Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality.
OBJECTIVE
To investigate the magnitude and independence of the effects of childhood neglect, physical abuse, and sexual abuse on adolescent and adult depression and suicidal behavior.


METHODS
A cohort of 776 randomly selected children was studied from a mean age of 5 years to adulthood in 1975, 1983, 1986, and 1992 during a 17-year period. Assessments included a range of child, family, and environmental risks and psychiatric disorders. A history of abuse was determined by official abuse records and by retrospective self-report in early adulthood on 639 youths. Attrition rate since 1983 has been less than 5%.


RESULTS
Adolescents and young adults with a history of childhood maltreatment were 3 times more likely to become depressed or suicidal compared with individuals without such a history (p < .01). Adverse contextual factors, including family environment, parent and child characteristics, accounted for much of the increased risk for depressive disorders and suicide attempts in adolescence but not in adulthood (p < .01). The effects of childhood sexual abuse were largest and most independent of associated factors. Risk of repeated suicide attempts was 8 times greater for youths with a sexual abuse history (odds ratio = 8.40, p < .01).


CONCLUSIONS
Individuals with a history of sexual abuse are at greater risk of becoming depressed or suicidal during adolescence and young adulthood. Adolescence is the most vulnerable period for those youths who may attempt suicide repeatedly. Many of the apparent effects of neglect, in contrast, may be attributable to a range of contextual factors, suggesting broader focus for intervention in these cases.
Brown
J
J
College of Physicians and Surgeons, Columbia University, New York, USA. JB58@columbia.edu
Cohen
P
P
Johnson
J G
JG
Smailes
E M
EM
D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology*; D002675:Child, Preschool; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005190:Family / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012931:Social Environment; D013406:Suicide, Attempted / Q000523:psychology*