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      Childhood Trauma as a risk factor for suicidal behaviour in prisons Translated title: El trauma infantil como factor de riesgo de conductas suicidas en las prisiones

      review-article
      1 , 2 , 3
      Revista Española de Sanidad Penitenciaria
      Sociedad Española de Sanidad Penitenciaria
      suicide, risk factors, prisons, prevalence, suicidio, factores de riesgo, prisiones, prevalencia

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          ABSTRACT

          Suicide is a public health problem worldwide. Although it affects people of any age, race, gender, nationality or culture, the studies reveal that one of the groups that present high risk are the inmates of a penitentiary institution, with suicide figures higher than those of the general population. In recent years, penitentiary institutions around the world are trying to reduce cases of suicide deaths through prevention and early detection programs. However, in countries such as the United Kingdom, Wales or Spain, the figures are still very high.

          Researchers and professionals from different disciplines have tried to establish the causes and risk factors that can lead to committing suicide. Among them, suffering traumatic events in childhood (childhood trauma) has been established as one of these factors. Recent studies have shown that childhood trauma has a significant incidence in the prison population, thus assuming an important specific risk factor in this population.

          The objective of this article is to review the risk factors associated with suicide in the penitentiary institution in order to understand the role of childhood trauma, its emotional impact and its relation to suicidal behavior in the prison environment, thereby contributing to the understanding and management of the cases having repercussions in an improvement in the programs for the prevention of suicide in prisons.

          RESUMEN

          El suicidio supone un problema de salud pública en el ámbito mundial. Aunque afecta a personas de cualquier edad, raza, género, nacionalidad o cultura, los estudios revelan que uno de los colectivos que presenta alto riesgo son las personas internas en una institución penitenciaria, siendo las cifras de suicidio superiores a las de la población general. En los últimos años, instituciones penitenciarias de todo el mundo intentan reducir los casos de muertes por suicidio a través de programas de prevención y detección temprana. No obstante, en países como Reino Unido, Gales o España, las cifras siguen siendo muy elevadas.

          Investigadores y profesionales de distintas disciplinas han intentado establecer las causas y factores de riesgo que pueden conducir a cometer el suicidio. El hecho de sufrir eventos traumáticos en la infancia (trauma infantil) ha sido establecido como uno de estos factores. Recientes estudios han demostrado que el trauma infantil tiene una incidencia significativa en la población penitenciaria, suponiendo así un importante factor de riesgo específico en esta población.

          El objetivo de este artículo es revisar los factores de riesgo asociados al suicidio en la institución penitenciaria para poder entender el papel del trauma infantil, su impacto emocional y su relación con el comportamiento suicida en el entorno penitenciario, contribuyendo con ello al entendimiento y manejo de los casos, lo cual repercute en una mejora en los programas de prevención del suicidio en las prisiones.

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          Most cited references62

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          Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study.

          Suicide is a leading cause of death in the United States, but identifying persons at risk is difficult. Thus, the US surgeon general has made suicide prevention a national priority. An expanding body of research suggests that childhood trauma and adverse experiences can lead to a variety of negative health outcomes, including attempted suicide among adolescents and adults. To examine the relationship between the risk of suicide attempts and adverse childhood experiences and the number of such experiences (adverse childhood experiences [ACE] score). A retrospective cohort study of 17 337 adult health maintenance organization members (54% female; mean [SD] age, 57 [15.3] years) who attended a primary care clinic in San Diego, Calif, within a 3-year period (1995-1997) and completed a survey about childhood abuse and household dysfunction, suicide attempts (including age at first attempt), and multiple other health-related issues. Self-reported suicide attempts, compared by number of adverse childhood experiences, including emotional, physical, and sexual abuse; household substance abuse, mental illness, and incarceration; and parental domestic violence, separation, or divorce. The lifetime prevalence of having at least 1 suicide attempt was 3.8%. Adverse childhood experiences in any category increased the risk of attempted suicide 2- to 5-fold. The ACE score had a strong, graded relationship to attempted suicide during childhood/adolescence and adulthood (P<.001). Compared with persons with no such experiences (prevalence of attempted suicide, 1.1%), the adjusted odds ratio of ever attempting suicide among persons with 7 or more experiences (35.2%) was 31.1 (95% confidence interval, 20.6-47.1). Adjustment for illicit drug use, depressed affect, and self-reported alcoholism reduced the strength of the relationship between the ACE score and suicide attempts, suggesting partial mediation of the adverse childhood experience-suicide attempt relationship by these factors. The population-attributable risk fractions for 1 or more experiences were 67%, 64%, and 80% for lifetime, adult, and childhood/adolescent suicide attempts, respectively. A powerful graded relationship exists between adverse childhood experiences and risk of attempted suicide throughout the life span. Alcoholism, depressed affect, and illicit drug use, which are strongly associated with such experiences, appear to partially mediate this relationship. Because estimates of the attributable risk fraction caused by these experiences were large, prevention of these experiences and the treatment of persons affected by them may lead to progress in suicide prevention.
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            Childhood Abuse, Household Dysfunction, and the Risk of Attempted Suicide Throughout the Life Span

