Child maltreatment, recent stressful life events, and suicide ideation: A test of the stress sensitivity hypothesis

Abstract

Background: Exposure to child maltreatment is a well-known risk factor for suicide ideation among adolescents. Recent stressful life events may also contribute to this risk. However, the association between these risk factors is unclear in the etiology of suicide ideation for adolescents from socio-economically disadvantaged backgrounds.

Objective: The present study tested the stress generation and stress sensitivity hypotheses in relation to child maltreatment, recent stressful life events (in the past year), and suicide ideation (in the past two weeks).

Participants and setting: We utilized a sample of diverse, socioeconomically disadvantaged, depressed adolescent girls (N = 175) who were part of a depression treatment intervention.

Results: Child maltreatment was significantly associated with adolescent suicide ideation, β = .40, p < .001. Results supported the stress sensitivity hypothesis, in that exposure to interpersonal stressors in the past year exacerbated the association between child maltreatment and adolescents' suicide ideation, β = .18, p < .05. We found evidence for a protective factor, cognitive reappraisal, in the association between stressful life events and suicide ideation, β = -.15, p < .05.

Conclusions: These findings have several implications for clinical practice and suicide prevention with adolescent girls, and contribute to the extant literature on the role of chronic and acute stress in the etiology of adolescent suicide ideation.

Keywords: Adolescence; Child maltreatment; Depression; Stressful life events; Suicidal ideation.

Fig. 1.

Depiction of the stress-generation and stress-sensitization hypotheses as applied to the association between child maltreatment and adolescent suicidal ideation.

Fig. 2.

Structural equation model testing the stress-sensitization hypothesis. Note. An interaction term (stressful life events * CTQ) was included in the model to test for moderation. Model fit was excellent, CFI = 1.00, SRMR = .01, χ² = .93 (5), p = .97. *p < .05, **p < .01, ***p < .001.

Fig. 3.

(a) Experiences of maltreatment moderate the association between stressful life events and SI (N = 175).Note. The shaded area represents the values of the moderator (maltreatment) in which the effect of stressful life events on SI is significant. Z-scores on CTQ (number of maltreatment types) were used in the analysis and then converted to raw scores to improve interpretability of the diagram. On the y-axis, numbers represent the adjusted effect size between stressful life events and suicidal ideation. (b) Experiences of maltreatment moderate the association between stressful life events and SI (N = 175). Note. In this moderation plot, “low” and “high” values of stressful life events are −1 SD and +1 SD from the mean, respectively. Low child maltreatment refers to children who experienced no subtypes, while high child maltreatment refers to adolescents who experienced three subtypes.