title: Disturbed self concept mediates the relationship between childhood maltreatment and adult personality pathology.
abstract: BACKGROUND
  Despite a robust literature documenting the relationship between childhood maltreatment and personality pathology in adulthood, there is far less clarity about the mechanism underlying this relationship. One promising candidate for such a linking mechanism is disturbance in the sense of self. This paper tests the hypothesis that disturbances in the sense of self mediate the relationship between childhood maltreatment and adult personality pathology. Specifically, we assess the self-related traits of stable self-image, self-reflective functioning, self-respect and feeling recognized.
  
  
  METHODS
  The sample included 113 non-psychotic psychiatric inpatients. Participants completed the Child Trauma Questionnaire (CTQ), the Personality Diagnostic Questionnaire-4 (PDQ-4+), and the self-reflexive functioning, stable self image, self-respect, and feeling recognized scales from the Severity Indices of Personality Problems (SIPP-118). A series of linear regressions was then performed to assess the direct and indirect effects of childhood trauma on personality disorder traits (PDQ-4+ total score), as mediated by self concept (SIPP-118 scales). Aroian tests assessed the statistical significance of each mediating effect.
  
  
  RESULTS
  There was a significant mediating effect for all SIPP self concept variables, with a full mediating effect for the SIPP composite score and for SIPP feeling recognized and self-reflexive functioning, such that the direct effect of childhood trauma on personality did not retain significance after accounting for the effect of these variables. There was a partial mediating effect for SIPP stable self image and self-respect, such that the direct effect of the CTQ retained significance after accounting for these variables. SIPP feeling recognized had the strongest mediating effect.
  
  
  CONCLUSIONS
  Multiple facets of self concept, particularly the degree to which an individual feels understood by other people, may mediate the relationship between childhood maltreatment and adult personality pathology. This underscores the importance of attending to disturbances in the sense of self in patients with personality pathology and a history of childhood maltreatment. These findings also support the centrality of disturbed self concept to the general construct of personality pathology.
authors.affiliation: Dept. of Psychiatry, Mount Sinai Beth Israel, 1st Ave. & 16t St., NY, NY, 10003. Electronic address: LCohen@chpnet.org.
authors.forename: Lisa
authors.initials: L
authors.lastname: Cohen
authors.affiliation: New York Presbyterian Hospital, 622 W. 168th St., NY, NY, 10032. Electronic address: olgaleibumd@gmail.com.
authors.forename: Olga
authors.initials: O
authors.lastname: Leibu
authors.affiliation: City College of the City University of New York, 160 Convent Ave., NY, NY, 10031. Electronic address: Ctanis@chpnet.org.
authors.forename: Thachell
authors.initials: T
authors.lastname: Tanis
authors.affiliation: Dept. of Psychiatry, Mount Sinai Beth Israel, 1st Ave. & 16t St., NY, NY, 10003. Electronic address: Fardalan@chpnet.org.
authors.forename: Firouz
authors.initials: F
authors.lastname: Ardalan
authors.affiliation: Dept. of Psychiatry, Mount Sinai Beth Israel, 1st Ave. & 16t St., NY, NY, 10003. Electronic address: IGalynke@chpnet.org.
authors.forename: Igor
authors.initials: I
authors.lastname: Galynker
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D012649:Self Concept; D011795:Surveys and Questionnaires