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Childhood maltreatment and suicide attempts in prisoners: a systematic meta-analytic review.

ABSTRACT: In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. We searched Medline, PsychINFO, Embase, Web of Science and CINAHL from inception until August 2019. Meta-analyses using random effect models were applied, and heterogeneity was quantified using the I2 statistic. Publication bias and risk of bias across studies were assessed. We identified 24 studies comprising 16 586 prisoners. The rates of different types of childhood maltreatment ranged between 29% and 68% [95% confidence interval (CI) 18-81%]. The rate of suicide attempts in prisoners was 23% (95% CI 18-27%). Main results demonstrated that sexual abuse [odds ratio (OR) 2.68, 95% CI 1.86-3.86], physical abuse (OR 2.16, 95% CI 1.60-2.91), emotional abuse (OR 2.70, 95% CI 1.92-3.79), emotional neglect (OR 2.29, 95% CI 1.69-3.10), physical neglect (OR 1.57, 95% CI 1.27-1.94) and combined abuse (OR 3.09, 95% CI 2.14-4.45) were strongly associated with suicide attempts in prisoners. There was an indication of publication bias. Duval and Tweedie's trim-and-fill method was applied, which increased the odds for suicide attempts. Given the high rates of prison suicide deaths and suicide attempts, our findings suggest an urgent need for targeted suicide prevention priorities for prisoners, with a particular focus on ameliorating the effects of childhood traumatic experiences on suicidal prisoners.

SUBMITTER: Angelakis I

PROVIDER: S-EPMC6945324 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Childhood maltreatment and suicide attempts in prisoners: a systematic meta-analytic review.

Angelakis Ioannis I Austin Jennifer L JL Gooding Patricia P

Psychological medicine 20191030 1

In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. We searched Medline, PsychINFO, Embase, Web of Science and CINAHL from inception until August 2019 ...[more]

PMID: 31663847

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Project description:ImportanceChildren and young people's reports of experiences of adverse childhood events have increased in recent years, and this trend has been associated with an elevated risk for suicide behaviors. However, a systematic review and meta-analysis is needed to confirm the significance of this association in young people.ObjectiveTo quantify the association between core types of childhood maltreatment, including sexual, physical, and emotional abuse and/or neglect and suicide behaviors in children and young adults.Data sourcesMedline, PsychInfo, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health) databases were searched from January 1, 1980, until December 31, 2019. The reference lists of all the included studies were also checked.Study selectionQuantitative studies that focused on the association between core types of childhood abuse and/or neglect and suicide ideation, plans, and attempts.Data extraction and synthesisData were extracted by 2 independent raters. Publication bias and risk of bias across studies were assessed. Meta-analyses using random-effect models were applied, and heterogeneity was quantified using the I2 statistic. Data were analyzed from January to May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines.Main outcomes and measuresThe association between core types of childhood maltreatment and suicide behaviors.ResultsSeventy-nine studies with 337 185 young individuals (mean [SD] age, 15.67 [2.11] years; 63.19% female) were included. The findings demonstrated that sexual abuse (odds ratio [OR], 3.41; 95% CI, 2.90-4.00), physical abuse (OR, 2.18; 95% CI, 1.75-2.71), emotional abuse (OR, 2.21; 95% CI, 1.37-3.57), emotional neglect (OR, 1.93; 95% CI, 1.36-2.74), physical neglect (OR, 1.79; 95% CI, 1.27-2.53), and combined abuse (OR, 3.38; 95% CI, 2.09-5.47) were significantly associated with higher rates of suicide attempts. Core types of childhood maltreatment were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4.0-fold increase for suicide plans. Studies based on community samples (β [SE] = -1.68 [0.79]; P = .04) or with lower methodological quality (β [SE] = -2.86 [1.30]; P = .03) were associated more strongly with suicide attempts in those reporting experiences of sexual abuse, whereas young age was associated with both suicide attempts (β [SE] = -0.59 [0.27]; P = .03) and ideation (β [SE] = -0.41 [0.18]; P = .03).Conclusions and relevanceThese findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect.

