"Suicide Attempts" Are 12 Times Higher—Understanding and Breaking the "Aftermath of Adversity" That Persists Into Adulthood in Society

Table of Contents

1. What are ACEs? — International Definitions and Assessments

2. Why Does It Increase by "12 Times"? — Organizing the Evidence

3. Brain, Genes, and Immunity: Mechanisms Described by Science

4. Current Situation in Japan: Increase in Child Abuse Reports and Child Suicides

5. Social Costs and Preventive Effects Shown by Overseas Research

6. Prevention and Early Intervention: What Can Be Done in Families, Schools, Healthcare, Communities, and Companies

7. Considerations for Foreign Residents and Multicultural Families Living in Japan

8. Supporting Survivor Recovery in Practice (Therapy and Daily Life)

9. Common Misunderstandings Q&A

10. Consultation Services Available Now (Multilingual)
    
    

Introduction — Not a "Personal Problem" but a "Social Issue"

Sudden hyperventilation, sleepless nights, and the fear of broken trust that resurfaces even in adulthood—childhood adversity is not merely a "past event." Human brains and bodies develop based on safe relationships with others. When this foundation is shaken, the very blueprint of development can be rewritten.

International research shows that adverse experiences can affect multiple areas, leading to depression, anxiety, addiction, chronic pain, and cardiovascular diseases in adulthood. Among these, the most significant impact on society is the increased risk of suicide. The symbolic number from ACE research—"12.2 times higher suicide attempt rate"—teaches us how outdated the mindset of demanding "endurance or perseverance" from individuals is.Journal of the American Medical AssociationJ-Stage

1) Overview and Measurement of ACEs

ACEs are a screening to confirm the presence of events, not a diagnosis. A high score does not necessarily mean problems will occur, but the greater the accumulation, the progressively higher the risk."Invisible adversities" (verbal abuse, neglect, domestic violence in front of children, parental mental health issues) tend to be overlooked in Japan's "discipline culture" and the virtue of "endurance." Utilizing the Japanese version of the questionnaire helps healthcare, schools, and welfare services to understand risks in a common language.ACEs Aware

2) The Background of "12 Times": Layers of Evidence

The initial ACE studies were epidemiological studies targeting health insurance subscribers, longitudinally tracking a wide range of outcomes from lifestyle diseases to mental health. In groups with ACE scores of 4 or more, there were findings such as 12.2 times higher suicide attempts, 10.3 times higher drug injection, and 7.4 times higher alcohol problems, illustrating a **"graded relationship" between cumulative exposure and increased risk**. Subsequent reviews have reinforced the possibility that sexual abuse has particularly strong effects and that multiple adversities act synergistically.J-Stage+1

A systematic review/meta-analysis in 2020 examined the association between experiences of abuse and suicidal thoughts and attempts across multiple studies, showing that the relationship remains robust even after adjusting for biases. Importantly, there is a possibility that independent effects remain even through "mediating factors" such as depression, anxiety, and addiction. In other words, abuse itself can become an independent variable for long-term high suicide risk.PMC

3) Mechanisms Explained by Science: The Three Layers of Brain, Genes, and Immunity

• HPA Axis and Stress Hormones: Chronic stress flattens the diurnal rhythm of cortisol, leading to insomnia, hyperarousal, and depression.

• Neurodevelopment: **Volume reduction in the hippocampus (memory) and prefrontal cortex (executive function)**, and sensitization of the amygdala (fear learning) have been reported. As a result, individuals may overreact to past threats and find it difficult to feel safe in the present.

• Epigenetics: Early adversity leaves a long-term imprint on gene expression on/off.

• Immunity and Inflammation: Chronic inflammation is associated with depressive symptoms and atherosclerosis, also increasing the risk of physical diseases.

These factors intertwine and affect the "foundation" of learning, emotions, and interpersonal relationships. Therefore, understanding that there is biology behind "difficulty in living" weakens stigma.

4) Challenges in Japan: The Reality Told by Numbers

The number of child abuse cases handled by child consultation centers is increasing. Although visualization has progressed, the current situation where psychological abuse accounts for 60% serves as a warning that words and atmosphere can harm children. Schools need to understand that suicide risk increases before and after long vacations and incorporate **"enhanced monitoring" during school transition periods** into their systems. The number of child suicides is 513 (2023). This is not just a statistic. It represents the number of individual stories that were prematurely cut off.National Diet LibraryMinistry of Health, Labour and WelfareHouse of Representatives

5) Cost-Effectiveness Perspective: Prevention is the Best Investment

As estimated in Australia, a significant portion of mental illnesses and suicide-related behaviors caused by abuse are "preventable". Expanding parental leave, childcare, home nursing, and financial support require short-term fiscal expenditure but can be recovered through reducing long-term medical, correctional, and social security costs. A shift in mindset is needed to view policy as **"investment" rather than "cost"**.The Guardian