This study examined associations among interpersonal and non-interpersonal trauma exposure, posttraumatic overmodulation and under-modulation, and non-suicidal self-injury (NSSI) in a sample of justice-involved youth.
Previous research has established associations among childhood trauma exposure, posttraumatic stress symptoms (PTSSs), and adolescent non-suicidal self-injury (NSSI). In fact, numerous studies have suggested that PTSSs may serve as a mechanism linking trauma exposure and NSSI; however, studies to date have not used newer models of PTSSs that differentiate between symptoms of overmodulation and under-modulation. Participants in the current study were 566 youth (2 transgender youth, 142 girls, and 422 boys). On average, youth were 16 years old (SD = 1.27), and approximately half self-identified as an ethnic minority. Participants completed measures of lifetime trauma exposure and NSSI, and past-month PTSSs. Structural equation modeling demonstrated that interpersonal trauma exposure was associated with symptoms of overmodulation (95 percent confidence interval [CI] [.180, .340]) and under-modulation (95 percent CI [.179, .338]) as well as NSSI (95 percent CI [.156, .572]). Additionally, symptoms of overmodulation were differentially associated with NSSI (95 percent CI [.158, .720]), and there was a significant indirect effect between interpersonal trauma exposure and NSSI via overmodulation (95 percent CI [.015, .095]). This study highlights the utility of conceptualizing posttraumatic stress disorder as a disorder of emotion regulation characterized by symptoms of overmodulation and under-modulation, and has clinical implications for mental health professionals who interact with youth in the justice system. (publisher abstract modified)