Study data suggest that emotional neglect and abuse are more significant predictors for nonsuicidal self-injury (NSSI) than depressive and anxiety disorders, according to research published in BMC Psychiatry.

Researchers surveyed a representative sample of the German population of mean age 48.4 years (n=2498; 53.3% women) for childhood maltreatment and self-injury. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire; lifetime engagement in NSSI was measured using a question from the Self-Injurious Thoughts and Behavior Interview. Depressive and anxiety symptoms were captured with the Patient Health Questionnaire and the General Anxiety Disorder Questionnaire, respectively.

Of the total cohort, 3.3% reported engagement in NSSI and 30.8% reported experiencing at least 1 type of child maltreatment. Among those who reported NSSI, 65.1% also reported at least 1 type of child maltreatment compared with just 29.7% of those in the non-NSSI group (P <.001). In addition, 48.2% of respondents in the NSSI group reported multiple types of child maltreatment compared with just 12.8% in the non-NSSI group (P <.001).

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Per a path analytic model, emotional abuse (P <.001) and emotional neglect (P =.001) were the only forms of childhood maltreatment significantly correlated with NSSI. The effects of physical neglect and sexual abuse on NSSI engagement were fully mediated by depression and anxiety scores. Patients with higher scores of depression and anxiety symptoms were also more likely to report NSSI, as were women and individuals of younger age.

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These data suggest a strong correlation between childhood mistreatment and engagement in self-harm. Although emotional abuse and neglect may not be as easily detected as other forms of maltreatment, professionals must be aware of their long-term effect on NSSI likelihood.


Brown RC, Heines S, Witt A, et al. The impact of child maltreatment on non-suicidal self-injury: data from a representative sample of the general population. BMC Psychiatry. 2018;18:181.