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      Exposure to Early Life Adversity and Interpersonal Functioning in Attempted Suicide

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          Abstract

          Background

          Early life adversity (ELA) may lead to an increased risk for mental health problems including suicidal behavior. ELA alters biological stress systems that affect behavior and control within the individual that in turn will affect interpersonal behavior. Strained relations and interpersonal conflicts leading to rejection and isolation have been shown to be factors for suicidal behavior. Difficulties in interpersonal relationships are a common reason for seeking help in psychiatric care. In the present study, we examined relationship between different types of interpersonal problems and adverse childhood experiences in patients with a recent suicide attempt.

          Method

          The study included 181 recent suicide attempters. We assessed early life adversity and specific interpersonal problems by using the Karolinska Interpersonal Violence Scale and the Inventory of Interpersonal problems respectively.

          Results

          Suicide attempters with high levels of early life adversity expressed a more socially avoidant, non-assertive, and exploitable personal style even after adjustment for comorbidities with personality disorder and substance use disorder.

          Conclusions

          Patients with a recent suicide attempt with high levels of early life adversity tend to isolate themselves, of being introvert, and having difficulties to open up and confide in others. They report low self-confidence and self-esteem and problems with feeling and expressing anger. These behaviors complicate interaction with others and make establishment of solid relationships more difficult. In regards to detection of suicidal communication and treatment of suicidal patients, this may lead to misinterpretations and difficulties to fully benefit from treatment given or for professionals to provide the appropriate treatment. Clinicians should closely investigate the presence of early life adversity in suicidal patients and pay attention to their personal style and their difficulties in interpersonal exchange.

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          Most cited references38

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          The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

          Mark Bellis, Katherine A Hardcastle, Dinesh Sethi … (2017)
          A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done.
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            Inventory of interpersonal problems: psychometric properties and clinical applications.

            Leonard M Horowitz, Saul Rosenberg, Barbara Baer … (1988)
            Article 0 comments Cited 294 times – based on 0 reviews     Review now
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              Suicide

              Keith Hawton, Kees van Heeringen (2009)
              The Lancet, 373(9672), 1372-1381
              Article 0 comments Cited 167 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Psychiatry
                Journal ID (publisher-id): Front. Psychiatry
                Title: Frontiers in Psychiatry
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-0640
                Publication date (Electronic): 17 September 2020
                Publication date Collection: 2020
                Volume: 11
                Electronic Location Identifier: 552514
                Affiliations
                [1] 1 Department of Clinical Sciences, Umeå University , Umeå, Sweden
                [2] 2 Centre for Psychiatry Research, Stockholm , Stockholm County Council, Stockholm, Sweden
                [3] 3 Paediatric Neuropsychiatry Unit, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Department of Women’s and Children’s Health, Karolinska Institutet , Stockholm, Sweden
                [4] 4 Habilitation & Health , Stockholm County Council, Stockholm, Sweden
                [5] 5 Department of Clinical Sciences, Danderyd Hospital (KI DS) , Stockholm, Sweden
                [6] 6 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
                Author notes

                Edited by: Xenia Gonda, Semmelweis University, Hungary

                Reviewed by: Massimo Pasquini, Sapienza University of Rome, Italy; Nils Opel, University of Münster, Germany

                This article was submitted to Mood and Anxiety Disorders, a section of the journal Frontiers in Psychiatry

                Article
                DOI: 10.3389/fpsyt.2020.552514
                PMC ID: 7527599
                PubMed ID: 33093835
                SO-VID: 2b3dd87b-d041-42dd-933e-3f546147b8a1
                Copyright © Copyright © 2020 Rajalin, Hirvikoski, Renberg, Åsberg and Jokinen
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 16 April 2020
                Date accepted : 31 August 2020
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 42, Pages: 6, Words: 3290
                Funding
                Funded by: Vetenskapsrådet 10.13039/501100004359
                Award ID: 5454
                Funded by: Stockholms Läns Landsting 10.13039/501100004348
                Categories
                Subject: Psychiatry
                Subject: Original Research

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: interpersonal problems,suicide attempt,early life adversity,adverse childhood experiences,inventory of interpersonal problems,karolinska interpersonal violence scale,suicide – attempted,mood disorder
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: interpersonal problems, suicide attempt, early life adversity, adverse childhood experiences, inventory of interpersonal problems, karolinska interpersonal violence scale, suicide – attempted, mood disorder

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