# The mediating effect of emotion dysregulation on the relationship between childhood maltreatment and suicidal ideation in patients with depression

## TL;DR

Childhood maltreatment increases suicidal thoughts in depressed patients, partly by impairing their ability to regulate emotions.

## Contribution

This study identifies emotion dysregulation as a partial mediator between childhood maltreatment and suicidal ideation in depression.

## Key findings

- Childhood maltreatment is significantly linked to higher suicidal ideation in depression.
- Emotion regulation difficulties are associated with increased suicidal ideation.
- Emotion dysregulation partially mediates the maltreatment-suicidal ideation relationship.

## Abstract

Childhood maltreatment is a well-established risk factor for suicidal ideation in patients with depression. However, the psychological mechanisms linking early adversity to current suicide risk remain incompletely understood. Early traumatic experiences may impair emotion regulation capacities, thereby exacerbating suicidal ideation.

This study aimed to clarify the association between childhood maltreatment and suicidal ideation in depression by examining the potential mediating role of emotion regulation difficulties.

We recruited 595 inpatients meeting ICD-10 criteria for a depressive episode. Participants underwent a comprehensive assessment, including sociodemographic and clinical data collection. Childhood maltreatment, suicidal ideation, and emotion regulation difficulties were evaluated using the Childhood Trauma Questionnaire (CTQ), the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), and the Difficulties in Emotion Regulation Scale (DERS), respectively. Pearson correlation analysis was used to examine associations among childhood maltreatment, difficulties in emotion regulation, and suicidal ideation. Structural equation modeling (SEM) and the bootstrap method were used to test the mediating effect, and the model was modified transparently according to modification indices.

Childhood maltreatment was significantly associated with higher levels of suicidal ideation in patients with depression. Furthermore, greater difficulties in emotion regulation were linked to increased suicidal ideation. Critically, mediation analysis indicated that emotion regulation difficulties partially mediated the relationship between childhood maltreatment and suicidal ideation.

These findings suggest that childhood maltreatment exerts both a direct effect on suicidal ideation in patients with depression and an indirect effect through the exacerbation of difficulties in emotion regulation.