The impact of child maltreatment on non-suicidal self-injury: data from a representative sample of the general population

Rebecca C Brown,Elmar Braehler,Daniela Harsch,Paul L Plener,Joerg M Fegert,Andreas Witt,Stefanie Heines

doi:10.1186/s12888-018-1754-3

Rebecca C Brown, Elmar Braehler + Show 5 more

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https://doi.org/10.1186/s12888-018-1754-3

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Abstract

BackgroundChild maltreatment is an identified risk factor for Non-Suicidal Self-Injury (NSSI). The aim of the current study was to investigate effects of different types of maltreatment, and mediating effects of depression and anxiety on NSSI in the general population.MethodsA representative sample of the German population, comprising N = 2498 participants (mean age = 48.4 years (SD = 18.2), 53.3% female) participated in this study. Child maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ),NSSI was assessed with a question on lifetime engagement in NSSI, depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-2) and anxiety symptoms by the General Anxiety Disorder questionnaire (GAD-2).ResultsLifetime prevalence of NSSI in this sample was 3.3, and 30.8% reported at least one type of child maltreatment. Participants in the NSSI group reported significantly more experiences of child maltreatment. Emotional abuse was endorsed by 72% of all participants with NSSI. A path analytic model demonstrated an unmediated direct effect of emotional neglect, a partially mediated effect of emotional abuse, and a fully mediated effect of sexual abuse and physical neglect by depression and anxiety on NSSI.ConclusionsEspecially emotional neglect and abuse seem to play a role in the etiology of NSSI above and beyond depression and anxiety, while sexual and physical abuse seem to have a rather indirect effect.

Highlights

IntroductionThe aim of the current study was to investigate effects of different types of maltreatment, and mediating effects of depression and anxiety on Non-Suicidal Self-Injury (NSSI) in the general population
Child maltreatment is an identified risk factor for Non-Suicidal Self-Injury (NSSI)
It was hypothesized that (1) having experienced any type of child maltreatment would lead to a higher vulnerability for engaging in NSSI, (2) a cumulating effect of different types of child maltreatment on lifetime NSSI would be found, (3) especially emotional abuse and neglect would directly affect NSSI, and (4) that physical abuse and –neglect, as well as sexual abuse, would be mediated by depression and anxiety symptoms

Summary

Introduction

The aim of the current study was to investigate effects of different types of maltreatment, and mediating effects of depression and anxiety on NSSI in the general population. Child maltreatment (emotional, physical, and sexual abuse, as well as physical and emotional neglect) has shown to be associated with a large variety of different mental- and physical health problems throughout the lifespan [1, 2]. Brown et al BMC Psychiatry (2018) 18:181 lifetime prevalence of 5.9 and 0.9% within the last year [8] These results correspond well to a recent study of a representative sample of the German general population, finding a lifetime prevalence of 3 and 0.3% within the last year [9]. A very recent study [10] reported a direct association of emotional abuse and NSSI, while the effect of sexual and physical abuse was mediated completely by emotion expressivity (i.e. difficulties in expressing emotions appropriately) and emotion coping (ability to cope with negative emotions)

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