Self-injury and suicidality: the impact of trauma and dissociation

In the growing research literature on nonsuicidal self-injury (NSSI) and suicidality (SA), there are many questions still unresolved about the role played by exposure to traumatic stressors (including but not limited to childhood maltreatment) and posttraumatic disorders (including dissociative features and disorders). In this special issue of the Journal of Trauma & Dissociation, a review article and 4 empirical studies attempt to provide additional insight into the relationship of traumatization and dissociation to NSSI and SA. The review article describes similarities and differences in the relationships that have been empirically documented between trauma exposure and posttraumatic stress or dissociative symptoms with NSSI versus SA and highlights the need for research to identify and test integrative clinical constructs, such as emotion dysregulation, in order to develop systematic risk, assessment, and intervention models. The empirical reports provide illustrative examples of conceptually and clinically integrated research on traumatic stress, dissociation, and NSSI and SA. Their findings offer a more nuanced picture of the potential role of different forms and degrees of dissociation in SA and NSSI and suggest that dissociation and emotion dysregulation may play a mediating role linking childhood maltreatment and adult or adolescent NSSI. In this introduction, we briefly summarize key points from the special issue articles and point out directions that their findings suggest for future research, including incorporating multiple predictors in studies of NSSI and SA, utilizing longitudinal studies to assess the etiology and course of NSSI and SA, and sampling diverse populations.