Children who are repeatedly abused, or are
abused by a member of their immediate family, are at higher risk of
attempting suicide in later life, a Canadian
study has shown.
Sexual abuse and, to a lesser extent, physical
abuse in childhood have both been associated with suicidality.
However, not all individuals who were abused as children go on to
attempt suicide. This latest study, published in the August issue
of the British Journal of Psychiatry, sheds new light on
the indicators of risk for suicide attempt.
Between 1986 and 1988, researchers recruited
families of children attending French-speaking nursery schools in
Quebec, Canada, to take part in the study. A total of 3388 children
participated.
Contact sexual abuse in childhood was reported
by 9.9% of the children (men 2.7%, women 18.0%), physical abuse by
20.6% (men 26.3%, women 14.3%) and both types of abuse by 8.2% (men
4.0%, women 12.8%). The least severe type of contact sexual abuse,
involving touch, was, at 49%, the most frequent. Threats and force
were reported in 22% and 30% of the remaining sexual abuse cases
respectively. In a third of the sexual abuse cases the abuser was a
family member, and in about two-thirds the abuse occurred on
multiple occasions.
Overall, participants with no history of
childhood abuse were less likely to demonstrate suicidal behaviour
than those who had been abused. Analysis shows that the non-abused
group had a lower prevalence of lifetime suicide attempts (6.0%)
than the physical abuse (11.7%), sexual abuse (14.8%) and both
abuse types (32.2%) groups.
The study also indicates that the risk of
suicide in later life is related to the frequency of abuse during
childhood and the identity of the abuser.
Repeated abuse was generally more strongly
associated with suicide attempts than a single occurrence of abuse.
Furthermore, sexual abuse by an immediate family member (such as a
father, stepfather or brother) carried the greatest risk. Abuse
perpetrated by an extended family member (uncle or cousin) carried
an intermediate risk, while abuse by an unrelated individual (an
acquaintance, romantic partner or stranger) carried a weaker
risk.
The researchers propose two possible
explanations for this pattern. First, abuse by a father or
stepfather is considered especially traumatic, possibly because
such abuse is more likely to occur in families with multiple
problems and also because these families cannot provide safe and
healing conditions following abuse. Second, abuse by close family
members may have long-term consequences on the development of
health attachment patterns necessary for mental health.
The study confirms the association between
suicide attempts and childhood abuse, and shows that the
characteristics of the abuser and abusive acts may be important
additional indicators of risk for suicide attempts.