Childhood sexual abuse and non-suicidal self-injury: Meta-analysis

Background: Many theorists posit that childhood sexual abuse has a central role in the aetiology of self-injurious behaviour. Studies that report statistically significant associations between a history of such abuse and self-injury are cited to support this view. Aims: A meta-analysis was conducted to determine systematically the magnitude of the association between childhood sexual abuse and self-injurious behaviour. Method: Forty-five analyses of the association were identified. Effect sizes were converted to a standard metric and aggregated. Results: The relationship between childhood sexual abuse and self-injurious behaviour is relatively small (mean weighted aggregate φ=0.23). This figure may be inflated owing to publication bias. In studies that statistically controlled for psychiatric risk factors, childhood sexual abuse explained little or no unique variance in self-injurious behaviour. Conclusions: Theories that childhood sexual abuse has a central or causal role in the development of self-injurious behaviour are not supported by the available empirical evidence. Instead, it appears that the two are modestly related because they are correlated with the same psychiatric risk factors.