Project description:AIM:To estimate the pooled prevalence and incidence of suicidal ideation, attempts, and deaths in people with sleep apnea. METHOD:We will identify epidemiological studies reporting the prevalence or incidence rate of suicide in people with sleep apnea. We will search the following databases: PubMed (MEDLINE), Scopus, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE) and Joana Briggs Institute EBF Database. No age, geographical location, study-design or language limits will be applied. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Two reviewers (YY and YP) will independently screen citations, abstracts and will identify full-text articles for inclusion, extract data, and appraise the quality and bias of included studies. Discrepancies will be resolved by consulting with a third researcher (MC). Study quality will be assessed by the Newcastle-Ottawa Scale. The primary outcomes will be the overall prevalence or incidence of suicidal ideation, attempts and completion and the risk of suicide in people with sleep apnea. For pooling of the studies, we will use a random-effects model with a logit transformation. The DerSimonian and Laird (DL) random-effects method will be used to estimate the pooled inter-study variance. We will assess the between-study heterogeneity using I2 statistics, and Cochrane's Q statistic (significance level < 0.05). If the I2 is high (>75%), we will perform subgroup meta-analyses and conduct a meta-regression analysis to explore sources of study heterogeneity using study level median age, study-level proportions of race, gender, depression and quality scores. We will report effect estimates as suicide risk per 1000 individuals. Egger's test and funnel plots will be used to assess publication bias, and adjusted estimates using trim and fill methods will be reported if publication bias is suspected. ETHICS AND DISSEMINATION:No ethics clearance is required as no primary data will be collected. The results of this systematic review and meta-analysis will be presented at scientific conferences and published in a peer-review journal. The results may shed more light on the burden of suicide risk among individuals with sleep apnea and may guide future population-specific interventions. TRIAL REGISTRATION:PROSPERO registration number: CRD42020165404.

Project description:ImportanceChildhood maltreatment is associated with mental illness. Researchers, clinicians, and public health professionals use prospective or retrospective measures interchangeably to assess childhood maltreatment, assuming that the 2 measures identify the same individuals. However, this assumption has not been comprehensively tested.ObjectiveTo meta-analyze the agreement between prospective and retrospective measures of childhood maltreatment.Data sourcesMEDLINE, PsycINFO, Embase, and Sociological Abstracts were searched for peer-reviewed, English-language articles from inception through January 1, 2018. Search terms included child* maltreatment, child* abuse, child* neglect, child bull*, child* trauma, child* advers*, and early life stress combined with prospective* and cohort.Study selectionStudies with prospective measures of childhood maltreatment were first selected. Among the selected studies, those with corresponding retrospective measures of maltreatment were identified. Of 450 studies with prospective measures of childhood maltreatment, 16 had paired retrospective data to compute the Cohen κ coefficient.Data extraction and synthesisMultiple investigators independently extracted data according to PRISMA and MOOSE guidelines. Random-effects meta-analyses were used to pool the results and test predictors of heterogeneity.Main outcomes and measuresThe primary outcome was the agreement between prospective and retrospective measures of childhood maltreatment, expressed as a κ coefficient. Moderators of agreement were selected a priori and included the measure used for prospective or retrospective assessment of childhood maltreatment, age at retrospective report, sample size, sex distribution, and study quality.ResultsSixteen unique studies including 25 471 unique participants (52.4% female [SD, 10.6%]; mean [SD] age, 30.6 [11.6] years) contained data on the agreement between prospective and retrospective measures of childhood maltreatment. The agreement between prospective and retrospective measures of childhood maltreatment was poor, with κ = 0.19 (95% CI, 0.14-0.24; P < .001). Agreement was higher when retrospective measures of childhood maltreatment were based on interviews rather than questionnaires (Q = 4.1521; df = 1; P = .04) and in studies with smaller samples (Q = 4.2251; df = 1; P = .04). Agreement was not affected by the type of prospective measure used, age at retrospective report, sex distribution of the sample, or study quality.Conclusions and relevanceProspective and retrospective measures of childhood maltreatment identify different groups of individuals. Therefore, children identified prospectively as having experienced maltreatment may have different risk pathways to mental illness than adults retrospectively reporting childhood maltreatment. Researchers, clinicians, and public health care professionals should recognize these critical measurement differences when conducting research into childhood maltreatment and developing interventions.

Dataset Information

Childhood maltreatment and suicide attempts in prisoners: a systematic meta-analytic review.

Publications

Childhood maltreatment and suicide attempts in prisoners: a systematic meta-analytic review.

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