Observational Study
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World J Psychiatry. Mar 19, 2022; 12(3): 483-493
Published online Mar 19, 2022. doi: 10.5498/wjp.v12.i3.483
Childhood maltreatment and suicide ideation: A possible mediation of social support
Roland Donald Ahouanse, Wei Chang, Hai-Liang Ran, Die Fang, Yu-San Che, Wen-Hang Deng, Si-Fan Wang, Jun-Wei Peng, Lin Chen, Yuan-Yuan Xiao
Roland Donald Ahouanse, Wei Chang, Hai-Liang Ran, Die Fang, Yu-San Che, Wen-Hang Deng, Si-Fan Wang, Jun-Wei Peng, Lin Chen, Yuan-Yuan Xiao, Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
Author contributions: Ahouanse RD and Chang W contributed equally as joint first authors; Xiao YY designed the study; Ahouanse RD, Chang W, Ran HL, Fang D, Che YS, Deng WH, Wang SF, Peng JW, and Chen L collected and verified the data; Ahouanse RD and Xiao YY performed data analysis; Ahouanse RD and Chang W drafted the manuscript; Xiao YY provided critical revision of the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82060601; Top Young Talents of Yunnan Ten Thousand Talents Plan, No. YNWR-QNBJ-2018-286; and Innovative Research Team of Yunnan Province, No. 202005AE160002.
Institutional review board statement: Before the survey, study protocol was reviewed and approved by the Ethics Committee of Kunming Medical University.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The database of the current study is available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Yuan Xiao, PhD, Professor, Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, No. 1168 West Chunrong Road, Yuhua Street, Chenggong District, Kunming 650500, Yunnan Province, China. 33225647@qq.com
Received: August 9, 2021
Peer-review started: August 17, 2021
First decision: October 17, 2021
Revised: October 23, 2021
Accepted: February 19, 2022
Article in press: February 19, 2022
Published online: March 19, 2022
ARTICLE HIGHLIGHTS
Research background

Suicide represents a major public health problem among the child and adolescent populations worldwide. Suicide ideation (SI) is the percussor of suicidal behavior. In China, over 32% of children and adolescents have reported SI. Adverse lifetime events such as childhood maltreatment (CM) increase the risk of SI. Meanwhile, social support protects against SI. Thus, a pathway between CM and SI via social support may exist.

Research motivation

Although the mediation of social support in the association between CM and SI seems plausible, this hypothesis has not been discussed. The motivation of our study is to investigate the mediation role of social support.

Research objectives

To investigate whether social support significantly mediates the association between CM and SI.

Research methods

A large representative sample of 4732 adolescents from southwest China Yunnan province was surveyed. CM was defined into five types according to the 28-items Childhood Trauma Questionnaire (CTQ) Short-form: physical abuse (PA), emotional abuse (EA), sexual abuse (SA), physical neglect (PN), and emotional neglect (EN). The Chinese version of the Beck Scale for Suicide Ideation, the Child and Adolescent Social Support Scale, the Patient Health Questionnaire, and the 7-item anxiety scale were used to measure suicide ideation, social support, depression, and anxiety, respectively. We performed logistic regression and path analysis to evaluate the mediation of social support.

Research results

The prevalence rates of 1-wk, 1-year, and lifetime SI were 26.85% (95%CI: 24.30%-30.00%), 34.99% (95%CI: 30.60%-40.00%), and 55.69% (95%CI: 51.50%-60.00%), respectively. In addition, based on the cutoffs for subscales of CTQ, 928 (19.61%), 1269 (26.82%), 595 (12.57%), 2337 (49.39%), and 3067 (64.81%) were PA, EA, SA, PN and EN victims. According to the multivariate logistic regression, EA, PN and EN were consistently associated with SI. In addition, parental social support was inversely associated with SI. Following the multivariate analysis results, we performed path analysis. Parent social support presented as a significant mediator in the associations between emotional maltreatment (EA and EN) and SI.

Research conclusions

The current study suggests that parental social support may be considered as a potential mediator in the relationship between CM and SI. Intervention to rebuild the parent-child relationship may help to intervene CM-associated suicide risk.

Research perspectives

Future longitudinal studies are needed to verify the mediation of parental social support in the association between CM and SI.