Does child abuse influence the persistence of suicidal ideation in patients with high suicide risk?

Background:Child abuse (CA) is a well-established risk factor for suicidal ideation (SI) and suicidal behaviour (SB). However, only few studies have investigated the impact of CA on the persistence of SI over time. Those existing studies have used varying operationalizations to measure the persistence of SI, leading to inconsistent findings. Objective:The aim of this study is to examine the persistence of SI by integrating prospective ecological momentary assessments (EMAs) with retrospective structured interviews within one clinical sample. Method:Patients admitted to psychiatric hospitals following an acute suicidal crisis (n = 75) or recent suicide attempt (n = 107) were assessed shortly after admission and then, after discharge, engaged in a 3-week EMA (EMA phase 1), followed by a 6-month EMA period (EMA phase 2). SI was measured using the Self-Injurious Thoughts and Behaviors Interview at baseline and via EMA prompts during both phases. Persistence was indicated by the number of episodes and repeated reports of SI. Multiple regression analyses were conducted to examine the influence of CA on the persistence of SI. Results:Retrospective interview data showed that CA predicted the persistence of SI over the year before a suicidal crisis or suicide attempt (β = .22, t = 2.67, p = .008). Prospective EMA data indicated that CA was associated with greater persistence of passive SI during EMA phase 1 (β = .20, t = 2.19, p = .030) and with higher persistence of active SI in EMA phase 2 (β = .21, t = 1,99, p = .050). Conclusions:This study shows that CA is linked to greater persistence of SI across different methods and time points. It also highlights the importance of distinguishing between passive and active SI when examining persistence. Retrospective data showed that child abuse is associated with a higher persistence of suicidal ideation, but not with suicide plans, over the year before a suicidal crisis or suicide attempt.Prospective data showed that child abuse predicts a higher persistence of passive suicidal ideation in the first three weeks after discharge.Child abuse predicted a higher persistence of active suicidal ideation regardless of mental disorders over a six months period after discharge. Retrospective data showed that child abuse is associated with a higher persistence of suicidal ideation, but not with suicide plans, over the year before a suicidal crisis or suicide attempt. Prospective data showed that child abuse predicts a higher persistence of passive suicidal ideation in the first three weeks after discharge. Child abuse predicted a higher persistence of active suicidal ideation regardless of mental disorders over a six months period after discharge.