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http://dx.doi.org/10.5765/jkacap.180019

Factors on the Pathway from Trauma to Suicidal Ideation in Adolescents  

Kwon, Seo Young (Department of Neuropsychiatry, Eulji University School of Medicine, Eulji University Hospital)
Nam, Ji Ae (Daedeok-gu Mental Health Center)
Ko, Boo Sung (Daedeok-gu Mental Health Center)
Lee, Chang Wha (Department of Neuropsychiatry, Eulji University School of Medicine, Eulji University Hospital)
Choi, Kyeong-Sook (Department of Neuropsychiatry, Eulji University School of Medicine, Eulji University Hospital)
Publication Information
Journal of the Korean Academy of Child and Adolescent Psychiatry / v.30, no.1, 2019 , pp. 26-33 More about this Journal
Abstract
Objectives: Suicide is the most frequent cause of death among Korean adolescents, and adolescents who have experienced trauma have an increased risk of post-traumatic stress disorder (PTSD) symptoms, depression, and suicide attempts. However, resilience and self-esteem are protective factors. We examined the effects of resilience and self-esteem on the relationship among traumatic experiences, PTSD symptoms, depression, and suicidal ideation. Methods: Middle-school students (n=403) completed questionnaires assessing traumatic experiences, PTSD symptoms, depression, suicidal ideation, resilience, and self-esteem. Path analysis was performed to investigate the mediating effects of PTSD symptoms, resilience, self-esteem, and depression on the relationship between trauma exposure and suicidal ideation. Results: Traumatic experience was positively correlated with PTSD symptoms, depression, and suicidal ideation. PTSD symptoms and depression were positively correlated with suicidal ideation. The relationship between traumatic experiences and suicidal ideation was mediated by PTSD symptoms, which had both direct and indirect effects on suicidal ideation; the indirect effect was mediated by resilience, self-esteem, and depression. Conclusion: Korean adolescents who had experienced trauma were more likely to develop PTSD symptoms, increasing their risk of depression and suicidal ideation. However, self-esteem and resilience may help protect against depression and suicidal ideation. Our findings could inform suicide prevention initiatives.
Keywords
Traumatic stress; Post-traumatic stress disorder; Depression; Suicidal ideation; Resilience; Self-esteem; Adolescents;
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1 OECD. OECD Health statistics 2016. Paris: OECD;2016.
2 Korea Statistics. Annual report on the cause of death statistics. Daejeon: Statistics Korea;2016.
3 Kim SW, Kim SY, Yang SJ, Kim JM, Shin IS, Jeong S, et al. Psychosocial correlates of suicidal ideation in middle-school students. J Korean Neuropsychiatr Assoc 2010;49:604-610.
4 George A, Moolman R. Resilience and suicide ideation: coping mediator-moderator effects among adolescent learners. Journal of Psychology in Africa 2017;27:494-502.   DOI
5 Benjet C, Bromet E, Karam EG, Kessler RC, McLaughlin KA, Ruscio AM, et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med 2016;46:327-343.   DOI
6 Wilcox HC, Storr CL, Breslau N. Posttraumatic stress disorder and suicide attempts in a community sample of urban American young adults. Arch Gen Psychiatry 2009;66:305-311.   DOI
7 Kang NR, Chung US, Kwack YS. Impact of peer's suicide on mental health of adolescents. J Korean Acad Child Adolesc Psychiatry 2015; 26:266-272.   DOI
8 Bae HN, Choi SW, Yu JC, Lee JS, Choi KS. Reliability and validity of the Korean version of the rosenberg self-esteem scale (K-RSES) in adult. J of Kor Soc for Dep and Bip Disorders 2014;12:43-49.
