The mediating role of complex posttraumatic stress and borderline pattern symptoms on the association between sexual abuse and suicide risk

Odeta Gelezelyte; Monika Kvedaraite; Agniete Kairyte; Neil P Roberts; Jonathan I Bisson; Evaldas Kazlauskas

doi:10.1186/s40479-022-00183-z

The mediating role of complex posttraumatic stress and borderline pattern symptoms on the association between sexual abuse and suicide risk

Borderline Personal Disord Emot Dysregul. 2022 Apr 12;9(1):13. doi: 10.1186/s40479-022-00183-z.

Authors

Odeta Gelezelyte¹, Monika Kvedaraite², Agniete Kairyte², Neil P Roberts^{3

4}, Jonathan I Bisson³, Evaldas Kazlauskas²

Affiliations

¹ Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania. odeta.gelezelyte@fsf.vu.lt.
² Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania.
³ Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.
⁴ Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK.

Abstract

Background: The 11th revision of the International Classification of Diseases (ICD-11) includes a new diagnosis of complex posttraumatic stress disorder (CPTSD). There has been very little research investigating associations between CPTSD symptoms and suicide risk following sexual abuse. This and questions concerning similarities and differences between CPTSD and borderline personality disorder (BPD), led to the current study that aimed to explore indirect associations between sexual abuse and suicide risk through the symptoms of CPTSD and borderline traits.

Methods: The study sample comprised 103 adults with a history of traumatic experiences (M_age = 32.64, SD_age = 9.36; 83.5% female). In total, 26.3% of the participants reported experiencing sexual abuse during their lifetime. The clinician-administered International Trauma Interview (ITI) was used for the assessment of ICD-11 CPTSD symptoms. Self-report measures were used for the evaluation of borderline pattern (BP) symptoms and suicide risk. Mediation analyses were performed to evaluate the mediating effects of CPTSD and BP symptoms for the association between sexual trauma and suicide risk.

Results: In a parallel mediation model, CPTSD and BP symptoms mediated the association between sexual abuse and suicide risk, following adjustment for the covariates of age, gender, and whether the traumatic experience occurred in childhood or adulthood. Around 73% of participants who met diagnostic criteria for CPTSD reported previous suicide attempt(s).

Conclusions: Suicide risk assessment and intervention should be an important part of the management of victims of sexual abuse with CPTSD and BP symptoms.

Keywords: borderline; complex posttraumatic stress disorder; sexual abuse; suicidal behavior; suicide risk.