Attachment style shapes the effect of adverse childhood experience on non-suicidal self-injury among teenagers
image: Sequential mediation model between ACEs, cPTSD, Dissociative experiences (DE), and NSSI.
Credit: Rodolfo Rossi, Tommaso B Jannini, Valentina Socci, Francesca Pacitti, Alessandro Rossi, Giorgio Di Lorenzo.
Non-suicidal self-injury (NSSI) has increasingly become a public health concern among teenagers, not only because of its harmful consequences but also due to its potential role as a risk factor for other severe psychiatric conditions. A recent study published in General Psychiatry reveals how adverse childhood experience（ACE）translates into NSSI may depend largely on an individual’s attachment style.
Researchers from the Tor Vergate University of Rome, along with collaborators from other Italian institutions, conducted a cross-sectional study, involving 1010 high school adolescents. Data were all acquired via self-report questionnaires.
This study explored how ACE affects NSSI, and then looked at how complex post-traumatic stress disorder (cPTSD) and dissociation might impact the original relationship, specifically in participants with distinct attachment styles. Attachment style refers to how a person typically forms emotional bonds with others. Overall, ACEs were found to have a significant impact on NSSI, with both cPTSD and dissociation acting as mediating factors. However, when participants were categorized into three groups based on their attachment style —fearful attachment, preoccupied attachment, and secure attachment —the pattern changed. The link between ACEs and NSSI was weakest in those with a fearful attachment style. For participants with a preoccupied attachment, only cPTSD mediated the connection. In contrast, for those with a fearful attachment, dissociation — not cPTSD — was the key mediator. Taken together, these findings highlight that attachment style plays an important role in shaping how ACEs lead to NSSI through different psychological pathways.
Given that NSSI is most prevalent during adolescence, the study offers valuable novel insights into the psychological mechanisms underlying the severe phenomenon, which could help refine clinical interventions for young individuals with adverse experiences during childhood. “Our study findings emphasize the need for attachment-focused interventions in addressing NSSI,” said author Rodolfo Rossi. “Tailoring therapeutic approaches based on individuals’ attachment styles, such as using mentalization-based therapy for those with insecure attachment, could be more effective.”