Elsevier

Journal of Affective Disorders

Volume 299, 15 February 2022, Pages 658-665
Journal of Affective Disorders

Research paper
The relationship between childhood trauma and suicidal ideation, the mediating role of identification of all humanity, indifference and loneliness

https://doi.org/10.1016/j.jad.2021.12.052Get rights and content

Highlights

  • Childhood trauma was positively correlated with suicidal ideation, indifference, loneliness.

  • High identification with all humanity was associated with lower suicidal ideation.

  • Childhood trauma can lead to non -emotional behaviors and increase suicidal ideation.

  • Individuals are recognized by people and included in their groups; it may reduce suicidal ideation.

Abstract

Background

Research shows that childhood trauma has a detrimental impact on an individual's health, including suicidal ideation. In order to intervene with suicidal ideation, it is necessary to study the impact of childhood trauma on emotional and social functioning. This study explored the relationship between childhood trauma and suicidal ideation from the perspectives of indifference, identification with all humanity, and loneliness.

Methods

A total number of 8,452 college students completed the study. Childhood trauma was measured by the short form of Childhood Trauma Questionnaire (CTQ-SF). The Identification With All Humanity scale (IWAH) was used to measure individual's ability to identify or not identify with humanity. For indifference, we used the Inventory of Callous-Unemotional Traits, and Loneliness was assessed by the Loneliness Scale. The relationship of indifference, identification with all humanity, and loneliness were explored to further understand the relationship between childhood trauma and suicidal ideation's correlations, regression analysis, and path analysis were employed for data analysis.

Results

Childhood trauma was positively correlated with indifference, loneliness, and suicidal ideation, and negatively correlated with identification with all humanity (r = −0.140∼0.335, p < .001). Suicidal ideation was positively correlated with indifference and loneliness, and negatively correlated with identification with all humanity (r = −0.082∼0.260, p < .001). The results indicated that childhood trauma leads to indifference, which increases loneliness, and results in suicidal ideation (β = 0.073∼0.335, p < 0.001). If an individual with childhood trauma were to gain more recognition from social groups, this would reduce their loneliness and suicidal ideation (β = −0.125∼0.228, p < 0.001).

Discussion

Individuals with childhood trauma were more likely to display apathy, including non-emotional behavior. This makes individuals lonelier and may increase suicidal ideation. However, if individuals are further recognized by others and social groups within their environment it is possible to intervene in this process.

Introduction

Childhood trauma, also known as early adversity and early life stress, refers to when an individual who is exposed to one or more events beyond their coping ability in their childhood, which causes them to be in a state of stress for a prolonged period resulting in emotional or psychological pain (Pechtel and Pizzagalli, 2011). Childhood trauma is a very complex concept with a variety of classifications, with physical abuse, psychological/emotional abuse, sexual abuse, and neglect as four of the widely recognized types (Gilbert et al., 2009). The profound impact of childhood trauma on poor mental health has been widely researched (Isvoranu et al., 2017; Kessler et al., 2010), with childhood trauma being associated with an increased 2–3-fold risk for poor mental health (Trotta et al., 2015; van Dam et al., 2012; Varese et al., 2012). Childhood trauma could lead to detrimental consequences, including the impact on an individual's physical and mental health, material use, and criminal behavior (Gilbert et al., 2009), as well as an increased risk for physical and psychological diseases such as cancer, suicidal behavior, personality disorders, and depression (Anda et al., 2006). More importantly, studies have shown that childhood trauma is positively correlated with suicidal ideation (Angelakis et al., 2019), meaning individuals who have experienced childhood trauma are more likely to have suicidal ideation than those who have not.

Suicide is a major global public health concern, and the loss and negative impact on individuals are immeasurable (Miller et al., 2017). An early psychological indicator of suicidal behavior is suicidal ideation. Suicidal ideation refers to an individual's desire to attempt suicide when they want to end their life, but it does not lead to actual physical injury or death (Nordström et al., 1995). Therefore, it is important to study the risk factors of suicidal ideation in order to prevent suicide attempts.

