The impact of dissociation and trauma on non-suicidal self-injury

BACKGROUND: The primary outcomes of this study were to explore the role of dissociation and social problem-solving in non-suicidal self-injury (NSSI) and to test whether dissociation is a mediator of the path from trauma to NSSI. Secondary outcomes were to demonstrate possible variables related to NSSI functions. METHODS: The sample consisted of 90 adolescents, aged 12-18 years, and 90 age and gender-matched control subjects. Hierarchical logistic regression analysis was performed to predict the occurrence and recurrence of NSSI. The predictors were entered in three steps as demographic data, internalizing symptoms, and dissociative symptoms. Mediation analyses were performed to demonstrate pathway trauma up to NSSI. RESULTS: Hierarchical logistic regression analysis showed that depersonalization/derealization (OR=3.91 and OR=12.13, respectively) and depression severity (OR=1.05 and OR=1.22, respectively) were independent predictors of the occurrence and recurrence of NSSI. The same was not seen for social problem-solving so that avoidance coping style was not determined to have a direct effect on NSSI independent of depression severity (b=-0.031, SE=0.030, P=0.296, CI -0.090, 0.027). Depersonalization/derealization (b=0.0129) accounted for significant mediation in the relationship between trauma severity and number of NSSI episodes. Trauma severity was determined to be an independent predictor for the emotion regulation function of NSSI (adjusted R-2=0.387, beta=0.625, P<0.001). CONCLUSIONS: The results of this study emphasized that the dissociative variant of NSSI could be valuable, especially in abused adolescents. Emotional regulation function was the most prevalent intrapersonal function, so future intervention research should concentrate on emotional regulation strategies for NSSI.