicide attempts. Using a generalized structural equation model, the effects of adverse childhood experience scores are estimated on suicidal behavior through pathways of certain aspects of a child’s personality development (aggression and impulsivity), as well as adolescent problem behaviors (school difficulties and substance abuse). The results show that a large proportion of the relationship between childhood adversity and suicide is mediated by the aforementioned individual characteristics, specifically through the youth’s maladaptive personality development. These results suggest that, if identified early enough, the developmental issues for these youth could potentially be addressed in order to thwart potential suicidal behavior.
KeywordsJuveniles Suicide ACE assessment Maltreatment Aggression Impulsivity Substance abuse School difficulties
We wish to acknowledge and thank Director Mark Greenwald and Nathan Epps from the Office of Research and Data Integrity at the Florida Department of Juvenile Justice for allowing access to the sensitive data provided for this study. Opinions or points of view expressed are those of the authors’ alone and do not necessarily reflect the official position or policies of the Florida Department of Juvenile Justice or the members of the FDJJ Office of Research and Data Integrity.
Nicholas Perez conceived of the study, participated in its design and coordination and drafted the manuscript; Wesley Jennings participated in the design of the study and aided with the interpretation of the data; Alex R. Piquero aided with the interpretations of the data and reviewed the manuscript; Michael Baglivio assisted with data collection, aided with the design of the study, and aided with the interpretations of the data. All authors read and approved the final manuscript.
Conflicts of interest
The authors report no conflict of interests.
The study detailed in this manuscript was approved by both the University of South Florida’s IRB (CR1_Pro00015635) and the Florida Department of Juvenile Justice’s (FDJJ) IRB.
Informed consent was waived/did not apply as the data relied on in this study represented a secondary analysis of de-identified, pre-existing agency data.
- Aber, J. L., Allen, J. P., Carlson, V., & Cicchetti, D. (1989). The effects of maltreatment on development during early childhood: Recent studies and their theoretical, clinical, and policy implications. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 579–619). New York: Cambridge University Press.CrossRefGoogle Scholar
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
- Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., et al. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174–186.PubMedCrossRefGoogle Scholar
- Baglivio, M. T., Epps, N., Swartz, K., Sayedul, M., Sheer, A., & Hardt, N. S. (2014). The prevalence of adverse childhood experiences (ACE) in the lives of juvenile offenders. Journal of Juvenile Justice, 3(2), 1–23.Google Scholar
- Baird, C., Healy, T., Johnson, K., Bogie, A., Dankert, E. W., & Scharenbroch, C. (2013). A comparison of risk assessment instruments in juvenile justice. Madison, WI: National Council on Crime and Delinquency.Google Scholar
- Bornstein, M. H. (Ed.). (2002). Handbook of parenting: Volume 4: Social conditions and applied parenting. Mahwah, NJ: Psychology Press.Google Scholar
- Center for Disease Control. (2014). Suicide prevention: Youth suicide. http://www.cdc.gov/violenceprevention/pub/youth_suicide.html. Accessed 6 Jan 2015.
- Chapman, D. P., Dube, S. R., & Anda, R. F. (2007). Adverse childhood events as risk factors for negative mental health outcomes. Psychiatric Annals, 37(5), 359–364.Google Scholar
- Dong, M., Anda, R. F., Felitti, V. J., Williamson, D. F., Dube, S. R., Brown, D. W., et al. (2005). Childhood residential mobility and multiple health risks during adolescence and adulthood: The hidden role of adverse childhood experiences. Archives of Pediatrics and Adolescent Medicine, 159(12), 1104–1110.PubMedCrossRefGoogle Scholar
- Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D. F., & Giles, W. H. (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.PubMedCrossRefGoogle Scholar
- Erickson, M. F., Egeland, B., & Pianta, R. (1989). The effects of maltreatment on the development of young children. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 647–684). New York: Cambridge University Press.CrossRefGoogle Scholar
- Farrington, D. P. (1978). The family backgrounds of aggressive youths. In L. Hersov, M. Berger, & D. Shaffer (Eds.), Aggression and antisocial behavior in childhood and adolescence (pp. 73–93). Oxford: Pergamon.Google Scholar
- Felitti, V. J., & Anda, R. F. (2010). The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior: Implications for healthcare. In R. Lanius & E. Vermetten (Eds.), The impact of early life trauma on health and disease: The hidden epidemic (pp. 77–87). New York: Cambridge University Press.CrossRefGoogle Scholar
- Gottfredson, M. R., & Hirschi, T. (1990). A general theory of crime. Stanford, CA: Stanford University Press.Google Scholar
- Jessor, R., & Jessor, S. L. (1977). Problem behavior and psychosocial development: A longitudinal study of youth. New York, NY: Academic Press.Google Scholar
- Kaslow, N.J. (2014). Suicidal behavior in children and adolescents. American Psychological Association, Presentation. http://www.apa.org/about/governance/president/suicidal-behavior-adolescents.pdf Accessed 13 Feb 2015.
