@article{ref1,
title="Models of trauma exposure, depression, and suicidality in safety-net primary care",
journal="Journal of Traumatic Stress",
year="2021",
author="Mladen, Samantha N. and Williams, Allison B. and Griffin, Sarah C. and Perrin, Paul B. and Rybarczyk, Bruce D.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Suicidality is a major public health concern, particularly for low-income, trauma-exposed patients with limited access to mental health providers. However, limited research has modeled pathways of suicidality in safety-net primary care samples. Patients (N = 207) in a safety-net primary care clinic completed measures of childhood and adult trauma exposure, depression, and suicidality. Participants (M age = 44.8 years, SD = 11.6), were 60.4% male, 63.8% Black/African American, and predominantly low-income (i.e., 69.1% reported an annual income less than $5,000 USD). Half of the sample reported at least four childhood traumatic events (M = 3.9 events, SD = 3.0) and approximately three adult traumatic events (M = 3.0 events, SD = 2.1). Most participants (82.1%) reported significant depressive symptoms, and 43.5% endorsed recent suicidality. Models showing the mediational effect of depression on the association between trauma exposure and suicidality, β =.20, B = 0.23, SE = 0.05, 95% CI [0.16, 0.32], and the moderational effect of trauma exposure on the association between depression and suicidality, β =.16, B = 0.20, SE = 0.08, p =.007, were both supported. These results underscore the high prevalence of trauma exposure, depression, and suicidality in a safety-net primary care sample. They also highlight the pervasiveness and complexity of suicidality in low-income primary care patients, emphasize the importance of trauma-informed suicide assessment, and identify trauma sequelae and depression as potential treatment targets to reduce suicidality.<p /> <p>Language: en</p>",
language="en",
issn="0894-9867",
doi="10.1002/jts.22658",
url="http://dx.doi.org/10.1002/jts.22658"
}