The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem

J Clin Psychol. 2024 Mar;80(3):664-677. doi: 10.1002/jclp.23646. Epub 2024 Jan 24.

Abstract

Background: The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients.

Methods: Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships.

Results: Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality.

Conclusions: Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.

Keywords: NSSI; childhood trauma; psychiatric outpatients; self-esteem; suicidality.

MeSH terms

  • Adult
  • Adverse Childhood Experiences*
  • Female
  • Humans
  • Retrospective Studies
  • Self-Injurious Behavior* / psychology
  • Suicidal Ideation
  • Suicide*