In my end is my beginning: developmental trajectories of adverse childhood experiences to late-life suicide.
OBJECTIVE
Converging evidence suggests that the sequelae of adverse childhood experiences (ACEs) including childhood abuse (e.g., sexual, physical, emotional/verbal abuse, neglect) and other ACE (e.g., family dysfunction, parental loss, parental psychopathology, substance abuse, incarceration, and domestic violence) have pronounced effects on suicidal behaviors (suicidal ideation, attempts, and death by suicide) in older age. There are fundamental changes in the developmental trajectory of biological, psychological and behavioral processes that result from ACE and that exert influence throughout the life span. Different moderators and mediators may affect the extent and nature of the relationship. However, the literature on the specific mechanisms whereby ACE affects suicidality in later life has not been well identified.


METHODS
We review and draw from extant multidisciplinary evidence to develop a heuristic framework through which to understand how ACE may lead to suicide in later life.


RESULTS
Proposed mechanisms span biological factors (neurological, gene-environment), psychiatric and health functioning, and psychosocial development (cognitive biases, coping resources, interpersonal deficits). Evidence suggests that ACEs affect each of these constructs, and it is likely in the interaction of these constructs with late-life stressors that suicidality in older adulthood emerges.


CONCLUSIONS
ACEs have persistent and multifaceted effects on suicidality in late life. This association is due to multi-varied pathways. It is believed that the explanatory framework developed herein--in which biological, psychological and behavioral factors are organized, and the role of late-life stressors is highlighted--will spark further scientific inquiry into this important area.
a Department of Psychology , Florida State University , FL , USA.
Natalie J
NJ
Sachs-Ericsson
b Department of Psychology , Coastal Carolina University , SC , USA.
Nicole C
NC
Rushing
c Department of Psychology , Florida State University , FL , USA.
Ian H
IH
Stanley
c Department of Psychology , Florida State University , FL , USA.
Julia
J
Sheffler
D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D000067073:Psychological Trauma / Q000523:psychology*; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*
child abuse; late-life suicide; psychosocial and cultural aspects