Research Division, Institute of Mental Health, Singapore.
Research Division, Institute of Mental Health, Singapore.
Child Abuse Negl. 2017 May;67:383-390. doi: 10.1016/j.chiabu.2017.03.013. Epub 2017 Mar 31.
Although child maltreatment exposure is a recognized risk factor for self-harm, mechanisms underlying this relationship remain unclear. Self-harm may function as a compensatory strategy to regulate distressing emotions. This cross-sectional study examines if emotion dysregulation mediates between the severity of maltreatment exposure and self-harm, adjusting for demographic variables and depressive symptoms. Participants were 108 adolescent patients recruited from a psychiatric hospital in Singapore (mean age 17.0 years, SD=1.65; 59.3% female). Study measures included the Childhood Trauma Questionnaire (CTQ-SF), Functional Assessment of Self-Mutilation (FASM), Difficulties in Emotion Regulation Scale (DERS), and the Patient Health Questionnaire (PHQ-8). Path analysis was conducted to examine the direct and indirect effects of maltreatment exposure on self-harm via emotion dysregulation, controlling for demographic variables and depressive symptoms. Indirect effects were tested using bootstrapped confidence intervals (CI). Results showed that self-harm was highly prevalent in our sample (75.9%). Emotion dysregulation and depressive symptoms were found to be associated with higher self-harm frequency. In addition, results from path analysis showed that the association between the severity of maltreatment exposure and self-harm frequency was significantly mediated by emotion dysregulation B=0.07, p<0.05, 95% CI [0.02, 0.16]. Thus, emotion dysregulation may be a proximal mechanism linking maltreatment exposure and adolescent self-harm. Notably, self-harm may represent maladaptive attempts to manage emotion dysregulation that may have resulted from maltreatment. Findings from the study have implications for the prevention and treatment of self-harm in maltreated youth.
尽管儿童虐待暴露是自我伤害的公认风险因素，但这种关系的机制仍不清楚。自我伤害可能是一种调节痛苦情绪的补偿策略。本横断面研究通过调整人口统计学变量和抑郁症状，检验情绪调节障碍是否在虐待暴露的严重程度与自我伤害之间起中介作用。参与者是从新加坡一家精神病院招募的 108 名青少年患者（平均年龄 17.0 岁，标准差=1.65；59.3%为女性）。研究措施包括儿童创伤问卷（CTQ-SF）、自我伤害功能评估（FASM）、情绪调节困难量表（DERS）和患者健康问卷（PHQ-8）。通过路径分析，控制人口统计学变量和抑郁症状，检验了虐待暴露对自我伤害的直接和间接影响，以及情绪失调的中介作用。使用 bootstrap 置信区间（CI）检验间接效应。结果表明，我们的样本中自我伤害非常普遍（75.9%）。情绪失调和抑郁症状与更高的自我伤害频率有关。此外，路径分析的结果表明，虐待暴露严重程度与自我伤害频率之间的关联，通过情绪失调显著中介（B=0.07，p<0.05，95%CI[0.02，0.16]）。因此，情绪失调可能是将虐待暴露与青少年自我伤害联系起来的近端机制。值得注意的是，自我伤害可能代表了对情绪失调的适应不良的尝试，这种失调可能是由于虐待而产生的。该研究的结果对受虐待的青少年的自我伤害预防和治疗具有启示意义。
