Relational Factors Critical in the Link Between Childhood Emotional Abuse and Suicidal Ideation

Understanding the pathways leading to suicidal behavior is critical for the development and implementation of effective assessment efforts and suicide prevention programs in public health care systems. Childhood trauma, such as emotional abuse, is one robust risk factor, but only recently have efforts been made to determine mediators of the link between childhood emotional abuse and suicidal ideation. Given that adult survivors of childhood emotional abuse often have attachment difficulties and problems securing positive social support, these interpersonal factors may serve such a mediating role. Using bootstrapping techniques, this investigation tested attachment security and social-support-seeking behaviors as serial mediators of the association between childhood emotional abuse and suicidal ideation in a sample of 150 low-income African American female childhood emotional abuse survivors receiving services in a public health system. Support seeking from family members and friends were tested separately. Results revealed the presence of serial mediation, as predicted. Specifically, increased childhood emotional abuse was associated with decreased attachment security, which, in turn, was related to decreased social support seeking from family members and from friends. These 3 factors combined in sequence subsequently were associated with increased suicidal ideation. Results illuminate the importance of attending to attachment security and social-support-seeking behaviors when designing and implementing assessment and suicide prevention programs for African American women who are survivors of childhood emotional abuse seeking services in public health care systems. Suggestions for universal, selective, and targeted prevention efforts for this population are discussed.