History of Maltreatment, Positive Coping, and Current Suicidal Ideation in Adolescents

Background and Purpose: Suicidal ideation is a warning indicator of more serious suicidal behavior. While there is an extant research base on the relationship between suicidal ideation and maltreatment history, protective factors that might buffer suicidality in this high-risk group are less clear. Adolescents’ intrinsic qualities, including positive mental health and coping skills, can enable successful adaptation after adversity. The present study sought to examine whether adolescents with maltreatment histories are at heightened risk for suicidal ideation. In addition, we examined the impact of positive mental health and coping skills as buffers to suicidal ideation.

Methods: We analyzed data from 224 youth from San Diego and Seattle at Wave 7 of the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) study. Recruitment at both sites included children reported to the child protection systems for alleged maltreatment. Data on suicidal ideation was collected at ages 16 and 18; discrete reports at both time points were combined resulting in ideation being reported by 17.6% of adolescents. A project developed single item measure assessed positive mental health asking ‘In the last 12 months, have you had any mental health or emotional illness or problems?’ (yes/no). The Adolescent-Coping Orientation for Problem Experiences assessed coping skills (at age 18). Items related to physical (parental abuse and harsh punishment) and sexual abuse measured two types of maltreatment (ever/never). Hierarchical logistic regression was conducted to determine whether maltreatment history would significantly predict past 12-month reported suicidal ideation, controlling for positive mental health and coping skills.

Results: The suicidal ideation rate for female adolescents were significantly higher than for male adolescents (χ²₁ = 10.53, p < .01). Male adolescents had significantly higher prior mental health problems compared to female (χ²₁ = 3.90, p < .05). While there were no gender differences for physical abuse difference, female adolescents had higher rates of experiencing sexual abuse (χ²₁ = 13.34, p < .001). Individuals who report positive mental health [OR=0.14, CI 0.05-0.38, p<.001] and better coping skills [OR=0.98, CI 0.96-1.00, p<.10] were less likely to report suicidal ideation. However, adolescents with sexual abuse histories were 4.9 times more likely to report suicidal ideation compared to those with no sexual abuse [CI 1.53-15.65, p<.01], even controlling for positive mental health and coping skills.

Implications: Our findings indicate that positive mental health and coping skills work to reduce suicidal risk; this has implications for early intervention efforts. Building youth assets through promotion of positive youth development may serve as an important buffer to reduce negative outcomes in youth who have experienced maltreatment. However, while positive mental health and coping skills were statistically significant, the clinical significance is limited. Thus, trauma-focused interventions remain critical for youth who have experienced maltreatment.