Trauma-Related Cognitions and Discrimination as Predictors of Maladaptive Coping Among Marginalized Maltreated Youth

Maltreated youth are at an increased risk for engaging in direct or indirect self-injurious behavior to cope with the aftereffects of a traumatic event. These behaviors are often associated with negative health outcomes, substance use and premature death. Existing research proposes a link between child maltreatment and indirect self-harm but the mechanism into why this occurs is unclear. The present study examined two key research questions: (1) which specific trauma-related cognitions, sexual identity and cultural factors predict direct self-injurious behavior (previous suicide attempt(s) and NSSI) among marginalized maltreated youth?; and (2) which specific trauma-related cognitions, sexual identity and cultural factors predict indirect self-injurious behavior (recklessness, intentional misbehavior, delinquent behavior, problematic sexual behavior, substance use, and running away) among marginalized maltreated youth? A classification and regression tree (CART) analysis identified predictors of direct and indirect self-injurious behaviors. Participants included 133 sexual and racially/ethnically diverse maltreated youth in Department of Family Services (DFS) custody following removal from their home after substantiated child maltreatment. Hypothesis 1 was partially supported. The final models identified several predictors that best determined previous suicide attempt(s) and/or NSSI: (1) negative cognitions of self, (2) sexual orientation, (3) negative cognitions of world, (4) race/ethnicity, and (5) self-blame. Hypothesis 2 was partially supported. The final models identified several predictors that best determined one or more forms of indirect self-injurious behavior: (1) sexual orientation, (2) negative cognitions of self, (3) race/ethnicity, (4) self-blame, (5) experience cultural identity discrimination, (6) age, and (7) gender identity. The findings offer important implications for understanding the relationship between maltreatment, discrimination, trauma-related cognitions, and self-injurious behaviors to better inform assessment and treatment of marginalized maltreated youth.