Complex PTSD linked to suicidal behavior in sexual minorities

A study from the University of Georgia has found that complex post-traumatic stress disorder—a type of PTSD caused by chronic, long-lasting or repeated traumatic events—plays an important role in how trauma impacts lesbian, gay and bisexual individuals.

The study, from Émilie Ellis in the College of Family and Consumer Sciences, found that repeatedly encountering traumatic events, such as sexual abuse or physical attacks, can lead to CPTSD among sexual minorities. Those who experience CPTSD are also more likely to attempt suicide.

The study included 1,351 participants, with 71 percent of respondents reporting experiencing a traumatic event and 1 in 6 having at least one suicide attempt. Better understanding this association may help improve outcomes, Ellis said.

"My hope is that understanding complex PTSD as a mechanism between trauma exposure and suicidality opens up treatment options," Ellis said. "With more research or evidence to support complex PTSD's role between trauma exposure and suicidality, there can be more of a push to develop evidence-based treatments and interventions."

Repeated exposure to trauma tied to CPTSD

CPTSD includes symptoms of PTSD—intrusive thoughts, distress, nightmares and other signs—as well as symptoms that affect emotional and social well-being. It can occur in individuals who have repeated or long-term traumatic experiences, Ellis said, and can impact emotional regulation and interpersonal relationships.

Sexual minorities frequently face these traumas, including discrimination, hate speech and physical harm.

To quantify discrimination over the last 12 months and over their lifetime, participants answered questions about being treated differently because they were lesbian, gay or bisexual, facing physical threats or facing challenges in health care. Based on these answers, a mean score was calculated.

Lifetime exposure magnifies effect of traumatic events

Among female participants, individuals who had a past suicide attempt had a slightly higher mean score for LGB discrimination—3.95 compared to 2.97. For men, however, the mean score among those with a suicide attempt was significantly higher—9.21 compared to 4.31. While both populations had a relationship between higher mean score and a suicide attempt, these variations highlight how traumatic experiences affect different genders.

Additionally, being exposed to traumatic events over a lifetime had a more significant effect on male participants than female participants.

"Based on our model, we can say there is a really strong relationship between complex PTSD and the existence of a lifetime suicide attempt among female participants, but among the male sample, complex PTSD did not account for everything," Ellis said. "To me, that shows there's even more research that needs to be done to see what is it that we're missing among male populations."

Moving forward, Ellis hopes an awareness of CPTSD's relationship to a lifetime suicide event helps improve care and intervention among sexual minorities.

"A lot of the practical implications may be clinical. In terms of hoping that therapists and other clinicians might put a little bit more effort into assessments of complex PTSD especially among sexual minorities," Ellis said. "This needs to not just be therapists and clinicians, but also health care workers and education systems."

The study is published in the Journal of Homosexuality.