Published online Mar 19, 2022. doi: 10.5498/wjp.v12.i3.483
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
Processing time: 221 Days and 5.5 Hours
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.
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.
To investigate whether social support significantly mediates the association between CM and SI.
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.
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.
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.
Future longitudinal studies are needed to verify the mediation of parental social support in the association between CM and SI.