Adverse and positive childhood experiences and suicidal ideation onset in a US pre-early adolescent cohort

BACKGROUND: Suicide rates among U.S. pre-early adolescents have increased in the past two decades. Exposure to adverse childhood experiences (ACEs) is a strong risk factor for suicidality; however, little is known about the protective influence of positive childhood experiences (PCEs) in this age group. We investigated whether PCEs at the family, peer, school, and neighborhood levels have a protective association with onset of suicidal ideation in the presence of ACEs (compensatory protection) and buffer the association between ACEs and suicidal ideation (moderating protection) in a cohort of pre-early adolescents. METHODS: This study utilized a community-based cohort of the Adolescent Brain Cognitive Development (ABCD) study, which recruited 9-10 year olds at baseline. We longitudinally analyzed baseline (2016-2018) to year-5 (2021-2023) data (N = 7361). A DSM-V module measured suicidal ideation, and standardized scales were used to assess PCEs. We used mixed logistic regression to assess whether PCEs are associated with first onset of suicidal ideation in the presence of ACEs and moderate the association between ACE exposure and suicidal ideation. All the models accounted for study site clustering and controlled for demographics and medical factors. RESULTS: There was a graded relationship between ACEs and first onset of suicidal ideation. However, prosocial peer involvement (aOR:0.84, 95%CI: 0.78,0.90) and school engagement (aOR:0.71, 95%CI: 0.66,0.77) remained protective in the presence of ACEs. None of the PCEs buffered the association between ACE exposure and suicidal ideation. CONCLUSIONS: We found evidence of compensatory protection through prosocial peer involvement and school engagement. Trauma-informed interventions in school environments are warranted.