Edinburgh Napier University

  Background:
Childhood trauma is an oft cited risk factor for suicidal behaviour, however, the reasons behind this relationship are not well understood. This project aimed to uncover psychological factors which may mediate the relationship between childhood trauma and suicidal behaviour. Based on previous theoretical perspectives and empirical findings, psychological factors within the domains of self-perception, relational functioning, and emotion regulation were focused on. Understanding such mediating factors is essential in developing interventions aimed at minimising suicide risk within the childhood trauma population.

Methods:
Study 1: Previously identified theoretical pathways between childhood trauma and Non-Suicidal Self-Injury (NSSI), in addition to demographic features, were tested for their association with suicidality in a sample of traumatised adults (N=113). Data were gathered through self-report questionnaires, with relationships explored through logistic regression analyses.
Study 2: Mediating pathways between childhood trauma and suicide attempt through attachment style, Complex Posttraumatic Stress Disorder symptomatology, and cognitive emotion regulation strategies were explored in a sample of traumatised adults (N=330). Mediating relationships were examined through bias-corrected bootstrapped mediation models.

Results
Study 1: Results did not support the ability of the NSSI theory tested to predict the presence of suicidality. Childhood emotional abuse and unemployment were found to be associated with lifetime experiences of suicidality.
Study 2: The relationship between childhood trauma and suicidal behaviour was found to be mediated by disturbances of self-organisation (DSO) in the areas of self-concept, relational disturbances, and emotion dysregulation. The relationship between childhood trauma and DSO was mediated by insecure attachment, internal attributions of blame, a sense of current threat, and intrusive thoughts or memories.

Discussion
A theoretical framework is proposed whereby disturbances of self-organisation in the areas of emotional dysregulation, negative self-concept, and disturbed relationships operate in combination to mediate the relationship between childhood trauma and suicide risk. This framework could be used to inform clinical interventions aimed at reducing suicide risk following childhood trauma by treating disturbances of self-organisation. Further implications for trauma-informed training for health and social care professionals are discussed.