The influence of childhood trauma on the onset and repetition of suicidal behavior: An investigation in a high risk sample of male prisoners

Background and Aims: Childhood trauma is a well recognized risk factor for attempting suicide. However, its relationship to the age of onset of first suicide attempt and the repetition of attempts has been little studied. Methods: One thousand five hundred and fifty-three prisoners underwent a psychiatric interview which included the Brown-Goodwin Lifetime History of Aggression (BGHA) interview. The prisoners completed the Childhood Trauma Questionnaire (CTQ) and the Buss-Durkee Hostility Inventory (BDHI). Results: Two hundred prisoners (12.9%) had a history of attempting suicide. Subjects who had attempted suicide had significantly higher CTQ scores than subjects who had never attempted. Childhood traumas were also significantly associated with the early onset of suicidal behavior, while repeated attempts were predicted by sexual abuse only. Early suicidal behavior was further associated with young age, psychiatric disease, aggressive traits and violent behavior. Early age at onset of suicidal behavior was also associated with repetition of suicide attempts. Repetition of suicide attempt was further associated with other self-injurious behaviors (self-harm). Conclusions: These results confirm that a history of attempting suicide is frequent among prisoners. Childhood trauma is a risk factor not only for suicidal behavior but also for its early onset as is having a psychiatric disorder and aggressive traits. Sexual abuse may increase the risk for multiple attempts, which strongly correlated with age at onset and other self-harm behaviors