A new study published in the Journal of Clinical Medicine reveals child abuse increase some determining risk factors in adolescents’ suicidal behaviours.
The research found that people who suffered child abuse are more likely to show personality traits that are related to intense anger, impulsivity, and emotional dysregulation. They also tend to undergo more stressful situations in their life. These new stressors and emotional dysregulation would be the factors that could lead to suicidal behaviours in adolescents.
The study was led by Professor Lourdes Fañanás, from the Faculty of Biology of the University of Barcelona, the Institute of Biomedicine of the UB (IBUB) and the Mental Health Networking Biomedical Research Centre (CIBERSAM). Researcher Laia Marques-Feixa, also a member of these institutions, is the first author of the article.
The link between suicide and child abuse
In Spain, suicide is the main cause of death amongst young people. Although suicide in adults has a higher prevalence in men than women, women show more suicidal and non-suicidal attempts (self-harming) than men. During the COVID-19 pandemic, the number of hospitalisations of women aged between 12 and 18 with self-harming behaviours increased.
The study analysed 187 children and adolescents aged seven to seventeen, with and without mental disorders. The researchers focussed on their experiences of child abuse, recent stressful life episodes, some personality traits and the risk of suicidal behaviours.
“Adolescence is a period of high emotional vulnerability and 70% of mental disorders are estimated to come up during this time”, noted Professor Lourdes Fañanás, member of the Department of Evolutionary Biology, Ecology and Environmental Sciences of the UB and principal researcher at the CIBERSAM group. “The brain of an adolescent undergoes a process of maturation and this process might involve difficulties in self-control and a higher impulsivity and emotional instability, which are decisive elements for developing some risky behaviours”.
“It is also a period full of changes (family dynamics, new groups with classmates, new challenges and activities, etc.) that can involve an increase of stressful situations for young people.”
Laia Marques-Feixa (UB-IBUB-CIBERSAM) further commented that “when there is a relational trauma during childhood —for instance, psychological, physical or sexual abuse or negligence, three primary developmental capacities can be altered: emotional regulation, identity and interpersonal relatedness. If one reaches adolescence without having a consolidated good basis in these skills, this person can have more difficulties due to the lack of solid psychological resources to deal with challenges, conflicts and daily difficulties that come up over the course of our life.
Suicide in adolescents
The study did not establish a direct link between child abuse and the possibility of expressing suicidal behaviour in young adults. However, the conclusions indicated that suffering from child abuse increases the risk factors leading to suicidal behaviours in adolescents.
“Our research shows that to reduce suicidal behaviours in adolescents, we need to work on the regulation strategies of emotions, as well as to reduce the potential exposure to new stressful events (changing homes, fights, suspension from school, etc.), especially regarding those people with records of child abuse”, noted Laia Marques-Feixa.
Since adolescence is the period where the foundations of our personality are being built, it is hard to make a diagnosis of these disorders among youngsters. “Moreover, there are some common traits between the different personality disorders, and this condition makes it harder for us to make a specific diagnostic,” highlighted expert Jorgue Moya-Higueras, from the University of Lleida and CIBERSAM.
“This is why approaching this issue from a more dimensional perspective —with transdiagnostic personality traits over a continuous period of time, such as emotional dysregulation— can be a more useful strategy than the categorical classification (present disorder or not present).”
More investment in public healthcare needed
Currently, the SURVIVE consortium is promoted by the European Regional Development Fund (ERDF) from the European Union, the Carlos III Health Institute, and the Ministry of Science, Innovation and Universities. The purpose of the initiative is to study the suicide incidence, assess risk factors and design intervention and prevention strategies.
The researchers noted that the first step to preventing suicidal behaviours “would be to invest more money in prevention, especially regarding the young population. This means we need to support the families so that these children can grow up in a healthy and safe atmosphere.”
Furthermore, the experts highlighted the importance of good detection and early intervention in children and adolescents who show emotional or behavioural difficulties. Although there is a code for suicidal risk, public healthcare should offer a wide network of professionals, services, and resources to aid as soon as possible. “Since most people who present suicidal behaviours have an associated mental disorder, the most important thing to start with should be this,” said the experts.
Despite the population high demand for these services over the last years, the ratio of public professionals of mental health in Spain is only six per every 100,000 people. These figures are tripling in Europe. “Therefore, to solve this shameful deficit, we should start by investing in mental health, especially in children and adolescents, from the different health services, education, justice, etc.,” concluded the research team.