title: Sexual abuse and suicidal behavior: a model constructed from a large community sample of adolescents.
abstract: OBJECTIVE
  To investigate relationships between self-reported sexual abuse, depression, hopelessness, and suicidality in a community sample of adolescents.
  
  
  METHODS
  In 1995, students (mean age 13 years) from 27 high schools in Australia (n = 2,603) completed a questionnaire including measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale), hopelessness, sexual abuse, and suicidality. Data analysis included logistic regression.
  
  
  RESULTS
  Sexual abuse is associated with suicidality, both directly and indirectly through hopelessness and depressive symptoms in the model developed. High suicide risk (behavior exceeding thoughts such as plans and threats, or deliberate self-injury) is strongly correlated with suicide attempts (odds ratio 28.8, 95% CI 16-52, p <.001). Hopelessness is associated with high suicide risk only, whereas depressive symptoms are associated with high suicide risk and attempts. Hopelessness is more strongly associated with sexual abuse in boys than girls. Depressive symptoms are more strongly associated with high suicide risk in girls than boys. Controlling for other variables, sexual abuse is independently associated with suicide attempts in girls but not boys.
  
  
  CONCLUSIONS
  Clinical assessment should consider gender differences in relationships between sexual abuse, depressive symptoms, hopelessness, and suicidality. Sexually abused girls may be at increased risk of attempting suicide, independent of other psychopathology.
authors.affiliation: Department of Psychiatry, University of Queensland Mental Health Center, Royal Brisbane Hospital, Herston, Queensland 4029, Australia.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Bergen
authors.forename: Graham
authors.initials: G
authors.lastname: Martin
authors.forename: Angela S
authors.initials: AS
authors.lastname: Richardson
authors.forename: Stephen
authors.initials: S
authors.lastname: Allison
authors.forename: Leigh
authors.initials: L
authors.lastname: Roeger
mesh_terms: D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012737:Sex Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires