The role of autobiographical memory specificity in deliberate self-harm: correlates and consequences.

BACKGROUND: Several studies have identified reduced specificity of autobiographical memory in deliberate self-harm (DSH) patients. However it is not clear which clinical variables are associated with low memory specificity in this group, or whether low specificity is particularly associated with recent DSH. METHOD: 68 individuals followed up seven years after an index episode of DSH were re-interviewed and data collected on current psychiatric disorder, repetition of DSH in the intervening period and autobiographical memory specificity. Data on history of sexual and physical abuse during childhood were available from the index assessment. RESULTS: A hierarchical regression analysis identified older age, current affective disorder and level of familial sexual abuse during childhood as independent predictors of reduced memory specificity. Sixteen participants who had a further episode of DSH in the year prior to the current assessment were classified as having 'recent' DSH. Results of logistic regression suggest that low memory specificity mediates the association between childhood sexual abuse and recent DSH and partially mediates the association between current affective disorder and recent DSH. LIMITATIONS: The results are based on a relatively small sample of patients from a mixed clinical group, limiting the statistical power of the analysis. CONCLUSIONS: The findings confirm the association between low memory specificity and DSH. They are consistent with a multi-factorial model of impaired specificity and suggest that low specificity may be one of the mechanisms through which abuse history and affective disorder increase an individual's vulnerability to deliberate self-harm.