Health Risk Behaviors and Attempted Suicide in Adolescents Who Report Prior Maltreatment

We hypothesized that high school students who experienced prior maltreatment would be more likely than their peers to report health risk behaviors and suicide attempts. Before the establishment of an urban public high school-based clinic, an anonymous needs assessment survey was completed by 600 adolescents (grades 9-12). Sociodemographic information was obtained and questions were asked about physical and sexual abuse, health-related behaviors and habits, and suicide attempts. The mean age of the students was 15.8 years; 52 percent were girls; 23 percent were from families on welfare; and 56 percent from single-parent families or other living arrangements (e.g., with grandparents). Thirteen percent of the adolescents had been maltreated: 5.2 percent reported prior physical abuse, 5.4 percent sexual abuse, and 2.7 both physical and sexual abuse. Multivariate statistical techniques were used to clarify how previous abuse was related to adolescent risk-taking behaviors and suicide. Students with a history of physical abuse were 3.3 times more likely (CI_95%: 1.2-9.6; p≤0.01) than nonabused peers to drink alcohol and smoke cigarettes, almost twice as likely (CI_95%: 1.0-5.1; p=0.05) to use illicit drugs, 5.8 times more likely (CI_95%: 1.3-26.1; p<0.01) to self-induce vomiting, and 5.2 times more likely (CI_95%: 1.8-15.4; p≤0.01) to attempt suicide. A student with a history of prior sexual abuse had a 3.5 times greater chance of being sexually active and was more than three times more likely to attempt suicide. These data on a nonclinical, nondeviant population of adolescents indicated that physical or sexual abuse in childhood may have a significant impact on adolescent health risk behaviors and suicide attempts.