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Child and adolescent suicide attempts, suicidal behavior, and adverse childhood experiences in South Africa: a prospective study

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dc.date.accessioned 2017-09-05 en
dc.date.accessioned 2020-02-19T13:37:25Z
dc.date.available 2020-02-19T13:37:25Z
dc.date.issued 2017-09-05 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/11187
dc.description.abstract This is the first known prospective study of child suicidal behavior in sub-Saharan Africa. Aims were to determine whether (1) cumulative exposure to adverse childhood experiences (ACEs) predicts later suicidality and(2) heightened risks are mediated by mental health disorder and rug/alcohol misuse. Longitudinal repeated interviews were conducted 1 year apart (97% retention) with 3,515 adolescents aged 10-18 years in South Africa (56% female; <2.5% refusal). Random selection of census enumeration areas from urban/rural sites within two provinces and door-to-door sampling included all homes with a resident adolescent. Measures included past-month suicide attempts, planning, and ideation, mental health disorders, drug/alcohol use, and ACE, for example, parental death by AIDS or homicide, abuse, and exposure to community violence. Analyses included multivariate logistic regression and multiple mediation tests. Past-month suicidality rates were 3.2% of adolescents attempting, 5.8% planning, and 7.2% reporting ideation. After controlling for baseline suicidality and sociodemographics, a strong, graded relationship was shown between cumulative ACE and all suicide behaviors 1 year later. Baseline mental health, but not drug/alcohol misuse, mediated relationships between ACE and subsequent suicidality. Suicide attempts rose from 1.9% among adolescents with no ACE to 6.3% among adolescents with >5 ACEs (cumulative odds ratio [OR], 2.46; confidence interval [CI], 1.00e6.05); for suicide planning, from 2.4% to 12.5% (cumulative OR, 4.40; CI, 2.08e9.29); and for suicide ideation, from 4.2% to 15.6% (cumulative OR, 2.99; CI, 1.68e5.53). Preventing and mitigating childhood adversities have the potential to reduce suicidality. Among adolescents already exposed to adversities, effective mental health services may buffer against future suicidality. en
dc.format.medium Print en
dc.subject SUICIDE en
dc.subject CHILDREN en
dc.subject ADOLESCENTS en
dc.subject MENTAL HEALTH en
dc.subject SUBSTANCE ABUSE en
dc.title Child and adolescent suicide attempts, suicidal behavior, and adverse childhood experiences in South Africa: a prospective study en
dc.type Journal articles - non-HSRC staff en
dc.description.version Y en
dc.ProjectNumber TAAMAA en
dc.Volume 57 en
dc.BudgetYear 2015/16 en
dc.ResearchGroup Service Delivery, Democracy and Governance en
dc.SourceTitle Journal of Adolescent Health en
dc.ArchiveNumber 9915 en
dc.PageNumber 52-59 en
dc.outputnumber 8838 en
dc.bibliographictitle Cluver, L., Orkin, M., Boyes, M.E. & Sherr, L. (2015) Child and adolescent suicide attempts, suicidal behavior, and adverse childhood experiences in South Africa: a prospective study. <i>Journal of Adolescent Health</i>. 57:52-59. en
dc.publicationyear 2015 en
dc.contributor.author1 Cluver, L. en
dc.contributor.author2 Orkin, M. en
dc.contributor.author3 Boyes, M.E. en
dc.contributor.author4 Sherr, L. en


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