9 Jeong HS, Kang I, Namgung E, Im JJ, Jeon Y, Son J, et al. Validation of the Korean version of the Connor-Davidson Resilience Scale-2 in firefighters and rescue workers. Compr Psychiatry 2015;59:123-128.   DOI
10 Block J, Kremen AM. IQ and ego-resiliency: conceptual and empirical connections and separateness. J Pers Soc Psychol 1996;70:349-361.   DOI
11 Fincham DS, Altes LK, Stein DJ, Seedat S. Posttraumatic stress disorder symptoms in adolescents: risk factors versus resilience moderation. Compr Psychiatry 2009;50:193-199.   DOI
12 Nrugham L, Holen A, Sund AM. Associations between attempted suicide, violent life events, depressive symptoms, and resilience in adolescents and young adults. J Nerv Ment Dis 2010;198:131-136.   DOI
13 Folkman S. Stress: appraisal and coping. In: Gellman MD, Turner JR, editors. Encyclopedia of behavioral medicine. New York: Springer; 2013. p.1913-1915.
14 Arslan G. Psychological maltreatment, emotional and behavioral problems in adolescents: the mediating role of resilience and selfesteem. Child Abuse Negl 2016;52:200-209.   DOI
15 Lee KM, Jeong SH, Lee WK, Chung US. Reliability and validity of the Korean version of the child report of post-traumatic symptoms (CROPS) and the parent report of post-traumatic symptoms (PROPS). J Korean Acad Child Adolesc Psychiatry 2011;22:169-181.   DOI
16 Copeland WE, Keeler G, Angold A, Costello EJ. Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry 2007; 64:577-584.   DOI
17 Ramsawh HJ, Fullerton CS, Mash HB, Ng TH, Kessler RC, Stein MB, et al. Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army. J Affect Disord 2014;161:116-122.   DOI
18 Bae H, Kim D, Koh H, Kim Y, Park JS. Psychometric properties of the life events checklist-Korean version. Psychiatry Investig 2008; 5:163-167.   DOI
19 Cho MJ, Kim KH. Diagnostic validity of the CES-D (Korean version) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc 1993;32:381-399.
20 Heo EH, Choi KS, Yu JC, Nam JA. Validation of the center for epidemiological studies depression scale among Korean adolescents. Psychiatry Investig 2018;15:124-132.   DOI
21 Shin MS. An empirical study of the mechanism of suicide: validation of the scale for escape from the self. Seoul: Yonsei Univ.;1992.
22 Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 1999;6:1-55.   DOI
23 Eun HJ, Lee SM, Kim TH. The epidemiological study of posttraumatic stress disorder in an urban area. J Korean Neuropsychiatr Assoc 2001;40:581-591.
24 Choi JH, Yu M, Kim KE. Suicidal ideation in adolescents: a structural equation modeling approach. Nurs Health Sci 2015;17:119-125.   DOI
25 Wisco BE, Marx BP, Wolf EJ, Miller MW, Southwick SM, Pietrzak RH. Posttraumatic stress disorder in the US veteran population: results from the National Health and Resilience in Veterans Study. J Clin Psychiatry 2014;75:1338-1346.   DOI
26 Tang TC, Yen CF, Cheng CP, Yang P, Chen CS, Yang RC, et al. Suicide risk and its correlate in adolescents who experienced typhooninduced mudslides: a structural equation model. Depress Anxiety 2010;27:1143-1148.   DOI
27 Warheit GJ, Zimmerman RS, Khoury EL, Vega WA, Gil AG. Disaster related stresses, depressive signs and symptoms, and suicidal ideation among a multi-racial/ethnic sample of adolescents: a longitudinal analysis. J Child Psychol Psychiatry 1996;37:435-444.   DOI
28 Kim-Cohen J, Gold AL. Measured gene-environment interactions and mechanisms promoting resilient development. Curr Dir Psychol Sci 2009;18:138-142.   DOI
29 Stratta P, Capanna C, Riccardi I, Carmassi C, Piccinni A, Dell'Osso L, et al. Suicidal intention and negative spiritual coping one year after the earthquake of L'Aquila (Italy). J Affect Disord 2012;136:1227-1231.   DOI
30 Bahk YC, Jang SK, Choi KH, Lee SH. The relationship between childhood trauma and suicidal ideation: role of maltreatment and potential mediators. Psychiatry Investig 2017;14:37-43.   DOI
31 Davidson CL, Babson KA, Bonn-Miller MO, Souter T, Vannoy S. The impact of exercise on suicide risk: examining pathways through depression, PTSD, and sleep in an inpatient sample of veterans. Suicide Life Threat Behav 2013;43:279-289.   DOI