Risk of Suicidal Behavior in Children and Adolescents Exposed to Maltreatment: The Mediating Role of Borderline Personality Traits and Recent Stressful Life Events

Abstract

Childhood maltreatment (CM) is associated with increased non-suicidal self-injury (NSSI) and suicidal behavior (SB), independently of demographic and mental health conditions. Self-Trauma Theory and Linehan’s Biopsychosocial Model might explain the emergence of Borderline Personality Disorder (BPD) symptoms as mediators of the association between CM and the risk of SB. However, little is known regarding such relationships when the exposure is recent for young persons. Here, we study 187 youths aged 7–17, with or without mental disorders. We explore CM experiences (considering the severity and frequency of different forms of neglect and abuse), recent stressful life events (SLEs), some BPD traits (emotion dysregulation, intense anger and impulsivity), and the risk of SB (including NSSI, suicide threat, suicide ideation, suicide plan and suicide attempt). We study the direct and mediating relationships between these variables via a structural equation analysis using the statistical software package EQS. Our findings suggest that youths exposed to more severe/frequent CM have more prominent BPD traits, and are more likely to have experienced recent SLEs. In turn, BPD traits increase the risk of SLEs. However, only emotion dysregulation and recent SLEs were found to be correlated with SB. Therefore, targeted interventions on emotion dysregulation are necessary to prevent NSSI or SB in children and adolescents exposed to CM, as is the minimization of further SLEs.

Childhood maltreatment and homicidal ideation among Chinese early adolescents: The serial mediating role of borderline personality features and aggression

“…This finding was consistent with previous research which demonstrated that mental disorders and poor adaptability of an individual after trauma may have mediated the risk of juveniles committing homicide (Abreu Minero et al, 2017; Crump et al, 2013). CM, an adverse childhood experience, could have affected core personality domains by altering the way one perceives and interprets the world, which consequently led to the emergence of BPF (Duque‐Alarcón et al, 2019; Marques‐Feixa et al, 2021; Widom et al, 2009); the emotional instability and impulsivity associated with BPF may have fostered the risk of homicidal ideation (Carbone et al, 2020). Similarly, a recent study suggested that most people who committed one or more murders had typical psychopathological features such as borderline, antisocial, or paranoid personality (Barbieri et al, 2022).…”

Psychological resilience mediates the association between childhood maltreatmentand self-harm phenotype in Chinese early adolescents

“…In line with the self-trauma model [33], CM experiences can result in the maladaptive development of the three primary capacities of affect regulation, identity, and interpersonal relatedness. Consequently, when an individual with a history of CM is confronted with new stressful circumstances during a challenging life period such as early adolescence, adolescents may be unable to rely on these internal resources and may resort to maladaptive tension-reducing behaviors, such as SH or suicidal behaviors [34]. Based on this nding, we can deduce that strategies towards the prevention of SH in early adolescents need to pay more attention to individuals who have experienced CM.…”

Psychological Resilience Mediates the Association Between Childhood Maltreatment and Self-Harm Phenotype in Chinese Early Adolescents

“…In line with the self-trauma model [32], CM experiences can result in the maladaptive development of the three primary capacities of affect regulation, identity, and interpersonal relatedness. Consequently, when an individual with a history of CM is confronted with new stressful circumstances during a challenging life period such as early adolescence, adolescents may be unable to rely on these internal resources and may resort to maladaptive tension-reducing behaviors, such as SH or suicidal behaviors [33]. Based on this nding, we can deduce that strategies towards the prevention of SH in early adolescents need to pay more attention to individuals who have experienced CM.…”