Early life adversity and suicide: the role of childhood trauma and risk factors in adolescent suicidal behavior

Suicide is a major global health issue and a leading cause of death among adolescents. Research highlights that suicidal behavior arises from the interaction of multiple risk factors, including emotional dysregulation, depression, prior attempts, and exposure to trauma. Early life adversity, including various forms of childhood trauma such as physical abuse, emotional abuse, sexual abuse and neglect has long-term implications on mental health. Objective: This study investigates the influence of different types of childhood trauma and other risk factors (depression, substance use, and emotional dysregulation) on suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) among adolescents in Spain. Methods: A sample of adolescents aged 12–16 years in Madrid completed validated assessments, including the Childhood Trauma Questionnaire (CTQ), Paykel Suicide Scale (PSS), Beck Depression Inventory (BDI-II), and others. Predictive models were constructed using LASSO Regression to explore key predictors of suicidal behavior. Results: Depression was the strongest predictor for suicidal ideation, suicide attempts, and NSSI. Emotional abuse was the second most significant factor, surpassing other types of trauma. Sexual abuse, peer relationship issues, and cannabis use were also identified as moderate risk factors for suicide attempts. Age showed an inverse association with NSSI risk. Conclusion: Depression and emotional abuse are critical predictors of suicidal behavior, suggesting the need for targeted interventions addressing emotional regulation and trauma symptoms. Prevention efforts should also focus on early identification of self-harm behaviors and the influence of substance use, particularly cannabis, among youth. Further research is recommended to refine intervention strategies.