Longitudinal associations between childhood maltreatment and suicidal ideation in youth: the roles of complex posttraumatic stress disorder symptoms and interpersonal factors

Abstract

Globally, suicide ranks as the third leading cause of death among youth, with risk particularly pronounced among those who have experienced childhood maltreatment. Guided by the developmental model of suicide risk and the interpersonal theory of suicide, this study aimed to examine the link between childhood maltreatment and suicidal ideation in youth, and to investigate the mediating roles of complex posttraumatic stress disorder (CPTSD) symptoms and interpersonal needs. Three-wave longitudinal data from 1,427 college students (53.7% female) with childhood maltreatment were included. Participants completed self-report measures assessing childhood maltreatment, CPTSD symptoms, perceived burdensomeness (PB) and thwarted belongingness (TB), and suicidal ideation. Structural equation modeling was conducted to evaluate the proposed pathways. Findings indicated that PB, rather than TB, functions as the primary proximal risk factor for suicidal ideation. Furthermore, within CPTSD, disturbances in self-organization (DSO), rather than posttraumatic stress (PTS), mediated the association between childhood maltreatment and PB. Specifically, childhood maltreatment was indirectly associated with PB through the negative self-concept dimension of DSO, and PB was subsequently positively associated with suicidal ideation. These findings suggest that, for youth with childhood maltreatment, DSO may be even more critical than PTS in understanding suicidal ideation. Intervention strategies targeting negative self-concept may be particularly effective in reducing suicidal ideation among youth.