PURPOSE: To investigate the associations of childhood adversities (CAs) with lifetime onset and transitions across suicidal thoughts and behaviors (STB) among incoming college students.
METHODS: Web-based self-report surveys administered to 20,842 incoming college students from nine countries (response rate 45.6%) assessed lifetime suicidal ideation, plans and attempts along with seven CAs: parental psychopathology, three types of abuse (emotional, physical, sexual), neglect, bully victimization, and dating violence. Logistic regression estimated individual- and population-level associations using CA operationalizations for type, number, severity, and frequency.
RESULTS: Associations of CAs with lifetime ideation and the transition from ideation to plan were best explained by the exact number of CA types (OR range 1.32-52.30 for exactly two to seven CAs). Associations of CAs with a transition to attempts were best explained by the frequency of specific CA types (scaled 0-4). Attempts among ideators with a plan were significantly associated with all seven CAs (OR range 1.16-1.59) and associations remained significant in adjusted analyses with the frequency of sexual abuse (OR = 1.42), dating violence (OR = 1.29), physical abuse (OR = 1.17) and bully victimization (OR = 1.17). Attempts among ideators without plan were significantly associated with frequency of emotional abuse (OR = 1.29) and bully victimization (OR = 1.36), in both unadjusted and adjusted analyses. Population attributable risk simulations found 63% of ideation and 30-47% of STB transitions associated with CAs.
CONCLUSION: Early-life adversities represent a potentially important driver in explaining lifetime STB among incoming college students. Comprehensive intervention strategies that prevent or reduce the negative effects of CAs may reduce subsequent onset of STB.
Bibliographical noteFunding Information:
Funding to support this project was received from the National Institute of Mental Health (NIMH) R56MH109566 (RPA), and the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or NIMH; the Belgian Fund for Scientific Research (11N0514N/11N0516N/1114717N) (PM), the King Baudouin Foundation (2014-J2140150-102905) (RB), and Eli Lilly (IIT-H6U-BX-I002) (RB, PM); BARMER, a health care insurance company, for project StudiCare (DDE); ZonMw (Netherlands Organisation for Health Research and Development; grant number 636110005) and the PFGV (PFGV; Protestants Fonds voor de Geestelijke Volksgezondheid) in support of the student survey project (PC); South African Medical Research Council (Mid-Career Scientist Programme awarded to Jason Bantjes); Consejo Nacional de Ciencia y Tecnología (CONACyT: CB-2016–01-28554) (BC); Fondo de Investigación Sanitaria, Instituto de Salud Carlos III—FEDER (PI13/00343), ISCIII (Río Hortega, CM14/00125), ISCIII (Sara Borrell, CD12/00440); European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for Northern Ireland, Northern Ireland Public Health Agency (HSC R&D), and Ulster University (TB); Ministerio de Sanidad, Servicios Sociales e Igualdad, PNSD (Exp. 2015I015); DIUE Generalitat de Catalunya (2014 SGR 748), FPU (FPU15/05728) (JA). In Australia, the World Mental Health International College Student project is supported by Suicide Prevention Australia. Philippe Mortier has a Sara Borrell research contract awarded by the Instituto de Salud Carlos IIII (SCIII—CD18/00049). The World Mental Health International College Student project is carried out as part of the WHO World Mental Health (WMH) Survey Initiative. The WMH survey is supported by the National Institute of Mental Health NIMH R01MH070884, the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb.
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
- College students
- Multivariate models
- Suicide attempt
- Childhood adversity
- Population-attributable risk
- Suicidal ideation