Please cite this article in press as: Swannell, S., et al. Child maltreatment, subsequent non-suicidal self- injury and the mediating roles of dissociation, alexithymia and self-blame. Child Abuse & Neglect (2012), http://dx.doi.org/10.1016/j.chiabu.2012.05.005 ARTICLE IN PRESS G Model CHIABU-2458; No. of Pages 13 Child Abuse & Neglect xxx (2012) xxx–xxx Contents lists available at SciVerse ScienceDirect Child Abuse & Neglect Child maltreatment, subsequent non-suicidal self-injury and the mediating roles of dissociation, alexithymia and self-blame  Sarah Swannell a,* , Graham Martin a , Andrew Page b , Penelope Hasking c , Philip Hazell d , Anne Taylor e , Melinda Protani b a Discipline of Psychiatry, School of Medicine, Faculty of Health Sciences, The University of Queensland, K Floor, Mental Health Centre, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia b Division of Epidemiology and Social Medicine, School of Population Health, Faculty of Health Sciences, The University of Queensland, Herston, Qld, Australia c School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia d Infant, Child and Adolescent Mental Health Services, Medical School, University of Sydney, Thomas Walker Hospital (Rivendell), Sydney South West Area Health Service, Sydney, NSW, Australia e Population Research and Outcome Studies, South Australian Department of Health, Adelaide, SA, Australia a r t i c l e i n f o Article history: Received 26 January 2011 Received in revised form 18 May 2012 Accepted 31 May 2012 Available online xxx Keywords: Child maltreatment Non-suicidal self-injury (NSSI) Dissociation Alexithymia Self-blame Attributional style Abuse Neglect a b s t r a c t Objective: Although child maltreatment is associated with later non-suicidal self-injury (NSSI), the mechanism through which it might lead to NSSI is not well understood. The current retrospective case–control study examined associations between child maltreat- ment and later NSSI, and investigated the mediating roles of dissociation, alexithymia, and self-blame. Methods: Participants were 11,423 Australian adults (response rate 38.5%), randomly selected from the Australian Electronic White Pages, aged between 18 and 100 (M = 52.11, SD = 16.89), 62.2% female. Data were collected via telephone interviewing. Main outcome measures were reported history of child maltreatment (sexual abuse, physical abuse, neglect) and reported 12-month NSSI. Dissociation, alexithymia, and self-blame were examined as potential mediating variables in the relationship between child maltreatment and later NSSI. All analyses were conducted using logistic regression and adjusted for age and psychiatric diagnosis. Results: Results differed by gender. Compared to no child maltreatment, physical abuse (OR 2.75, 95% CI 1.68–4.51) and neglect (OR 2.56, 95% CI 1.65–3.99) independently increased the odds of NSSI among females. Physical abuse (OR 2.69, 95% CI 1.44–5.03) increased the odds of NSSI among males. Sexual abuse did not independently increase the odds of NSSI for males or females. For females, self-blame had the greatest effect on the child maltreatment–NSSI relationship (OR decreased by 14.6%, p < .000), although dissociation and alexithymia also partially mediated the relationship. For males, dissociation had the greatest effect (OR decreased by 12.9%, p = .003) with self-blame also having a relatively strong effect.  The ANESSI project was funded by the Australian Government Department of Health and Ageing. The funding body approved the collection, manage- ment, analysis, and interpretation of the data for the ANESSI project, but played no role in the design and conduct of the study specified in the paper, nor in the preparation, review, or approval of the manuscript. The principal investigator takes full responsibility for the integrity of the data and the accuracy of the data analysis, and all authors had full access to all the data in the study. * Corresponding author. 0145-2134/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.chiabu.2012.05.005