Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning.

Adverse childhood experiences Child maltreatment Childhood trauma Personality functioning Self-harm Suicide

Journal

Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702

Informations de publication

Date de publication:
11 2022
Historique:
received: 19 04 2022
revised: 18 07 2022
accepted: 31 08 2022
pubmed: 10 9 2022
medline: 28 9 2022
entrez: 9 9 2022
Statut: ppublish

Résumé

Child maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention. To investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population. Data were drawn from a representative German population sample (N = 2510). Participants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm. Individuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects. The results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.

Sections du résumé

BACKGROUND
Child maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention.
OBJECTIVE
To investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population.
PARTICIPANTS AND SETTING
Data were drawn from a representative German population sample (N = 2510).
METHODS
Participants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm.
RESULTS
Individuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects.
CONCLUSIONS
The results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.

Identifiants

pubmed: 36084408
pii: S0145-2134(22)00404-5
doi: 10.1016/j.chiabu.2022.105870
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105870

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Mareike Ernst (M)

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. Electronic address: Mareike.Ernst@unimedizin-mainz.de.

Elmar Brähler (E)

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany.

Hanna Kampling (H)

Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany.

Johannes Kruse (J)

Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany.

Jörg M Fegert (JM)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany.

Paul L Plener (PL)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.

Manfred E Beutel (ME)

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.

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