Insights Into Suicide and Adverse Childhood Experiences

This post is part of a series on adverse childhood experiences. Read the other parts here.

Adverse childhood experiences (ACEs) are a major cause of suicide in America. It is estimated that nearly 90 percent of suicide attempts among high school students under age 18 and as many as two-thirds of adult suicide attempts are directly attributable to ACEs. Individuals with 6 ACEs are 13-30 times more likely to attempt suicide (depending on age), while those with at least 7 ACEs show up to a 51-fold increase. In other words, if we prevent and treat ACEs, we could prevent the majority of suicides. Unfortunately, the prevalence of ACEs appears to be increasing in recent decades.

Recent research sheds light on the connection between ACEs and high suicide risk. In a nationally representative sample of veterans (Fischer et al. 2025), 11.5 percent screened positive for high suicide risk according to scores on a scale measuring the following six cognitions (that is, thoughts or beliefs):

1. I’m completely unworthy of love.
2. There is nothing redeeming about me.
3. I can’t cope with my problems any longer.
4. I can’t imagine anyone being able to withstand this kind of pain.
5. Nothing can help me solve my problems.
6. Suicide is the only way to end this pain.

Interestingly, those scoring above the cutoff for high suicide risk reported an ACEs score that was approximately twice as high as those falling below the cutoff score. Notice that the first two items on the scale are indicative of shame (self-loathing, worthlessness), which commonly results from ACEs, especially those occurring in the earliest years. The second two questions indicate a sense of inadequacy and helplessness, which is also common to those shamed in childhood.

In addition, inadequacy or helplessness is related to the last two questions, which signify the sense that things are hopeless and that one’s pain and problems will never end. These thoughts parallel the depression triad of famed depression theorist Aaron Beck. The thoughts of the depression triad, in essence, say: I am no good, I can’t do anything, and things will never get better.

In simple comparisons, those at a higher risk of suicide, compared to those at a lower risk, had higher scores on PTSD, depression, anxiety, alcohol and drug use, loneliness, and military sexual trauma—as one would expect. Those at a higher risk were also less likely to be married, highly educated, and financially secure. In addition, those at a higher risk scored lower in malleable protective factors, including resilience, purpose in life, gratitude, and social connectedness.

However, multivariate analysis revealed that most of the variance separating the two groups was accounted for by the malleable protective factors (resilience—the ability to adapt and thrive in the face of adversity, purpose in life, gratitude, and social connectedness). This is actually good news, suggesting that learning to grow inner strengths might largely counter the negative effects of ACEs.

The ACEs Connection

ACEs, including toxic shame from parental mistreatment and attachment disruptions in the earliest years, lead to toxic thoughts that put people at greater risk for suicide. ACEs also lead to dysregulated physical and emotional arousal, which in turn leads to a range of biological changes in the brain. These changes tend to accumulate over time without intervention, and predispose people to conditions such as post-traumatic stress disorder, depression, anxiety, and alcohol or drug use disorders, all of which increase vulnerability to suicide.

Implications

1. Hidden wounds from childhood adversity must be healed by interventions that specifically rewire the traumatic memories that maintain emotional pain and self-destructive thoughts. Emotional pain and self-destructive thoughts are linked to higher suicide risk and harm that is passed from parents to children (see Schiraldi, 2021). Evidence suggests that the earlier the trauma is treated, the greater the likelihood of preventing suicide.
2. To further prevent intergenerational cycles of childhood wounding, parents and prospective parents can be equipped with effective couples and parenting skills (see, for example, Nelson, 2006).
3. It is critical that children and adults who have survived ACEs learn psychological coping skills that develop positive strengths, such as resilience, purpose in life, gratitude, and sociability (See Schiraldi 2017, 2016).

Conclusion

The emotional pain that results from a difficult childhood need not be a life sentence. We now understand how the inner wounds of childhood trauma can be healed through trauma treatments that are effective, well-tolerated, and fairly quick. We also understand the elements of effective parenting and that people can learn effective parenting skills. Thus, there is great hope that the intergenerational cycle of childhood wounding can be broken.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.