Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-09-28T11:48:48Z No. of bitstreams: 1 475267 - Texto Completo.pdf: 1615328 bytes, checksum: 3f7d24664f5e67651b5c246d51836ae2 (MD5) / Made available in DSpace on 2015-09-28T11:48:48Z (GMT). No. of bitstreams: 1 475267 - Texto Completo.pdf: 1615328 bytes, checksum: 3f7d24664f5e67651b5c246d51836ae2 (MD5) Previous issue date: 2015-07-30 / Introduction: Adverse childhood experiences are important risk factors for lifetime suicide attempts. However, little is known about the specific contribution of each type of maltreatment on suicidal behavior. The aim of this study was to examine the association between the level of each type of childhood trauma and suicidal behavior severity, controlling for their co-occurrence and common psychiatric disorders. Methods: The data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). The final sample consisted of 71429 self-selected volunteers. Childhood maltreatment assessed with the Childhood Trauma Questionnaire (CTQ). Lifetime suicidal behavior was assessed by using the first item of the Suicidal Behavior Questionnaire (SBQ- 17). Results: Controlling for demographic variables, childhood trauma subtypes scores, and psychiatric diagnoses (depression, bipolar disorder, and posttraumatic stress disorder), severe emotional abuse was associated with suicidal ideation and attempts, mainly for serious suicide attempts (OR, 17.76; 95%CI, 14.59-21.62). Emotional abuse had an exponential association with serious suicide attempts, with a peak at the 99th percentile (OR, 53.37; 95%CI, 22.67- 86.58). For other types of trauma, we found positive associations of smaller magnitude: at the 99th percentile for emotional neglect (OR, 1.9; 95%CI, 1.1- 3.0) and sexual abuse (OR, 2.6; 95%CI, 1.9-3.5), and no meaningful trend for physical abuse and physical neglect. Major depressive disorder and emotional abuse had the highest attributable risk fractions, 58% and 56%, respectively. Conclusions: The risk of suicide attempts increased exponentially with higher scores of emotional abuse. Physical maltreatment in childhood was weakly associated with suicidal behavior severity when controlled for emotional trauma. For suicide prevention, mental health public policies should consider including interventions to prevent and treat the consequences of emotional abuse. / Introdu??o: Os traumas infantis s?o importantes fatores de risco para tentativas de suic?dio. Contudo, pouco se sabe sobre a contribui??o espec?fica de cada tipo de trauma no comportamento suicida. O objetivo deste estudo foi examinar a associa??o entre o n?vel de cada tipo de trauma infantil e a gravidade do comportamento suicida, controlando para poss?veis co-ocorr?ncias e transtornos psiqui?tricos. M?todos: Os dados foram coletados pelo Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). A amostra final foi de 71.429 volunt?rios. OS maus tratos na inf?ncia foram avaliados com a Childhood Trauma Questionnaire (CTQ). O comportamento suicida foi avaliado utilizando o primeiro item do Suicidal Behavior Questionnaire (SBQ-17). Resultados: Controlando para dados sociodemogr?ficos, n?veis dos tipos de trauma na inf?ncia e diagn?sticos psiqui?tricos (depress?o, transtorno bipolar e transtorno de estresse p?s-traum?tico), o abuso emocional grave foi associado com idea??o suicida e tentativas de suic?dio, principalmente para as graves (OR, 17,76; 95% CI, 14,59-21,62). O abuso emocional teve uma associa??o exponencial com tentativas de suic?dio graves, com um pico no percentil 99 (OR, 53,37; IC95% 22,67-86,58). Para outros tipos de trauma, encontramos associa??es positivas de magnitude menor: no percentil 99 para neglig?ncia emocional (OR, 1,9; 95% CI, 1,1-3,0) e para abuso sexual (OR, 2,6; 95% CI, 1,9- 3,5), e nenhuma tend?ncia significativa para o abuso f?sico e para a neglig?ncia f?sica. O transtorno depressivo maior e o abuso emocional apresentaram as maiores fra??es de risco atribu?veis, 58% e 56%, respectivamente. Conclus?es: O risco de tentativas de suic?dio aumentou exponencialmente com n?veis mais altos de abuso emocional. Os maus tratos f?sicos na inf?ncia foram fracamente associados com a gravidade do comportamento suicida quando controlados para trauma emocional. Para preven??o do suic?dio, as pol?ticas p?blicas de sa?de mental devem considerar a inclus?o de interven??es para prevenir e tratar as conseq??ncias do abuso emocional.