Elsevier

The Journal of Pediatrics

Volume 151, Issue 5, November 2007, Pages 482-487
The Journal of Pediatrics

Original article
Protective Factors and Suicide Risk in Adolescents with a History of Sexual Abuse

https://doi.org/10.1016/j.jpeds.2007.04.033Get rights and content

Objective

To test the hypothesis that certain protective factors will reduce the risk of suicide behaviors in youth who are sexually abused.

Study design

Survey data come from 83,731 students in the 6th, 9th, and 12th grades in Minnesota. Four childhood sexual abuse groups were created: a) no history of sexual abuse; b) abuse by non-family member; c) abuse by family member; and d) abuse by both. Dependent variables included suicidal ideation and attempts. Four protective factors included: family connectedness, teacher caring, other adult caring, and school safety. Logistic regression was used in detecting differences in suicide behaviors across the 4 childhood sexual abuse categories.

Results

Four percent of students reported sexual abuse by a non-family member, 1.3% by a family member, and 1.4% by both. Although youth with a history of childhood sexual abuse were at increased risk for suicide behaviors compared with other youth, when protective factors were accounted for, the predicted probabilities of suicide behaviors for childhood sexual abuse youth were substantially reduced. Family connectedness was the strongest of the 4 protective factors.

Conclusion

Modifying select protective factors, particularly family connectedness, may reduce suicide risk in adolescents with childhood sexual abuse.

Section snippets

Methods

The 2004 Minnesota Student Survey (MSS) data were used for this study. This statewide survey assesses a wide variety of health behaviors and related factors in students enrolled in the 6th, 9th, and 12th grades every 3 years. Surveys were administered in schools during class time; no identifying information was collected. Passive parental consent procedures were used in most districts; active parental consent was used when required by school or district research protocols. The University of

Characteristics of the Sample

In the whole sample, 93.1% of students reported no history of sexual abuse, including 96.0% of male students and 90.3% of female students. Four percent of students reported sexual abuse by a non-family member, 1.3% by a family member, and 1.4% by both a family and non-family perpetrator. Demographic characteristics differed significantly across sexual abuse categories (Table I).

Across the sample, 24.5% of male and 34.1% of female students reported thinking about suicide, and 7.4% of male and

Discussion

Results suggest that specific protective effects operate in the lives of young people who are at increased risk for suicide attempt because of a history of sexual abuse. Family connectedness, teacher caring, other adult caring, and school safety were associated with lower levels of suicidal ideation and attempts for both male and female adolescents. Family connectedness appeared to have a particularly strong protective association with the outcomes. This finding suggests that if levels of

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  • Family processes: Risk, protective and treatment factors for youth at risk for suicide

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    Among sexual minority youth, a group at higher risk for suicide compared to their heterosexual counterparts, connectedness to parents was also associated with lower suicidal thoughts and fewer attempts (Eisenberg & Resnick, 2006). Further, family connectedness was found to be the strongest of four protective factors in buffering against suicide risk among youth who experienced sexual abuse (Eisenberg et al., 2007). Together, these studies underscore the unique potential for family connectedness to buffer against suicidal ideation, behavior, and death by suicide among diverse youth, over and above other social relationships.

  • Adverse childhood experiences and suicidality: school connectedness as a protective factor for ethnic minority adolescents

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    Evidence suggests that relationships with adults at school represent an important protective factor against suicidality for many youth (Borowsky et al., 2001; Eisenberg et al., 2007; Marraccini & Brier, 2017), including high-risk groups such as lesbian, gay, and bisexual adolescents (Eisenberg & Resnick, 2006; Taliaferro & Muehlenkamp, 2017). However, the buffering effect of the school environment in the context of ACEs remains understudied (Eisenberg et al., 2007), and studies examining ACE and suicidality in large non clinical samples either aggregate racial/ethnic groups or do not address racial/ethnic differences in these associations. In a prior study that used MSS data, Forster et al. (2020) found that school/ teacher connections were not universally protective for suicidality for adolescents with a history of ACEs.

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Supported by the Prevention Research Centers Program, Centers for Disease Control and Prevention (Cooperative Agreement Number 1-U48-DP-000063). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

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