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Citation
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Stagaki M, Nolte T, Feigenbaum J, King-Casas B, Lohrenz T, Fonagy P, Montague PR. Child Abuse Negl. 2022; 128: e105576. |
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Abstract
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BACKGROUND: Although the relationship between childhood maltreatment, self-harm and suicidality is well-established, less is known about the mediating mechanisms explaining it. Based on a developmental mentalisation-based theoretical framework, childhood adversity compromises mentalising ability and attachment security, which in turn increase vulnerability to later stressors in adulthood.
OBJECTIVE: This study aimed to investigate the role of attachment and mentalising as potential mechanisms in the relationship between childhood maltreatment, self-harm and suicidality. PARTICIPANTS AND SETTING: We recruited 907 adults from clinical and community settings in Greater London.
METHODS: The study design was cross-sectional. Participants completed self-report questionnaires on retrospectively rated childhood trauma, and current attachment to the romantic partner, mentalising, self-harm, suicidal ideation and attempt. We used structural equation modelling to examine the data and conceptualized childhood maltreatment as a general factor in a confirmatory bifactor model.
RESULTS: The results showed that childhood maltreatment was both directly associated with self-harm and suicidality and indirectly via the pathways of attachment and mentalising.
CONCLUSIONS: These findings indicate that insecure attachment and impaired mentalising partially explain the association between childhood maltreatment, self-harm and suicidality. Clinically, they provide support for the potential of mentalisation-based therapy or other psychosocial interventions that aim to mitigate the risk of self-harm and suicidality among individuals who have experienced childhood maltreatment via increasing understanding of self and other mental states.
Language: en |