Abstract
BACKGROUND: The mechanisms through which childhood trauma contributes to increased suicide risk in individuals diagnosed with major depressive disorder (MDD) have not been comprehensively explored. This study aimed to investigate the role of resilience and cognitive emotion regulation strategies in the link between childhood trauma and recent suicide risk in MDD patients. METHODS: The study included 136 MDD patients and 112 healthy participants. Standardized instruments were utilized to collect demographic and clinical data, including the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Connor-Davidson Resilience Scale (CD-RISC). Structural equation modeling (SEM) was employed, and mediation analysis was conducted. RESULTS: Significant correlations were observed between recent suicide risk in MDD patients and various factors, including childhood trauma (emotional abuse, emotional neglect; positive correlation), maladaptive strategies (positive correlation), and resilience traits (tenacity, strength, optimism; negative correlations). An ordinal logistic regression identified gender and maladaptive strategies as significant predictors of suicide risk. Most importantly, the bootstrap test showed that the direct effect (β = 0.114, 95% CI: -0.103–0.362) of childhood trauma on recent suicide risk was not significant, but the indirect (β = 0.224, 95% CI: 0.099–0.461) and total effects (β = 0.338, 95% CI: 0.180–0.552) of childhood trauma on recent suicide risk were significant. CONCLUSIONS: Building on cross-sectional data, our path analysis supports a model in which childhood trauma exerts its influence on recent suicide risk in MDD patients indirectly through resilience and emotion regulation, rather than through direct effects. In terms of suicide risk prevention and intervention for MDD patients with childhood trauma, the application of emotion regulation-oriented intervention measures is recommended. CLINICAL TRIAL NUMBER: Not applicable.