(PS9-D96) How Childhood Adversity Impacts Interpersonal Risk for Suicide: Relative Contributions of PTSD and Relationship Distress

Background: Individuals who have lived through a number of adverse childhood experiences (ACEs) are often at increased risk for suicide in adulthood. The Interpersonal Theory for Suicide (Van Orden et al., 2010) suggests suicide risk is largely accounted for by thwarted belongingness and perceived burdensomeness. One way ACEs can impact adult interpersonal functioning is through enduring posttraumatic stress (PTSD). ACEs also provide negative models of family relationships, thereby impairing close relationships in adulthood. However, there has been little research examining the relative role of this PTSD pathway and impaired relationship pathway.

Method: We examine intake data from two studies of a VA relationship consultation program for couples experiencing a combination of mental health and romantic relationship concerns (Sample 1 n=20 couples; Sample 2 Ongoing, Expected n=20 couples by November 2023; combined N=80 individuals). At baseline, all participants completed the Adverse Childhood Experiences Scale, the PTSD Check List-5, the Couples Satisfaction Index to measure romantic relationship distress, and the Interpersonal Needs Questionnaire to measure thwarted belongingness and perceived burdensomeness.
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Discussion: We will evaluate a multiple mediation model exploring the link between ACEs, two potential mediators (PTSD and relationship distress), and interpersonal needs (burdensomeness and belongingness). The magnitude of effect and bias-corrected bootstrap confidence intervals will be used to examine the relative contribution of each mediator to each interpersonal suicide risk factor. Although preliminary, results will be used to provide insight into unique role of the PTSD pathway and impaired relationship pathway in explaining the impact of childhood adversity on adult interpersonal risk for suicide. We will discuss implications of these findings on identifying potential entry points to lower suicide risk in individuals experiencing multiple childhood traumas.