title: Associations between the timing of childhood adversity and adulthood suicidal behavior: A nationally-representative cohort.
abstract: BACKGROUND
  Although childhood adversities (CAs) are known to be associated with later suicidal behavior, it is uncertain whether the timing of specific CAs may influence this association.
  
  
  METHODS
  We analyzed nationally representative data for 9205 participants from the Korean Welfare Panel Study. Four different CAs (parental death, parental divorce, suspension of school education and being raised in a relative's house due to financial strain) were assessed and were categorized as early childhood and adolescent onset. Lifetime experiences of suicidal behaviors along with the age of the first time experience were recorded. Cox regression was used.
  
  
  RESULTS
  After adjusting for age, sex, and childhood socioeconomic status, parental death before the age of 12 was associated with adulthood suicidal behavior (ideation HR 1.35, 95% CI 1.13, 1.61; attempt HR 1.60, 95% CI 1.02, 2.52), while suspension of school due to financial strain was associated with suicidal behavior when it occurred at adolescence (ideation HR 1.48, 95% CI 1.22, 1.79; plan HR 1.69, 95% CI 1.16, 2.48). When we also adjusted for adulthood SES, which is a potential mediator, there was no significant change except that the association between early parental death and suicidal attempt became non-significant (HR: 1.43, 95% CI: 0.92, 2.26).
  
  
  CONCLUSIONS
  Experience of CA was assessed retrospectively, and the assessment of suicidal attempt was not specifically defined. There could be selection bias due to loss to the follow-up.
  
  
  CONCLUSIONS
  There may be a critical period for the effect of CA on later suicidal behavior depending on the characteristics of CA.
authors.affiliation: Department of Psychiatry, College of Medicine, Ajou University, Gyeonggi-do, Republic of Korea; Sunflower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Republic of Korea; Center for Traumatic Stress, Ajou University Medical Center, Suwon, Republic of Korea.
authors.forename: Hyoung Yoon
authors.initials: HY
authors.lastname: Chang
authors.affiliation: Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.
authors.forename: Yeonseung
authors.initials: Y
authors.lastname: Chung
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, US.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Jung
authors.affiliation: Department of Public Health Sciences, Korea University, Seoul, Republic of Korea. Electronic address: ssk3@korea.ac.kr.
authors.forename: Seung-Sup
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000523:psychology*; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D004243:Divorce / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D056910:Republic of Korea; D012189:Retrospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Attempted suicide; Childhood adversity; Epidemiology; Republic of Korea; Suicidal ideation