Childhood adversity profiles and psychosocial recovery after suicide attempt: A cross-sectional analysis of 2023-2025 population-based surveillance data in Colombia.

BACKGROUND: Adverse childhood experiences (ACEs) are associated with mental disorders and suicidal behavior but less is known about their relationship with psychosocial recovery after a suicide attempt in Latin American adults. OBJECTIVE: To examine associations between ACE-IQ exposure and multidimensional psychosocial recovery among adults with a documented suicide attempt. PARTICIPANTS AND SETTING: The analytic sample included 1044 adults reported to the departmental surveillance system for suicidal behavior in Caldas, Colombia, 2023-2025. METHODS: Thirteen ACE categories were analyzed as any exposure, cumulative count, specific exposure types, and latent profiles. Outcomes included depression, persistent suicidal ideation, loneliness, subjective well-being, resilience, sense of community, continuity of care, and theory-informed composite recovery indices. Regression models adjusted for life-course group, year of attempt, marital status, educational level, number of children, sex, procedence, previous suicide attempts, and chronic disease. RESULTS: Any ACE exposure was reported by 51.4% of participants. 46.8% had no reattempts, 26.0% had one, and 27.2% had two or more. ACE accumulation correlated with lower global recovery (rho = -0.41) and higher symptom (rho = 0.44). Each additional ACE category was associated with lower global recovery (B = -2.18, 95% CI [-2.49, -1.86]) and higher symptom burden (B = 1.85, 95% CI [1.52, 2.18]). Emotional abuse/bullying and emotional-relational polyadversity profiles showed the poorest recovery. Emotional abuse, neglect, and bullying were the most consistent category-level associations. CONCLUSIONS: Childhood adversity was associated with poorer multidimensional recovery after suicide attempt. Screening should consider cumulative burden and relational-emotional adversity patterns, not only single ACE categories.