Trauma Symptoms and Deliberate Self-Harm Among Sexual Violence Survivors: Examining State Emotion Regulation and Reactivity as Dual Mechanisms

Objective: Posttraumatic stress disorder (PTSD) symptoms have been associated with elevated rates of deliberate self-harm, including among women who have experienced sexual violence (SV); however, processes underlying this association have not been widely examined. Because a common function of deliberate self-harm is to reduce negative internal states, SV survivors may use self-harm to cope with impairments in broader affective processes associated with PTSD symptoms. To test this hypothesis, the present study examined the role of two aspects of emotional responding (i.e., state emotional reactivity and emotion dysregulation) as mechanisms between greater PTSD symptoms and risk for future deliberate self-harm among SV survivors. Method: Participants were 140 community women with a history of SV who completed two waves of data collection. At baseline, participants reported on their PTSD symptoms, as well as state emotional reactivity and state emotion dysregulation following a standardized laboratory stressor task (i.e., the Paced Auditory Serial Addition Task [PASAT-C]). Participants then completed a self-report measure of deliberate self-harm 4 months later. Results: Results from a parallel mediation analysis indicated that greater state emotion dysregulation, but not state emotional reactivity, mediated prospective associations between more severe PTSD symptoms at baseline and greater risk for deliberate self-harm 4-months later. Conclusions: Applied to the context of survivors' daily lives, these findings underscore the importance of deficits in emotion regulation during times of distress in predicting risk for later deliberate self-harm.