Abstract
Post-traumatic stress symptoms, depressive symptoms, and psychological dysregulation have been shown to mediate the relationship between child maltreatment and non-suicidal self-injury. However, these proposed mediators often co-occur and previous research has not tested mediation when all variables are assessed simultaneously. The current study sought to advance the literature on maltreatment and self-injury by estimating the mediational effects of post-traumatic stress symptoms, depressive symptoms, and psychological dysregulation in the same multiple mediator model. Both maltreated (n = 129) and non-maltreated (n = 82) adolescent females, consisting of Caucasian (55%), African-American (37%), and Bi-racial (8%) backgrounds, participated in the study. Results indicated that only post-traumatic stress symptoms mediated the relationship between maltreatment and self-injury when all variables were included in the model. Overall, post-traumatic symptoms represented a unique pathway from maltreatment to self-injury and warrant special attention when assessing and treating such behavior with adolescent females.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Press.
Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77–84.
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35(2), 205–230.
Barnes, J. E., Noll, J. G., Putnam, F. W., & Trickett, P. K. (2009). Sexual and physical revictimization among victims of severe childhood sexual abuse. Child Abuse & Neglect, 33(7), 412–420.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.
Cicchetti, D., & Toth, S. L. (2005). Child maltreatment. Annual Review of Clinical Psychology, 1(1), 409–438.
Davidson, J., Kudler, H. S., & Smith, R. (1989). Validity and reliability of the DSM-III criteria for posttraumatic stress disorder. Journal of Nervous and Mental Disease, 177, 336–341.
Fruzzetti, A. E., Shenk, C., & Hoffman, P. D. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development & Psychopathology, 17(4), 1007–1030.
Glassman, L. H., Weierich, M. R., Hooley, J. M., Deliberto, T. L., & Nock, M. K. (2007). Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism. Behaviour Research and Therapy, 45(10), 2483–2490.
Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76(2), 238–250.
Gratz, K. L., & Roemer, L. (2008). The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cognitive Behaviour Therapy, 37(1), 14–25.
Hilt, L. M., Cha, C. B., & Nolen-Hoeksema, S. (2008). Nonsuicidal self-injury in young adolescent girls: Moderators of the distress-function relationship. Journal of Consulting and Clinical Psychology, 76(1), 63–71.
Horowitz, L. (1998). The relationship of child sexual abuse to revictimization: Mediating variables and developmental processes. Catholic University of America.
Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113(1), 164–180.
Lloyd-Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristic and functions on non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37(8), 1183–1192.
MacKinnon, D. P., & Dwyer, J. H. (1993). Estimating mediated effects in prevention studies. Evaluation Review, 17(2), 144–158.
Mezzich, A. C., Tarter, R. E., Giancola, P. R., & Kirisci, L. (2001). The dysregulation inventory: A new scale to assess the risk for substance use disorder. Journal of Child & Adolescent Substance Abuse, 10(4), 35–43.
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. New York, NY: Guilford.
Nock, M. K., & Favazza, A. R. (2009). Nonsuicidal self-injury: Definition and classification. In M. K. Nock (Ed.), Understanding nonsuicidal self-injury: Origins, assessment, and treatment (pp. 9–18).
Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885–890.
Nock, M. K., & Prinstein, M. J. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology, 114(1), 140–146.
Noll, J. G., Horowitz, L. A., Bonanno, G. A., Trickett, P. K., & Putnam, F. W. (2003). Revictimization and self-harm in females who experienced childhood sexual abuse: Results from a prospective study. Journal of Interpersonal Violence, 18(12), 1452–1471.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.
Romans, S. E., Martin, J. L., Anderson, J. C., Herbison, G. P., et al. (1995). Sexual abuse in childhood and deliberate self-harm. American Journal of Psychiatry, 152(9), 1336–1342.
Ross, S., & Heath, N. (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence, 31(1), 67–77.
Shipman, K., Zeman, J., Penza, S., & Champion, K. (2000). Emotion management skills in sexually maltreated and nonmaltreated girls: A developmental psychopathology perspective. Developmental Psychopathology, 12(1), 47–62.
Sim, L., Adrian, M., Zeman, J., Cassano, M., & Friedrich, W. N. (2009). Adolescent deliberate self-harm: Linkages to emotion regulation and family emotional climate. Journal of Research on Adolescence, 19(1), 75–91.
Weierich, M. R., & Nock, M. K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology, 76(1), 39–44.
Acknowledgments
The authors wish to thank Christie Crosbie, Jaclyn Barnes, Andrea Powers, Liza Prost, Kate Haralson, and Erica Clark for their hard work and dedication on this project. We also thank Joe Rausch, PhD, and Paul Succop, PhD, for their invaluable advice on statistical methodology and analyses. Most importantly, we thank the families who so graciously agreed to participate in this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shenk, C.E., Noll, J.G. & Cassarly, J.A. A Multiple Mediational Test of the Relationship Between Childhood Maltreatment and Non-suicidal Self-Injury. J Youth Adolescence 39, 335–342 (2010). https://doi.org/10.1007/s10964-009-9456-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10964-009-9456-2