Association of Dissociation with Suicide Attempt and Non-Suicidal Self Injury in Adolescents with a History of Sexual Abuse

Objective: Dissociative symptoms are considered risk factors for suicide and nonsuicidal self-injury (NSSI). In this study, the relationship between suicidal behaviors and NSSI with dissociative symptoms in adolescents with a history of Child Sexual Abuse (CSA) was investigated. Methods: A total of 100 adolescents with a history of CSA were evaluated with a detailed forensic psychiatric interview. Dissociative symptoms were measured with the self-report Adolescent Dissociative Experiences Scale (A-DES) and the parent-reported Child Dissociative Checklist (CDC). Results: While dissociative symptoms did not differ between adolescents with and without suicide attempts (CDC; p =.068 and A-DES; p =.060), they were significantly higher in adolescents with non-suicidal self-harming behavior (CDC; p <.001 and A-DES; p =.001). Suicide attempts and NSSI were more common in those who reported genital touching as a type of sexual abuse (respectively, p =.003; p =.048). In regression analysis; history of psychiatric treatment (OR = 9.09 [95% CI = 1.52, 54.29]) and NSSI (OR = 8.18 [95% CI = 2.01, 33.23]) were independently associated with suicide attempts. In addition, parent-reported dissociative symptoms (CDC scores) (OR = 1.27 [95% CI = 1.06, 1.53] and suicide attempt (OR = 8.09 [95%CI = 1.96,33.42] showed independent association with NSSI. Conclusions: Dissociative symptoms may be predictive factors for NSSI and should be considered in risk assessment of adolescents with a history of CSA.