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Anxiety Disorders / Anxiety Disorder / Depressive Disorder · Journal article
Journal of Affective Disorders · August 25, 2026
Encouraging direction, but not yet definitive.
In 1572 individuals with depression and/or anxiety disorder, childhood trauma severity was associated with suicide ideation (OR=1.51) and ideation with attempt (OR=2.68). Multiple personality traits, insomnia, and low social support statistically mediated these associations, with direct effects reduced by 40–66% in multiple-mediator models. The cross-sectional design prevents causal inference, and longitudinal validation is required before these pathways can be considered actionable intervention targets.
Cross-sectional mediation analysis using generalized structural equation modeling. 1572 respondents with a 12-month depressive and/or anxiety disorder from the Netherlands Study of Depression and Anxiety (NESDA).. Intervention: Childhood trauma exposure (measured by NEMESIS interview). Compared with: No formal comparator; associations modelled with and without mediating variables. n = 1,572. Netherlands.
Higher childhood trauma scores associated with suicide ideation only: OR = 1.51 (95% CI: 1.32–1.73) Higher childhood trauma scores associated with suicide ideation with attempt: OR = 2.68 (95% CI: 2.21–3.27) In multiple-mediator models, direct effects reduced by 65.6% for suicide ideation only and 39.1% for ideation with attempt
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These findings suggest that clinicians should assess and address insomnia, social isolation, and aggression in individuals with depression/anxiety and childhood trauma exposure, as these variables may partially explain elevated suicide risk. However, the cross-sectional design means temporal relationships remain unclear and these associations should not yet drive treatment protocols without prospective validation.
A well-designed cross-sectional mediation analysis in a large clinical sample identifies plausible pathways between childhood trauma and suicide outcomes, but cross-sectional design prevents causal inference and limits actionability.
As stated by the source record.
Quoted from the source exactly as published.
These findings suggest that clinicians should assess and address insomnia, social isolation, and aggression in individuals with depression/anxiety and childhood trauma exposure, as these variables may partially explain elevated suicide risk. However, the cross-sectional design means temporal relationships remain unclear and these associations should not yet drive treatment protocols without prospective validation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. Childhood trauma (CT) is robustly associated with suicide ideation (SI) and attempts (SA) in individuals with depressive and/or anxiety disorders. However, pathways underlying these associations and whether they differ between suicide ideation only (SI+SA-) and suicide ideation with attempt (SI+SA+) remain unclear. Variables that may statistically account for CT-SI+SA- and CT-SI+SA+ associations were examined.Methods. Data from 1572 respondents with a 12-month depressive and/or anxiety disorder from the Netherlands Study of Depression and Anxiety were used. The NEMESIS childhood trauma interview (0-8 score) measured CT severity. Single and multiple-mediator models via generalized structural equation modeling (GSEM) were used to investigate whether psychosocial, personality, lifestyle and biological variables showed indirect associations consistent with mediation of the association between CT and suicide outcomes.Results. Higher CT scores were associated with SI+SA- (OR = 1.51, 95% CI: 1.32-1.73) and SI+SA+ (OR = 2.68, 95% CI: 2.21-3.27). In single mediator models, personality traits, insomnia, low social support and loneliness statistically accounted for a part of the association between CT and both outcomes. Interleukin-6 statistically accounted for a small portion of the CT-SI+SA+ link. In multiple-mediator models, direct effects reduced by 65.6% (SI+SA-) and 39.1% (SI+SA+) and aggression, insomnia, social support (both outcomes), neuroticism, introversion, hopelessness (SI+SA-) and locus of control (SI+SA+) remained significant.Limitations. The cross-sectional design limits causal inferences.Conclusion. Multiple personality traits, insomnia and lower social support statistically accounted for a portion of the association between CT and suicide outcomes. Especially aggression, insomnia and social support may represent actionable suicide prevention targets, pending longitudinal validation.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.