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A cross-sectional study of adolescent non-suicidal self-injury: support for a specific distress-function relationship.

Zetterqvist M, Lundh LG, Svedin CG - Child Adolesc Psychiatry Ment Health (2014)

Bottom Line: Having experienced physical abuse, having made a suicide attempt and symptoms of dissociation were significant predictors in both final models.Experiences of emotional abuse and symptoms of depression could guide clinical work in the direction of emotion regulation skills since in this study these variables were uniquely associated with the need to engage in NSSI to regulate emotions, to self-punish or to generate feelings.The presence of physical abuse, a suicide attempt and symptoms of dissociation could alert clinicians to a broad treatment approach since they were associated with performing NSSI to regulate both social and automatic experiences.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical and Experimental Medicine; Child and Adolescent Psychiatry, Linköping University, Linköping SE-581 85, Sweden ; Child- and Adolescent Psychiatric Clinic, University Hospital, Linköping SE-581 85, Sweden.

ABSTRACT

Background: This study has investigated the specific relationship between childhood adversities, individual trauma symptoms and the functions of non-suicidal self-injury (NSSI). The aim was to examine whether different self-reported adverse experiences and trauma symptoms predict the need to engage in NSSI, either to regulate emotions or to communicate with and influence others.

Method: The participants were a community sample of 816 adolescents aged 15-17 years with NSSI. Hierarchical multiple regression was used, controlling for NSSI frequency and gender. The dependent variables were the automatic and social functions of NSSI, respectively. The predictors entered in the model were several different maltreatment and adversity experiences as well as individual trauma symptoms. Mediation analyses were also performed using the bootstrapping method with bias-corrected confidence estimates.

Results: Frequency of NSSI, gender (female), emotional abuse, prolonged illness or handicap during upbringing and symptoms of depression uniquely predicted the automatic functions of NSSI in the final regression model, but not the social functions. Symptoms of anxiety uniquely predicted social but not automatic functions. Having experienced physical abuse, having made a suicide attempt and symptoms of dissociation were significant predictors in both final models. The model for automatic functions explained more of the variance (62%) than the social model (28%). The relationship between childhood emotional, physical and sexual abuse and performing NSSI for automatic reasons was mediated by symptoms of depression and dissociation. The relationship between physical abuse and the social functions of NSSI was mediated by symptoms of anxiety and dissociation.

Conclusions: It is important to understand the specific context in which NSSI has developed and is maintained. Experiences of emotional abuse and symptoms of depression could guide clinical work in the direction of emotion regulation skills since in this study these variables were uniquely associated with the need to engage in NSSI to regulate emotions, to self-punish or to generate feelings. The presence of physical abuse, a suicide attempt and symptoms of dissociation could alert clinicians to a broad treatment approach since they were associated with performing NSSI to regulate both social and automatic experiences.

No MeSH data available.


Related in: MedlinePlus

Indirect effect of emotional abuse on automatic functions through symptoms of depression and dissociation.Note. **p <. 01. ***p <. 001.
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Figure 1: Indirect effect of emotional abuse on automatic functions through symptoms of depression and dissociation.Note. **p <. 01. ***p <. 001.

Mentions: Firstly, it was found that self-reported experience of emotional (B = 4.04, t (813) = 12.97, p < .001), physical (B = 3.48, t (813) = 8.72, p < .001) and sexual abuse (B = 4.73, t (813) = 10.48, p < .001), separately, were positively associated with the automatic functions of NSSI. It was also found that self-reported experience of emotional, physical and sexual abuse, separately, was positively associated with symptoms of depression (emotional abuse: B = 5.31, t (813) = 15.01, p < .001; physical abuse: B = 4.06, t (813) = 8.69, p < .001; sexual abuse: B = 5.55, t (813) = 10.53, p < .001) as well as dissociation (emotional abuse: B = 4.84, t (813) = 12.80, p < .001; physical abuse: B = 4.11, t (813) = 8.45, p < .001; sexual abuse: B = 4.21, t (813) = 7.45, p < .001). Lastly, it was found that the mediators, symptoms of depression (emotional abuse: B = .50, t (813) = 15.93, p < .001; physical abuse: B = .51, t (813) = 16.84, p < .001; sexual abuse: B = .49, t (813) = 15.88, p < .001) and dissociation (emotional abuse: B = .13, t (813) = 4.39, p < .001; physical abuse: B = .13, t (813) = 4.39, p < .001; sexual abuse: B = .14, t (813) = 4.80, p < .001), were associated with the automatic functions of NSSI (Figures 1, 2 and 3). Because both the a-paths and the b-paths were significant in all three models, mediation analyses were tested using the bootstrapping method with bias-corrected confidence estimates [54]. In the present study, the 95% CI of the indirect effects was obtained with 5000 bootstrapping resamples [55]. Results of the mediation analyses confirmed the mediating role of trauma symptoms (depression and dissociation) in the relationship between self-reported experiences of emotional abuse (B = 3.24, CI = 2.79-3.73), physical abuse (B = 2.58, CI = 1.99-3.18), as well as sexual abuse (B = 3.28, CI = 2.60-4.04) and the automatic functions of NSSI in all three models. The results indicated that the direct effect of emotional abuse (B = .79, t (813) = 3.05, p = .002) and physical abuse (B = .90, t (813) = 3.05, p = .002) as well as sexual abuse (B = 1.44, t (813) = 4.22, p < .001) on the automatic functions of NSSI, when controlling for symptoms of depression and dissociation, was still significant (Figures 1, 2 and 3).


