Understanding Relationships Between Childhood Abuse, Mental Illness, and Suicidality and Self-Harm Behaviors in a Psychiatric Sample

Empirical research suggests a link between childhood abuse and adult onset of depression, anxiety, personality disorders, and psychosis. Research also suggests a positive relationship between childhood abuse and both self-harm behaviors and suicide. However, important relationships between these variables remain unclear, nor have they been studied within the context of significant comorbidity. The current study looks at the relationship between multiple occurrences of childhood abuse and self-harm behaviors and suicide attempts, within the context of depression, anxiety, borderline personality disorder, and psychosis. We hypothesize that these diagnoses mediate relationships between recurring childhood abuse and selfharm behaviors and suicide attempts. A sample of 494 psychiatric inpatients were used for analysis (54.7% Caucasian, 41.7% African American, 1.6% Hispanic, .5% Asian, .6% Native American, .6% Mixed, and .4% other/unknown). Over half of the patients presented with a mood disorder (55.9%) and/or a psychotic spectrum disorder (61.5%). The study found a positive and significant correlation between abuse history and the presence of self-harm (r=.241, p\u3c.001) as well as number of suicide attempts (r=.176, p\u3c.001). These results were expected and are consistent with the current empirical literature. The significant relationship between abuse and self-harm was mediated by depression (rpartial=.229), anxiety, (rpartial=.234), and borderline personality disorder (rpartial=.211). Similarly, the relationship between abuse and suicide attempts was significantly mediated by depression (rpartial=.166), anxiety (rpartial=.155), and borderline personality disorder (rpartial=.157). This suggests a strong relationship between abuse and self-harm behaviors as well as suicide attempts that is impacted be various psychiatric diagnoses. Depression, anxiety, and borderline personality disorder serve as significant mediators while psychosis showed no significant influence. These effects are interesting because psychosis is most impacted by biological factors where as depression, anxiety, and borderline personality disorder are influenced greatly by experience. These findings allow us to better understand the nature of suicide and self-harm behavior within the context of abuse and psychiatric comorbidity in order to help in treatment planning for such individuals