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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6326 |
| Date | 30 July 2015 |
| Creators | Ara?jo, Rafael Moreno Ferro de |
| Contributors | Lara, Diogo Rizzato |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 600, 600, 600, -8624664729441623247, -969369452308786627 |
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