Exploring associations between childhood emotional abuse, suicidal behaviour and deliberate self-harm: the mediating role of distress tolerance

Abstract

Childhood Emotional Abuse (CEA) has been linked extensively with psychological difficulties such as deliberate self-harm (DSH), and suicidal behaviours (SB), indicating that they may represent considerable risk factors for later psychopathology. CEA is associated with poorer emotional coping skills, which may mediate the severity of later outcomes. Low distress tolerance (DT) is associated with DSH and an increased capacity for suicide that can be understood within a negative reinforcement framework. DT has been found to mediate associations between negative life events and maladaptive emotional coping. No study to date, however, has explored whether DT mediates the relationships between CEA and DSH, and CEA and SBs. The study reported here was conducted with a clinical population accessing psychological support (n=70) and aimed to explore whether experiencing CEA was associated with difficulties tolerating distressing situations, and maladaptive coping mechanisms such as DSH and SBs. Correlations found significant relationships between all variables. The study also investigated whether DT mediated the relationship between CEA and DSH, and CEA and SBs. Mediation analysis showed that DT did not mediate the relationship between CEA and DSH. However, DT significantly mediated the relationship between CEA and SBs. The study has implications for future clinical practise and makes suggestions regarding clinical interventions that focus on DT skills as a way of reducing SBs.