European Child & Adolescent Psychiatry

, Volume 24, Issue 12, pp 1423–1446 | Cite as

Life adversities and suicidal behavior in young individuals: a systematic review

  • Gianluca SerafiniEmail author
  • Caterina Muzio
  • Giulia Piccinini
  • Eirini Flouri
  • Gabriella Ferrigno
  • Maurizio Pompili
  • Paolo Girardi
  • Mario Amore


Suicidal behavior in young people is a significant public health problem. However, it is not yet clear whether adversities (adverse life events) may be related to suicidality in adolescence and early adulthood. This paper aimed to investigate systematically the association between the type/number of adverse life events and experiences and suicidal behavior in young people. We developed a detailed strategy to search relevant articles in Pubmed, Scopus, PsycInfo, and Science Direct (January 1980–January 2015) about adverse life events and suicidal behavior. Adverse life events and experiences included maltreatment and violence, loss events, intra-familial problems, school and interpersonal problems. Studies were restricted to suicidal behavior in young people aged 10–25 years. The search yielded 245 articles, of which 28 met our inclusion criteria. Most studies reported a strong association between adversities and suicidality (both suicidal ideation and attempts). Based on the main results, the number of adversities or negative life events experienced seemed to have a positive dose–response relationship with youth suicidal behavior. However, the type of event experienced also appeared to matter: one of the most consistent findings was the association between suicidal behavior and experience of sexual abuse. More prospective studies are needed to elucidate the relative importance of risk accumulation and risk specificity for youth suicide.


Suicidal behavior Adolescence Life adversities Abuse Maltreatment 


Compliance with ethical standards

Conflicts of interest

The authors declare no conflicts of interest regarding this manuscript.


