Self-Injury and Suicidality: The Impact of Trauma and Dissociation

Abstract

In the growing research literature on nonsuicidal self-injury (NSSI) and suicidality (SA), there are many questions still unresolved about the role played by exposure to traumatic stressors (including but not limited to childhood maltreatment) and posttraumatic disorders (including dissociative features and disorders). In this special issue of the Journal of Trauma & Dissociation, a review article and 4 empirical studies attempt to provide additional insight into the relationship of traumatization and dissociation to NSSI and SA. The review article describes similarities and differences in the relationships that have been empirically documented between trauma exposure and posttraumatic stress or dissociative symptoms with NSSI versus SA and highlights the need for research to identify and test integrative clinical constructs, such as emotion dysregulation, in order to develop systematic risk, assessment, and intervention models. The empirical reports provide illustrative examples of conceptually and clinically integrated research on traumatic stress, dissociation, and NSSI and SA. Their findings offer a more nuanced picture of the potential role of different forms and degrees of dissociation in SA and NSSI and suggest that dissociation and emotion dysregulation may play a mediating role linking childhood maltreatment and adult or adolescent NSSI. In this introduction, we briefly summarize key points from the special issue articles and point out directions that their findings suggest for future research, including incorporating multiple predictors in studies of NSSI and SA, utilizing longitudinal studies to assess the etiology and course of NSSI and SA, and sampling diverse populations.

Isn’t It All About Victimization? (Intra)cultural Pressure and Cutural Betrayal Trauma in Ethnic Minority College Women

“…In the current study, cultural betrayal trauma was associated with PTSS and dissociation while controlling for age, ethnicity, and interracial trauma. In addition to providing evidence for the cultural betrayal component of trauma, these findings are in line with those that link trauma victimization with PTSS (e.g., Kelley et al, 2012) and dissociation (e.g., Ford & Gómez, 2015).…”

International Olympic Committee consensus statement: harassment and abuse (non-accidental violence) in sport

“…The risk of non-suicidal self-injury/self-harm, suicide attempts and completed suicide increases with the number of harassment types that an adolescent experiences 159. Early detection and intervention, which reduces the incidence of harassment, is particularly important in mitigating mental health difficulties and behavioural self-harm among adolescents 160. Other physical impacts of sexual abuse include sexually transmitted illnesses, urogenital and anogenital trauma, and unwanted pregnancy.…”

The Mediating Roles of Hostility and Dissociation in the Relationship Between Sexual Assault and Suicidal Thinking in College Students

“…In addition, Hetzel-Riggin and Wilber (2010) found peritraumatic dissociation was associated with different physiological and emotional responses to trauma. Recurrent suicidal thinking or self-harm behaviors might be used among survivors of sexual abuse to feel in control of dissociative experiences and regulate or soothe extreme emotions (Erbuto et al, 2016; Ford & Gomez, 2015). Franzke, Wabnitz, and Catani (2015) found that dissociative symptoms moderated the relationship between interpersonal violence and nonsuicidal self-injury.…”

“…To summarize, there is a collection of research suggesting that the emotional dysregulation and dissociative reactions experienced after sexual assault may be involved in the relationship between experiences of sexual assault and suicidal thinking or attempts (see Ford & Gómez, 2015, for a review). However, there are several limitations to the current research: (a) Most studies that have addressed mediating variables have focused solely on a single potential mediator in the relationship between sexual assault and suicide without considering multiple factors in the multifaceted trauma response system; (b) the degree to which these trauma symptoms may be involved in that relationship; and (c) studies have focused on nonsuicidal self-injury related to sexual victimization and neglected suicidal thinking for college students (e.g., Chaplo et al, 2015).…”