Childhood abuse and neglect, attachment states of mind, and non-suicidal self-injury

ABSTRACT

This investigation examined preoccupied attachment states of mind as both a risk factor for non-suicidal self-injury (NSSI) and as a mechanism by which prospectively assessed childhood experiences of abuse and neglect predicted the frequency/severity of NSSI behavior up to age 26 years in 164 individuals (83 females) who were followed from birth in the Minnesota Longitudinal Study of Risk and Adaptation. Preoccupied (but not dismissing) states of mind regarding both childhood caregivers and adult romantic partners were correlated with more frequent/severe NSSI. Furthermore, preoccupied states of mind regarding caregivers partially accounted for the association between childhood abuse/neglect and NSSI. This work represents a rare prospective test of a developmental psychopathology framework for understanding NSSI behavior, in which atypical caregiving experiences are carried forward through attachment representations of caregivers that reflect behavioral risk.

KEYWORDS:

• Non-suicidal self-injury
• attachment states of mind
• physical abuse
• sexual abuse
• neglect
• mediation

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. At the request of a reviewer, we completed analyses using a variant of the preoccupied composites at both ages 19 and 26 years which excluded the Unresolved abuse indicator. These composites had either similar or marginally lower internal consistency compared to the composites used in our focal analyses (19 years: α = .75 compared to original α = .72, Feldt test: w = .89, p = .24; 26 years: α = .61 compared to original α = .69, Feldt test: w = .79, p = .09). Nonetheless, we found that the alternate preoccupied composites (excluding unresolved abuse) were each still significantly predicted by having experienced childhood abuse or neglect, albeit to a lesser degree (19 years: r = .17, p < .05, Steiger’s z = −2.40, p < .01; 26 years: r = .16, p < .05, Steiger’s z = −4.20, p < .001). Moreover, the alternate preoccupied composites (excluding unresolved abuse) were also significantly associated with NSSI frequency/severity at similar magnitude for the age 19 year composite (r = .29, p < .001; Steiger’s z = .22, p = .82), and at lower magnitude for the age 26 year composite (r = .22, p < .001; Steiger’s z = 2.11, p < .05). The indirect effect of childhood abuse or neglect to NSSI through preoccupied state of mind (excluding unresolved abuse) fell short of statistical significance (19 years: B = .06, SE = .03, p = .06; 26 years: B = .03, SE = .02, p = .19). Of note, the magnitude of coefficients for indirect effects using the AAI preoccupied composites (excluding unresolved abuse) remained similar to those reported in primary analyses.

Additional information

Funding

This work was supported by a Social Sciences and Humanities Research Council of Canada Postdoctoral Fellowship (Award Number 756-2014-0109) awarded to Jodi Martin, and by a National Institute on Aging grant (R01 AG039453) awarded to Jeffry A. Simpson (PI) to support current assessments of the Minnesota Longitudinal Study of Risk and Adaptation.