Background

Research has indicated an association between child abuse and adolescent suicide. Little population-based information exists, however, about the nature of maltreatment experiences or interactions with the child protection system (CPS).

Objective

To examine child maltreatment characteristics and system-level responses associated with risk of adolescent suicide.

Participants and setting

Linked vital death records and CPS records were used to identify the population of adolescents who died by suicide in California between 2010 and 2017 and who had a history of at least one report to CPS prior to death.

Method

A case control design was used, with cases defined as a suicide of an adolescent with a history of CPS involvement. Using CPS records, living controls were then matched to cases based on year of birth, sex, race and ethnicity, and age of first child maltreatment allegation. A conditional logistic regression model was used to estimate the adjusted odds of adolescent suicide across various CPS and maltreatment characteristics.

Results

Recent CPS involvement, allegations of physical abuse, and allegations of sexual abuse emerged as significant risk factors for death by suicide. No differences in suicide risk were observed between youth with unsubstantiated or substantiated allegations.

Conclusions

Suicide risk appears to be more closely tied to specific maltreatment experiences than to substantiation or placement into foster care. As adolescent suicide rates rise, better a understanding of risk factors among already vulnerable populations of youth is critical.

中文翻译：

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一项关于因虐待和忽视而报告的青少年自杀的基于人群的病例对照研究

背景

研究表明虐待儿童与青少年自杀之间存在关联。然而，关于虐待经历的性质或与儿童保护系统 (CPS) 的互动，几乎没有基于人群的信息。

客观的

研究与青少年自杀风险相关的儿童虐待特征和系统级反应。

参与者和设置

关联的生命死亡记录和 CPS 记录用于确定 2010 年至 2017 年间在加利福尼亚州因自杀而死亡的青少年群体，这些青少年在死亡前至少向 CPS 报告过一次。

方法

使用病例对照设计，病例定义为有 CPS 参与史的青少年自杀。使用 CPS 记录，然后根据出生年份、性别、种族和民族以及第一胎虐待指控的年龄将生活控制与案例进行匹配。条件逻辑回归模型用于估计各种 CPS 和虐待特征中青少年自杀的调整几率。

结果

最近 CPS 的参与、身体虐待的指控和性虐待的指控成为自杀死亡的重要危险因素。在未经证实或证实指控的青年之间，没有观察到自杀风险的差异。

结论

自杀风险似乎与特定的虐待经历更紧密地联系在一起，而不是与证实或安置在寄养中的联系更紧密。随着青少年自杀率的上升，更好地了解已经处于弱势的青少年群体的风险因素至关重要。