Trauma exposure, posttraumatic overmodulation and undermodulation, and nonsuicidal self-injury in traumatized justice-involved adolescents.

Previous research has established associations among childhood trauma exposure, posttraumatic stress symptoms (PTSSs), and adolescent nonsuicidal self-injury (NSSI). In fact, numerous studies have suggested that PTSSs may serve as a mechanism linking trauma exposure and NSSI. However, studies to date have not utilized newer models of PTSSs that differentiate between symptoms of overmodulation and undermodulation. This study investigated associations among interpersonal and noninterpersonal trauma exposure, posttraumatic overmodulation and undermodulation, and NSSI in a sample of justice-involved youth.Participants were 566 youth (2 transgender youth, 142 girls, and 422 boys). On average, youth were 16 years old (SD = 1.27), and approximately half self-identified as an ethnic minority. Participants completed measures of lifetime trauma exposure and NSSI, and past-month PTSSs.Structural equation modeling demonstrated that interpersonal trauma exposure was associated with symptoms of overmodulation (95% confidence interval [CI] [.180, .340]) and undermodulation (95% CI [.179, .338]) as well as NSSI (95% CI [.156, .572]). Additionally, symptoms of overmodulation were differentially associated with NSSI (95% CI [.158, .720]), and there was a significant indirect effect between interpersonal trauma exposure and NSSI via overmodulation (95% CI [.015, .095]).This study highlights the utility of conceptualizing posttraumatic stress disorder as a disorder of emotion regulation characterized by symptoms of overmodulation and undermodulation, and has clinical implications for mental health professionals who interact with youth in the justice system. (PsycINFO Database Record (c) 2019 APA, all rights reserved).