title: 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.
authors.affiliation: a Evangelisches Krankenhaus Bielefeld , Clinic for Psychotherapeutic and Psychosomatic Medicine , Bielefeld , Germany.
authors.forename: Iris
authors.initials: I
authors.lastname: Franzke
authors.forename: Pascal
authors.initials: P
authors.lastname: Wabnitz
authors.forename: Claudia
authors.initials: C
authors.lastname: Catani
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D002649:Child Abuse / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004213:Dissociative Disorders / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*
keywords: childhood trauma; depression; dissociation; nonsuicidal self-injury; path analysis; posttraumatic stress