Previous studies have suggested that the relationship between childhood trauma and suicidal ideation is explained by other important variables (Miller et al., 2013), and that intervention of these intermediate variables is the key to reducing the risk of suicide (Bahk et al., 2017). Research has mainly focused on the direct relationship between childhood trauma and suicidal ideation, but less attention has been paid to the underlying the influencing factors (Miller et al., 2014). This study identified three potential underlying influence factors of indifference, identification with all humanity, and loneliness, which will be explained in turn.

First, studies have shown that childhood trauma may lead to individual indifference (Bisby et al., 2017; Carnelley et al., 2015; Fang et al., 2020). Individuals during childhood who live with abusive families are under great pressure, with indifference being used as a coping to protect themselves from the abuse. Previous cross-sectional studies have shown that childhood trauma is significantly positively correlated with apathy (Bisby et al., 2017; Carlson et al., 2015; Kimonis et al., 2013a, 2013b). In addition, the results of two longitudinal studies support the stability of this positive correlation (Dhanani et al., 2018; Walters, 2018), and two additional studies have shown that indifference plays a role between childhood trauma and risk behavior (Carlson et al., 2015; McDonald et al., 2017). Specifically, the initial level of childhood trauma can significantly and positively predict the development of apathy after 18 months (Walters, 2018). Therefore, apathy may play a role between childhood trauma and suicidal ideation.

Second, research suggests that a weak identification with all humanity is a result of punitiveness and lack of affection in childhood; where a high identification with all humanity results from egalitarian and affectionate relationships in childhood (McFarland et al., 2012). This suggests that those who experience childhood trauma are more likely to display a weak identification with all humanity. Furthermore, McFarland et al. (2019) explain that once basic human needs are met then identification with all humanity can begin to develop. Traumatic events are then likely to disrupt one's basic human needs, resulting in the inability to develop or continue to develop any identification with all humanity. Furthermore, having childhood memories of empathy towards vulnerable groups and increased social interaction with those from different backgrounds (i.e. sex, race, socioeconomic) results in a higher identification with all humanity (McFarland et al., 2019). Not only do children need interaction with people from different backgrounds, they also require experiences with culture, more specifically experiences with someone from another culture, to increase identification with all humanity (Sparkman and Hamer, 2020). This would suggest that there may be reduced empathy and reduced social interaction in those who have experienced childhood trauma. In a study by Vazquez et al. (2021), looking at post traumatic growth during the COVID-19 pandemic, findings showed that in their model identification with all humanity indicated a pathway to both post-traumatic stress symptoms and post traumatic growth. Those with a lower score for identification with all humanity showed more post-traumatic stress symptoms, and a higher identification with all humanity was related to post-traumatic growth. There is an absence of research to explain the relationship of identification with all humanity and childhood trauma, however as suggested it is likely to have a buffering effect on post-traumatic stress symptoms from childhood trauma and build resilience against future traumatic events such as a pandemic (Valiente et al., 2021). There is also the ability to predict a risk of Generalized Anxiety Disorder, with a lower score on identification with all humanity predicting a risk of the disorder (Hyland et al., 2021). These variables require further exploration. In a previous systematic review, the authors showed that regaining the connection with others may decrease the risk of suicide (Lakeman and FitzGerald, 2008). Researchers also argued that the decreased social connection could increase the risk of suicide (Riblet et al., 2021).

