- Adolescents with childhood sexual abuse and self-injury exhibited highest suicide risk, hopelessness, suicidal ideation, greater depressive severity and pronounced emotion dysregulation.
- Depressive severity was the strongest correlate of overall suicide risk; limited access to regulation strategies and suicidal ideation were central nodes.
- Rapid assessment should prioritise depressive severity, suicidal ideation and emotion regulation strategy deficits; trauma informed interventions may address less explicit motives.
Early Interv Psychiatry. 2026 Oct;20(10):e70251. doi: 10.1111/eip.70251.
ABSTRACT
BACKGROUND: Childhood sexual abuse is a major developmental trauma associated with elevated risk for non-suicidal self-injury and suicidal behaviour in adolescence. Yet, it remains unclear whether abused adolescents show distinct motivational profiles for self-injury and how depression and emotion dysregulation jointly relate to suicide risk.
AIMS: To compare suicide risk, depressive severity, and emotion dysregulation across adolescents with childhood sexual abuse and self-injury, adolescents with self-injury without sexual abuse, and controls; to identify unique predictors of suicide risk; and to examine construct-level symptom and motivation networks using a network analytic approach.
METHODS: This cross-sectional study included 120 adolescents (12-18 years; n = 40 per group) assessed with measures of suicide risk, depressive symptoms, emotion dysregulation, and self-injury characteristics/motives. Group differences were tested using appropriate parametric/nonparametric methods. Multiple regression models evaluated predictors of suicide risk. Networks were estimated using regularized partial correlation models.
RESULTS: Adolescents with childhood sexual abuse and self-injury showed the highest overall suicide risk, hopelessness, and suicidal ideation, alongside greater depressive severity and emotion dysregulation, particularly in impulse control and limited access to regulation strategies. In regression analyses, depressive severity was the strongest correlate of overall suicide risk, while specific emotion dysregulation facets showed domain-specific associations with hostility and negative self-image. Network analysis identified suicidal ideation and limited access to regulation strategies as the most central nodes. Motivation networks appeared more diffuse in the CSA group, although pronounced floor effects and zero-inflation in this subgroup’s responses warrant caution in this interpretation.
CONCLUSIONS: Adolescents with childhood sexual abuse and self-injury represent a high-priority early intervention subgroup with elevated suicidality and regulatory difficulties. Rapid assessment should prioritize depressive severity, suicidal ideation, and emotion regulation strategy deficits, while trauma-informed interventions may be required to address less explicit self-injury motivations.
PMID:42855177 | DOI:10.1111/eip.70251
Share Evidence Blueprint
Save to Google Notes
Search Google Scholar
Save as PDF
⭐ My Revision List