  1. 1.
    Dahl RE (2004) Adolescent brain development: a period of vulnerabilities and opportunities. Keynote address. Ann N Y Acad Sci 1021:1–22CrossRefPubMedGoogle Scholar
  2. 2.
    Fine JG, Sung C (2014) Neuroscience of child and adolescent health development. J Couns Psychol 61:521–527CrossRefPubMedGoogle Scholar
  3. 3.
    Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 14:245–258CrossRefPubMedGoogle Scholar
  4. 4.
    Danese A, McEwen BS (2012) Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav 106:29–39CrossRefPubMedGoogle Scholar
  5. 5.
    Oldehinkel AJ, Ormel J (2014) A longitudinal perspective on childhood adversities and onset risk of various psychiatric disorders. Eur Child Adolesc Psychiatry. doi: 10.1007/s00787-014-0540-0 (in press) PubMedCentralGoogle Scholar
  6. 6.
    Schilling EA, Aseltine RH Jr, Gore S (2007) Adverse childhood experiences and mental health in young adults: a longitudinal survey. BMC Public Health 7:30PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, Read J, van Os J, Bentall RP (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull 38:661–671PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Brodsky BS, Stanley B (2008) Adverse childhood experiences and suicidal behavior. Psychiatr Clin North Am 31:223–235CrossRefPubMedGoogle Scholar
  9. 9.
    WHO (2014) Health for the world’s adolescents. A second chance in the second decade. Available at: Accessed 11 Dec 2014
  10. 10.
    Flaherty EG, Thompson R, Dubowitz H, Harvey EM, English DJ, Proctor LJ, Runyan DK (2013) Adverse childhood experiences and child health in early adolescence. JAMA Pediatr 167:622–629PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Tamayo T, Christian H, Rathmann W (2010) Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health 10:525PubMedCentralCrossRefPubMedGoogle Scholar
  12. 12.
    Hawton K, Saunders KE, O’Connor RC (2012) Self-harm and suicide in adolescents. Lancet 379:2373–2382CrossRefPubMedGoogle Scholar
  13. 13.
    Miller AB, Esposito-Smythers C, Weismoore JT, Renshaw KD (2013) The relation between child maltreatment and adolescent suicidal behavior: a systematic review and critical examination of the literature. Clin Child Fam Psychol Rev 16:146–172PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Teicher MH, Samson JA (2013) Childhood maltreatment and psychopathology: a case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. Am J Psychiatry 170:1114–1133PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Santa Mina EE, Gallop RM (1998) Childhood sexual and physical abuse and adult self-harm and suicidal behaviour: a literature review. Can J Psychiatry 43:793–800PubMedGoogle Scholar
  16. 16.
    Molnar BE, Berkman LF, Buka SL (2001) Psychopathology, childhood sexual abuse and other childhood adversities: relative links to subsequent suicidal behaviour in the US. Psychol Med 31:965–977CrossRefPubMedGoogle Scholar
  17. 17.
    Martin G, Bergen HA, Richardson AS, Roeger L, Allison S (2004) Sexual abuse and suicidality: gender difference in a large community sample of adolescents. Child Abuse Negl 28:491–503CrossRefPubMedGoogle Scholar
  18. 18.
    Johnson JG, Cohen P, Gould MS, Kasen S, Brown J, Brook JS (2002) Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Arch Gen Psychiatry 59:741–749CrossRefPubMedGoogle Scholar
  19. 19.
    Roberts TA, Klein JD, Fisher S (2003) Longitudinal effect of intimate partner abuse on high-risk behavior among adolescents. Arch Pediatr Adolesc Med 157:875–881CrossRefPubMedGoogle Scholar
  20. 20.
    Brezo J, Paris J, Vitaro F, Hébert M, Tremblay RE, Turecki G (2008) Predicting suicide attempts in young adults with histories of childhood abuse. Br J Psychiatry 193:134–139CrossRefPubMedGoogle Scholar
  21. 21.
    Nrugham L, Holen A, Sund AM (2010) Associations between attempted suicide, violent life events, depressive symptoms, and resilience in adolescents and young adults. J Nerv Ment Dis 198:131–6. Erratum in: J Nerv Ment Dis 198:389Google Scholar
  22. 22.
    Tanaka M, Wekerle C, Schmuck ML, Paglia-Boak A, MAP Research Team (2011) The linkages among childhood maltreatment, adolescent mental health, and self-compassion in child welfare adolescents. Child Abuse Negl 35:887–898CrossRefPubMedGoogle Scholar
  23. 23.
    Thompson R, Litrownik AJ, Isbell P, Everson MD, English DJ, Dubowitz H, Proctor LJ, Flaherty EG (2012) Adverse experiences and suicidal ideation in adolescence: exploring the link using the LONGSCAN samples. Psychol Violence 2. doi: 10.1037/a0027107
  24. 24.
