Psychology, Department of
Date of this Version
11-2009
Abstract
Child maltreatment victims are at increased risk for a multitude of symptoms, including: internalizing problems (e.g., depression, anxiety), behavior problems (e.g., aggression) and post-traumatic stress symptoms (Paolucci, Genuis, & Violato, 2001). Not all maltreated children present with the same outcomes, and research consistently demonstrates child abuse does not have an inevitable pattern or a unified presentation of symptoms. Some youth may be asymptomatic following abuse; others display a myriad of symptoms at varying levels of severity (Kendall-Tackett, Williams, & Finkelhor, 1993). A small percentage of this group becomes suicidal.
Recent studies have presented accumulating evidence that suicidality and self-harm warrant concern in the maltreated population. Child maltreatment has bivariate associations with suicidal ideation (Brezo, Paris, Tremblay, Vitaro, Zoccolillo, Hebert, et al., 2006), and childhood sexual abuse is a consistent correlate of suicide attempts (Brezo, Paris, Tremblay, Vitaro, Hébert, and Turecki, 2007). However, the majority of the literature addresses adults and adolescents; little is known about early onset of self-harm and suicidality.
In addition to maltreatment, maternal factors, such as substance abuse and depression, form a potentially important construct with regards to childhood suicidality and self-harm. Goodman (1994) found 20 percent of depressed mothers had a child with major depression or dysthymia. Research has further shown children of depressed parents are at greater risk for suicidal behavior (Warner, Weissman, Fendrich, Wickramaratne, & Moreaur, 1992). The current study builds on existing research to examine child maltreatment, maternal mental health, and child thoughts of self-harm and suicidality in concert.
Participants included 1,117 children drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) Consortium. At age 8, the child completed the Trauma Symptom Checklist (TSCL; Briere & Runtz, 1989), which assesses the effects of childhood trauma through self-report. The child and the primary maternal caregiver completed alternate forms of the Child Behavior Checklist (CBCL; Achenbach, 1991), which assesses internalizing and externalizing behaviors. Domains assessed by the TSCL and the CBCL include suicidal desire and wanting to self-harm. The mother completed the Brief Symptom Inventory (BSI; Derogatis, 1975), a screening test to identify self-reported clinically relevant psychological symptoms (e.g., depression). Additionally, the Modified Maltreatment Classification System (MMCS; English & the LONGSCAN Investigators, 1997) was utilized to code official CPS records of child sexual, physical and emotional abuse.
The present study uses a series of hierarchical (nested) regression analyses predicting suicidality and thoughts of self-harm at age 8, accounting for reports of abuse before age 8. Reported physical, sexual and emotional abuse prior to age 8 is entered in Step 1, followed by mother’s depression score and mother’s substance abuse in Step 2. Analyses reveal several variables that significantly influence children’s thoughts of self-harm and suicidality. For example, physical abuse (M = 6.16, S = 1.773) was a significant predictor for “talks about killing self” (M = .04, S = .200), r (2370) = .046, p = .026. Results of this study will guide the development of more effective clinical interventions in child abuse victims and their caregivers.
Comments
Presented at Association for Behavioral and Cognitive Therapies Annual Convention. New York, NY, November 2009.
Also available at: http://works.bepress.com/tarakc/4