@article{ref1,
title="Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning",
journal="Child abuse and neglect",
year="2022",
author="Ernst, Mareike and Brahler, Elmar and Kampling, Hanna and Kruse, Johannes and Fegert, Jörg M. and Plener, Paul L. and Beutel, Manfred E.",
volume="133",
number="",
pages="e105870-e105870",
abstract="BACKGROUND: Child maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention. <br><br>OBJECTIVE: To investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population. PARTICIPANTS AND SETTING: Data were drawn from a representative German population sample (N = 2510). <br><br>METHODS: Participants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm. <br><br>RESULTS: Individuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects. <br><br>CONCLUSIONS: The results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.<p /> <p>Language: en</p>",
language="en",
issn="0145-2134",
doi="10.1016/j.chiabu.2022.105870",
url="http://dx.doi.org/10.1016/j.chiabu.2022.105870"
}