Brief Report: The Association of Adverse Childhood Experiences and Suicide-Related Behaviors Among 10th-Grade Secondary School Students

Abstract

The association between adverse childhood experiences and suicide-related behaviors (SRB) of adolescents has been widely studied in Western high-income countries, but not yet in Latin America. The aim of this study was to determine this association and to explore a dose-response relationship between adverse childhood experiences and SRB in Chile. We conducted a cross-sectional survey to assess adverse childhood experiences up to 1 year prior to the survey and SRB (suicide ideation and attempts) in a sample of secondary school students. Multilevel and multivariable logistic regressions were run with SRB as dependent and adverse childhood experiences as independent variables, adjusted by self-esteem, general mental health, friend and parental support, and the age at onset of cannabis and alcohol use. We included 7,458 adolescents (48.7% girls), mean age = 16.0 (SD = 0.7), and found a prevalence of 78.1% for at least one adverse childhood experience. The 6-month prevalence of suicidal ideation was 18.1% (95% confidence interval [CI]: 17.2%–19.0%), and the prevalence of suicide attempts was 5.0% (95% CI: 4.6–5.6). Among all adverse childhood experiences, only sexual abuse was a risk factor for both SRB. We also found an independent effect of the total number of adverse childhood experiences on suicidal ideation (p < .001) and on suicide attempts (p < .001). Additionally, ages at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively. This is the first study exploring the influence of adverse childhood experiences on suicide-related behaviors in adolescents from Latin America.

HIGHLIGHTS

• Sexual abuse is associated with suicidal ideation and suicide attempts in 10th-grade secondary school students

• There is a dose-response effect between adverse childhood experiences and suicide-related behavior

• Ages at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively

Keywords:

• Adolescents
• adverse childhood experiences
• suicide attempts
• suicide ideation

ACKNOWLEDGEMENTS

We thanks all students and their parents or main caregivers who participated in this study.

Additional information

Notes on contributors

Daniel Núñez

Daniel Núñez, Faculty of Psychology, Universidad de Talca, Talca, Chile; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile; Associative Research Program, Center or Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca, Chile.

Jorge Gaete

Jorge Gaete, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile; Faculty of Education, Universidad de los Andes, Santiago, Chile.

Viviana Guajardo

Viviana Guajardo, Nicolás Libuy, Ana María Araneda, and Lorena Contreras, Department of Psychiatry and Mental Health, Medical Faculty, Universidad de Chile, Santiago, Chile.

Nicolás Libuy

Viviana Guajardo, Nicolás Libuy, Ana María Araneda, and Lorena Contreras, Department of Psychiatry and Mental Health, Medical Faculty, Universidad de Chile, Santiago, Chile.

Ana María Araneda

Viviana Guajardo, Nicolás Libuy, Ana María Araneda, and Lorena Contreras, Department of Psychiatry and Mental Health, Medical Faculty, Universidad de Chile, Santiago, Chile.

Lorena Contreras

Viviana Guajardo, Nicolás Libuy, Ana María Araneda, and Lorena Contreras, Department of Psychiatry and Mental Health, Medical Faculty, Universidad de Chile, Santiago, Chile.

Paula Donoso

Paula Donoso, Department of Pediatrics, Universidad de Chile, Santiago, Chile.

Carlos Ibañez

Carlos Ibañez, Department of Psychiatry and Mental Health, Medical Faculty, Universidad de Chile, Santiago, Chile.

Adrian P. Mundt

Adrian P. Mundt, Department of Psychiatry and Mental Health, Universidad de Chile, Santiago, Chile; Medical Faculty, Universidad Diego Portales, Santiago, Chile.