Citation

Schönfelder A, Rath D, Forkmann T, Paashaus L, Stengler K, Teismann T, Juckel G, Glaesmer H. Clin. Psychol. Psychother. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1002/cpp.2501

PMID

32816347

Abstract

While there is evidence for an association of child abuse with lifetime suicidal behavior, the underlying mechanisms remain unclear. In recent research we found this relationship to be indirect and mediated by capability for suicide (CS). Emotional and sexual abuse were directly associated with CS. Based on the Interpersonal Psychological Theory of Suicide the result for emotional abuse was surprising and raised the question for a missing link in this association. Consequently, this study examines NSSI as an additional mediator (M1 ) between child abuse (X), pain tolerance (M2 ), and suicide attempts (Y). We included 308 psychiatric inpatients (M = 36.9 years, 53% female) with either an acute suicidal crisis (n = 146) or a recent suicide attempt (n = 157). For the assessment we used the Childhood Trauma Screener (CTS), the German version of the self-injurious thoughts and behaviors interview (SITBI-G), the German Capability for Suicide Questionnaire (GCSQ), and a pressure algometer for measuring pain tolerance objectively. Serial mediator analyses were applied. All types of abuse showed relationships with NSSI, which itself was connected to suicidal behavior in almost all models, while pain tolerance did not show the expected relations. The results suggest that NSSI is an important predictor for suicide attempts and should be considered in suicide risk assessment. Future research should address this topic in prospective studies with a more comprehensive assessment of child abuse. In summary, this study once again highlights the serious effects of child abuse and in particular the mediating role of NSSI.

Language: en

Keywords

suicide attempt; child abuse; nonsuicidal self-injury; IPTS; pain tolerance