Finally, weakening of emotional function will gradually marginalize individuals, reducing the possibility of recognition by social groups and acceptance within society (Iskric et al., 2020). Research shows that identity is related to an individual's prosocial behavior (Brito-Pons et al., 2018). In other words, the stronger the individual's group identity, the more prosocial behavior they will tend to display. On the contrary, if the individual is marginalized, the corresponding tendency for prosocial behavior will be reduced (Brito-Pons et al., 2018). However, people who gradually break away from the normal social circle have a significantly increased sense of loneliness, and the feelings of emotional distress are gradually aggravated (Calati et al., 2019). These factors that lead to loneliness may potentially be the influencing factors behind people's suicidal ideations. This is supported by previous research, where experiencing childhood trauma and loneliness predicts suicidal ideation in both adolescence and adulthood (Stravynski and Boyer, 2001).

Considering the close relationship between childhood trauma and suicidal ideation (Angelakis et al., 2019), this study explored the specific influencing factors of identification with all humanity (Frick et al., 2014), indifference (Hodges and Gore, 2019), and loneliness (McClelland et al., 2020). These factors, as discussed above, are related to childhood trauma, which is in turn related to the activation of suicidal ideation. If underlying related factors of childhood trauma are identified and treated, this is likely to reduce an individual's likelihood towards suicidal ideation (Sparkman and Hamer, 2020). Based on these reviewed studies, this current study hypothesized that emotional indifference and loneliness will increase the impact of childhood trauma on suicidal ideation. In addition, the novel exploration of identifying with all humanity, as an protective influencing factor, compared with the risk factor of indifference, can provide ideas for interventions that aid in the recovery of childhood trauma and the reduction of suicidal ideation (McFarland et al., 2013).

Section snippets

Participants and sampling

The study was conducted from 15th of September to 10th of October 2020. Using a cross-sectional design, colleges students were invited to participate in a survey from two Universities, one in Beijing (North China), and one in Xiamen (South China) (Wang et al., 2021). The electronic questionnaire was sent via a QR code link to all students from each class teacher who was in charge. All participants were informed of the purpose and procedure of this study before completing the survey, as well as

Measures

Demographic characteristics were collected through some sociodemographic-related questions, including: age, gender, education level, ethnicity, urban-rural provenance, sibling status, family economic status, and parental education levels. Since this study took place during the COVID-19 pandemic, the fear of COVID-19 was also included as a background variable. Fear of COVID was assessed by the Fear of COVID-19 Scale (Ahorsu et al., 2020). This scale consists of seven items, with questions

Statistical analysis

First, Pearson's correlation coefficients were calculated to analyze the relationship between childhood trauma, suicide ideation, indifference, loneliness, identification with all humanity, and background variables. Second, after controlling demographic variables and fear of COVID-19 as covariates, path analysis was used to analyze the direct and indirect relationships between childhood trauma, indifference, loneliness, and identification with all humanity on suicide ideation. Third,

Characteristics of the participants

As can be seen in Table 1, the demographics of the final sample included an average age of 21 (Mage = 21.29, SD = 2.94). 66.7% of the participants were female and 33.2% were male. 16 participants (0.2%) were other sex (i.e., transgender, non-binary, or gender queers). Undergraduate students (sophomores, juniors, and seniors) constituted 74.9% of the sample, whereas 25.2% were postgraduates, so either Master's or PhD students. The large majority was Han (86.8%) and came from a city (65.0%) or a

Multiple mediating effects

The results of path analysis showed a multiple mediating model (see Fig. 1). In this model, after adjusting for age, gender, and Fear of COVID-19, childhood trauma was positively related with suicide ideation (β = 0.111, p < .001), indifference (β = 0.321, p < .001), and loneliness (β = 0.237, p = < 0.001), and negatively related with IWAH (β = −0.127, p < .001). Indifference was positively related with loneliness (β = 0.058, p = < 0.001), whereas IWAH was negatively related with loneliness (β

Discussion

This study focuses on the relationship between childhood trauma and suicidal ideation, as well as whether IWAH can reduce the suicidal ideation of individuals who have experienced childhood trauma. The results showed that childhood trauma was positively correlated with suicidal ideation, indifference, loneliness, and negatively correlated with identification with all humanity. Suicide ideation was positively correlated with indifference and loneliness was negatively correlated with IWAH.

