TY - JOUR PY - 2022// TI - Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning JO - Child abuse and neglect A1 - Ernst, Mareike A1 - Brahler, Elmar A1 - Kampling, Hanna A1 - Kruse, Johannes A1 - Fegert, Jörg M. A1 - Plener, Paul L. A1 - Beutel, Manfred E. SP - e105870 EP - e105870 VL - 133 IS - N2 - 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.

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).

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.

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.

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.

Language: en

LA - en SN - 0145-2134 UR - http://dx.doi.org/10.1016/j.chiabu.2022.105870 ID - ref1 ER -