QJM Advance Access published online on April 21, 2007
QJM, doi:10.1093/qjmed/hcm024
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Childhood abuse, adult alcohol use disorders and suicidal behaviour
From the Division of Neuroscience, Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, NY, USA
Address correspondence to Dr L. Sher, Division of Neuroscience, Department of Psychiatry, Columbia University, 1051 Riverside Drive, Suite 2917, Box 42, New York, NY 10032, USA. email: ls2003{at}columbia.edu
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Abstract |
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Childhood abuse is linked to a variety of maladaptive outcomes that can extend far into adulthood. Two of the most significant are alcohol use disorders and suicidal ideation/behaviour. This article explores the pathway from childhood abuse to suicidal behaviour through the development of alcohol use disorders, and examines the significance of a familial history of alcohol misuse in exacerbating suicidal behaviour in adults who were abused as children. It discusses the implications of this pathway, and describes areas of focus for those who work with child abuse victims and/or patients experiencing alcohol use disorders. Practitioners working with children or adolescents who have experienced or are experiencing abuse should take a preventative approach, identifying and treating those at risk for alcohol misuse and/or suicide. Practitioners working with adults who are already abusing alcohol and/or are suicidal should work with the adult to identify and examine life events such as abuse that may be responsible. By identifying factors that have led to the misuse of alcohol and/or suicidal ideation, adults can obtain appropriate psychotherapy and deal in a more productive and beneficial manner with the pain that underlies their self-destructive impulses.