(PS9-A14) Adverse Childhood Experiences (ACES) as a Moderator in the Prospective Relationship Between Defeat, Entrapment, and Suicide Ideation

Background and

Objective: Rates of suicide ideation (SI) are high among young adults (11.3%; SAMHSA, 2023). Defeat and entrapment are established risk factors for SI (Stenzel et. al., 2020); defeat is defined as the perception of failure or loss of power and entrapment is defined as the perception of the inability to escape a situation or state of mind (Oakey-Frost et. al. 2022). Adverse childhood experiences (ACES) are traumatic events that take place when a child is 0-17 years old; such events include being a victim of or witnessing violence, neglect, abuse, or exposure to suicide (CDC, 2022). ACES have been shown to associate with a greater likelihood of SI in young adults (Bhargav & Swords, 2022). Despite these associations, limited research exists on longitudinal associations between defeat, entrapment, and SI, as well as how history of ACEs may affect these relationships. The current study examined total ACES as a moderator in the relationship between baseline defeat and entrapment and SI at both baseline and 6-month follow-up.

Methods: The study included 408 young adults who provided data at baseline, and 208 who completed a 6-month follow-up. The mean age was 23.3 (SD = 3.5); the majority identified as female (54.9%) and heterosexual (61%). Less than half were white (48.4%); 12.5% Latinx; 13.7% Asian; 10% Black. Less than half were current college students (42%), and 35% had at least a bachelor’s degree. Almost 56% reported lifetime SI. Data were collected through the online survey site Prolific in 2021-2022. Participants completed the following measures: the Adverse Childhood Experiences Scale (ACES), the Brief Defeat and Entrapment Scale (BDES), and the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF).

Results: Total ACES were found to significantly moderate the relationships between both baseline defeat and entrapment and baseline SI; simple slope analyses showed significant relationships between entrapment and SI at all levels of ACES, but was strongest at low levels (b=.34, p< .01) compared to mean (b=.25, p< .01), and high levels (b=.11, p =.01). Simple slope analyses found the same pattern for defeat and SI, with the strongest relationship at low levels of ACES (b=.37, p < .01). Significant moderation was also found when predicting SI at follow-up. Simple slope analyses showed that baseline entrapment associated with future SI when ACES were low (b=.24, p< .01) and at mean levels (b=.18, p < .01), but not at high levels (b=.08, p=.17). Simple slope analyses found that baseline defeat was associated with future SI more strongly at low levels of ACES (b=.56, p< .01) than at mean (b=.19, p< .01), and high levels (b=.09, p=.07).

 




Conclusion: The results support previous research on the greater likelihood of SI in individuals who have experienced more adverse childhood experiences, as well as feelings of entrapment and defeat being indicators of SI (Bhargav & Swords, 2022; Stenzel et. al., 2020). However, stronger relationships between defeat, entrapment, and SI when ACES are low indicates that defeat and entrapment may signal suicide risk more prominently in those with little to no adverse childhood experiences. Individuals with ACES seem to be at increased risk for feelings of defeat, entrapment, and SI across the board.