Dissociation as a Mediator of the Relationship Between Childhood Trauma and Nonsuicidal Self-Injury in Females: A Path Analytic Approach

Abstract

New theoretical models of nonsuicidal self-injury (NSSI) postulate that symptoms subsequent to childhood maltreatment rather than childhood maltreatment itself may lead to engagement in NSSI. However, little is known concerning which specific syndromes serve as underlying mechanisms. In this study we sought to examine the mediating effects of dissociative, posttraumatic, and depressive symptoms, 3 often comorbid syndromes following childhood trauma. In addition, we aimed to assess differences between women with and without NSSI. A sample of 87 female inpatients with a history of childhood abuse and neglect was divided into 2 subgroups (NSSI: n = 42, no NSSI: n = 45). The assessment included measures of NSSI characteristics; adverse childhood experiences; and posttraumatic, dissociative, and depressive symptoms. The NSSI group reported significantly more cases of childhood maltreatment and higher levels of current dissociative, posttraumatic, and depressive symptoms than patients without NSSI. The results of a path analysis showed that only dissociation mediated the relationship between a history of child maltreatment and NSSI when all 3 psychopathological variables were included in the model. The findings point toward a strong and rather specific association between dissociative experiences and NSSI and therefore have important implications for clinical practice.

Self-Injury and Suicidality: The Impact of Trauma and Dissociation

“…A better understanding of the impact of trauma and dissociation on NSSI and SA could lead to valuable advances in theoretical models and clinical interventions for these extremely challenging, treatment-refractory, and potentially life-threatening conditions. CLARIFYING RISK FACTORS FOR AND POTENTIAL PATHWAYS TO NSSI Two contributions to this special issue (Chaplo, Kerig, Bennett, & Modrowski, 2015;Franzke, Wabnitz, & Catani, 2015) replicate and extend the growing research literature linking exposure to childhood maltreatment with subsequent NSSI (Ford & Gómez, 2015). There are conflicting findings in the research regarding the association between different types of childhood maltreatment and NSSI.…”

“…In another study (Franzke et al, 2015), adult female psychiatric inpatients who had engaged in NSSI were more likely than comparable adult female inpatients with no NSSI history to report incidents of childhood maltreatment and also higher levels of current dissociative, posttraumatic, and depressive symptoms. Thus, consistent with prior studies (Ford & Gómez, 2015), multiple forms of adult posttraumatic symptomatology might link childhood maltreatment with NSSI in adulthood.…”

The mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury among adolescents: Findings from community and inpatient mental health settings in Ontario, Canada

“…Specifically, 13.8% of the effect of bullying victimization was mediated by depressive symptoms. It is important to also point out that this was after adjusting for the effect of age, gender, history of childhood abuse, and mental health diagnoses, all of which are well established predictors of NSSI (Franzke et al, 2015;Smith et al, 2014). Given that the onset of depression typically occurs during the period of adolescence (Kessler et al, 2005;Schwartz et al, 2012) and bullying victimization peaks during the age of middle school (Kljakovic and Hunt, 2016), interventions aimed at reducing NSSI among adolescents should also take into account how bullying exacerbates depressive symptoms and consequently NSSI.…”

“…To date, various studies have investigated NSSI among adolescents with most showing that adolescents with a history of childhood abuse are at significant risk of engaging in NSSI (Brausch and Holaday, 2015;Ford and Gómez, 2015;Franzke et al, 2015;Gratz, 2006;Smith et al, 2014). However, few studies have examined the relationship between bullying victimization and NSSI among adolescents (e.g., Bakken and Gunter, 2012;Claes et al, 2015;Heilbron and Prinstein, 2010).…”

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings

“…One consistent factor that has been identified as a significant predictor of NSSI among adolescents is adverse childhood experiences (ACEs) (Franzke, Wabnitz, & Catani, 2015;Glassman, Weierich, Hooley, Deliberto, & Nock, 2007;Gratz, 2006;Kaess et al, 2013;Zetterqvist et al, 2014). Yates (2009) observed that as much as 80% of those who engaged in NSSI reported having a history of ACEs.…”