Childhood trauma, dissociation and self-harming behaviour: A pilot study

Objective: Childhood trauma is known to be an important antecedent in those who engage in deliberate self-harm (DSH). We aimed to explore the mediatin g mechanisms between childhood trauma and subsequent DSH in a sample of wom en detained in a high secure setting. Method: From a previous incidence stu dy into DSH, we subdivided a group of 50 women as follows: non-harmers (N = 13), infrequent harmers (N = 22) and frequent harmers (N = 15). These thre e groups were then compared on several measures believed to be associated w ith DSH. Results: The frequency of DSH was related to low self-esteem incre ased dissociation, anger (both inwardly and outwardly directed), impulsivit y, and a history of sexual and physical abuse. When these variables were en tered into a path analytic model exploring the relationship between childho od trauma and subsequent DSH, two paths emerged: one major path which linke d childhood sexual abuse to DSH via increased dissociation and another, mor e minor association, linking childhood sexual abuse via reduced self-esteem . Conclusion: This study shows a strong association between high levels of dissociation and an increased frequency of self-harming behaviour. This ass ociation is theoretically plausible and has therapeutic implications.