Patterns of Adverse Childhood Experience and Their Influences on Suicide Attempts Among Adults in South Korea

Background and Purpose: Adverse childhood experiences (ACEs) such as abuse, neglect, and family dysfunctions are associated with a wide range of deleterious outcomes in adulthood. Research has found that children who are exposed to one type of childhood abuse or family dysfunctions are likely to be exposed to another exposure. Recent research on ACEs explores whether different classes of ACEs exposures can be identified and how these ACEs classes are associated with deleterious outcomes in adulthood. Despite the accumulation of research in this area, relatively little is known about whether different classes of ACEs influence suicide attempts in adulthood. In particular, Korea has the highest number of suicide rates per capita (28.5 per 100,000) compared to 12.1 per 100,000 OECD countries. Thus, this study aims to investigate patterns of ACEs and how different patterns of ACEs relate to suicide attempts.

Methods: We used the Korean General Social Survey (KGSS) collected by Sungkyunkwan University in Korea. The analysis sample includes 1,033 adults who participated in the ‘family and gender role change IV’ survey conducted in 2012. The dependent variable is a suicide attempt measured by whether they had ever attempted suicide (yes=1; no = 0). The independent variable is ACEs. Ten binary variables are used to capture the following adversities respectively: physical abuse, emotional abuse, neglect, sexual abuse, parent died or got sick, brothers/sisters died or injured, divorce/separation, victim of or witness to family violence, mental illness, substance abuse. Also this study controlled for several variables such as age, gender, education, and income. We employed a Latent Class Analysis (LCA) employed to identify heterogeneous subgroups of adults with distinct patterns of ACEs. A logistic regression was used to examine the relationships between ACE classes and a suicide attempt controlling for covariates.

Results: The LCA results indicate that three classes best fit the data best across the sample – child maltreatment group (20%), global adversity group (19%), and low ACE group (61%). The Child maltreatment group are estimated to experience physical abuse (82%), neglect (62%). The global adversity group shows additional high probabilities of having family mental illness, parental alcohol, and drug use. The logistic regression indicates that compared to the low ACE group, the child maltreatment group (OR = 3.34, p < .05), and the global adversity group (OR = 4.24, p < .01) were associated with increased odds of a suicide attempt respectively.

Discussion and Implications: This study provides empirical evidence on the three distinct classes of ACEs in Korea. It is important to note that adults exposed to ACEs are more likely to experience a suicide attempt than adults with a history of low ACEs. This study discusses policy and practice implications that should be addressed in global social contexts to prevent negative consequences of adverse childhood experiences .