Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation.

Journal: Child abuse & neglect

Volume: 151

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli , Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito , Rome, Italy. Electronic address: marco.dinicola@policlinicogemelli.it. Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito , Rome, Italy. Department of Mental Health, ASL Roma , Rome, Italy. Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli , Rome, Italy. Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli , Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito , Rome, Italy.

Abstract summary 

Suicide attempts (SA) are a public health concern because of increasing prevalence and clinical implications. Childhood trauma (CT) and emotion dysregulation (ED) have been proposed as predictors of SA, but few data are available in patients with Substance Use Disorder (SUD).Our study aims to investigate the association of sociodemographic/clinical variables, CT typologies, and ED features with SA in SUD patients.Subjects with SUD were screened in an outpatient setting. The final sample consisted of 226 patients, subdivided according to the presence of lifetime SA (SUD, n = 163 vs. SUD-SA, n = 63).Participants were compared for sociodemographic and clinical information. CT and ED were assessed through the Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Difficulties in Emotion Regulation Scale (DERS), respectively. We performed a mediation analysis to test the effect of CT and ED on SA.Patients with a history of SA (27.9 %) displayed more psychiatric comorbidities (p = 0.002) and hospitalizations (p < 0.001), higher scores at CTQ-SF sexual abuse (p < 0.001) and DERS 'impulse' (p = 0.002), 'goals', 'non-acceptance', 'strategies' (p < 0.001) subscales. The relationship between CTQ-SF sexual abuse and SA was significantly mediated by DERS 'strategies' (p = 0.04; bootstrapped 95 % LLCI-ULCI = 0.004-0.024).CT and different dimensions of ED were associated with SA in SUD patients. In our sample, the effects of childhood sexual abuse on SA were mediated by limited access to emotion regulation strategies. SUD patients are burdened with higher all-cause mortality, and CT and lifetime SA can worsen clinical outcomes. Clarifying the reciprocal interactions of psychopathological dimensions may help deliver targeted interventions and reduce suicide risk in specific populations.

Authors & Co-authors:  Di Nicola Pepe Montanari Marcelli Panaccione Janiri Janiri Sani

Study Outcome 

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Statistics
Citations : 
Authors :  8
Identifiers
Doi : 10.1016/j.chiabu.2024.106731
SSN : 1873-7757
Study Population
Male,Female
Mesh Terms
Other Terms
Childhood adverse events;Personality traits;Sexual abuse;Substances;Suicide
Study Design
Study Approach
Country of Study
Publication Country
England