Suicide and history of childhood trauma among street youth

Abstract

Background: Street youth represent a marginalized population marked by early mortality and elevated risk for suicide. It is not known to what extent childhood abuse and neglect predispose to suicide in this difficult-to-study population. This study is among the first to examine the relationship between childhood trauma and subsequent attempted suicide during adolescence and young adulthood among street youth.

Methods: From October 2005 to November 2007, data were collected for the At Risk Youth Study (ARYS), a cohort of 495 street-recruited youth aged 14-26 in Vancouver, Canada. Self-reported attempted suicide in the preceding six months was examined in relation to childhood abuse and neglect, as measured by the Childhood Trauma Questionnaire (CTQ), using logistic regression.

Results: Overall, 46 (9.3%) youth reported a suicide attempt during the preceding six months. Childhood physical and sexual abuse were highly prevalent, with 201 (40.6%) and 131 (26.5%) of youth reporting history of each, respectively. Increasing CTQ score was related to risk for suicide attempt despite adjustment for confounders (adjusted odds ratio [AOR], 1.45 per standard deviation increase in score; 95% confidence interval [CI], 1.08-1.91).

Limitations: Use of snowball sampling may not have produced a truly random sample, and reliance on self-report may have resulted in underreporting of risk behaviors among participants. Moreover, use of cross-sectional data limits the degree to which temporality can be concluded from the results of this study alone.

Conclusions: There exists a strong and graded association between childhood trauma and subsequent attempted suicide among street youth, an otherwise 'hidden' population. There is a need for effective interventions that not only prevent maltreatment of children but also aid youth at increased risk for suicide given prior history of trauma.

Figure 1

Proportion of youth reporting types of abuse/neglect (n = 495). Error bars represent +/− 95% confidence intervals for the estimate.