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Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys

BACKGROUND: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progressio...

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Autores principales: Stein, Dan J., Chiu, Wai Tat, Hwang, Irving, Kessler, Ronald C., Sampson, Nancy, Alonso, Jordi, Borges, Guilherme, Bromet, Evelyn, Bruffaerts, Ronny, de Girolamo, Giovanni, Florescu, Silvia, Gureje, Oye, He, Yanling, Kovess-Masfety, Viviane, Levinson, Daphna, Matschinger, Herbert, Mneimneh, Zeina, Nakamura, Yosikazu, Ormel, Johan, Posada-Villa, Jose, Sagar, Rajesh, Scott, Kate M., Tomov, Toma, Viana, Maria Carmen, Williams, David R., Nock, Matthew K.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869349/
https://www.ncbi.nlm.nih.gov/pubmed/20485530
http://dx.doi.org/10.1371/journal.pone.0010574
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author Stein, Dan J.
Chiu, Wai Tat
Hwang, Irving
Kessler, Ronald C.
Sampson, Nancy
Alonso, Jordi
Borges, Guilherme
Bromet, Evelyn
Bruffaerts, Ronny
de Girolamo, Giovanni
Florescu, Silvia
Gureje, Oye
He, Yanling
Kovess-Masfety, Viviane
Levinson, Daphna
Matschinger, Herbert
Mneimneh, Zeina
Nakamura, Yosikazu
Ormel, Johan
Posada-Villa, Jose
Sagar, Rajesh
Scott, Kate M.
Tomov, Toma
Viana, Maria Carmen
Williams, David R.
Nock, Matthew K.
author_facet Stein, Dan J.
Chiu, Wai Tat
Hwang, Irving
Kessler, Ronald C.
Sampson, Nancy
Alonso, Jordi
Borges, Guilherme
Bromet, Evelyn
Bruffaerts, Ronny
de Girolamo, Giovanni
Florescu, Silvia
Gureje, Oye
He, Yanling
Kovess-Masfety, Viviane
Levinson, Daphna
Matschinger, Herbert
Mneimneh, Zeina
Nakamura, Yosikazu
Ormel, Johan
Posada-Villa, Jose
Sagar, Rajesh
Scott, Kate M.
Tomov, Toma
Viana, Maria Carmen
Williams, David R.
Nock, Matthew K.
author_sort Stein, Dan J.
collection PubMed
description BACKGROUND: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. METHODOLOGY/PRINCIPAL FINDINGS: Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. CONCLUSIONS/SIGNIFICANCE: This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt.
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spelling pubmed-28693492010-05-19 Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys Stein, Dan J. Chiu, Wai Tat Hwang, Irving Kessler, Ronald C. Sampson, Nancy Alonso, Jordi Borges, Guilherme Bromet, Evelyn Bruffaerts, Ronny de Girolamo, Giovanni Florescu, Silvia Gureje, Oye He, Yanling Kovess-Masfety, Viviane Levinson, Daphna Matschinger, Herbert Mneimneh, Zeina Nakamura, Yosikazu Ormel, Johan Posada-Villa, Jose Sagar, Rajesh Scott, Kate M. Tomov, Toma Viana, Maria Carmen Williams, David R. Nock, Matthew K. PLoS One Research Article BACKGROUND: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. METHODOLOGY/PRINCIPAL FINDINGS: Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. CONCLUSIONS/SIGNIFICANCE: This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt. Public Library of Science 2010-05-13 /pmc/articles/PMC2869349/ /pubmed/20485530 http://dx.doi.org/10.1371/journal.pone.0010574 Text en Stein et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Stein, Dan J.
Chiu, Wai Tat
Hwang, Irving
Kessler, Ronald C.
Sampson, Nancy
Alonso, Jordi
Borges, Guilherme
Bromet, Evelyn
Bruffaerts, Ronny
de Girolamo, Giovanni
Florescu, Silvia
Gureje, Oye
He, Yanling
Kovess-Masfety, Viviane
Levinson, Daphna
Matschinger, Herbert
Mneimneh, Zeina
Nakamura, Yosikazu
Ormel, Johan
Posada-Villa, Jose
Sagar, Rajesh
Scott, Kate M.
Tomov, Toma
Viana, Maria Carmen
Williams, David R.
Nock, Matthew K.
Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
title Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
title_full Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
title_fullStr Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
title_full_unstemmed Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
title_short Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
title_sort cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the who world mental health surveys
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869349/
https://www.ncbi.nlm.nih.gov/pubmed/20485530
http://dx.doi.org/10.1371/journal.pone.0010574
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