The Relation Between Childhood Maltreatment and Self-Injury: A Review of the Literature on Conceptualization and Intervention

Abstract

The following article reviews literature pertaining to the association between child maltreatment and self-injury and the ways it varies according to maltreatment type. Research supporting various mediators of the relations between different maltreatment types and self-injury is summarized. Informing mediator models, dominant theories of functionality, particularly affect regulation theories, are summarized and granted empirical support. Following from explanations of its functionality, three developmental pathways (regulatory, representational/interpersonal, and reactive/neurobiological) leading from child maltreatment to self-injury are presented within an organizational model of psychopathology. Understanding the deviations in these pathways that perpetuate self-injury helps to inform intervention approaches that forge pathways perpetuating resilience instead. Three psychosocial treatments (i.e., Dialectical Behavior Therapy [DBT], Trauma-Focused Cognitive—Behavioral Therapy [TF-CBT], and Acceptance and Commitment Therapy [ACT]) were chosen for review, based upon their accumulating evidence bases, as well as upon the relevance of their core components in correcting or compensating for trauma-related developmental deviations.