title: The relationship of psychological trauma and dissociative and posttraumatic stress disorders to nonsuicidal self-injury and suicidality: a review.
abstract: We reviewed research on the relationship between (a) exposure to psychological trauma and (b) nonsuicidal self-injury (NSSI) and suicidality (suicidal ideation [SI] and suicide attempts [SA]) in individuals with dissociative disorders and posttraumatic stress disorder (PTSD). The review provides a context for the special issue of the Journal of Trauma & Dissociation on these topics. Exposure to childhood sexual abuse is the most consistent traumatic antecedent of self-harm, although traumatic violence in childhood (particularly physical abuse) and adulthood (particularly domestic violence) and exposure to multiple types of traumatic stressors also are associated with NSSI and SI/SA. Dissociative disorders and PTSD are consistently associated with increased NSSI and SA/SI. There is preliminary cross-sectional evidence that dissociation and posttraumatic stress disorders may mediate the relationship between psychological trauma and NSSI and SI/SA. Research on emotion dysregulation as a potential cross-cutting mechanism linking dissociation, PTSD, and self-harm is also reviewed. We conclude with a discussion of implications for clinical practice and future directions for scientific research.
authors.affiliation: a Department of Psychiatry , University of Connecticut School of Medicine , Farmington , Connecticut , USA.
authors.forename: Julian D
authors.initials: JD
authors.lastname: Ford
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Gómez
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology; D004213:Dissociative Disorders / Q000523:psychology*; D004644:Emotions; D006801:Humans; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*
keywords: dissociation; emotion dysregulation; nonsuicidal self-injury; posttraumatic stress disorder; suicidality; trauma