- Kendall, P. C., Ronan, K. R., & Epps, J. (1991). Aggression in children/adolescents: Cognitive-behavioral treatment perspectives. In D. J. Pepler & K. H. Rubin (Eds.), The development and treatment of childhood aggression (pp. 341–360). New Jersey: Lawrence Erlbaum Associates.Google Scholar
- King, R. A., Schwab-Stone, M., Flisher, A. J., Greenwald, S., Kramer, R.A., Goodman, S. H., et al. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child & Adolescent Psychiatry, 40(7), 837–846.CrossRefGoogle Scholar
- Maser, J., Akiskal, H., Schettler, P., Scheftner, W., Mueller, T., Endicott, J., et al. (2002). Can temperament identify affectively ill patients who engage in lethal or near-lethal suicidal behavior? A 14-year prospective study. Suicide and Life Threatening Behavior, 32(1), 10–32.PubMedCrossRefGoogle Scholar
- Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., et al. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent supplement. JAMA Psychiatry, 70(3), 300–310.PubMedCrossRefGoogle Scholar
- Piquero, A. R., Jennings, W. G., Diamond, B., Farrington, D. P., Tremblay, R. E., Welsh, B., et al. (2016). A meta-analysis update on the effects of early family/parent training programs on antisocial behavior and delinquency. Journal of Experimental Criminology, 12(2), 229–248.CrossRefGoogle Scholar
- Sampson, R. J., & Wilson, W. J. (1995). Toward a theory of race, crime, and urban inequality. In J. Hagan & R. D. Peterson (Eds.), Crime and inequality (pp. 37–56). Stanford, CA: Stanford University Press.Google Scholar
- Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In S. Leinhardt (Ed.), Sociological methodology 1982 (pp. 290–312). Washington, DC: American Sociological Association.Google Scholar
- Sobel, M. E. (1986). Some new results on indirect effects and their standard errors in covariance structure models. In N. Tuma (Ed.), Sociological methodology 1986 (pp. 159–186). Washington, DC: American Sociological Association.Google Scholar
- Sousa, C., Herrenkohl, T. I., Moylan, C. A., Tajima, E. M., Klika, J. B., Herrenkohl, R. C., et al. (2010). Longitudinal study on the effects of child abuse and children’s exposure to domestic violence, parent-child attachments, and antisocial behavior in adolescence. Journal of Interpersonal Violence, 26(1), 111–136.PubMedPubMedCentralCrossRefGoogle Scholar
- StataCorp. (2013a). Stata 13 base reference manual. College Station, TX: Stata Press.Google Scholar
- StataCorp. (2013b). Stata statistical software: Release 13. College Station, TX: StataCorp LP.Google Scholar
- Steinberg, L. (2010). A dual systems model of adolescent risk taking. Development and Psychobiology, 52, 216–224.Google Scholar
- U.S. Census Bureau. (2015). U.S.A. QuickFacts. Retrieved July 14, 2015 from http://www.census.gov/en.html.
- Wasserman, G. A., & Miller, L. S. (1998). The prevention of serious and violent juvenile offending. In R. Loeber & D. P. Farrington (Eds.), Serious and violent juvenile offenders: Risk factors and successful interventions (pp. 197–247). Thousand Oaks, CA: Sage.Google Scholar
- Wilbum, V. R., & Smith, D. E. (2005). Stress, self-esteem, and suicidal ideation in late adolescents. Adolescence, 40(157), 33–45.Google Scholar
- Zigler, E., & Hall, N. W. (1989). Physical child abuse in America: Past, present, and future. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 38–75). New York: Cambridge University Press.CrossRefGoogle Scholar