Adverse childhood experiences, sexual victimization, and suicide ideation and attempts: A longitudinal path analysis spanning 22 years.

Suicide is an urgent public health problem. The purpose of this study was to determine if adverse childhood experiences (ACEs) increased the risk for suicide ideations and attempts approximately 22 years later, and if sexual victimization (SV) in adulthood mediated these associations. Prospective data from a nationally representative sample of 10,914 participants in the National Longitudinal Study of Adolescent to Adult Health were used to test direct associations of ACEs (physical, sexual, and emotional abuse, neglect, family history of suicide attempts, and parental death, alcoholism, and incarceration) with suicide ideation and attempts and their indirect effects through sexual victimization in adulthood. All but one ACE significantly predicted increased odds of making a suicide attempt. Physical, sexual, and emotional abuse as well as family history of suicide attempts and parental incarceration predicted seriously considering suicide. All forms of childhood abuse and family history of suicide attempts predicted increased odds of sexual victimization. In multivariate longitudinal models controlling for age, race, and gender, the odds of seriously considering suicide and making a suicide attempt increased as the number of ACEs increased. Experiencing two or more ACEs also was associated with an increased likelihood of experiencing sexual victimization in adulthood, which in turn mediated the effects of ACEs on suicide ideation but not suicide attempts. Findings indicate that reducing ACEs is an important strategy for suicide prevention not only due to ACEs' direct association with suicide ideation and attempts, but also due to their indirect association via subsequent sexual victimization. (PsycInfo Database Record (c) 2022 APA, all rights reserved).