Immediate and short-term effects of childhood trauma have been a focus of clinical attention. However, recent studies demonstrate the far-reaching effects of childhood trauma related to depression and suicidality in adulthood. The evidence to support these associations is presented here.
Childhood trauma and suicidality
Fuller-Thomson and colleagues1 examined the relationship between adverse childhood experiences and suicidality in adulthood. Data were obtained from the 2012 Canadian Community Health Survey-Mental Health for men and women 18 years or older who completed information on adverse childhood experiences and suicide attempts. The adverse childhood experiences included sexual abuse, physical abuse, and parental domestic violence.
The survey comprised 22,559 persons. The mean age of the sample was 47 years; 51% were women. Of the total sample, 9.8% experienced physical abuse, 5.9% experienced sexual abuse, and 4.2% experienced parental domestic violence; 3% of the sample reported a history of having attempted suicide.
The prevalence of suicide attempts was significantly higher among those adults who had experienced trauma: physical abuse (12.4% vs 1.9% with no abuse) and sexual abuse (16.9% vs 2.1% with no abuse) as children; and among those who had witnessed parental domestic violence (7.3% vs 2.3% with no domestic violence). Gender did not moderate the relationship between childhood trauma and suicidality in adulthood. Depression, anxiety, substance abuse, and chronic pain accounted for some of the relationship between childhood trauma and adult suicidality. Of those factors, depression accounted for 25% of the association.
Childhood bullying and depression
Klomek and colleagues2 studied the effects of childhood bullying in their review of prospective longitudinal studies of children who had been bullied. Children who were bullied had a high risk of depression and anxiety disorders in adulthood. They also frequently had higher rates of suicidal thoughts and plans than children who had not been bullied. The consequences of childhood bullying were worse for girls than for boys. Overall, the higher the frequency of childhood bullying, the worse the adult outcomes. These long-term effects of childhood bullying were found even after controlling for preexisting psychopathology.
Childhood trauma and antidepressant response
Not only does childhood trauma lead to increased risk of depression in adulthood, it can affect antidepressant treatment response in adults with major depression. Williams and colleagues3 assessed the role of early-life trauma in predicting acute response outcomes to antidepressants. The Early-Life Stress Questionnaire was used to gauge exposure to 18 types of traumatic events before the age of 18 years. The study enrolled 1008 adults with MDD and 336 healthy controls. The patients with depression were randomized to escitalopram, sertraline, or venlafaxine for 8 weeks.
Compared with healthy controls, patients with MDD had experienced significantly more childhood trauma: 62.5% of the participants with MDD reported more than 2 traumatic events compared with 28.4% of controls. Rates of sexual, physical, and emotional abuse; neglect; witnessing domestic violence; and bullying or rejection were significantly higher among patients with MDD compared with controls.
1. Fuller-Thomson E, Baird SL, Dhrodia R, Brennenstuhl S. The association between adverse childhood experiences (ACEs) and suicide attempts in a population-based study. Child Care Health Dev. 2016; 42:725-734.
2. Klomek AB, Sourander A, Elonheimo H. Bullying by peers in childhood and effects on psychopathology, suicidality, and criminality in adulthood. Lancet Psychiatry. 2015;31:930-941.
3. Williams LM, Debattista C, Duchemin AM, et al. Childhood trauma predicts antidepressant response in adults with major depression: data from the randomized International Study to Predict Optimized Treatment for Depression. Transl Psychiatry. 2016;6:e799.
4. Roberts AL, Chen Y, Slopen N, et al. Maternal experience of abuse in childhood and depressive symptoms in adolescent and adult offspring: a 21-year longitudinal study. Depress Anxiety. 2015;32:709-719.