Early Life Stress: a Key Link between Childhood Adversity and Risk of Attempting Suicide

Epidemiology shows that the major risk factors for suicide or attempting suicide are childhood adversities such as sexual and/or physical abuse, neglect, mental illness of caregiver, and family or community violence. Suicide, whether attempted or completed, is a significant social, financial and emotional burden worldwide. Identification of risk factors and antecedents predisposing individuals to increased risk of suicide is hence imperative so as to afford prompt and appropriate monitoring and intervention.

Using epidemiological data from the Survey of adverse childhood experiences (ACE) among young people in the Republic of Macedonia to examine their association with suicide attempt and to discuss possible mechanisms within the 'stress biology research'.

A representative sample consisted of total 1277 students (58.6% female and 41.6%), aged 18 and above in year four of 664 secondary school and 613 first- and second-year university students. The data were obtained using Adverse Childhood Experiences Study Questionnaires (Family Health History Questionnaire) for collecting information on child maltreatment, household dysfunction and other socio-behavioural factors, applying WHO/CDC-recommended methodology. Statistical significance was set up at p<0.05.

Emotional neglect, physical abuse and physical neglect were the most frequent abusive experiences students had. Overall, suicide attempts were reported by 3.1% of respondents (4.7% by females and 0.8% by males). Those respondents who had been emotionally abused were almost three times as likely to attempt suicide, physical abuse almost doubles the chances of attempting suicide, substance abuse in the family increased the chances 2.3 times for attempting suicide, violent treatment of the mother almost quadrupled them for attempted suicide, having a family member who had been in prison increased the odds of almost 3.5 times for attempting suicide. Attempted suicide was found to be 1.5 times more likely as the number of ACEs reaches 3 and 3.4 times more likely as the number of adverse childhood experiences reached four or more.

Identifying and treating children, adolescents and young adults who have been affected by adverse childhood experiences may have substantial value in our evolving efforts to prevent suicide.