A cross-sectional study of adolescent non-suicidal self-injury: support for a specific distress-function relationship.

Zetterqvist M, Lundh LG, Svedin CG - Child Adolesc Psychiatry Ment Health (2014)

Indirect effect of emotional abuse on automatic functions through symptoms of depression and dissociation.Note. **p <. 01. ***p <. 001.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4127172&req=5

Figure 1: Indirect effect of emotional abuse on automatic functions through symptoms of depression and dissociation.Note. **p <. 01. ***p <. 001.
Mentions: Firstly, it was found that self-reported experience of emotional (B = 4.04, t (813) = 12.97, p < .001), physical (B = 3.48, t (813) = 8.72, p < .001) and sexual abuse (B = 4.73, t (813) = 10.48, p < .001), separately, were positively associated with the automatic functions of NSSI. It was also found that self-reported experience of emotional, physical and sexual abuse, separately, was positively associated with symptoms of depression (emotional abuse: B = 5.31, t (813) = 15.01, p < .001; physical abuse: B = 4.06, t (813) = 8.69, p < .001; sexual abuse: B = 5.55, t (813) = 10.53, p < .001) as well as dissociation (emotional abuse: B = 4.84, t (813) = 12.80, p < .001; physical abuse: B = 4.11, t (813) = 8.45, p < .001; sexual abuse: B = 4.21, t (813) = 7.45, p < .001). Lastly, it was found that the mediators, symptoms of depression (emotional abuse: B = .50, t (813) = 15.93, p < .001; physical abuse: B = .51, t (813) = 16.84, p < .001; sexual abuse: B = .49, t (813) = 15.88, p < .001) and dissociation (emotional abuse: B = .13, t (813) = 4.39, p < .001; physical abuse: B = .13, t (813) = 4.39, p < .001; sexual abuse: B = .14, t (813) = 4.80, p < .001), were associated with the automatic functions of NSSI (Figures 1, 2 and 3). Because both the a-paths and the b-paths were significant in all three models, mediation analyses were tested using the bootstrapping method with bias-corrected confidence estimates [54]. In the present study, the 95% CI of the indirect effects was obtained with 5000 bootstrapping resamples [55]. Results of the mediation analyses confirmed the mediating role of trauma symptoms (depression and dissociation) in the relationship between self-reported experiences of emotional abuse (B = 3.24, CI = 2.79-3.73), physical abuse (B = 2.58, CI = 1.99-3.18), as well as sexual abuse (B = 3.28, CI = 2.60-4.04) and the automatic functions of NSSI in all three models. The results indicated that the direct effect of emotional abuse (B = .79, t (813) = 3.05, p = .002) and physical abuse (B = .90, t (813) = 3.05, p = .002) as well as sexual abuse (B = 1.44, t (813) = 4.22, p < .001) on the automatic functions of NSSI, when controlling for symptoms of depression and dissociation, was still significant (Figures 1, 2 and 3).

Bottom Line: Having experienced physical abuse, having made a suicide attempt and symptoms of dissociation were significant predictors in both final models.Experiences of emotional abuse and symptoms of depression could guide clinical work in the direction of emotion regulation skills since in this study these variables were uniquely associated with the need to engage in NSSI to regulate emotions, to self-punish or to generate feelings.The presence of physical abuse, a suicide attempt and symptoms of dissociation could alert clinicians to a broad treatment approach since they were associated with performing NSSI to regulate both social and automatic experiences.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical and Experimental Medicine; Child and Adolescent Psychiatry, Linköping University, Linköping SE-581 85, Sweden ; Child- and Adolescent Psychiatric Clinic, University Hospital, Linköping SE-581 85, Sweden.

ABSTRACT

Background: This study has investigated the specific relationship between childhood adversities, individual trauma symptoms and the functions of non-suicidal self-injury (NSSI). The aim was to examine whether different self-reported adverse experiences and trauma symptoms predict the need to engage in NSSI, either to regulate emotions or to communicate with and influence others.

Method: The participants were a community sample of 816 adolescents aged 15-17 years with NSSI. Hierarchical multiple regression was used, controlling for NSSI frequency and gender. The dependent variables were the automatic and social functions of NSSI, respectively. The predictors entered in the model were several different maltreatment and adversity experiences as well as individual trauma symptoms. Mediation analyses were also performed using the bootstrapping method with bias-corrected confidence estimates.

Results: Frequency of NSSI, gender (female), emotional abuse, prolonged illness or handicap during upbringing and symptoms of depression uniquely predicted the automatic functions of NSSI in the final regression model, but not the social functions. Symptoms of anxiety uniquely predicted social but not automatic functions. Having experienced physical abuse, having made a suicide attempt and symptoms of dissociation were significant predictors in both final models. The model for automatic functions explained more of the variance (62%) than the social model (28%). The relationship between childhood emotional, physical and sexual abuse and performing NSSI for automatic reasons was mediated by symptoms of depression and dissociation. The relationship between physical abuse and the social functions of NSSI was mediated by symptoms of anxiety and dissociation.

Conclusions: It is important to understand the specific context in which NSSI has developed and is maintained. Experiences of emotional abuse and symptoms of depression could guide clinical work in the direction of emotion regulation skills since in this study these variables were uniquely associated with the need to engage in NSSI to regulate emotions, to self-punish or to generate feelings. The presence of physical abuse, a suicide attempt and symptoms of dissociation could alert clinicians to a broad treatment approach since they were associated with performing NSSI to regulate both social and automatic experiences.

No MeSH data available.


Related in: MedlinePlus