J Korean Med Sci.  2021 Mar;36(10):e72. 10.3346/jkms.2021.36.e72.

Early Trauma and Relationships among Recent Stress, Depressive Symptoms, Anxiety Symptoms, and Suicidal Ideation in Korean Women

• Park CHK
• Lee JW
• Moon J
• Jeon DW
• Lee SY
• Shim SH
• Kim SG
• Lee J
• Paik JW
• Cho SJ
• Kim MH
• You S
• Jeon HJ
• Rhee SJ
• Kim MJ
• Kim J
• Ahn YM

• KMID: 2513709
• DOI: http://doi.org/10.3346/jkms.2021.36.e72

Abstract

Background
Evidence continues to accumulate that the presence or absence of early trauma (ET) implies unique characteristics in the relationships between suicidal ideation and its risk factors. We examined the relationships among recent stress, depressive symptoms, anxiety symptoms, and suicidal ideation in Korean suicidal women with or without such a history.
Methods
Using data on suicidal adult females, 217 victims and 134 non-victims of ET, from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we performed structural equation modeling to investigate the contribution of recent stress, depressive symptoms, and anxiety symptoms on suicidal ideation within each group according to the presence or absence of a history of ET.
Results
Structural equation modeling with anxiety and depressive symptoms as potential mediators showed a good fit. Recent stress had a direct effect on both depressive symptoms and anxiety symptoms in both groups. Only anxiety symptoms for victims of ET (standardized regression weight, 0.281; P = 0.005) and depressive symptoms for non-victims of ET (standardized regression weight, 0.326; P = 0.003) were full mediators that increased suicidal ideation. Thus, stress contributed to suicidal ideation by increasing the level of anxiety and depressive symptoms for victims and non-victims, respectively.
Conclusion
Tailored strategies to reduce suicidal ideation should be implemented according to group type, victims or non-victims of ET. Beyond educating suicidal women in stressmanagement techniques, it would be effective to decrease anxiety symptoms for those with a history of ET and decrease depressive symptoms for those without such a history.

Keyword

Psychological Trauma; Psychological Stress; Depression; Anxiety; Suicidal Ideation

Figure

• 

  Fig. 1 SEM with standardized parameter estimates for relationships among stress, depressive symptoms, anxiety symptoms, and suicidal ideation for non-victims of ET. Thick lines connecting latent variables indicate significant path estimates (P < 0.050).SEM = structural equation model, ET = early trauma, PHQ-9 = Patient Health Questionnaire-9, SQ = Stress Questionnaire, KNHANES = Korean National Health and Nutrition Examination Survey, C-SSRS = Columbia-Suicide Severity Rating Scale, BAI = Beck Anxiety Inventory.

• 

  Fig. 2 SEM with standardized parameter estimates for relationships among stress, depressive symptoms, anxiety symptoms, and suicidal ideation for victims of ET. Thick lines connecting latent variables indicate significant path estimates (P < 0.050).SEM = structural equation model, ET = early trauma, PHQ-9 = Patient Health Questionnaire-9, SQ = Stress Questionnaire, KNHANES = Korean National Health and Nutrition Examination Survey, C-SSRS = Columbia-Suicide Severity Rating Scale, BAI = Beck Anxiety Inventory.

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