Internalizing and Externalizing Pathways to Suicidality in Abused and Neglected Children Grown Up
Item
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Title
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Internalizing and Externalizing Pathways to Suicidality in Abused and Neglected Children Grown Up
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Identifier
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d_2009_2013:ff6c6372cbc3:11049
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identifier
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11262
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Creator
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Landry, Elise C.,
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Contributor
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Cathy Spatz Widom
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Date
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2011
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Language
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English
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Publisher
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City University of New York.
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Subject
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Clinical psychology | Abuse | Antisocial Personality | Borderline Personality | Depression | Neglect | Suicidality
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Abstract
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This dissertation examines major depressive disorder (MDD), substance abuse and/or dependence (DA), antisocial personality disorder (ASPD), and borderline personality disorder (BPD) as potential mediators of the relationship between child abuse/neglect and suicidality in middle adulthood. Children with documented cases of physical and sexual abuse and neglect (ages 0-11) during 1967--1971 were matched with non-maltreated children and followed into middle adulthood (approximately age 40). Mediators were assessed in young adulthood (approximately age 29) through in-person interviews between 1989 and 1995. Suicidality was assessed via self-report during 2000--2002 (N = 892). Logistic regressions were used to test whether: (1) Children with documented histories of child abuse/neglect (as well as specific types of abuse/neglect) were at increased risk for suicidal ideation and suicidal behavior in middle adulthood in comparison with matched controls; (2) Children who have documented histories of abuse/neglect were at increased risk for lifetime diagnoses of MDD, DA, ASPD, and BPD in comparison with matched controls; and (3) Diagnoses of MDD, DA, ASPD, and BPD mediate the relationship between child abuse/neglect and suicidality. Interactions for sex and race were also examined and separate analyses were conducted for males, females, Blacks, and Whites. Child abuse/neglect was associated with increased risk for suicidality in middle adulthood and only MDD mediated the relationship between child abuse/neglect and suicidality. When specific types of abuse/neglect were considered, ASPD mediated the relationship for neglect and suicidality, while MDD and BPD mediated the associations for physical abuse and suicidality and multiple forms of maltreatment and suicidality. Separate analyses for males and females revealed significant sex differences. MDD acted as a mediator between child abuse/neglect and suicidality only for females, BPD was a mediator between child abuse/neglect and suicidality for males, and ASPD was a mediator for both abused/neglected males and sexually abused females. While MDD significantly mediated the relationship between child abuse/neglect for Whites, none of the diagnoses mediated the relationship between abuse/neglect and suicidality for Blacks. These results suggest the importance of considering the roles not only of internalizing symptoms but also of externalizing symptoms in suicide risk assessments among the maltreated population.
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Type
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dissertation
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Source
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2009_2013.csv
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degree
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Ph.D.
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Program
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Psychology