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              The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes.

              Early life stress (ELS; sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect) has been the focus of numerous studies. It has been associated with the onset and the severity of psychiatric disorders in adults. The objective of this study was to review the literature on ELS associated with psychiatric disorders in adulthood, seeking to identify whether there are independent effects between subtypes of early stress in triggering psychopathology in adults. We reviewed articles from 2001 to 2011 in four databases (PubMed, SciELO, LILACS, and PsycINFO), with the following key words: child abuse, maltreatment, early life stress, psychiatric disorders, mental disease, and psychopathology. Forty-four articles were selected, and most of these articles demonstrate that the subtypes of ELS are associated with several psychiatric disorders, more specifically: physical abuse, sexual abuse, and unspecified neglect with mood disorders and anxiety disorders; emotional abuse with personality disorders and schizophrenia; and physical neglect with personality disorders. Physical neglect had the weakest association between the subtypes. ELS subtypes in childhood and adolescence can predict the development of psychopathology in adults. Scientific evidence shows that ELS triggers, aggravates, maintains, and increases the recurrence of psychiatric disorders. These results demonstrate the importance of a deeper understanding about the unique effects of ELS subtypes, especially for mental health professionals.
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                Author and article information

                Journal
                Rev Esp Sanid Penit
                Rev Esp Sanid Penit
                sanipe
                Revista Española de Sanidad Penitenciaria
                Sociedad Española de Sanidad Penitenciaria
                1575-0620
                2013-6463
                Jan-Apr 2019
                01 June 2019
                : 21
                : 1
                : 42-51
                Affiliations
                [1 ] originalUniversity of Castilla-La Mancha. Master’s Degree in Criminology and Young Offenders. Faculty of Law. Albacete. normalizedUniversidad de Castilla-La Mancha orgnameUniversity of Castilla-La Mancha orgdiv2Master’s Degree in Criminology and Young Offenders orgdiv1Faculty of Law Albacete, Spain
                [2 ] originalUniversity of Castilla-La Mancha. Faculty of Occupational Therapy, Speech Therapy and Nursing. Talavera de la Reina. Toledo. normalizedUniversidad de Castilla-La Mancha orgnameUniversity of Castilla-La Mancha orgdiv1Faculty of Occupational Therapy, Speech Therapy and Nursing Talavera de la Reina. Toledo, Spain
                [3 ] originalUniversity of Castilla-La Mancha. Faculty of Medicine. Albacete. normalizedUniversidad de Castilla-La Mancha orgnameUniversity of Castilla-La Mancha orgdiv1Faculty of Medicine Albacete, Spain
                Author notes
                CORRESPONDENCE: Carmen Zabala-Baños. E-mail: Carmen.Zabala@ 123456uclm.es
                Article
                00007
                6788201
                31498859
                30c07172-cda7-48a7-b1df-8ecf97bfeaf0

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 02 February 2018
                : 25 May 2018
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 55, Pages: 10
                Categories
                Review

                suicide,risk factors,prisons,prevalence,suicidio,factores de riesgo,prisiones,prevalencia

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