Suicidal Ideation among Japanese Undergraduate Students: Relationships with Borderline Personality Trait, Depressive Mood, and Childhood Abuse Experiences
Although previous studies repeatedly noted that childhood abuse experiences and borderline personality traits, and depressive mood would influence suicidal ideation, few studies have attempted to reveal the independent contributory role of each factor to suicidal ideation. A multi-wave questionnaire survey among approximately 500 Japanese college students. Using structural equation modeling, we found childhood abuse experiences assessed by the Child Abuse and Trauma Scale had statistically significant impact on suicidal ideation through borderline personality characteristics assessed by the Inventory of Personality Organization, and depressive mood assessed by the Self-rating Depression Scale as mediators. The effects of childhood abuse experiences on trait suicidal ideation (persistent suicidal ideation) may be mediated by borderline personality traits and depressive mood. Future public health efforts should address suicide in the framework of personality characteristics.
Suicidal Ideation, Borderline Personality, Depressed Mood, Childhood Adversity
[1]
Borges, G., Angst, J., Nock, M., Ruscio, A., & Kessler, R. (2008). Risk factors for the incidence and persistence of suicide-related outcomes: A 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders, 105, 25-33.
[2]
Fawcett, J. A., Scheftner, W. A., Fogg, L. F., Clark, D. C., Young, M. A., Hedeker, D., & Gibbons, R. (1990). Time-related predictors of suicide in major affective disorder. American Journal of Psychiatry, 147, 1189-1194.
[3]
Owens, D., Wood, C., Greenwood, D. C., Hughes, T., & Dennis, M. (2005). Mortality and suicide after non-fatal self- poisoning: 16-year outcome study. British Journal of Psychiatry, 187, 470-475.
[4]
Shaffer, D., Gould, M, S., Fisher, P., Trautman, P., Moreau, D., Kleinman, M., & Flory, M. (1996). Psychiatric diagnosis in child and adolescent suicide. Archives of General Psychiatry, 53, 339-348.
[5]
Kessler, R. C., Borges, G., & Walters, E. E. (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry, 56, 617-626.
[6]
Ennis, J., Barnes, R. A., Kennedy, S., & Trachtenberg, D. D. (1989). Depression in self-harm patients. British Journal of Psychiatry, 154, 41-47.
[7]
Suominen, K., Henriksson, M., Suokas, J., Isometsä, E., Ostamo, A., & Lönqvist, J. (1996). Mental disorders and Comorbidity in attempted suicide. Acta Psychiatrica Scandinavica, 94, 234-240.
[8]
Yen, S., Shea, M. T., Snislow, C. A., Grilo, C. M., Skodol, A. E., Gunderson, J. G., McGlashan, T. H., Zanarini, M. C., & Morely, L. C. (2004). Borderline personality disorder criteria associated with prospectively observed suicidal behavior. American Journal of Psychiatry, 161, 1296-1298.
[9]
Zanarini, M. C., Wiliams, A. A., Lewis, R. E., Reich, R. B., Vera, S. C., Marino, M. F., … Frankenburg, F. R. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154 (8), 1101-1106.
[10]
Stanley, B., Gameroff, M. J., Michalsen, V., and Mann, J.J. (2001). Are suicide attempters who self-mutilate a unique population? American Journal of Psychiatry, 158, 427-432.
[11]
Gunderson, J. G., & Elliott, G. R (1985). The interface between borderline personality disorder and affective disorder. American Journal of Psychiatry, 142, 277-288.
[12]
McGirr, A., Alda, M., Seguin, M., Cabot, S., Lesage, A., & Turecki, G. (2009). Familial aggregation of suicide explained by cluster b traits: A three-group family study of suicide controlling for major depressive disorder. American Journal of Psychiatry, 166, 1124-1134.
[13]
McGlashan, T. H. (1987). Borderline personality disorder and unipolar affective disorder: Long-term effects of comorbidity. Journal of Nervous and Mental Disease, 175, 467-473.
[14]
Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B., & Silk, K. R. (2004). Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. American Journal of Psychiatry, 161, 2108-2114.
[15]
Bensley, L. S., Van Eenwyk, J., Spieker, S. J., & Schoder, J. (1999). Self-reported abuse history and adolescent problem behaviors. I. Antisocial and suicidal behaviors. Journal of Adolescent Health, 24, 63-172.
[16]
Davidson, J. R. T., Huges, D. C., George, L. K., & Blazer, D. G. (1996). The association of sexual assault and attempted suicide within the community. Archives of General Psychiatry, 53,550-555.
[17]
Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Childhood sexual abuse and subsequent psychopathology: Results from the National Comorbidity Survey. American Journal of Public Health, 91, 753-760.
[18]
Silverman, A. B., Reinherz, H. Z., & Giaconia, R. M. (1996). The long-term sequelae of child and adolescent abuse: a longitudinal community study. Child Abuse and Neglect, 20, 709-723.
[19]
Santa Mina, E. E., & Gallop, R. M. (1998). Childhood physical and sexual abuse and adult self-harm and suicidal behaviour: A literature review. Canadian Journal of Psychiatry, 43, 793-800.
[20]
Brown, J., Cohen, P., Johnson, J. G., & Smailes, E. M. (1999). Childhood abuse and neglect: Specificity of effects on adolescent and young adult depression and suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1490-1496.
[21]
Brown, G. R., & Anderson, B. (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55-61.
[22]
Ystgaard, M., Hestetun, I., Loeb, M., Schjelderup, G., & Mehlum, L. (2004). Does there exist a specific relationship between childhood sexual abuse and repeated suicidal behaviour. Child Abuse and Neglect, 28, 863-875.
