Posttrauma Cognitions and Shame: The Relation Between Childhood Sexual Abuse and Self-injurious Behavior

Date of Submission

2020

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Stephanie Felgoise, Ph.D., ABPP

First Advisor

Susan M. Panichelli Mindel, Ph.D.

Second Advisor

Bruce S. Zahn, Ed.D., ABPP

Third Advisor

Melanie S. Harned, Ph.D., ABPP

Abstract

Despite the apparent clinical significance of self-injurious behavior (SIB; i.e., non-suicidal self-injury [NSSI] and suicide attempts [SA]) among individuals with Posttraumatic Stress Disorder (PTSD), there is no definitive understanding of the factors that escalate the risk for these behaviors in individuals with PTSD and histories of Childhood Sexual Abuse (CSA), the etiology of that relationship, or mediators of the association between PTSD and SIB (Dixon-Gordon, Tull, & Gratz, 2014; Weierich & Nock, 2008). Moreover, the role of sexual abuse in childhood as a causal factor for SIB in adolescence or adulthood is not well understood (Maniglio, 2011). The current study used an archival data set, n = 74, that included adult and adolescent males and females who participated in one of three psychotherapy outcome studies. Data analyzed included information from the baseline assessment prior to treatment. It was hypothesized that posttrauma cognitions and characterological shame (i.e., shame concerning personal habits, one’s manner with others, self-perceived personal abilities, and self-perceptions of the type of person one is) mediate the relation between a history of CSA and frequency of SIB. Findings from this study did not support a mediational relationship between CSA and SIB through the mechanisms of posttrauma cognitions and characterological shame. However, negative cognitions about the self and self-blame for one’s trauma directly predicted an increased frequency of SIB. These findings add to the body of research on the relationship between CSA and SIB, as well as inform treatment of survivors of CSA also diagnosed with PTSD who self-injure.

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