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. 2019 Oct;60(10):1085-1093.
doi: 10.1111/jcpp.13096. Epub 2019 Jul 24.

Childhood maltreatment, neuropsychological function and suicidal behavior

Jamie Zelazny  1 , Nadine Melhem  1 , Giovanna Porta  1 , Candice Biernesser  1 , John G Keilp  2 , J John Mann  2 , Maria A Oquendo  3 , Barbara Stanley  2 , David A Brent  1
Affiliations

Childhood maltreatment, neuropsychological function and suicidal behavior

Jamie Zelazny et al. J Child Psychol Psychiatry. 2019 Oct.

Abstract

Background: Suicide is the second leading cause of death in young people. Childhood maltreatment, neuropsychological dysfunction and psychopathology have each been shown to increase risk for suicidal behavior. However, few studies have examined their interactions and the effects of those interactions on suicidal behavior.

Methods: Across two sites, a total of 382 offspring of depressed parents underwent neuropsychological assessments. This high-risk sample included nearly equal numbers of males and females. Average age at the time of neuropsychological assessment was 18.5 years. The most prevalent lifetime psychiatric disorders were mood (43%), anxiety (37%) and alcohol and substance use disorders (21%). Childhood maltreatment was reported by 44% of offspring. Participants underwent extensive neuropsychological testing assessing the following domains: attention, memory, executive function, working memory, language fluency, and impulse control. Logistic regression was used to examine the association of reported childhood maltreatment, neuropsychological functioning, psychopathology and their interactions with suicidal behavior. Bonferroni correction was used to adjust for multiple comparisons.

Results: Maltreatment was associated with increased risk of suicidal behavior with odds ratios ranging between 2.40 and 4.43. Moderation analyses found that adaptive neuropsychological functioning was not protective against childhood maltreatment's effect on suicidal risk. While lifetime history of mood disorder was strongly associated with suicidal behavior, higher scores in working memory (OR = 0.21; 95% CI = 0.09, 0.45; p < .001) and executive function (OR = 0.15; 95% CI = 0.05, 0.43; p < .001) were protective against suicidal behavior even in the presence of a lifetime history of mood disorder.

Conclusions: Further research is needed to determine how neuropsychological capacity protects depressed patients against the risk of suicidal behavior.

Keywords: Maltreatment; depression; executive function; suicidal behavior.

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Conflict of interest statement

Conflict of interest statement: See Acknowledgements for full disclosures.

Figures

Figure 1
Figure 1
Moderation of the maltreatment effect on SB risk by attention domain scores
Figure 2
Figure 2
Moderation of the mood disorder effect on SB risk by working memory domain score
See this image and copyright information in PMC

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