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Childhood Sexual Abuse Differentially Predicts Outcome of Cognitive-Behavioral Therapy for Deliberate Self-Harm

Spinhoven, Philip PhD*; Slee, Nadja PhD*; Garnefski, Nadia PhD*; Arensman, Ella PhD†

Journal of Nervous & Mental Disease:
doi: 10.1097/NMD.0b013e3181a620c8
Brief Report

This study examined the association of childhood abuse with deliberate self-harm and related psychopathology and the impact of childhood abuse on treatment outcome as assessed in a randomized controlled trial of cognitive-behavioral therapy for 90 young people who recently engaged in Deliberate Self-Harm (DSH). Participants with a history of childhood sexual abuse manifested more Axis I disorders and reported higher levels of DSH, depression, suicidal cognitions, anxiety, and dissociation. After statistically controlling for baseline differences in DSH and related psychopathology, participants with a reported history of childhood sexual abuse showed a significantly lower risk of repeated DSH in the Cognitive-Behavioral Therapy condition compared with those receiving treatment-as-usual (TAU). Our results suggest that a structured treatment format and focus on adequate emotion regulation skills may be essential elements in the treatment of persons with DSH and a history of childhood sexual abuse.

Author Information

*Department of Psychology and Psychiatry, Leiden University, Leiden, The Netherlands; and †National Suicide Research Foundation, Cork, Ireland.

Supported by The Netherlands Organization for Health Research and Development (ZonMw) (contract grant number: 2100.0068).

Send reprint requests to Philip Spinhoven, PhD, Department of Psychology and Psychiatry, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.