title: Childhood trauma, dissociation and self-harming behaviour: a pilot study.
abstract: OBJECTIVE
  Childhood trauma is known to be an important antecedent in those who engage in deliberate self-harm (DSH). We aimed to explore the mediating mechanisms between childhood trauma and subsequent DSH in a sample of women detained in a high secure setting.
  
  
  METHODS
  From a previous incidence study into DSH, we subdivided a group of 50 women as follows: non-harmers (N = 13), infrequent harmers (N = 22) and frequent harmers (N = 15). These three groups were then compared on several measures believed to be associated with DSH.
  
  
  RESULTS
  The frequency of DSH was related to low self-esteem, increased dissociation, anger (both inwardly and outwardly directed), impulsivity, and a history of sexual and physical abuse. When these variables were entered into a path analytic model exploring the relationship between childhood trauma and subsequent DSH, two paths emerged: one major path which linked childhood sexual abuse to DSH via increased dissociation and another, more minor association, linking childhood sexual abuse via reduced self-esteem.
  
  
  CONCLUSIONS
  This study shows a strong association between high levels of dissociation and an increased frequency of self-harming behaviour. This association is theoretically plausible and has therapeutic implications.
authors.affiliation: Rampton Hospital, Retford, UK.
authors.forename: G
authors.initials: G
authors.lastname: Low
authors.forename: D
authors.initials: D
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: MacLeod
authors.forename: M
authors.initials: M
authors.lastname: Power
authors.forename: C
authors.initials: C
authors.lastname: Duggan
mesh_terms: D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D004213:Dissociative Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D012649:Self Concept; D016728:Self-Injurious Behavior / Q000523:psychology*