Funding

None.

CRediT authorship contribution statement

Yuanyuan Wang: Visualization, Writing – original draft, Writing – review & editing, Formal analysis. Helmut Warmenhoven: Formal analysis, Writing – original draft. Yi Feng: Formal analysis, Data curation, Writing – original draft. Amanda Wilson: Writing – original draft, Writing – review & editing. Dandan Guo: Methodology, Writing – original draft. Runsen Chen: Visualization, Formal analysis, Writing – review & editing.

Declaration of Competing Interest

None.

Acknowledgment

None.

References (62)

  • A. Iskric et al.

    Alexithymia and self-harm: a review of nonsuicidal self-injury, suicidal ideation, and suicide attempts

    Psychiatry Res.

    (2020)
  • E.R. Kimonis et al.

    Assessing callous-unemotional traits in adolescent offenders: validation of the inventory of callous-unemotional traits

    Int. J. Law Psychiatry

    (2008)
  • L. Kivelä et al.

    Longitudinal course of suicidal ideation and predictors of its persistence-a NESDA study

    J. Affect. Disord.

    (2019)
  • X Kwete et al.

    Gender equity, caregiving, and the 1-2-3-child policy in China

    The Lancet

    (2021)
  • H. McClelland et al.

    Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies

    J. Affect. Disord.

    (2020)
  • H. McClelland et al.

    Exploring the role of loneliness in relation to self-injurious thoughts and behaviour in the context of the integrated motivational-volitional model

    J. Psychiatr. Res.

    (2021)
  • S.E. McDonald et al.

    The role of callous/unemotional traits in mediating the association between animal abuse exposure and behavior problems among children exposed to intimate partner violence

    Child Abuse Negl.

    (2017)
  • A.B. Miller et al.

    Parents and friendships: a longitudinal examination of interpersonal mediators of the relationship between child maltreatment and suicidal ideation

    Psychiatry Res.

    (2014)
  • D.J. Sparkman et al.

    Seeing the human in everyone: multicultural experiences predict more positive intergroup attitudes and humanitarian helping through identification with all humanity

    Int. J. Intercul. Relat.

    (2020)
  • R. Thompson et al.

    Suicidal ideation in adolescence: examining the role of recent adverse experiences

    J. Adolesc.

    (2012)
  • G.D. Walters

    Child and adolescent maltreatment as a mediator of continuity in callous-unemotional traits and low self-control

    Child Youth Serv. Rev.

    (2018)
  • Y. Wang et al.

    Methods of attempted suicide and risk factors in LGBTQ+ youth

    Child Abuse Negl.

    (2021)
  • P. Xie et al.

    Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China

    J. Affect. Disord.

    (2018)
  • D.K. Ahorsu et al.

    The fear of COVID-19 Scale: development and initial validation

    Int. J. Ment. Health Addict.

    (2020)
  • F. Albarello et al.

    Developing identification with humanity and social well-being through social identification with peer groups in adolescence

    J. Youth Adolesc.

    (2021)
  • R.F. Anda et al.

    The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology

    Eur. Arch. Psychiatry Clin. Neurosci.

    (2006)
  • I. Angelakis et al.

    Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis

    Psychol. Med.

    (2019)
  • Y.C. Bahk et al.

    The relationship between childhood trauma and suicidal ideation: role of maltreatment and potential mediators

    Psychiatry Investig.

    (2017)
  • M.A. Bisby et al.

    Low Maternal warmth mediates the relationship between emotional neglect and callous-unemotional traits among male juvenile offenders

    J. Child Fam. Stud.

    (2017)
  • G. Brito-Pons et al.

    Implicit or explicit compassion? Effects of compassion cultivation training and comparison with mindfulness-based stress reduction

    Mindfulness

    (2018)
  • K.B. Carnelley et al.

    The effects of attachment priming on depressed and anxious mood

    Clin. Psychol. Sci.

    (2015)
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