    Stone LB, Liu RT, Yen S (2014) Adolescent inpatient girls׳ report of dependent life events predicts prospective suicide risk. Psychiatry Res 219:137–142PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Moher D, Liberati A, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The Prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    McKeown RE, Garrison CZ, Cuffe SP, Waller JL, Jackson KL, Addy CL (1998) Incidence and predictors of suicidal behaviors in a longitudinal sample of young adolescents. J Am Acad Child Adolesc Psychiatry 37:612–619CrossRefPubMedGoogle Scholar
  27. 27.
    King RA, Schwab-Stone M, Flisher AJ, Greenwald S, Kramer RA, Goodman SH, Lahey BB, Shaffer D, Gould MS (2001) Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. J Am Acad Child Adolesc Psychiatry 40:837–846CrossRefPubMedGoogle Scholar
  28. 28.
    Liu X, Tein JY (2005) Life events, psychopathology, and suicidal behavior in Chinese adolescents. J Affect Disord 86:195–203CrossRefPubMedGoogle Scholar
  29. 29.
    Kaplow JB, Gipson PY, Horwitz AG, Burch BN, King CA (2014) Emotional suppression mediates the relation between adverse life events and adolescent suicide: implications for prevention. Prev Sci 15:177–185CrossRefPubMedGoogle Scholar
  30. 30.
    Bhatta MP, Jefferis E, Kavadas A, Alemagno SA, Shaffer-King P (2014) Suicidal behaviors among adolescents in juvenile detention: role of adverse life experiences. PLoS One 9:e89408PubMedCentralCrossRefPubMedGoogle Scholar
  31. 31.
    Horesh N, Nachshoni T, Wolmer L, Toren P (2009) A comparison of life events in suicidal and nonsuicidal adolescents and young adults with major depression and borderline personality disorder. Compr Psychiatry 50:496–502CrossRefPubMedGoogle Scholar
  32. 32.
    Rhodes AE, Boyle MH, Bethell J, Wekerle C, Tonmyr L, Goodman D, Leslie B, Lam K, Manion I (2013) Child maltreatment and repeat presentations to the emergency department for suicide-related behaviors. Child Abuse Negl 37:139–149CrossRefPubMedGoogle Scholar
  33. 33.
    Rew L, Taylor-Seehafer M, Fitzgerald ML (2001) Sexual abuse, alcohol and other drug use, and suicidal behaviors in homeless adolescents. Issues Compr Pediatr Nurs 24:225–240CrossRefPubMedGoogle Scholar
  34. 34.
    Bensley LS, Van Eenwyk J, Spieker SJ, Schoder J (1999) Self-reported abuse history and adolescent problem behaviors I. Antisocial and suicidal behaviors. J Adolesc Health 24:163–172CrossRefPubMedGoogle Scholar
  35. 35.
    Blosnich J, Bossarte R (2012) Drivers of disparity: differences in socially based risk factors of self-injurious and suicidal behaviors among sexual minority college students. J Am Coll Health 60:141–149PubMedCentralCrossRefPubMedGoogle Scholar
  36. 36.
    Muehlenkamp JJ, Gutierrez PM (2004) An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide Life Threat Behav 34:12–23CrossRefPubMedGoogle Scholar
  37. 37.
    Kaplan SJ, Pelcovitz D, Salzinger S, Mandel F, Weiner M (1997) Adolescent physical abuse and suicide attempts. J Am Acad Child Adolesc Psychiatry 36:799–808CrossRefPubMedGoogle Scholar
  38. 38.
    Salzinger S, Rosario M, Feldman RS, Ng-Mak DS (2007) Adolescent suicidal behavior: associations with preadolescent physical abuse and selected risk and protective factors. J Am Acad Child Adolesc Psychiatry 46:859–866CrossRefPubMedGoogle Scholar
  39. 39.
    Lipschitz DS, Winegar RK, Nicolaou AL, Hartnick E, Wolfson M, Southwick SM (1999) Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. J Nerv Ment Dis 187:32–39CrossRefPubMedGoogle Scholar
  40. 40.
    Jakobsen IS, Christiansen E (2011) Young people’s risk of suicide attempts in relation to parental death: a population-based register study. J Child Psychol Psychiatry 52:176–183CrossRefPubMedGoogle Scholar
  41. 41.
    Wilcox HC, Kuramoto SJ, Lichtenstein P, Långström N, Brent DA, Runeson B (2010) Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. J Am Acad Child Adolesc Psychiatry 49:514–523; quiz 530. Erratum in: J Am Acad Child Adolesc Psychiatry 49:858–859Google Scholar
  42. 42.
    Xing XY, Tao FB, Wan YH, Xing C, Qi XY, Hao JH, Su PY, Pan HF, Huang L (2010) Family factors associated with suicide attempts among Chinese adolescent students: a national cross-sectional survey. J Adolesc Health 46:592–599CrossRefPubMedGoogle Scholar
  43. 43.
    Baldry AC, Winkel FW (2003) Direct and vicarious victimization at school and at home as risk factors for suicidal cognition among Italian adolescents. J Adolesc 26:703–716CrossRefPubMedGoogle Scholar
  44. 44.
    Laederach J, Fischer W, Bowen P, Ladame F (1999) Common risk factors in adolescent suicide attempters revisited. Crisis 20:15–22CrossRefPubMedGoogle Scholar
  45. 45.
    Deykin EY, Alpert JJ, McNamarra JJ (1985) A pilot study of the effect of exposure to child abuse or neglect on adolescent suicidal behavior. Am J Psychiatry 142:1299–1303CrossRefPubMedGoogle Scholar
  46. 46.
    Plunkett A, O’Toole B, Swanston H, Oates RK, Shrimpton S, Parkinson P (2001) Suicide risk following child sexual abuse. Ambul Pediatr 1:262–266CrossRefPubMedGoogle Scholar
