title: Childhood sexual abuse differentially predicts outcome of cognitive-behavioral therapy for deliberate self-harm.
abstract: This study examined the association of childhood abuse with deliberate self-harm and related psychopathology and the impact of childhood abuse on treatment outcome as assessed in a randomized controlled trial of cognitive-behavioral therapy for 90 young people who recently engaged in Deliberate Self-Harm (DSH). Participants with a history of childhood sexual abuse manifested more Axis I disorders and reported higher levels of DSH, depression, suicidal cognitions, anxiety, and dissociation. After statistically controlling for baseline differences in DSH and related psychopathology, participants with a reported history of childhood sexual abuse showed a significantly lower risk of repeated DSH in the Cognitive-Behavioral Therapy condition compared with those receiving treatment-as-usual (TAU). Our results suggest that a structured treatment format and focus on adequate emotion regulation skills may be essential elements in the treatment of persons with DSH and a history of childhood sexual abuse.
authors.affiliation: Department of Psychology and Psychiatry, Leiden University, Leiden, The Netherlands. spinhoven@fsw.leidenuniv.nl
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.forename: Nadja
authors.initials: N
authors.lastname: Slee
authors.forename: Nadia
authors.initials: N
authors.lastname: Garnefski
authors.forename: Ella
authors.initials: E
authors.lastname: Arensman
mesh_terms: D000293:Adolescent; D000328:Adult; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult