Does Multidimensional Self-Concept Mediate the Relationship of Childhood Sexual Abuse and Bullying Victimization on Deliberate Self-Harm and Suicidal Ideation Among Adolescent Girls?

Childhood sexual abuse (CSA) and bullying victimization are well-established risk factors for deliberate self-harm (DSH) and suicidal ideation (SI). Research ties aspects of self-concept, such as self-esteem, with victimization and self-harm. Yet, there is limited evidence of the role of multidimensional self-concept in the victimization-self-harm association. Using a longitudinal sample of 422 adolescent girls from a large midwestern city, 35% with recently substantiated CSA-exposure and 51% with recent bullying victimization at baseline, we examined pathways from CSA-exposure and bullying victimization to subsequent DSH and SI, with global self-worth and five subscales of self-concept as mediators (social competence, close friendships, physical appearance, scholastic competence, and behavioral conduct). Data was collected from 2012 to 2015. CSA-exposure directly increased the risk of both SI (B .50, SE .23, p < .05) and DSH (B .53, SE .22, p < 5), while global self-worth fully mediated the relationship between bullying victimization, SI (B .21, SE .07, 95% BCB-CI 1.17-1.95, p < .01), and DSH (B .15, SE .06, 95% BCB-CI 1.10-1.69, p < .05), We found no evidence of mediation for the subscales model. Both CSA-exposure and bullying victimization directly reduced specific subscales of self-concept, while behavioral conduct increased the risk of DSH. The role of self-concept in the bullying/self-harm association and the direct effects of CSA-exposure on self-harm highlight areas of need in social work practice, specifically the need to incorporate an emphasis on trusting relationships, overall well-being, and the reduction of shame into trauma-informed therapy and bullying prevention efforts.

Automated summary

Childhood sexual abuse and bullying victimization are important risk factors for deliberate self-harm and suicidal ideation. Self-concept, such as self-esteem, plays a mediating role in the association between victimization and self-harm. This study emphasizes the need for social work practice to focus on building trusting relationships, overall well-being, and reducing shame.