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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Cross-national analysis of the associations between traumatic events and suicidal behavior: Findings from the who world mental health surveys
PLoS ONE, Volume 5, No. 5, Article e10574, Year 2010
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Description
Background: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Methodology/Principal Findings: Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. Conclusions/Significance: This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt.©2010 Stein et al.
Authors & Co-Authors
Stein, Dan J.
South Africa, Observatory
Groote Schuur Hospital
Chiu, Wai Tat
United States, Boston
Harvard Medical School
Hwang, Irving H.
United States, Boston
Harvard Medical School
Kessler, Ronald C.
United States, Boston
Harvard Medical School
Sampson, Nancy A.
United States, Boston
Harvard Medical School
Alonso Caballero, J. L.
Spain, Barcelona
Institut Municipal D'investigacio Medica
Borges, Guilherme Luiz Guimaraes
Mexico, Mexico
Instituto Nacional de Psiquiatría Ramon de la Fuente
Bromet, Evelyn J.
United States, Stony Brook
Renaissance School of Medicine at Stony Brook University
Bruffaerts, Ronny
Belgium, Leuven
Ku Leuven– University Hospital Leuven
de Girolamo, Giovanni
Italy, Brescia
Irccs Centro San Giovanni Di Dio Fatebenefratelli
Florescu, Silvia E.
Romania, Bucharest
Scoala Nationala de Sanatate Publica si Management Sanitar, Bucharest
Gureje, Oye
Nigeria, Ibadan
University College Hospital, Ibadan
He, Yanling
China, Shanghai
Shanghai Mental Health Center
Kovess - Masfety, Viviane
France, Paris
Université Paris Cité
Levinson, Daphna
Israel, Jerusalem
Ministry of Health
Matschinger, Herbert
Germany, Leipzig
Universität Leipzig
Mneimneh, Zeina N.
Lebanon, Beirut
Research
United States, Ann Arbor
University of Michigan, Ann Arbor
Nakamura, Yosizkazu
Japan, Kawachi District
Jichi Medical University
Ormel, Johan Hans
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Posada-Villa, J. A.
Colombia, Bogota
Pontificia Universidad Javeriana
Sagar, Rajesh Pragna
India, New Delhi
All India Institute of Medical Sciences, new Delhi
Scott, Kate Margaret
New Zealand, Dunedin
Otago Medical School
Tomov, Toma
Bulgaria, Sofia
New Bulgarian University
Viana, Maria Carmen
Brazil, Sao Paulo
Universidade de São Paulo
Williams, David R.
United States, Boston
Harvard T.h. Chan School of Public Health
Nock, Matthew K.
United States, Cambridge
Harvard University
Statistics
Citations: 302
Authors: 26
Affiliations: 24
Identifiers
Doi:
10.1371/journal.pone.0010574
e-ISSN:
19326203
Research Areas
Mental Health
Sexual And Reproductive Health
Violence And Injury
Study Design
Cross Sectional Study