  47. 47.
    Riggs S, Alario AJ, McHorney C (1990) Health risk behaviors and attempted suicide in adolescents who report prior maltreatment. J Pediatr 116:815–821CrossRefPubMedGoogle Scholar
  48. 48.
    Brent DA, Greenhill LL, Compton Emslie G, Wells K, Walkup JT, Vitiello B, Bukstein O, Stanley B, Posner K, Kennard BD, Cwik MF, Wagner A, Coffey B, March JS, Riddle M, Goldstein T, Curry J, Barnett S, Capasso L, Zelazny J, Hughes J, Shen S, Gugga SS, Turner JB (2009) The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial. J Am Acad Child Adolesc Psychiatry 48:987–996PubMedCentralCrossRefPubMedGoogle Scholar
  49. 49.
    Evans E, Hawton K, Rodham K (2005) Suicidal phenomena and abuse in adolescents: a review of epidemiological studies. Child Abuse Negl 29:45–58CrossRefPubMedGoogle Scholar
  50. 50.
    Beautrais AL (2000) Risk factors for suicide and attempted suicide among young people. Aust N Z J Psychiatry 34:420–436CrossRefPubMedGoogle Scholar
  51. 51.
    Keiley MK, Howe TR, Dodge KA, Bates JE, Pettit GS (2001) The timing of child physical maltreatment: a cross-domain growth analysis of impact on adolescent externalizing and internalizing problems. Dev Psychopathol 13:891–912PubMedCentralPubMedGoogle Scholar
  52. 52.
    Kaplow JB, Widom CS (2007) Age of onset of child maltreatment predicts long-term mental health outcomes. J Abnorm Psychol 116:176–187CrossRefPubMedGoogle Scholar
  53. 53.
    Thornberry TP, Henry KL, Ireland TO, Smith CA (2010) The causal impact of childhood-limited maltreatment and adolescent maltreatment on early adult adjustment. J Adolesc Health 46:359–365PubMedCentralCrossRefPubMedGoogle Scholar
  54. 54.
    Dunn EC, McLaughlin KA, Slopen N, Rosand J, Smoller JW (2013) Developmental timing of child maltreatment and symptoms of depression and suicidal ideation in young adulthood: results from the National Longitudinal Study of Adolescent Health. Depress Anxiety 30:955–964PubMedGoogle Scholar
  55. 55.
    Bifulco A, Brown GW, Moran P, Ball C, Campbell C (1998) Predicting depression in women: the role of past and present vulnerability. Psychol Med 28:39–50CrossRefPubMedGoogle Scholar
  56. 56.
    Weiss MJS, Wagner SH (1998) What explains the negative consequences of adverse childhood experiences on adult health? Am J Prev Med 14:356–360CrossRefPubMedGoogle Scholar
  57. 57.
    Green AH, Voeller K, Gaines RW, Kubie J (1981) Neurological impairment in maltreated Children. Child Abuse Negl 5:129–134CrossRefGoogle Scholar
  58. 58.
    Perry BD, Pollard RA, Blakely TL, Baker WL, Vigilante D (1995) Childhood trauma, the neurobiology of adaptation and use-dependent development of the brain: how states become traits. Infant Ment Health J 16:271–291CrossRefGoogle Scholar
  59. 59.
    Van der Kolk BA, Fisler RE (1994) Childhood abuse and neglect and loss of self-regulation. Bull Menninger Clin 58:145–168PubMedGoogle Scholar
  60. 60.
    Pollak SD, Vardi S, Putzer Bechner A, Curtin JJ (2005) Physically abused children’s regulation of attention in response to hostility. Child Dev 76:968–977CrossRefPubMedGoogle Scholar
  61. 61.
    McCrory E, DeBrito SA, Viding E (2010) Research review: the neurobiology and genetics of maltreatment and adversity. J Child Psychol Psychiatry 51:1079–1095CrossRefPubMedGoogle Scholar
  62. 62.
    Perry BD, Pollard R (1998) Homeostasis, stress, trauma, and adaptation-a neurodevelopmental view of childhood trauma. Child Adolesc Psychiatr Clin N Am 7:33–51PubMedGoogle Scholar
  63. 63.
    DeBellis MD, Baum AS, Birmaher B, Keshavan MS, Eccard CH, Boring AM, Jenkins FJ, Ryan ND, A.E. Bennett Research Award (1999) Developmental traumatology part I. Biological stress systems. Biol Psychiatry 45:1259–1270CrossRefGoogle Scholar
  64. 64.
    Kleiman EM, Riskind JH, Schaefer KE (2014) Social support and positive events as suicide resiliency factors: examination of synergistic buffering effects. Arch Suicide Res 18:144–155CrossRefPubMedGoogle Scholar
  65. 65.
    Johnson J, Wood AM, Gooding P, Taylor PJ, Tarrier N (2011) Resilience to suicidality: the buffering hypothesis. Clin Psychol Rev 31:563–591CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gianluca Serafini
    • 1
    Email author
  • Caterina Muzio
    • 1
  • Giulia Piccinini
    • 1
  • Eirini Flouri
    • 2
  • Gabriella Ferrigno
    • 1
  • Maurizio Pompili
    • 3
  • Paolo Girardi
    • 3
  • Mario Amore
    • 1
  1. 1.Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of PsychiatryUniversity of Genoa, IRCCS San MartinoGenoaItaly
  2. 2.Department of Psychology and Human Development, UCL Institute of EducationUniversity College LondonLondonUK
  3. 3.Department of Neurosciences, Suicide Prevention CenterSant’Andrea HospitalRomeItaly

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