The relationship between childhood maltreatment and self-harm: the mediating roles of alexithymia, dissociation, internalizing and posttraumatic symptoms

Background: Although childhood maltreatment is associated with later self-harm, the mechanism through which it might lead to self-harm is not completely understood. The purpose of this study was to examine the roles of alexithymia, dissociation, internalizing and posttraumatic symptoms in the association between exposure to childhood maltreatment and subsequent self-harm.Methods: A total of 360 adolescents were asked to complete the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale, the Dissociative Experience Scale, the Somatoform Dissociation Questionnaire-20, the Posttraumatic Stress Checklist for DSM-5, and the Deliberate Self-Harm Inventory.Results: Results of structural equation modelling analysis revealed the significant mediation effects of alexithymia and dissociative symptoms in the relationship between childhood maltreatment and self-harm, while internalizing and posttraumatic symptoms did not significantly mediate.Conclusion: The findings indicate that alexithymia and dissociative symptoms may be proximal mechanisms linking maltreatment exposure and adolescence self-harm. Self-harm can be used as a maladaptive coping strategy in response to both hyper- and hypo-arousal symptoms.Alexithymia and dissociative symptoms may be proximal mechanisms linking maltreatment exposure and adolescent self-harm.Posttraumatic symptoms did not mediate the relationship between a history of childhood maltreatment and self-harm. Antecedentes: Aunque el maltrato infantil se asocia con la autolesi & oacute;n posterior, no se comprende completamente el mecanismo a trav & eacute;s del cual se podr & iacute;a conducir a la autolesi & oacute;n. El prop & oacute;sito de este estudio fue el de examinar los papeles de la alexitimia, disociaci & oacute;n, s & iacute;ntomas internalizantes y postraum & aacute;ticos en la asociaci & oacute;n entre la exposici & oacute;n a maltrato infantil y la autolesi & oacute;n subsecuente.M & eacute;todos: Se le solicit & oacute; a un total de 360 adolescentes que completaran el Cuestionario de Trauma Infantil, la Escala de Alexitimia de Toronto, la Escala de Experiencias Disociativas, el Cuestionario de Disociaci & oacute;n Somatomorfo-20, la Lista de Chequeo de Estr & eacute;s Postraum & aacute;tico para el DSM-5 y el Inventario de Autolesi & oacute;n Deliberada.Resultados: Los resultados del an & aacute;lisis del modelo de ecuaciones estructurales revelaron los efectos de mediaci & oacute;n significativos de la alexitimia y s & iacute;ntomas disociativos en la relaci & oacute;n entre maltrato infantil y autolesi & oacute;n, mientras que los s & iacute;ntomas internalizantes y postraum & aacute;ticos no mediaron significativamente.Conclusi & oacute;n: Los hallazgos indican que la alexitimia y s & iacute;ntomas disociativos pueden ser mecanismos proximales que vinculan la exposici & oacute;n al maltrato y la autolesi & oacute;n en la adolescencia.