The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression

Objective: This study investigated whether a higher frequency of reported c hildhood trauma would be found in depressed adults with higher levels of tr ait impulsivity, aggression, and suicidal behavior. Method: In 136 depressed adult inpatients, the authors assessed trait impul sivity, aggression history, and number of lifetime suicide attempts as well as the medical lethality and the intent to die associated with the most le thal attempt. These variables were then compared between those with and tho se without a reported history of, childhood physical or sexual abuse. Results: Subjects who reported an abuse history were more likely to have ma de a suicide attempt and had significantly higher impulsivity and aggressio n scores than those who did not report an abuse history. Impulsivity and ag gression scores were significantly higher in subjects with a history of at least one suicide attempt. A logistic regression analysis revealed that abu se history remained significantly associated with suicide attempt status af ter adjustment for impulsivity, aggression history, and presence of borderl ine personality disorder. Among those who attempted suicide, there were no significant differences in severity of suicidal behavior between those with and without a childhood history of abuse. Conclusions: Abuse in childhood may constitute an environmental risk factor for the development of trait impulsivity and aggression as well as suicide attempts in depressed adults. Alternatively, impulsivity and aggression ma y be inherited traits underlying both childhood abuse and suicidal behavior in adulthood disorders. Additional research is needed to estimate the rela tive contributions of heredity and environmental experience to the developm ent of impulsivity, aggression, and suicidal behavior.