A Longitudinal Study of Suicidal Ideation in Sexually Abused Adolescent Girls: Depressive Symptoms and Affect Dysregulation as Predictors

Girard et. Al

Journal of Traumatic Stress

• In a study of 147 sexually abused girls aged 14-18, 46% had developed suicidal ideations making this abuse an obvious risk factor. However, not all will experience suicidal ideation, which is why it is important to have a good understanding on determinants that influence suicidality
• Depressive symptoms appear to be one of the best predictors of suicidal ideation among adolescent females—especially among those who have been sexually abused
• Traumas experienced in childhood can interrupt a child’s development resulting in disturbances in affect regulation. The inability to cope with negative emotions related to the traumatic event may lead them to experience affect dysregulation
• Affect dysregulation: the difficulty or inability to identify one’s own emotions, differentiate and express them appropriately, and modulate and regulate them adequately
  • Therefore, the association between depressive symptoms and suicidal ideation in sexually abused adolescent girls may be explained by the presence of affect dysregulation
• This longitudinal study examines affect dysregulation as a mediator between depressive symptoms and suicidal ideations among sexually abused adolescent females.

Hypothesis: Higher levels of depressive symptoms would exacerbate affect dysregulation 6 months later, which would in turn, instigate the presence of suicidal ideation 1 year after the first assessment

Methods

• Sample consisted of 119 adolescent victims of sexual abuse
  • Participants indicated the frequency with which they experienced depressive symptoms in the last 3 months
  • Participants filled out a Difficulties in Emotion Regulation scale to measure affect dysregulation—scores ranged from 7-35; with higher scores reflecting more intense affect dysregulation
  • Suicidal ideation was assessed at all times with questions like “in the last 6 months, have you seriously thought of committing suicide?”

Result

• 1 in 3 girls reported suicidal ideation 1 year after the first assessment
• More than half (56%) reported having suicidal ideations at the two prior assessments as well making a total of 13.1% of the total sample maintaining suicidal ideation across all 3 assessments
• Affect dysregulation was shown to act as an explanatory mechanism in the association between depressive symptoms and suicidal ideation
• Hypothesis was proved to be correct

I chose to talk about this article because being able to understand the mechanism through which sexually abused adolescents may represent a suicide risk is a major priority in treatment. Being able to do so offers a foundation to build on for future intervention programs aimed towards victims of sexual assault. Clearly, we see that there needs to be an assessment of past depressive symptoms and subsequent affect regulation difficulties to prevent suicidal ideation. Additionally, we must create interventions that help youth regulate negative emotions specific to depression, such as hopelessness. With this study, we now know that we do not only have to rely on a history of suicidal ideation to predict future ideation, but that there can be early intervention when affect dysregulation and depression symptoms arise in order to actively prevent future suicide attempts.