Bedi, Saaniya

Bucholz, Kathleen K

Heath, Andrew C

Lynskey, Michael T

Madden, Pamela A F.

Martin, Nicholas G

McCutchen, Vivia V

Nelson, Elliot C

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Washington University School of MedicineDigital Commons@BeckerPosters2010: Disentangling the Genetics of Alcoholism:Understanding Pathophysiology and ImprovingTreatment2010CSA-associated risk for suicidal behavior in womenis not limited to those with a history of depressionSaaniya BediElliot C. NelsonMichael T. LynskeyVivia V. McCutchenPamela A F. MaddenSee next page for additional authorsFollow this and additional works at: http://digitalcommons.wustl.edu/guzeposter2010Part of the Medicine and Health Sciences CommonsThis Poster is brought to you for free and open access by the 2010: Disentangling the Genetics of Alcoholism: Understanding Pathophysiology andImproving Treatment at Digital Commons@Becker. It has been accepted for inclusion in Posters by an authorized administrator of DigitalCommons@Becker. For more information, please contact engeszer@wustl.edu.Recommended CitationBedi, Saaniya; Nelson, Elliot C.; Lynskey, Michael T.; McCutchen, Vivia V.; Madden, Pamela A F.; Bucholz, Kathleen K.; Heath,Andrew C.; and Martin, Nicholas G., "CSA-associated risk for suicidal behavior in women is not limited to those with a history ofdepression" (2010). Posters. Paper 1 Samuel B. Guze Symposium on Alcoholism.http://digitalcommons.wustl.edu/guzeposter2010/1AuthorsSaaniya Bedi, Elliot C. Nelson, Michael T. Lynskey, Vivia V. McCutchen, Pamela A F. Madden, Kathleen K.Bucholz, Andrew C. Heath, and Nicholas G. MartinThis poster is available at Digital Commons@Becker: http://digitalcommons.wustl.edu/guzeposter2010/1•A history of childhood sexual abuse (CSA) is associated with increased risk for adverse outcomes not limited to psychiatric disorders.•Risk for suicidal behavior has been reported across studies.•One difficulty complicating the interpretation of this association is the significant CSA- associated risk for psychiatric disorders also strongly associated with suicidality (e.g. depression, PTSD, alcohol and drug dependence). •Gender differences in the effects of CSA on suicidal behavior have been studied; however, results of such studies are inconsistent as to the presence or absence of gender differences.The current report examines gender differences in risk for suicidal behavior in individuals with a history of CSA. •Families were ascertained based on twins’ responses to screening questions about CSA and physical abuse (PA) in a prior assessment of a population-based young adult Australian twin cohort (born 1964–1971).•Initial design was to interview twins, siblings, and parents from 500 high-risk (one or both twins reporting a history of CSA and/or PA) and 500 control families (twins denied CSA and PA)Funding limitations necessitated a design change in which collection of twins from high- risk families were prioritized•Data here are from 2594 twins and full siblings from 524 high-risk and 373 control families•Participants were interviewed via telephone with a modified SSAGA from which lifetime diagnoses of MDD and PTSD were made and which included a section on suicidal behavior. Detailed childhood trauma history was obtained using the Christchurch Trauma Assessment. •Data analyses were conducted in SAS with Huber-White robust variance indicators used to adjust 95%CIs for the presence of multiple members of individual families in the sample.• Those who were abused had significantly higher prevalence of MDD and suicidal behavior than those who were non-abused. As suicidal outcome severity increased from suicidal ideation through multiple suicide attempts, the odd ratios tended to increase for females; odds ratios for males remained consistent regardless of outcome severity. (Table 1).•To control for the significant association between CSA and MDD, additional analyses included control for MDD and gender. Even while controlling for MDD and gender, persistent CSA- associated risk was found for suicidal ideation, persistent suicidal thoughts, suicidal plan, and multiple suicide attempts. (Table 2).•A significant interaction between sex and history of CSA that predicted suicide attempt outside of a lifetime history of MDD was seen. The odds ratio for risk of a suicide attempt in women with a history CSA attempting suicide, but no lifetime depressive episode, is 6.46 (95% Cl 1.14 – 36.48). (Table 3).•In women, a history of CSA without a history of a lifetime depressive episode was associated with a 6-fold increased risk of lifetime suicide attempt. This finding differs from prior reports that instead observed that depression acts as a mediator between CSA and suicide (Silverman, Reinherz, & Giaconia, 1996).•The strong relationship found in our study between sexual abuse and suicide attempts, even after controlling for depressive symptomalogy is in agreement with other studies as well. (Martin et al., 2004; Sigfusdottir et al., 2007). •These findings suggest that clinicians should be aware of the possibility of suicidal attempts in patients (primarily females) with a history of CSA that have never experienced a depressive episode. Saaniya Bedi, Elliot C. Nelson, Michael T. Lynskey, Vivia V. McCutcheon, Pamela A.F. Madden, Kathleen K. Bucholz, Andrew C. Heath, and Nicholas G. MartinBackground Purpose of Our StudyMethodsResultsDiscussionCSA-associated Risk for Suicidal Behavior in Women Is Not Limited to Those with a History of Depression CSA CSA(control for MDD & Gender) (control for PTSD, MDD & Gender)OR 95% CI OR 95% CISuicidal Ideation 1.86 1.52-2.26 1.63 1.32-2.01Persistent Suicidal Thought 1.87 1.44-2.42 1.55 1.16-2.07Suicidal Plan 2.32 1.73-3.15 1.91 1.37-2.68Multiple Suicide Attempts 2.78 1.50-5.15 2.01 0.93-4.34MDD only Suicide Attempt OnlyMDD & Suicide AttemptOR 95% CI OR 95% CI OR 95% CIFemale 1.37 1.09 -1.72 0.2 0.07-.60 1.27 .68-2.37CSA 1.9 1.29-2.79 1.51 .40-5.66 5 2.32-10.78Female X CSA 1.11 .70-1.74 6.46 1.14-36.48 0.72 .29-1.84Female MaleAbusedNon- Abused OR(95%CI) AbusedNon- Abused OR(95%CI)MDD 49% 31% 2.11 (1.70-2.63) 41% 25% 2.15 (1.50-3.07)Suicidal Ideation 41% 24% 2.24 (1.78-2.81) 49% 31% 2.21 (1.55-3.15)Persistent Suicidal Thought 19% 8% 2.75 (2.02-3.76) 20% 12% 1.87 (1.18-2.98)Suicidal Plan 15% 6% 2.95 (2.05-4.24) 22% 9% 2.93 (1.79-4.79)Suicide Attempt 10% 3% 3.23 (2.09-4.99) 11% 4% 2.74 (1.42-5.28)Multiple Suicide Attempts 5% 1% 4.65 (2.23-9.67) 3% 1% 2.23 (0.69-7.25)Table 1: Prevalence of suicidal behavior by CSA status and genderTable 3: Results of multinomial logistic regression focusing on risks associated with Gender, CSA status and interactionTable 2: CSA associated risk controlling for MDD, Gender, & PTSD

CSA-associated risk for suicidal behavior in women is not limited to those with a history of depression

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CSA-associated risk for suicidal behavior in women is not limited to those with a history of depression

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