The Relation Between Adverse Childhood Events and Self-harm with the Mediating Roles of Shame and Self-disgust

Abstract

Background: Adverse childhood events are one of the most important predictors of deliberate self-harm (DSH), and difficulty in regulating self-conscious emotions, including shame and self-disgust, forms the underlying mechanism of this relationship. Objectives: The present study aimed to investigate the relationship between adverse childhood experiences (ACEs) and DSH through the mediating roles of shame and self-disgust. Patients and Methods: The current descriptive-correlational study employed a structural equation modeling (SEM) approach. The sample included all of the Iranian over 18 years old who had engaged in self-harm within the past six months who used social media (e.g., Instagram, Telegram, and WhatsApp) in 2024. A sample of 269 individuals was selected using the convenience sampling method. Participants completed the following questionnaires: Gratz’s Deliberate Self-harm Inventory (DSHI), Bernstein’s Childhood Trauma Questionnaire (CTQ), Andrews and Hunter’s Experience of Shame Scale (ESS), and Overton’s Self-disgust Scale (SDS). Data were analyzed using Pearson’s correlation coefficient and SEM. Data analysis was conducted using SPSS-25 and AMOS-24. Results: Results indicated a significant positive correlation between DSH and ACEs (r = 0.28, P < 0.01). Furthermore, a significant positive correlation was observed between ACEs and the variables of shame (r = 0.28, P < 0.01) and self-disgust (r = 0.40, P < 0.01). SEM results demonstrated that the indirect relationships between DSH and ACEs through shame (β = 0.03, P = 0.034) and self-disgust (β = 0.06, P = 0.018) was significant. Shame and self-disgust components can serve as suitable mediators between self-harm and ACEs. The model accounted for approximately 10% of the variance in DSH. Conclusions: Trauma-related shame and self-disgust following ACEs could increase DSH. As emotions of shame and disgust may not be openly expressed, interventions addressing DSH by alleviating the negative impacts of these emotions are likely to foster the development of more adaptive coping strategies.