Abstract
Childhood maltreatment (CM) is associated with increased non-suicidal self-injury (NSSI) and suicidal behavior (SB), independently of demographic and mental health conditions. Self-Trauma Theory and Linehan’s Biopsychosocial Model might explain the emergence of Borderline Personality Disorder (BPD) symptoms as mediators of the association between CM and the risk of SB. However, little is known regarding such relationships when the exposure is recent for young persons. Here, we study 187 youths aged 7–17, with or without mental disorders. We explore CM experiences (considering the severity and frequency of different forms of neglect and abuse), recent stressful life events (SLEs), some BPD traits (emotion dysregulation, intense anger and impulsivity), and the risk of SB (including NSSI, suicide threat, suicide ideation, suicide plan and suicide attempt). We study the direct and mediating relationships between these variables via a structural equation analysis using the statistical software package EQS. Our findings suggest that youths exposed to more severe/frequent CM have more prominent BPD traits, and are more likely to have experienced recent SLEs. In turn, BPD traits increase the risk of SLEs. However, only emotion dysregulation and recent SLEs were found to be correlated with SB. Therefore, targeted interventions on emotion dysregulation are necessary to prevent NSSI or SB in children and adolescents exposed to CM, as is the minimization of further SLEs.
Highlights
Childhood is one of the most sensitive and neuroplastic periods of human development, as the stimuli and upbringing experienced during this stage is crucial for the maturation of brain systems and cognitive functions [1,2]
We found that youths with greater exposure more Borderline Personality Disorder (BPD) traits, which, in turn, directly predict higher incidence of had more BPD traits, which, in turn, directly predict higher incirecent stressful life events (SLEs)
The descriptive data of the main variables included in the analysis can be seen in The descriptive data of the main variables included in the analysis can be seen in
Summary
Childhood is one of the most sensitive and neuroplastic periods of human development, as the stimuli and upbringing experienced during this stage is crucial for the maturation of brain systems and cognitive functions [1,2]. When an individual has experienced multiple, severe and pervasive traumatic events during childhood (complex trauma), the psychological outcomes are often multiple and severe In this regard, it is not surprising that people with psychiatric disorders and a history of CM represent a clinically distinct subtype of patients, who have a worse clinical prognosis. It is not surprising that people with psychiatric disorders and a history of CM represent a clinically distinct subtype of patients, who have a worse clinical prognosis They are characterized by earlier onset, more severe symptoms and comorbidity, the need for a higher medication dosage, and more frequent and longer hospitalizations [5,6]. It seems that the timing, chronicity and the severity of the CM may play a role in clinical outcomes [7,8], establishing a dose–response relationship between multiplicity, severity or frequency of CM exposure on the one hand, and disease outcomes on the other [9,10]
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