[23]
Kender, K. S., Bulik, C. M., Silberg, J., Hettema, J. M., Myers, J., & Prescott, C. A. (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women. Archives of General Psychiatry, 57, 953-959.
[24]
Kendler, K. S., & Gardner, C. O. (2011). A longitudinal etiologic model for symptoms of anxiety and depression in women. Psychological Medicine, 41, 2035-2045.
[25]
Lee, S., Guo, W. J., Tsang, A., He, Y. L., Huang, Y. Q., Zhang, M. Y., Liu, Z. R., Shen, Y. C., & Kessler, R. C. (2011). The prevalence of family childhood adversities and their association with first onset of DSM-IV disorders in metropolitan China. Psychological Medicine, 41, 85-96.
[26]
Scott, K. M., McLaughlin, K. A., Smith, D. A. R., & Ellis, P. M. (2012). Childhood maltreatment and DSM-IV adult mental disorders: comparison of prospective and retrospective findings. British Journal of Psychiatry, 200, 469-475
[27]
Zung, W. W. K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 63-70.
[28]
Kitamura, T., & Suzuki, T. (1993a). A validation study of Parental Bonding Instrument in Japanese population. Japanese Journal of Psychiatry and Neurology, 47, 29-36.
[29]
Clarkin, J., Foelsch, P. A., & Kernberg, O. F. (2001). The Inventory of Personality Organization (IPO). Personality Disorder Institute, Department of Psychiatry, New York, NY: Weill College of Medicine of Cornell University.
[30]
Kernberg, O. F. (1975). Borderline Conditions and Pathological Narcissism. New York: Jason Aronson.
[31]
Lenzenweger, M. F., Clarkin, J. F., Kernberg, O. F., & Foelsch, P. A. (2001). The Inventory of Personality Organization: Psychometric properties, factor composition, and criterion relations with affect aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample. Psychological Assessment, 13, 577-591.
[32]
Critchfield, K. L., Levy, K. N., & Clarkin, J. F. (2004). The relationship between impulsivity, aggression, and impulsive-aggression in borderline personality disorder. An empirical analysis of self-report measures. Journal of Personality Disorders, 18, 555-570.
[33]
Igarashi, H., Kikuchi, H., Kano, R., Mitoma, H., Shono, M., Hasui, C., & Kitamura, T. (2009). The Inventory of Personality Organisation: its psychometric properties among student and clinical populations in Japan. Annals of General Psychiatry, 8, 9.
[34]
Sanders, B., & Becker-Lausen, E. (1995). The measurement of psychological maltreatment: Early data on the child abuse and trauma scale. Child Abuse & Neglect, 19, 315-323.
[35]
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238-246.
[36]
Schermelleh-Engel1, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8 (2), 23-74.
[37]
Arbuckle, J. L., & Wothke, W. (1955-1999). Amos 4.0 User’s Guide. Chicago: SmallWaters.
[38]
van Heeringen, K. The suicidal process and related concepts. In: van Heeringen, K., ed. Understanding suicidal behavior: the suicidal process approach to research, treatment and prevention. New York: Wiley, 2001.
[39]
Brezo, J., Paris, J., & Turecki, G. (2006). Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: a systematic review. Acta Psychiatrica Scandinavica, 113, 180-206.
[40]
Klonsky, E. D., & Moyer, A. (2008). Childhood sexual abuse and non-suicidal self-injury: meta-analysis. British Journal of Psychiatry, 192, 166-170.
[41]
Tanney, B. L. (2000). Psychiatric diagnoses and suicidal acts. In R. W. Maris, A. L. Berman & M. M. Silverman (Eds.), Comprehensive textbook of suicidology, New York: Guilford Press.
[42]
Brewin, C. R., Andrews, B., & Gotlib, I. H. (1993). Psychopathology and early experience: A reappraisal of retrospective reports. Psychological Bulletin, 113, 82-98.
[43]
Fogarty, S. J., & Hemsley, D. R. (1983). Depression and the accessibility of memories: A longitudinal study. British Journal of Psychiatry, 142, 232-237.
[44]
Glickman, L., Hubbard, M., Liveright, T., & Valciukas, J. A. (1990). Fall-off in reporting life events: Effects of life change, desirability, and anticipation. Behavioral Medicine, 16, 31-38.
[45]
Hepp, U., Gamma, A., Milos, G., Eich, D., Ajdacic-Gross, V., Rösser, W., Angst, J., & Schnyder, U. (2006). Inconsistency in reporting potentially traumatic events. British Journal of Psychiatry, 188, 278-283.
[46]
Jenkins, C. D., Hurst, M. W., & Rose, R. M. (1979). Life changes: do people really remember? Archives of General Psychiatry, 36, 379-384.
[47]
Kremers, I. P., Van Giezen, A. E., Van der Does, A. J. W., Van Dyck, R., & Spinhoven, Ph. (2007). Memory of childhood trauma before and after long-term psychological treatment of borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38, 1-10.
[48]
Herman, J. L., & Schatzow, E. (1987). Recovery and verification of memories of childhood sexual trauma. Psychoanalytic Psychology, 4, 1-14.
[49]
Widom, C. S., & Shepard, R. L. (1996). Accuracy of adult recollections of childhood victimization: Part 1. Childhood physical abuse. Psychological Assessment, 8, 412-421.
[50]
Widom, C. S., & Shepard, R. L. (1997). Accuracy of adult recollections of childhood victimization: Part 2. Childhood sexual abuse. Psychological Assessment, 9, 34-46.
[51]
Tomoda, A., Mori, K., Kimura, M., Takahashi, T., & Kitamura, T. (2000). One-year incidence and prevalence of depression among first-year university students in Japan: A preliminary study. Psychiatry and Clinical Neurosciences, 54, 583-588.
